To what extent can one’s mind promote “direct” changes to the body? Can one’s beliefs about the body become a physical reality, without mediating effects from behaviors? Specifically, can medical symptoms and the course of a disease be directly affected by a person’s mindset about the illness?

There is a vast literature about placebo and nocebo effects, which promote physical modifications by creating the expectation of a change through a primer (for example, a fake pill). However, expectations do not need a primer to be created. Every person who receives a diagnosis develops his/her own expectations about the course of the disease. This is the main core of the concept of “Illness Expectation” (IE). This new construct describes a cognitive schema that defines the future-oriented beliefs about the illness and the symptoms of someone with a chronic disease.These beliefs could be explicit (i.e., people are conscious of these thoughts – e.g., “My legs will never work again”, or “I will die soon because of this disease”), and implicit (i.e., unconscious beliefs - e.g., being afraid that the disease will get worst, but not being able to phrase it).

The schemas can be characterized by different degrees of rigidity, and it is argued here that these expectations can ultimately lead to changes in the disease progression. The IE model suggests that the influence that mindsets could exert on the body proceed through both behavior modifications (e.g., adherence and compliance, lifestyle), or through a non-behavioral pathway, which is the same “direct” effect that characterizes the placebo effect.

The overall aim of this project is to test the hypothesis that IEs have an unmediated effect on illness symptoms. This will be explored in the context of asthma, which is a debilitating respiratory disease, characterized by airway hyperresponsiveness, airflow obstruction, and chronic inflammation, with an increasing prevalence (more than 5%).

Working group:

• Prof. Francesco Pagnini - Faculty of Psychology

Partners:

• Università Cattolica del Sacro Cuore - Italy (Host entity)
• Fondazione Don Carlo Gnocchi - Italy (Participating institution)