Skip to main content
Log in

Expectations of chemotherapy-related nausea: Emotional and experiential predictors

  • Published:
Annals of Behavioral Medicine

Abstract

Despite literature indicating that expectations are important determinants of experiences of nonvolitional outcomes (e.g., pain, nausea), little research has explored their source. The dual process model suggests that concurrent experience of emotional distress should be a strong contributor, whereas social learning theory supports the position that expectations of nonvolitional outcomes should be based primarily on prior experience. These alternative hypotheses were tested in a sample of 80 breast cancer patients undergoing outpatient adjuvant chemotherapy, as such protocols provide a unique opportunity to study the impact of emotional distress and prior experience on patients ’ expectations of side effects. Bivariate analyses suggested that emotional distress contributed early in the course of treatment, but once prior experience of posttreatment nausea (PTN) was accounted for in the statistical model, distress no longer made significant contributions to patients ’ expectations of PTN, whereas prior experience did (p < .001). These findings suggest that experience of chemotherapy infusions is an important source of expectations for PTN, which may be representative of the source of expectations for nonvolitional outcomes in broader contexts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Montgomery GH, Tomoyasu N, Bovbjerg DH, et al.: Patients’ pretreatment expectations of chemotherapy-related nausea are an independent predictor of anticipatory nausea.Annals of Behavioral Medicine. 1998,20:104–109.

    PubMed  CAS  Google Scholar 

  2. Montgomery GH, Bovbjerg DH: Pre-infusion expectations predict post-treatment nausea during repeated adjuvant chemotherapy infusions for breast cancer.British Journal of Health Psychology. 2000,5:105–119.

    Article  Google Scholar 

  3. Montgomery GH, Bovbjerg DH: Specific response expectancies predict anticipatory nausea during chemotherapy for breast cancer.Journal of Consulting and Clinical Psychology. 2001,69:831–835.

    Article  PubMed  CAS  Google Scholar 

  4. Roscoe JA, Hickok JT, Morrow GR: Patient expectations as predictor of chemotherapy-induced nausea.Annals of Behavioral Medicine. 2000,22:121–126.

    Article  PubMed  CAS  Google Scholar 

  5. Montgomery GH, Kirsch I: Classical conditioning and the placebo effect.Pain. 1997,72:107–113.

    Article  PubMed  CAS  Google Scholar 

  6. Kirsch I:Changing Expectations: A Key to Effective Psychotherapy. Pacific Grove, CA: Brooks/Cole, 1990.

    Google Scholar 

  7. Kirsch I: Response expectancy as a determinant of experience and behavior.American Psychologist. 1985,40:1189–1202.

    Article  Google Scholar 

  8. Leventhal H: Findings and theory in the study of fear communications.Advances in Experimental & Social Psychology. 1970,5:119–186.

    Google Scholar 

  9. Leventhal H, Leventhal EA, Cameron L: Representations, procedures, and affect in illness, self-regulation: A perceptual-cognitive model. In Baum A, Revenson T, Singer JE (eds),Handbook of Health Psychology. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2001,10–47.

    Google Scholar 

  10. Leventhal H, Singer R, Jones S: Effects of fear and specificity of recommendations upon attitudes and behavior.Journal of Personality and Social Psychology. 1965,2:20–29.

    Article  Google Scholar 

  11. Leventhal H, Jones S, Trembly G: Sex differences in attitude and behavior change under conditions of fear and specific instructions.Journal of Experimental Social Psychology. 1966,2:387–399.

    Article  Google Scholar 

  12. Leventhal H: The integration of emotion and cognition: A view from the perceptual-motor theory of emotion. In Clark M, Fiske S (eds),Affect and Cognition: The 17th Annual Carnegie Symposium on Cognition. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1982,121–156.

    Google Scholar 

  13. Leventhal H, Scherer KR: The relationship of emotion to cognition: A Functional approach to semantic controversy.Cognition and Emotion. 1987,1:3–28.

    Article  Google Scholar 

  14. Leventhal H, Diefenbach M: The active side of illness cognition. In Skelton JA, Croyle RT (eds),Mental Representation in Health and Illness. New York: Springer-Verlag, 1991,247–272.

    Google Scholar 

  15. Leventhal H, Diefenbach M, Leventhal EA: Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions.Cognitive Therapy and Research. 1992,16:143–163.

    Article  Google Scholar 

  16. Rotter JB:The Development and Application of Social Learning Theory. New York: Praeger, 1982.

    Google Scholar 

  17. Bovbjerg DH, Redd WH, Jacobsen PB, et al.: An experimental analysis of classically conditioned nausea during cancer chemotherapy.Psychosomatic Medicine. 1992,54:623–637.

    PubMed  CAS  Google Scholar 

  18. Jacobsen PB, Bovbjerg DH, Schwartz MD, et al.: Formation of food aversions in cancer patients receiving repeated infusions of chemotherapy.Behaviour Research and Therapy. 1993,31:739–748.

    Article  PubMed  CAS  Google Scholar 

  19. DiLorenzo TA, Jacobsen PB, Bovbjerg DH, et al.: Sources of anticipatory emotional distress in women receiving chemotherapy for breast cancer.Annals of Oncology. 1995,6:705–711.

    PubMed  CAS  Google Scholar 

  20. Shacham N: A shortened version of the profile of mood states.Journal of Personality Assessment. 1983,47:305–306.

    Article  PubMed  CAS  Google Scholar 

  21. DiLorenzo TA, Bovbjerg DH, Montgomery GH, Jacobsen PB, Valdimarsdottir H: The application of a shortened version of the profile of mood states in a sample of breast cancer chemotherapy patients.British Journal of Health Psychology. 1999,4:315–325.

    Article  Google Scholar 

  22. Montgomery GH, McClary KA, Bovbjerg DH: Adjuvant therapy for breast cancer and psychological distress.Annals of Oncology. 1996,7:977–978.

    PubMed  CAS  Google Scholar 

  23. Jacobsen PB, Andrykowski MA, Redd WH, et al.: Nonpharmacologic factors in the development of posttreatment nausea with adjuvant chemotherapy for breast cancer.Cancer. 1988,61:379–385.

    Article  PubMed  CAS  Google Scholar 

  24. Cassileth BR, Lusk EJ, Bodenheimer BJ, et al.: Chemotherapeutic toxicity - The relationship between patients’ pretreatment expectations and post-treatment results.American Journal of Clinical Oncology. 1985,8:419–425.

    Article  PubMed  CAS  Google Scholar 

  25. Andrykowski MA, Redd WH, Hatfield AK: Development of anticipatory nausea: A prospective analysis.Journal of Consulting & Clinical Psychology. 1985,53:447–454.

    Article  CAS  Google Scholar 

  26. Carey MP, Burish TG: Etiology and treatment of the psychological side effects associated with cancer chemotherapy. Acritical review and discussion.Psychological Bulletin. 1988,104:307–325.

    Article  PubMed  CAS  Google Scholar 

  27. Taylor JA: A personality scale of manifest anxiety.Abnormal and Social Psychology. 1953,48:285–290.

    Article  CAS  Google Scholar 

  28. Crowne DP, Marlowe D:The Approval Motive: Studies in Evaluative Dependence. New York: Wiley, 1964.

    Google Scholar 

  29. Cohen J: A power primer.Psychological Bulletin. 1992,112:155–159.

    Article  PubMed  CAS  Google Scholar 

  30. Montgomery GH, Bovbjerg DH: The development of anticipatory nausea in patients receiving adjuvant chemotherapy for breast cancer.Physiology and Behavior. 1997,61:737–741.

    Article  PubMed  CAS  Google Scholar 

  31. Tomoyasu N, Bovbjerg DH, Jacobsen PB: Conditioned reactions to cancer chemotherapy: percent reinforcement predicts anticipatory nausea.Physiology and Behavior. 1996,59:273–276.

    Article  PubMed  CAS  Google Scholar 

  32. Montgomery GH, Weltz CR, Seltz G, Bovbjerg DH: Brief pre-surgery hypnosis reduces distress and pain in excisional breast biopsy patients.International Journal of Clinical and Experimental Hypnosis. 2002,50:17–32.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guy H. Montgomery Ph.D..

Additional information

This research was supported by research and training grants from the Department of the Army (DAMD17-94-J-4141) and the National Cancer Institute (CA87021-01A1). We are required to indicate that “the content of the information does not necessarily reflect the position or policy of the government.”

About this article

Cite this article

Montgomery, G.H., Bovbjerg, D.H. Expectations of chemotherapy-related nausea: Emotional and experiential predictors. ann. behav. med. 25, 48–54 (2003). https://doi.org/10.1207/S15324796ABM2501_07

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1207/S15324796ABM2501_07

Keywords

Navigation