Nocebo education and the pursuit of side-effect information: results from three experiments

Objective Informing individuals about the nocebo effect, termed nocebo education, can minimise the experience of side effects. One untested possibility is that nocebo education promotes behaviour change, such that it decreases the likelihood one actively gathers treatment side-effect information. Decreasing the acquisition of side-effect information should reduce awareness of potential side effects, a key cause of nocebo effects.Methods Three pre-registered online experiments with diverse community samples tested the hypothesis that nocebo education reduces the behavioural pursuit of side-effect information. In each study, participants were randomised to watch either a nocebo education video or a control video. Following this between-subjects manipulation, participants in Studies 1 (N = 181) and 2 (N = 183) were informed about a specific treatment and then given the opportunity to select among treatment-relevant information to read. In Study 3 (N = 185), participants self-generated two questions they wanted to ask about the treatment.Results In all three experiments, nocebo education reduced behaviours associated with acquiring treatment side-effect information. Two of the three studies found evidence that the effect of nocebo education was statistically mediated by the self-reported desire to avoid side-effect information. Finally, receiving nocebo education did not reduce satisfaction with the acquired treatment information, did not increase side-effect expectations, and did not increase treatment anxiety.Conclusions Nocebo education deters the pursuit of additional side-effect information, which could be a novel and useful approach for avoiding adverse nocebo effects.