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Main Authors: Anton Fischer, Li‐Ching Chuang, Nick Augustat, Pia von Blanckenburg, Erik M. Mueller
Format: Artículo Open Access
Published: Wiley 2026
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Online Access:https://onlinelibrary.wiley.com/doi/10.1111/jopy.70056
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author Anton Fischer
Li‐Ching Chuang
Nick Augustat
Pia von Blanckenburg
Erik M. Mueller
author_facet Anton Fischer
Li‐Ching Chuang
Nick Augustat
Pia von Blanckenburg
Erik M. Mueller
Anton Fischer
Li‐Ching Chuang
Nick Augustat
Pia von Blanckenburg
Erik M. Mueller
collection Wiley Open Access
contents Trait Neuroticism and the Nocebo Effect: The Mediating Role of Side‐Effect Expectations Anton Fischer Li‐Ching Chuang Nick Augustat Pia von Blanckenburg Erik M. Mueller Journal of Personality ABSTRACT Objective Neuroticism has not only been linked to heightened negative expectations and general somatic complaints but also to increased nocebo responses following medical treatments. Since side‐effect expectations are considered a main driver of nocebo responses, we tested whether side‐effect expectations mediate the neuroticism–nocebo relationship in a pharmacological study of healthy individuals. Method Participants ( N  = 275) provided self‐reported neuroticism and pretreatment side‐effect expectations before completing a 2 × 2 factorial design, receiving a placebo or the dopamine antagonist sulpiride (400 mg), which typically does not cause noticeable side effects after a single dose. Regardless of substance, participants received a substance vs. placebo expectation manipulation. We assessed self‐reported somatic symptoms at baseline and during the intervention. Results Neuroticism correlated with baseline somatic symptoms and with preintervention side‐effect expectations. Both neuroticism and side‐effect expectations, but not the pharmacological treatment or the explicit expectation manipulation, were associated with nocebo responses, defined as the relative increase in somatic symptoms from before to after the intervention. Crucially, path analyses indicated preintervention expectations partially mediated the neuroticism‐nocebo link. Conclusions These results suggest that negative expectations associated with neuroticism contribute to nocebo responses, potentially creating a feedback loop whereby negative expectations heighten side effects, reinforcing negative expectations in future treatments. 10.1111/jopy.70056 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/jopy.70056
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institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
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spellingShingle Trait Neuroticism and the Nocebo Effect: The Mediating Role of Side‐Effect Expectations
Anton Fischer
Li‐Ching Chuang
Nick Augustat
Pia von Blanckenburg
Erik M. Mueller
Journal of Personality
Trait Neuroticism and the Nocebo Effect: The Mediating Role of Side‐Effect Expectations Anton Fischer Li‐Ching Chuang Nick Augustat Pia von Blanckenburg Erik M. Mueller Journal of Personality ABSTRACT Objective Neuroticism has not only been linked to heightened negative expectations and general somatic complaints but also to increased nocebo responses following medical treatments. Since side‐effect expectations are considered a main driver of nocebo responses, we tested whether side‐effect expectations mediate the neuroticism–nocebo relationship in a pharmacological study of healthy individuals. Method Participants ( N  = 275) provided self‐reported neuroticism and pretreatment side‐effect expectations before completing a 2 × 2 factorial design, receiving a placebo or the dopamine antagonist sulpiride (400 mg), which typically does not cause noticeable side effects after a single dose. Regardless of substance, participants received a substance vs. placebo expectation manipulation. We assessed self‐reported somatic symptoms at baseline and during the intervention. Results Neuroticism correlated with baseline somatic symptoms and with preintervention side‐effect expectations. Both neuroticism and side‐effect expectations, but not the pharmacological treatment or the explicit expectation manipulation, were associated with nocebo responses, defined as the relative increase in somatic symptoms from before to after the intervention. Crucially, path analyses indicated preintervention expectations partially mediated the neuroticism‐nocebo link. Conclusions These results suggest that negative expectations associated with neuroticism contribute to nocebo responses, potentially creating a feedback loop whereby negative expectations heighten side effects, reinforcing negative expectations in future treatments. 10.1111/jopy.70056 http://creativecommons.org/licenses/by/4.0/
title Trait Neuroticism and the Nocebo Effect: The Mediating Role of Side‐Effect Expectations
topic Journal of Personality
url https://onlinelibrary.wiley.com/doi/10.1111/jopy.70056