LAUSR

The nocebo effect has been described as the flip side to the placebo effect, whereby an adverse reaction is experienced by someone who receives an inert exposure (Kennedy, 1961). An inert exposure in this context is a substance or procedure that has no active medicinal or physiological properties able to directly influence the symptom experience in the receiver. Nocebo effects seem to primarily occur due to negative expectations (Webster, Weinman, & Rubin, 2016) and are commonly encountered in clinical practice (Colloca & Miller, 2011). Experimental nocebo research commonly involves some element of deception by misleading participants about the nature of the experimental stimulus. Such procedures are often essential – informing participants that the stimulus is inert may dramatically change their expectations of side effects and hence their subsequent symptom experience. This reliance on deception raises a number of ethical concerns, not least in terms of informed consent. Due to concerns about these potential negative effects, deception is not always received favourably by institutional ethics review boards, making nocebo effects notoriously difficult to study. However, whilst the adverse ethical implications of deceptive studies are a concern, the costs of not conducting deceptive research should also be considered. Nocebo effects are one of the underlyingmechanisms for the development of non-specific side effects tomedications (Barsky, Saintfort, Rogers, & Borus, 2002). In their recent overview, Benedetti and Shaibani (2018) note the importance of understanding nocebo effects as something different from placebo effects, explaining that more research is needed to understand these nocebo-induced side effects which may prove crucial in controlling treatment adherence and therefore patient outcomes. In addition, many nocebo researchers still claim that their participants provide informed consent for their studies, when logically this cannot be the case if they are deceived as to the nature of the exposure. For example, in a systematic review conducted by our team, the majority of studies incorrectly explained that participants gave informed consent (Webster, Weinman, & Rubin, 2016). Therefore, further discussion around these issues is clearly warranted. This editorial provides an overview of what deception is, the current guidelines for using deception, and its effects. We include recommendations for deceptive research and