Preventing nocebo suggestions through mindfulness meditation

Abstract

The nocebo effect is a negative outcome resulting from the belief that a desired treatment has either not been received, or that a received treatment is harmful (Hurst, Foad & Beedie, 2015). This effect has been empirically demonstrated to have negative effects on sporting performance and physical endurance. Expectation has been the foremost mechanism in producing the nocebo response and manipulation through verbal suggestions is arguably the most powerful way to generate expectation (Carlino, Benedetti & Pollo, 2014). The purpose of the study was to investigate whether mindfulness practice can counteract the negative expectations given by potentially harmful nocebo effects, in this case verbal suggestions and a sham electrical stimulation. The majority of the published research on mindfulness has focused on the performance benefits (Gardner & Moore, 2012) and further evaluation is required to establish whether mindfulness can also prevent negative expectations on performance. Research combining the investigation of the nocebo effect and mindfulness is non-existent, both of which are already established topics in the field of sport and exercise psychology. The study hypothesises that mindfulness practice, at a low level of mastery, will combat, or even prevent, nocebo effects. The study contained 70 students from the University of Jyväskylä. The participants were randomly assigned into four groups: a) baseline; b) nocebo group; c) mindfulness intervention control; and d) mindfulness intervention and nocebo effect. Using a leg extension machine (Viveca Biomechanics Laboratory, Jyväskylä), performance was assessed through a combination of a 1-repetition maximum (1-RM) determination and subsequent exhaustion test (Pollo et al, 2012; Carlino et al., 2014). A two-ways mixed ANOVA was used to statistically analyse the data (Hurst, Foad & Beedie, 2015). Results indicated that it was not possible for mindfulness practice to counteract the nocebo effect. There was however further evidence for the efficacy of the nocebo conditioning protocol with nocebo conditions performing significantly worse in comparison the control conditions. The study suggests that combating the nocebo effect may play an important role, for example, in talent development for young athletes that have received negative verbal suggestions or have been rejected from sports academies. The study encourages future researchers to consider the use of single case study designs in the assessment and evaluation of mindfulness’s ability to combat the nocebo effect.