Saunders Cosette, Tan Winston, Faasse Kate, Colagiuri Ben, Sharpe Louise, Barnes Kirsten
School of Psychology, University of Sydney, Camperdown, Australia.
School of Psychology, University of New South Wales, Kensington, Australia.
Health Psychol Rev. 2024 Dec;18(4):934-953. doi: 10.1080/17437199.2024.2394682. Epub 2024 Aug 28.
Individuals frequently update their beliefs and behaviours based on observation of others' experience. While often adaptive, social learning can contribute to the development of negative health expectations, leading to worsened health outcomes, a phenomenon known as the nocebo effect. This systematic review and meta-analysis examined: whether social learning is sufficient to induce the nocebo effect, how it compares to other forms of induction (classical conditioning and explicit instruction), and factors that influence these effects. The meta-analysis included twenty studies ( = 1388). Social learning showed a medium-large effect size (Hedges' = .74) relative to no treatment and a to small-medium effect ( = .42) when compared to neutral modelling. The effect of social learning was similar in magnitude to classical conditioning but greater than explicit instruction with a small-medium effect ( = .46). Face-to-face social modelling, longer exposure, higher proportions of female participants and models, and greater observer empathy led to stronger socially-induced nocebo effects. However, further research is essential as only a minority of studies measured important constructs like negative expectancies and state anxiety. Nonetheless, the study highlights social learning as a key pathway for nocebo effects, suggesting it as a target for interventions to reduce the substantial personal and societal burden caused by nocebo effects.
个体经常根据对他人经历的观察来更新自己的信念和行为。虽然社会学习通常具有适应性，但它可能导致负面健康预期的形成，进而使健康状况恶化，这一现象被称为反安慰剂效应。本系统综述和荟萃分析探讨了：社会学习是否足以诱发反安慰剂效应，与其他诱发形式（经典条件反射和明确指导）相比如何，以及影响这些效应的因素。荟萃分析纳入了20项研究（=1388）。与无治疗相比，社会学习显示出中等偏大的效应量（赫奇斯' = 0.74），与中性示范相比则显示出小到中等的效应（= 0.42）。社会学习的效应在大小上与经典条件反射相似，但大于明确指导，后者显示出小到中等的效应（= 0.46）。面对面的社会示范、更长的暴露时间、女性参与者和示范者的更高比例以及观察者更强的同理心会导致更强的社会诱发反安慰剂效应。然而，进一步的研究至关重要，因为只有少数研究测量了诸如负面预期和状态焦虑等重要构念。尽管如此，该研究强调社会学习是反安慰剂效应的关键途径，表明它可作为干预目标，以减轻反安慰剂效应所造成的巨大个人和社会负担。
