Nocebo effects encompass psychophysiological, and neurobiological responses stemming from negative expectations and perceived harm. COVID-19 pandemic has created a context of infectious threat placing individuals at risk of a powerful nocebo effect. This cross-sectional study aims to investigate the specific impact of fear and expectations on self-perceived health among individuals who suspect COVID-19 infection but test negative, and to explore how personality traits and distrust in institutions mediate these impacts. To achieve this, 967 citizens with suspected COVID-19 symptoms who sought testing were surveyed online. Data from 523 individuals (283F), testing negative for COVID-19, were entered into a structural equation model. Individuals who strongly expect to have COVID-19 infection, coupled with a heightened fear of contagion, significantly contribute to a substantial portion (i.e., 60%) of the variance in perceived health status (i.e., general health condition and number of COVID-like symptoms). The model identifies an indirect effect of personality traits (i.e., pain catastrophizing and perceived vulnerability to disease), emphasizing their role as mediators, influencing susceptibility to nocebo effects. This study highlights how negative expectations related to infectious threats alter the perception of bodily experiences, reducing perceived health status and exacerbating symptoms. Understanding the interplay between these psychological factors and personality traits is essential for designing effective public health strategies during disease outbreaks. As such, this study also underscores the need for tailored interventions and educational programs for healthcare providers that focus on the psychological aspects of infectious threats. By addressing fear and negative expectations, these programs can help mitigate nocebo effects, improve patient outcomes, and promote overall well-being for individuals and communities during disease outbreaks.
Mattarozzi, K., Bagnis, A., Capucci, F., Cremonini, V., De Palma, A., Mazzoni, R., et al. (2025). Nocebo effects and health perception during infectious threats: A pandemic lesson. HELIYON, 11(5), 1-15 [10.1016/j.heliyon.2025.e42963].
Nocebo effects and health perception during infectious threats: A pandemic lesson
Mattarozzi, Katia;Bagnis, Arianna
;Capucci, Fabio;Cremonini, Valeria;Russo, Paolo M.
2025
Abstract
Nocebo effects encompass psychophysiological, and neurobiological responses stemming from negative expectations and perceived harm. COVID-19 pandemic has created a context of infectious threat placing individuals at risk of a powerful nocebo effect. This cross-sectional study aims to investigate the specific impact of fear and expectations on self-perceived health among individuals who suspect COVID-19 infection but test negative, and to explore how personality traits and distrust in institutions mediate these impacts. To achieve this, 967 citizens with suspected COVID-19 symptoms who sought testing were surveyed online. Data from 523 individuals (283F), testing negative for COVID-19, were entered into a structural equation model. Individuals who strongly expect to have COVID-19 infection, coupled with a heightened fear of contagion, significantly contribute to a substantial portion (i.e., 60%) of the variance in perceived health status (i.e., general health condition and number of COVID-like symptoms). The model identifies an indirect effect of personality traits (i.e., pain catastrophizing and perceived vulnerability to disease), emphasizing their role as mediators, influencing susceptibility to nocebo effects. This study highlights how negative expectations related to infectious threats alter the perception of bodily experiences, reducing perceived health status and exacerbating symptoms. Understanding the interplay between these psychological factors and personality traits is essential for designing effective public health strategies during disease outbreaks. As such, this study also underscores the need for tailored interventions and educational programs for healthcare providers that focus on the psychological aspects of infectious threats. By addressing fear and negative expectations, these programs can help mitigate nocebo effects, improve patient outcomes, and promote overall well-being for individuals and communities during disease outbreaks.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
