title: The effects of physicians' affect-oriented communication style and raising expectations on analogue patients' anxiety, affect and expectancies.
abstract: OBJECTIVE
  Patients' affect and expectancies can set off placebo effects and thus impact patients' health. We assessed the relative effects of physicians' affect-oriented communication style and raising expectations on patients' affective state and outcome expectancies.
  
  
  METHODS
  Thirty healthy women presented severe menstrual pain in a scripted consultation with a general practitioner (GP). In a 2x2 randomized controlled trial, the GP communicated in a warm, empathic or cold, formal way and raised positive or uncertain expectations. Effects on subjects' state anxiety, affective state and outcome expectancies were assessed.
  
  
  RESULTS
  Only warm, empathic communication combined with positive expectations led to a significant and relevant decrease in state anxiety. Subjects' positive and negative affects were influenced by GPs affect-oriented communication style. Negative affect and outcome expectancies are influenced by GP suggestions about outcomes.
  
  
  CONCLUSIONS
  Manipulations in physicians' affect-oriented and expectancy-related communication can have a large impact on patients' affective state and outcome expectations. A combination of a warm, empathic communication style and raising positive expectations resulted in optimal subject outcomes.
  
  
  CONCLUSIONS
  Physicians should take into account that communicating in warm, empathic way combined with raising positive expectations seems to lead to the most favorable effects on patients' state anxiety and outcome expectancies.
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, The Netherlands. w.verheul@nivel.nl
authors.forename: William
authors.initials: W
authors.lastname: Verheul
authors.forename: Ariëtte
authors.initials: A
authors.lastname: Sanders
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000523:psychology; D002983:Clinical Competence; D003142:Communication; D004412:Dysmenorrhea / Q000523:psychology / Q000628:therapy; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D011581:Psychological Tests; D011594:Psychometrics; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult