The impact of valence framing on response expectancies of side effects and subsequent experiences: a randomised controlled trial.

Pre-treatment side effect expectancies often influence subsequent experiences; however, expectancy-based reduction strategies are lacking. We explored whether framing information about adverse responses (in positive or negative formats) altered expectancies and experiences of a cold pressor task. We further investigated associations between expectancies and experiences, to inform potential interventions. Healthy volunteers ( = 134), randomised to receive positively- or negatively-framed pre-cold pressor task information, self-rated 12 expectancies for cold pressor experiences, emotional state and coping style. Self-reports of the same 12-experiences (recorded during and after the experiment) were assessed. Framing had minimal impact on expectancies and experiences; however, discomfort threshold ( = .08,  = 0.22) showed a trend in the expected direction. Hierarchical regressions revealed expectancies uniquely, significantly predicted 6-23% of the variance for 11 subsequent experiences. Following a popular charity event (Ice Bucket Challenge), all participants showed higher 'discomfort thresholds' ( = .001,  = 0.59), and those in the negative frame reported more overall 'discomfort' ( = .01,  = 0.60) than participants in the positive condition. Expectancies uniquely influenced subsequent cold pressor experiences. Framing had minimal impact in this 'analogue' medical setting, only influencing 'discomfort threshold'. 'Discomfort threshold' and overall 'discomfort' were also impacted by a social media challenge, highlighting a potential area for intervention.