Positive social modeling attenuates nocebo side effects

Receiving negative instructions and observing another's adverse treatment-related experience can lead to worsened health outcomes via the nocebo effect. However, it is unknown whether the observation of a positive treatment-related experience can mitigate these effects.

To investigate whether a positive social modeling intervention can reduce nocebo side effects induced by instruction and social modeling.

Participants (N = 160) were told the study assessed a new cognitive enhancer (actually a placebo). Participants received side effect warnings and viewed an informational video describing the medication. Placebo-treated groups were randomized to either watch an additional clip where a peer reported a positive experience with no side effects or not. These groups were further randomized to either encounter a live model exhibiting side effects or not. A Natural History group did not view any modeling nor receive the placebo. The primary outcome was the severity of side effects.

A significant nocebo effect was observed, with increased symptom severity in placebo-treated groups compared to the Natural History group. The positive social modeling intervention (i.e., viewing a peer experience no side effects) significantly reduced symptom severity. No significant difference in symptom severity was found between instruction alone and instruction with side effect modeling, nor was there an interaction between the induction method and the positive social modeling intervention.

Positive social modeling reduces nocebo side effects induced by instruction alone and instruction with side effect modeling. Positive social modeling may be an effective method to mitigate the burden of nocebo side effects in clinical settings.