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Negative expectations (nocebo phenomenon) in clinical interventions: A scoping review
Hamid Nasiri-Dehsorkhi1,2, Shahram Vaziri1, Ahmad Esmaillzadeh3
1Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran.
Journal of Education and Health Promotion
|May 10, 2024
Summary
Negative expectations, known as the nocebo effect, significantly impact clinical interventions. Understanding and mitigating these negative expectations can improve patient outcomes and treatment adherence.
Area of Science:
- Psychology
- Medicine
- Neuroscience
Background:
- Unpredictable reactions to medical and psychological interventions complicate clinical presentations.
- The nocebo phenomenon, driven by negative expectations, can explain these adverse responses and disrupt the doctor-patient relationship.
Purpose of the Study:
- To conduct a scoping review investigating the nocebo phenomenon (negative expectations) in clinical interventions.
- To explore the existence, importance, and multidimensional aspects of the nocebo effect in medical and psychological contexts.
Main Methods:
- Scoping review of literature databases (ProQuest, PubMed, Google Scholar, Scopus) from inception to 2023.
- Searched terms: negative expectations, nocebo effect, placebo effect, negative placebo, clinical interventions.
Main Results:
- Negative expectations (nocebo effect) play a crucial role in the process and effectiveness of clinical interventions.
- The nocebo effect significantly interferes with patient-provider rapport and treatment progression.
- Underlying components include cognitive factors (expectancies, learning, memory, distortions), motivational aspects, personality, anxiety, and neurophysiological factors (CCK, dopamine, cortisol).
Conclusions:
- The nocebo phenomenon, with its biopsychosocial dimensions, significantly impacts medical and psychological interventions.
- Strategies to reduce nocebo effects can enhance treatment compliance, adherence, and overall intervention effectiveness.
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