The influence of psychological traits and prior experience on treatment expectations.

expectancies nocebo effects personality placebo effects side effects treatment experience

Journal

Comprehensive psychiatry
ISSN: 1532-8384
Titre abrégé: Compr Psychiatry
Pays: United States
ID NLM: 0372612

Informations de publication

Date de publication:
11 2023
Historique:
received: 21 07 2023
revised: 09 10 2023
accepted: 12 10 2023
medline: 30 10 2023
pubmed: 21 10 2023
entrez: 20 10 2023
Statut: ppublish

Résumé

Placebo and nocebo responses are modulated by the treatment expectations of participants and patients. However, interindividual differences predicting treatment expectations and placebo responses are unclear. In this large-scale pooled analysis, we aim to investigate the influence of psychological traits and prior experiences on treatment expectations. This paper analyses data from six different placebo studies (total n = 748). In all studies, participants' sociodemographic information, treatment expectations and prior treatment experiences and traits relating to stress, somatization, depression and anxiety, the Big Five and behavioral inhibition and approach tendencies were assessed using the same established questionnaires. Correlation coefficients and structural equation models were calculated to investigate the relationship between trait variables and expectations. We found small positive correlations between side effect expectations and improvement expectations (r = 0.187), perceived stress (r = 0.154), somatization (r = 0.115), agitation (r = 0.108), anhedonia (r = 0.118), and dysthymia (r = 0.118). In the structural equation model previous experiences emerged as the strongest predictors of improvement (β = 0.32, p = .005), worsening (β = -0.24, p = .005) and side effect expectations (β = 0.47, p = .005). Traits related to positive affect (β = - 0.09; p = .007) and negative affect (β = 0.04; p = .014) were associated with side effect expectations. This study is the first large analysis to investigate the relationship between traits, prior experiences and treatment expectations. Exploratory analyses indicate that experiences of symptom improvement are associated with improvement and worsening expectations, while previous negative experiences are only related to side effect expectations. Additionally, a proneness to experience negative affect may be a predictor for side effect expectation and thus mediate the occurrence of nocebo responses.

Sections du résumé

BACKGROUND
Placebo and nocebo responses are modulated by the treatment expectations of participants and patients. However, interindividual differences predicting treatment expectations and placebo responses are unclear. In this large-scale pooled analysis, we aim to investigate the influence of psychological traits and prior experiences on treatment expectations.
METHODS
This paper analyses data from six different placebo studies (total n = 748). In all studies, participants' sociodemographic information, treatment expectations and prior treatment experiences and traits relating to stress, somatization, depression and anxiety, the Big Five and behavioral inhibition and approach tendencies were assessed using the same established questionnaires. Correlation coefficients and structural equation models were calculated to investigate the relationship between trait variables and expectations.
RESULTS
We found small positive correlations between side effect expectations and improvement expectations (r = 0.187), perceived stress (r = 0.154), somatization (r = 0.115), agitation (r = 0.108), anhedonia (r = 0.118), and dysthymia (r = 0.118). In the structural equation model previous experiences emerged as the strongest predictors of improvement (β = 0.32, p = .005), worsening (β = -0.24, p = .005) and side effect expectations (β = 0.47, p = .005). Traits related to positive affect (β = - 0.09; p = .007) and negative affect (β = 0.04; p = .014) were associated with side effect expectations.
DISCUSSION
This study is the first large analysis to investigate the relationship between traits, prior experiences and treatment expectations. Exploratory analyses indicate that experiences of symptom improvement are associated with improvement and worsening expectations, while previous negative experiences are only related to side effect expectations. Additionally, a proneness to experience negative affect may be a predictor for side effect expectation and thus mediate the occurrence of nocebo responses.

Identifiants

pubmed: 37862937
pii: S0010-440X(23)00068-8
doi: 10.1016/j.comppsych.2023.152431
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

152431

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Lukas A Basedow (LA)

Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany. Electronic address: lukas.basedow@uni-marburg.de.

Anton Fischer (A)

Philipps-Universität Marburg, Department of Differential Psychology and Personality Research, 35037 Marburg, Germany. Electronic address: anton.fischer@uni-marburg.de.

Sven Benson (S)

Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital of Essen, Essen, Germany. Electronic address: sven.benson@uk-essen.de.

Ulrike Bingel (U)

Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, DE, Germany. Electronic address: ulrike.bingel@uk-essen.de.

Stefanie Brassen (S)

Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: sbrassen@uke.de.

Christian Büchel (C)

Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: buechel@uke.de.

Harald Engler (H)

Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital of Essen, Essen, Germany. Electronic address: harald.engler@uk-essen.de.

Erik M Mueller (EM)

Philipps-Universität Marburg, Department of Differential Psychology and Personality Research, 35037 Marburg, Germany. Electronic address: erik.mueller@uni-marburg.de.

Manfred Schedlowski (M)

Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital of Essen, Essen, Germany; Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Electronic address: manfred.schedlowski@uk-essen.de.

Winfried Rief (W)

Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany. Electronic address: riefw@uni-marburg.de.

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Classifications MeSH