The desire for side-effect information in pain treatment: an experimental analysis of contextual and individual difference factors.

ABSTRACT: Informing patients about potential side effects of pain treatment is a requirement that protects patients and aids decision making, but it increases the likelihood of unwanted nocebo side effects. If patients do not desire all side-effect information, it may be possible to ethically reduce nocebo effects through authorized concealment of side effects, whereby patients and clinicians engage in shared decision-making to regulate the disclosure of side-effect information. Currently, there is no experimental data clarifying the factors that causally influence desire for side-effect information in pain treatment. In 2 cross-sectional, between-subjects scenario experiments (experiment 1 N = 498, experiment 2 N = 501), 18 to 79-year-old community adults learned about a lower back pain treatment, and potential side-effect severity, frequency, and duration were manipulated. Individual differences in information avoidance were also recorded. In both experiments, participants reported high desire for side-effect information, but the desire was reduced when side effects were described as less severe, less frequent, and participants scored high in information avoidance. Results were not moderated by participants' level of contact with the health care system, chronic health condition, or clinical pain history. Additional analyses indicated that low side-effect severity and frequency lessen desire for side-effect information because these variables reduce belief that side-effect information will be needed in the future and lower feelings of anticipated regret. The experiments identify situational and individual-difference factors that decrease the desire for side-effect information and provide evidence on when and for whom it may be useful for physicians to engage in shared medical decision-making with the goal of reducing nocebo side effects.

Study protocol of an investigation of attention and prediction error as mechanisms of action for latent inhibition of dental fear in humans.

BACKGROUND: Evidence suggests that dental anxiety and phobia are frequently the result of direct associative fear conditioning but that pre-exposure to dental stimuli prior to conditioning results in latent inhibition of fear learning. The mechanisms underlying the pre-exposure effect in humans, however, are poorly understood. Moreover, pain sensitivity has been linked to dental fear conditioning in correlational investigations and theory suggests it may moderate the latent inhibition effect, but this hypothesis has not been directly tested. These gaps in our understanding are a barrier to the development of evidence-based dental phobia prevention efforts. METHODS: Healthy volunteers between the ages of 6 and 35 years will be enrolled across two sites. Participants will complete a conditioning task in a novel virtual reality environment, allowing for control over pre-exposure and the examination of behaviour. A dental startle (a brief, pressurized puff of air to a tooth) will serve as the unconditioned stimulus. Using a within-subjects experimental design, participants will experience a pre-exposed to-be conditioned stimulus, a non-pre-exposed to-be conditioned stimulus, and a neutral control stimulus. Two hypothesized mechanisms, changes in prediction errors and attention, are expected to mediate the association between stimulus condition and fear acquisition, recall, and retention. To ascertain the involvement of pain sensitivity, this construct will be measured through self-report and the cold pressor task. DISCUSSION: Dental phobia negatively affects the dental health and overall health of individuals. This study aims to determine the mechanisms through which pre-exposure retards conditioned dental fear acquisition, recall, and retention. A randomized control trial will be used to identify these mechanisms so that they can be precisely targeted and maximally engaged in preventative efforts.

Social communication pathways to COVID-19 vaccine side-effect expectations and experience.

OBJECTIVE: Negative beliefs about medication and vaccine side-effects can spread rapidly through social communication. This has been recently documented with the potential side-effects from the COVID-19 vaccines. We tested if pre-vaccination social communications about side-effects from personal acquaintances, news reports, and social media predict post-vaccination side-effect experiences. Further, as previous research suggests that side-effects can be exacerbated by negative expectations, we assessed if personal expectations mediate the relationships between social communication and side-effect experience. METHOD: In a prospective longitudinal survey (N = 551), COVID-19 vaccine side-effect information from three sources-social media posts, news reports, and first-hand accounts from personal acquaintances-as well as side-effect expectations, were self-reported pre-vaccination. Vaccination side-effect experience was assessed post-vaccination. RESULTS: In multivariate regression analyses, the number of pre-vaccination social media post views (ß = 0.17) and impressions of severity conveyed from personal acquaintances (ß = 0.42) significantly predicted an increase in pre-vaccination side-effect expectations, and the same variables (ßs = 0.11, 0.14, respectively) predicted post-vaccination side-effect experiences. Moreover, pre-vaccination side-effect expectations mediated the relationship between both sources of social communication and experienced side-effects from a COVID-19 vaccination. CONCLUSIONS: This study identifies links between personal acquaintance and social media communications and vaccine side-effect experiences and provides evidence that pre-vaccination expectations account for these relationships. The results suggest that modifying side-effect expectations through these channels may change the side-effects following a COVID-19 vaccination as well as other publicly discussed vaccinations and medications.

Development and cross-national investigation of a model explaining participation in WHO-recommended and placebo behaviours to prevent COVID-19 infection.

To protect themselves from COVID-19, people follow the recommendations of the authorities, but they also resort to placebos. To stop the virus, it is important to understand the factors underlying both types of preventive behaviour. This study examined whether our model (developed based on the Health Belief Model and the Transactional Model of Stress) can explain participation in WHO-recommended and placebo actions during the pandemic. Model was tested on a sample of 3346 participants from Italy, Japan, Poland, Korea, Sweden, and the US. It was broadly supported: objective risk and cues to action showed both direct and indirect (through perceived threat) associations with preventive behaviours. Moreover, locus of control, decision balance, health anxiety and preventive coping moderated these relationships. Numerous differences were also found between countries. We conclude that beliefs about control over health and perceived benefits of actions are critical to the development of interventions to improve adherence to recommendations.

Do Side Effects to the Primary COVID-19 Vaccine Reduce Intentions for a COVID-19 Vaccine Booster?

BACKGROUND: Vaccines are being administered worldwide to combat the COVID-19 pandemic. Vaccine boosters are essential for maintaining immunity and protecting against virus variants. The side effects of the primary COVID-19 vaccine (e.g., headache, nausea), however, could reduce intentions to repeat the vaccination experience, thereby hindering global inoculation efforts. PURPOSE: The aim of this research was to test whether side effects of a primary COVID-19 vaccine relate to reduced intentions to receive a COVID-19 booster. The secondary aim was to test whether psychological and demographic factors predict booster intentions. METHODS: Secondary data analyses were conducted on a U.S. national sample of 551 individuals recruited through the online platform Prolific. Key measures in the dataset were side effects reported from a primary COVID-19 vaccination and subsequent intentions to receive a booster vaccine. Psychological and demographic variables that predicted primary vaccination intentions in prior studies were also measured. RESULTS: Booster intentions were high. COVID-19 booster vaccine intentions were uncorrelated with the number of side effects, intensity of side effects, or occurrence of an intense side effect from the primary COVID-19 vaccine. Correlational and regression analyses indicated intentions for a booster vaccination increased with positive vaccination attitudes, trust in vaccine development, worry about the COVID-19 pandemic, low concern over vaccine side effects, and democratic political party affiliation. CONCLUSIONS: Side effects of a primary COVID-19 vaccine were not directly associated with lower intentions to receive a booster of the COVID-19 vaccine early in the pandemic. However, many variables that predict primary vaccination intentions also predict booster intentions.

Treatment-relevant factors among adults receiving court-mandated substance use treatment: The role of emotion dysregulation.

Despite often being mandated to substance use treatment after release, many people on probation do not complete treatment. Several historical factors have been identified as relevant to substance use treatment in this population (i.e., past substance use, treatment history, and criminal history); however, less is known about the psychological characteristics, such as emotion dysregulation, that influence treatment-relevant factors among people in the criminal justice system. The present study used cross-sectional data to examine whether emotion dysregulation was associated with past-year substance use severity, engagement in prior drug and alcohol use treatments (yes/no, number of prior treatments), and previous criminal charges (total number of charges, number of charge types) in a sample of adults on probation who were receiving court-mandated substance use treatment (N = 163). We also examined whether these relationships varied across sex. Results showed that overall emotion dysregulation was more strongly linked to substance use severity and criminal charges for females than males. Emotion dysregulation dimensions of difficulties engaging in goal-directed behaviors and controlling impulsive behaviors when distressed were associated with more severe past-year substance use, more prior drug treatments, and a greater number of lifetime criminal charges and charge types. Emotion dysregulation plays a role in substance use treatment-relevant factors among people on probation. Sex-specific clinical implications of targeting emotion dysregulation in the context of mandated treatment in order to prevent treatment failures are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The influence of message framing on nocebo headaches: Findings from a randomized laboratory design.

Attribute framing presents an ethically sound approach for reducing adverse nocebo effects. In past studies, however, attribute framing has not always decreased nocebo effects. The present study used a sham tDCS procedure to induce nocebo headaches to explore factors that may contribute to the efficacy of attribute framing. Participants (N = 174) were randomized to one of three between-subject conditions: a no-headache instruction (control) condition and two conditions in which headaches were described as either 70% likely (negative framing) to occur or 30% unlikely (positive framing) to occur. Results revealed nocebo headaches in both framing conditions, as compared to the control condition. Attribute framing did not influence headache measures recorded during the sham tDCS task, but framing did have a modest influence on one of two headache items completed after the task. Results suggest that attribute framing could have a stronger influence on delayed nocebo effect measures or retrospective symptom reports; a finding that may explain inconsistencies in the existing framing-nocebo effect literature. Exploratory analyses also revealed that low negative affect was associated with stronger nocebo and attribute framing effects, although these effects were found on only a few headache measures. It is concluded that researchers should further investigate the influence of attribute framing on nocebo headaches as a function of both timing and emotional factors.

Handwashing Message Type Predicts Behavioral Intentions in the United States at the Beginning of the Global COVID-19 Pandemic.

Handwashing has been widely recommended to reduce the spread of COVID-19. Despite this, handwashing behavior remains low in the general public. Social marketing has been employed as a successful health promotion strategy for changing many health behaviors in the past. The present study examines if message framing influences the effectiveness of a handwashing health promotion messages at the early stages of the COVID-19 pandemic. In a between-subjects cross-sectional experiment, participants (N = 344) in the United States were randomly assigned to view one of four handwashing messages or a control message before completing self-report measures of attitudes, emotions, readiness to change, and behavioral intentions around handwashing. Simple handwashing messages were presented with different framings, including a simple exchange message, a gain message, a social norm appeal, and a guilt appeal. Results revealed that message type influenced handwashing behavioral intentions and emotions. Post-hoc comparisons revealed that the simple exchange message produced significantly higher intentions than other messages and that only the simple exchange message significantly differed from the control message on emotions regarding handwashing. Mediational analyses showed handwashing emotions fully mediated the relationship between messaging and handwashing intentions. This mediation effect was moderated by age, such that it occurred for the younger and middle age participants, but not older participants. These results suggest that even simple, brief, and easily conveyable messages can positively impact behavioral intentions around handwashing during the early stages of a health crisis. Consistent with recent research comparing affective and cognitive pathways for health behavior, the mediational analysis suggests that effect of the simple exchange message on intentions was due to increased positive emotions around handwashing.

Determinants of safety-focused product purchasing in the United States at the beginning of the global COVID-19 pandemic.

Public preparation for the COVID-19 pandemic was widely covered in the media due to its intensity and fast-pace. While some individuals prepared with personal safety supplies such as soap and hand sanitizer, many others did not purchase such preparatory products. There are many health and safety benefits to quick engagement and emergency preparedness in a pandemic, and it is important to identify those who conduct these behaviors. The present study examined who engaged in preparatory purchasing of safety and health care products during the early stages of the spread of COVID-19 and what stimulated this action. Results of a cross-sectional study (N = 344) indicates that possessing, or uncertainty about possessing a COVID-19 risk factor (but not differences in age, gender, race, or income), increased purchasing of preparatory health and safety products. Also, in line with past research on risk, affect, and behavior, worry mediated this relationship. Further, gender moderated the relationship between worry and purchasing, such that worry increased product purchasing for men, who were initially low in worry, but not for women. This study lends additional support to worry as a mediator between risk and safety-related behavior and has implications for understanding factors related to preparatory purchasing of health care products during pandemics.

The Role of Attitudes, Affect, and Income in Predicting COVID-19 Behavioral Intentions.

Handwashing is important in preventing infectious diseases like COVID-19. The current public health emergency has required rapid implementation of increased handwashing in the general public; however, rapidly changing health behavior, especially on this scale, is difficult. This study considers attitudes and affective responses to handwashing as possible factors predicting COVID-19 related changes to handwashing behavior, future intentions, and readiness to change during the early stages of the pandemic in the United States. Income was explored as a potential moderator to these relationships. To explore these issues, data from 344 community participants were analyzed. Results indicate that stronger affective responses toward handwashing relate to increases in handwashing since the outbreak of COVID-19, and both attitudes and affect uniquely predict handwashing intentions. Income significantly moderated the relationship between affect and readiness to change. Those with low income were more influenced by both affective responses and attitudes. These results suggest messages targeting both cognitions and affective responses are needed to increase the handwashing behavior during a global pandemic and these variables are critical in increasing readiness to change in low-income individuals.