Stein Madeline V, Heller Monika, Chapman Sarah, Rubin G James, Terhune Devin B
Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK.
Centre for Behavioural Medicine, UCL School of Pharmacy, London, UK.
Br J Health Psychol. 2025 Feb;30(1):e12774. doi: 10.1111/bjhp.12774.
BACKGROUND: Nocebo responding involves the experience of adverse health outcomes in response to contextual cues. These deleterious responses impact numerous features of mental and physical health but are characterized by pronounced heterogeneity. Suggestion is widely recognized as a contributing factor to nocebo responding but the moderating role of trait responsiveness to verbal suggestions (suggestibility) in nocebo responding remains poorly understood. OBJECTIVE: We conducted a pre-registered meta-analysis (PROSPERO registration number CRD42023425605) to quantitatively synthesize available research on the relationship between suggestibility and nocebo responding. METHODS: Four electronic databases were searched for original studies involving both the assessment of suggestibility and symptom reports in response to an inactive stimulus. RESULTS: Of 7729 search results, 10 articles presenting 13 correlations between suggestibility and nocebo responding were analysed. A random-effects meta-analysis revealed a significant, albeit weak, positive correlation, r = .21 [95% CI: .04, .37], between suggestibility and nocebo responses, such that more highly suggestible individuals displayed larger responses. Sensitivity and meta-regression analyses demonstrated that studies of higher methodological quality, including those that maintained experimenter blinding, exhibited stronger effect sizes. CONCLUSION: These results corroborate proposals that trait responsiveness to verbal suggestions confers greater response to nocebos and warrants renewed attention to the role of suggestibility in symptom induction and perception.
背景：反安慰剂效应是指个体因情境线索而经历不良健康结果。这些有害反应会影响身心健康的诸多方面，但具有明显的异质性。暗示被广泛认为是反安慰剂效应的一个促成因素，但特质性言语暗示反应性（暗示性）在反安慰剂效应中的调节作用仍未得到充分理解。 目的：我们进行了一项预先注册的荟萃分析（PROSPERO注册号CRD42023425605），以定量综合关于暗示性与反安慰剂效应之间关系的现有研究。 方法：检索了四个电子数据库，查找涉及暗示性评估和对无活性刺激的症状报告的原始研究。 结果：在7729条检索结果中，分析了10篇文章，其中呈现了暗示性与反安慰剂效应之间的13种相关性。随机效应荟萃分析显示，暗示性与反安慰剂反应之间存在显著的正相关，尽管较弱，r = 0.21 [95%置信区间：0.04, 0.37]，即暗示性较高的个体表现出更大的反应。敏感性和元回归分析表明，方法学质量较高的研究，包括那些保持实验者盲法的研究，效应量更强。 结论：这些结果证实了特质性言语暗示反应性会导致对反安慰剂有更大反应的观点，并值得重新关注暗示性在症状诱导和感知中的作用。
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