Chapter 1 – General introduction 21 Building on previous nocebo studies as described in the first chapters of this dissertation, Chapter 4 presents a randomized controlled trial investigating distinct learning schedules. This experiment aimed to examine the role of continuous versus partial learning and the consequences of such learning schedules for the persistence of nocebo hyperalgesia. For this purpose, both the induction and the attenuation of nocebo hyperalgesia are experimentally manipulated via distinct learning methods. Healthy participants were randomized to receive conditioning on nocebo effects with continuous reinforcement, partial reinforcement, or sham conditioning. In attenuation, counterconditioning (i.e., positive conditioning of the nocebo conditioned stimulus) was compared to extinction for the attenuation of nocebo hyperalgesia. This study provided important insights into the effect that different learning schedules may have on the acquisition and attenuation of nocebo responses. In Chapter 5 an experimental study of cognitive-emotional processes is presented. Here, we aimed to investigate how fear can augment nocebo responses and how this may affect the persistence of these responses over time. We experimentally manipulated fear of pain during the induction of nocebo responses. We used two distinct fear inductions. One fear induction method was to manipulate pain levels with the aim of inducing fear of the high pain stimulations. The other fear induction included a threat manipulation that convinced participants that their skin is critically sensitive to pain. This study provided insights into the role of specific types of fear in the acquisition and extinction of nocebo hyperalgesia, which may be of important relevance given the relationship between fear and pain in clinical practice. Chapter 6 presents an electrophysiological investigation into nocebo hyperalgesia. We aimed to explore alterations in EEG biomarkers during the anticipation, acquisition, and evocation of nocebo hyperalgesia. This thorough investigation served to unravel multiple electrophysiological
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