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Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms

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Abstract

Background

Negative non-specific (nocebo-like) effects of medications and electromagnetic fields are often described as results of mistaken attribution.

Purpose

The current study aimed to find empirical evidence supporting this theory.

Method

Participants completed questionnaires assessing modern health worries, health anxiety, and somatosensory amplification, were assigned to one of three conditions (placebo pill with sedative information, sham magnetic field, or control), and completed a 14-min vigilance task. Changes in physiological arousal (heart rate, heart rate variability, and skin conductance) and reported symptoms were also measured. Finally, causal attributions concerning cognitive performance and reported symptoms were assessed.

Results

No increase in symptom reports and physiological arousal was measured in the two intervention groups. A perceived negative effect on cognitive performance was attributed to both sham conditions, and attributions were connected to modern health worries. A proportion of reported symptoms was ascribed to the placebo pill but not to the sham magnetic field. Symptom attributions were not related to any assessed psychological variables.

Conclusions

An aroused physiological state is not necessary for the automatic causal attribution process. Negative effects attributed to medication and environmental factors can be regarded as unavoidable side effects of human cognitive-emotional functioning; they might be alleviated, but cannot be completely eradicated.

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Acknowledgments

The study was supported by the Hungarian National Scientific Research Fund (OTKA K109549).

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Conflict of Interest

The authors declare that they have no competing interests.

Human Rights and Informed Consent

The authors state that they conformed to the Helsinki Declaration concerning human rights and informed consent and that they followed correct procedures concerning treatment of humans in research.

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Authors and Affiliations

  1. Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary

    Renáta Szemerszky, Tímea Berkes & Ferenc Köteles

  2. Doctoral School of Psychology and Institute of Psychology, Eötvös Loránd University, Budapest, Hungary

    Zsuzsanna Dömötör

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  1. Renáta Szemerszky
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  2. Zsuzsanna Dömötör
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  4. Ferenc Köteles
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Correspondence to Ferenc Köteles.

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Szemerszky, R., Dömötör, Z., Berkes, T. et al. Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms. Int.J. Behav. Med. 23, 204–213 (2016). https://doi.org/10.1007/s12529-015-9511-1

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