Chapter 8 – General discussion 275 augmented pain), and novel biobehavioral manipulations and results. There is a known bias in publishing unique ideas that create novel scientific work. What our reviews (chapters 2 and 3) have inherently and inevitably discounted, is the unsuccessful attempts to induce or manipulate nocebo effects on pain. Our knowledge base for nocebo hyperalgesia thus has a blind spot, in that we cannot factor in those variables and outcomes that were never published in peer-reviewed scientific journals –an explicit inclusion criterion in chapter 2. With vast estimated numbers of “unexciting” unpublished scientific research in the social sciences, it is imperative for our scientific community to make an active effort in creating fairer and more accessible publication routes for those null results that add to our genuine understanding of complex and potentially detrimental biobehavioral effects on pain. Further limitations relate to the experimental work of this thesis and concern the methods used, as well as the reproducibility and clinical significance of findings. What is the significance of findings in young, educated, healthy participants that experienced short-lived experimentally induced pain, fear, and nocebo effects? Ours is not the only field of biobehavioral science that largely relies on psychophysiological modelling approaches 80 in order to induce and quantify phenomena such as nocebo hyperalgesia. But in the construction of experimental models of nocebo hyperalgesia, less attention is paid to their clinical validity and more to creating the strongest, most reliable, or most reproducible laboratory models. Some studies have paid particular attention to the accuracy of modeling clinical pain, by inducing realistic visceral pain symptoms 29,81,82, which is an important step towards the real-world applicability of experimental conclusions. In our studies, we carefully considered the different types of experimental models that we could possibly build to represent the putative clinical phenomenon of nocebo hyperalgesia. We opted for idealized and exploratory models 83, in which a deliberate simplification of hypothesized mechanisms and processes was able to keep other
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