title: Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms.
abstract: BACKGROUND
  Negative non-specific (nocebo-like) effects of medications and electromagnetic fields are often described as results of mistaken attribution.
  
  
  OBJECTIVE
  The current study aimed to find empirical evidence supporting this theory.
  
  
  METHODS
  Participants completed questionnaires assessing modern health worries, health anxiety, and somatosensory amplification, were assigned to one of three conditions (placebo pill with sedative information, sham magnetic field, or control), and completed a 14-min vigilance task. Changes in physiological arousal (heart rate, heart rate variability, and skin conductance) and reported symptoms were also measured. Finally, causal attributions concerning cognitive performance and reported symptoms were assessed.
  
  
  RESULTS
  No increase in symptom reports and physiological arousal was measured in the two intervention groups. A perceived negative effect on cognitive performance was attributed to both sham conditions, and attributions were connected to modern health worries. A proportion of reported symptoms was ascribed to the placebo pill but not to the sham magnetic field. Symptom attributions were not related to any assessed psychological variables.
  
  
  CONCLUSIONS
  An aroused physiological state is not necessary for the automatic causal attribution process. Negative effects attributed to medication and environmental factors can be regarded as unavoidable side effects of human cognitive-emotional functioning; they might be alleviated, but cannot be completely eradicated.
authors.affiliation: Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary.
authors.forename: Renáta
authors.initials: R
authors.lastname: Szemerszky
authors.affiliation: Doctoral School of Psychology and Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Dömötör
authors.affiliation: Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary.
authors.forename: Tímea
authors.initials: T
authors.lastname: Berkes
authors.affiliation: Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary. koteles.ferenc@ppk.elte.hu.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Köteles
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D001288:Attention / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D060526:Magnetic Fields; D008297:Male; D064786:Nocebo Effect; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Attribution; Magnetic fields; Nocebo