Chapter 5 – Experimental fear 179 (for all questionnaires P > 0.05). Detailed questionnaire results and Cronbach’s alpha scores are reported in supplementary material. Manipulation checks for nocebo and fear responses Pearson’s correlation analyses showed significant correlations between retrospectively assessed fear of the nocebo trials (reported at the end of the experiment) and the magnitude of nocebo responses (r = 0.25, P = 0.02) as well as reported fear differences (r = 0.63, P < 0.001). There were no significant correlations between any relevant manipulation check questions or questionnaires and nocebo magnitudes or reported fear (for all questions P > 0.05, please see supplementary material). Discussion This study investigated the facilitating effects of two distinct pain-related fear manipulations on nocebo responses. We expected that higher pain levels would lead to higher pain-related fear, which would augment nocebo responses. We confirmed this by demonstrating that, compared to lower pain, conditioning with higher pain administrations produced significantly larger nocebo responses. We also showed that this effect was mediated by reported fear levels, but not by eyeblink startle responses. Contrary to our expectation, nocebo responses extinguished at a similar rate in the High-pain and Control groups. However, we found that nocebo responses at the end of extinction were significantly larger in the High-pain group. A threat manipulation did not amplify
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