The desire for side-effect information in pain treatment: an experimental analysis of contextual and individual difference factors.

ABSTRACT: Informing patients about potential side effects of pain treatment is a requirement that protects patients and aids decision making, but it increases the likelihood of unwanted nocebo side effects. If patients do not desire all side-effect information, it may be possible to ethically reduce nocebo effects through authorized concealment of side effects, whereby patients and clinicians engage in shared decision-making to regulate the disclosure of side-effect information. Currently, there is no experimental data clarifying the factors that causally influence desire for side-effect information in pain treatment. In 2 cross-sectional, between-subjects scenario experiments (experiment 1 N = 498, experiment 2 N = 501), 18 to 79-year-old community adults learned about a lower back pain treatment, and potential side-effect severity, frequency, and duration were manipulated. Individual differences in information avoidance were also recorded. In both experiments, participants reported high desire for side-effect information, but the desire was reduced when side effects were described as less severe, less frequent, and participants scored high in information avoidance. Results were not moderated by participants' level of contact with the health care system, chronic health condition, or clinical pain history. Additional analyses indicated that low side-effect severity and frequency lessen desire for side-effect information because these variables reduce belief that side-effect information will be needed in the future and lower feelings of anticipated regret. The experiments identify situational and individual-difference factors that decrease the desire for side-effect information and provide evidence on when and for whom it may be useful for physicians to engage in shared medical decision-making with the goal of reducing nocebo side effects.

The Use of Authorized Concealment to Minimize Nocebo Side Effects: A Survey of US Public Attitudes.

INTRODUCTION: To minimize nocebo effects, it may be possible to employ authorized concealment, in which clinicians tell patients about the nocebo phenomenon and ask if they would prefer not to be informed about mild treatment side effects. OBJECTIVE: The objective of the study was to understand public evaluations of authorized concealment for reducing nocebo effects. METHODS: An online cross-sectional survey was completed by a demographically diverse US national community sample between June 2 and 6, 2023. Participants were 1,012 adults residing in 48 states, ages ranging from 18 to 94 (mean = 43.2), 65.4% regularly taking medication, and 66.6% reporting a chronic physical or mental health condition. After learning about nocebo effects, participants rated and estimated their likelihood of consenting to four potential methods for authorized concealment of mild side effects. The four methods were ranked for preference and ranked again with the options of (1) receiving all side-effect information and (2) having the opportunity to select among disclosure methods. RESULTS: A majority of participants (86.2%) positively endorsed at least one authorized concealment method and 88.2% estimated they would consent to at least one method. Authorized concealment in which individuals learned only the most common side effects or had side-effect information available online received more positive ratings and rankings. A final ranking yielded preferences for receiving all side-effect information (30.4%) and having the opportunity to select side-effect disclosure method (31.8%). CONCLUSIONS: Our study suggests that many in the public could be open to authorized concealment for mild side effects when it is explained in reference to nocebo effects.

Parents' emotion dysregulation and children's emotional overeating: The role of emotion regulation feeding.

Parents' use of food to regulate children's emotions (i.e., emotion regulation feeding) has been associated with children's emotional overeating. However, less is known about how parents' emotion regulation feeding acts as a moderator between parents' emotion dysregulation and children's emotional overeating. A total of 216 parents (Mage = 35.84 years, SD = 6.11) of 3- to 5-year-old children were recruited to complete an online survey. Analyses revealed that emotion regulation feeding moderated the association between parents' emotion dysregulation and children's emotional overeating, such that parents with high emotion dysregulation and high emotion regulation feeding had children who engaged in more emotional overeating compared to parents with low emotion regulation feeding. This finding suggests that less adaptive feeding aggravates the association between parents' emotion dysregulation and children's emotional overeating.

Children's media use and food approach behavior: Associations with temperament and food parenting.

Children's media use has been found to be associated with obesogenic eating and obesity risk. Children's temperament and food parenting have been found to be important factors associated with children's eating behavior. The current study examined whether children's temperament and food parenting moderated the associations between children's media use and children's food approach behaviors. Parents (n = 214) of children between 3- to 5- years old were recruited to complete an online survey. Findings showed that children's temperament (i.e., negative affectivity and effortful control) and food parenting (i.e., coercive control) moderated the relationship between children's media use and children's food approach behavior. The results suggest that children's temperament and food parenting play important roles in understanding the relationship among children's media use and children's eating behavior.

Mindful feeding: Associations with COVID-19 related parent stress and child eating behavior.

Parent perceived stress has been associated with child obesogenic eating, as parents who are stressed may be less responsive to their children during mealtimes (Gemmill et al., 2013). More recently, mindfulness-based interventions have successfully reduced people's stress levels. However, less is known regarding the role of mindfulness in the child feeding context. In this study, 249 parents of children between the ages of 3 and 12 completed a 20-minute online study to examine the associations among COVID-19 related parent stress (hereby referred to as parent stress), mindful feeding, and child obesogenic eating (i.e., food responsiveness, enjoyment of food, emotional overeating, and desire to drink). As hypothesized, we found that greater parent stress was associated with lower mindful feeding and greater child obesogenic eating. Furthermore, findings showed that parent stress interacted with mindful feeding to predict certain child obesogenic eating (i.e., food responsiveness, emotional overeating). Emotional overeating and food responsiveness were higher in children among parents with higher stress levels and lower levels of mindful feeding when compared to children of parents with greater mindful feeding. Taken together, these findings suggest the potential of mindful feeding in buffering the association between parent stress and child obesogenic eating.