Identifying Novel Behavioural Strategies to Inhibit Nocebo Hyperalgesia

Nocebo hyperalgesia is a pervasive phenomenon that significantly adds the global burden of pain. Many experimental and clinical studies demonstrate that verbal information and conditioning combine to produce negative expectancies that trigger nocebo hyperalgesia. Yet, there have been very few attempts to use this knowledge to identify behavioural strategies to inhibit nocebo hyperalgesia. In this talk, Ben Colaguiri will describe a series of novel studies providing evidence for two promising behavioural strategies for inhibiting nocebo hyperalgesia. The first is a communication strategy that involves positively framing verbal information (‘positive attribute framing’) in order to reduce the maladaptive expectancies that drive nocebo hyperalgesia. The second is a learning strategy involving pre-exposure to the target treatment context (‘laten inhibition’) that can undermine the formation of conditioned nocebo hyperalgesia. A critical feature of both strategies is that there is no deception involved, meaning that these techniques can be implemented ethically in clinical practice. Identifying effective behavioural techniques to inhibit nocebo hyperalgesia will pave the way for translational research to prevent the burden it causes.