Clinical application of nocebo research: Optimizing breast cancer patient´s expectations to prevent side effects and decreased quality of life during endocrine therapy

• Applicant: Professorin Dr. Yvonne Nestoriuc, since 11/2013
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: from 2012 to 2015
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 138279939

Side Effect Prevention Training for Nocebo Effects Summary: The majority of breast cancer patients discontinue todays standard adjuvant treatment (endocrine therapy) due to side effects and reduced quality of life. Thereby, most side effects are unspecific, thus, not related to the specific pharmacological action of the drug, but to the individual treatment context and patients´ expectations (nocebo effects). The aim of this project is to evaluate a side effect prevention training (SEPT) that optimizes patients response expectations before the start of pharmacotherapy to prevent nocebo side effects during longer term drug intake. SEPT is a three session cognitive-behavioural training providing psychoeducation, expectation manipulation and training of coping strategies. In a randomized trial, we will study the time course of response expectations and side effects in breast cancer patients receiving either SEPT, standard medical care or an attention-control intervention (supportive therapy) before the start of adjuvant endocrine therapy. We will analyze the effects of changing pre-treatment expectations on cancer-treatment related side effects, adherence and health-related quality of life. Treatment specificity will be analysed in comparison to a psychological placebo group receiving supportive therapy. Moderator analyses will be used to determine predictors of non-specific medication side effects and patients that are at high risk of experiencing them. Furthermore, we will explore the mediating influence of coping behaviours, thereby providing insights into pathways of clinical nocebo effects. The study findings promise significant advances in the clinical application of nocebo research with strong implications for clinical and research practice.

• DFG Programme: Research Units
• Subproject of: FOR 1328: Expectation and Conditioning as Basic Processes of the Placebo and Nocebo Response
• Participating Persons: Professorin Dr. Ute S. Albert; Professor Winfried Rief, Ph.D.
• Ehemalige Antragstellerin: Professorin Meike Shedden Mora, Ph.D., from 10/2013 until 11/2013