Preventing adverse information effects on health outcomes: A self-affirmation intervention reduced information-induced cognitive decline in gastrointestinal cancer patients.



Informing patients about chemotherapy-related cognitive problems increased CPR and decreased scores on two out of three memory measures. Self-affirmation reduced these AIE. Stigma conscious patients reported more problems in the information than the self-affirmation group.


Nocebo studies show that informing patients about treatment side effects can adversely impact expectancies and symptom reporting.


Participants were 90 Dutch and Belgian gastrointestinal cancer patients with and without chemotherapy experience. Patients were randomized across three experimental conditions (information about chemotherapy-related cognitive problems with or without self-affirmation; no-information control) before completing an online questionnaire. Data were collected from May until August 2015. Main dependent variables were CPR and verbal memory performance. Stigma consciousness was included as a moderator.


The current study examined how to inform patients fully about treatment side effects without increasing their occurrence. Extending theoretical assumptions about self-affirmation from the social-psychological to the medical domain, we tested whether allowing cancer patients to self-affirm prior to informing them about potential cognitive decline reduced the occurrence of Adverse Information Effects (AIE) on cognitive problem reporting (CPR) and verbal memory performance.


Nocebo effects may be reduced by allowing patients the opportunity to restore their self-integrity at the implicit level. Self-affirmation has the potential to reduce AIE in patient populations without withholding relevant information about potential treatment side effects.

More about this publication

Social science & medicine (1982)
  • Volume 226
  • Pages 47-55
  • Publication date 01-04-2019

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