Accentuate the positive: Counteracting psychogenic responses to media health messages in the age of the Internet
Introduction
The advent of the Internet has expanded the scope for creating, circulating and perpetuating health scares, and has dramatically increased the potential for consequent psychogenic responses in the community [1]. The Internet is now a pervasive source of misinformation about threats to personal health including those posed by outbreaks of infectious disease, such as H1N1 and Ebola [2], the dangers posed by public health interventions, such as fluoridation programmes [3], as well as possible health problems arising from new technologies [4], [5]. Common modern technology fears include the risks to health of vaccinations [6], genetically modified food [7], exposure to weak electromagnetic fields from cell phones and wifi [8], as well as health concerns about new forms of energy production, such as wind turbines [9]. The reporting of symptoms, as a result of being exposed to and accessing misinformation about modern technologies, can cause opposition to public health initiatives designed to improve community health, such as water fluoridation [e.g. 3]; reinforce irrational and sometimes socially damaging health behaviours, such as the avoidance of vaccinations [e.g. 10]; and result in on-going symptomatic experiences and distress in the community [11].
The availability of misinformation on the Internet can be very difficult to correct [12]. This has important public health implications because the dissemination of information, suggesting that adverse health effects may be induced by exposure to modern technologies and perceived environmental hazards, has been shown to create negative expectations prompting symptom reporting, during periods when exposure is irrefutably benign [e.g. [13], [14]. Reported health impacts can be explained on the basis that such information provokes nocebo-related effects, where it is the expectation of ill effects that causes people to experience symptoms [15], [16].
One solution to the use of the Internet to misrepresent science, and promote counterproductive health behaviours and expectation related responses, might be to employ the Internet to present alternative narratives [17]. Evidence indicates individuals are increasingly using the Internet to source health related information [18], so effective strategies designed to address the potential for consequential nocebo responding are likely to involve counteracting or mitigating the effect of accessing negative health messages, rather than attempting to prevent exposure to negative messages altogether. As expectations have been shown to influence health in both positive and negative directions [19], a successful approach might be to harness positive expectations as protection against the potential for adverse health experiences to arise from negative expectations formed from negative health information about modern technologies.
To test this we designed a study in which people were given both negative and positive health information about sound generated by wind turbines. In the case of wind farms, suggestions from antiwind farm activists that sub-audible sound (infrasound) produced by wind turbines is directly responsible for a number of non-specific symptoms, such as headache, fatigue and nausea have persisted over recent years, and are perpetuated on the Internet [20]. Although the science does not support the existence of a link between exposure to infrasound produced by wind turbines and adverse health effects, [21], [22], evidence indicates expectations triggered by negative information available on the Internet about the health effects of wind farms or formed from face to face encounters with those opposed to wind farms, provide a pathway for symptom reporting in community settings [23], [24]. Interestingly, infrasound exposure also has reputed therapeutic benefits [25] and there are infrasound-producing devices marketed to the public as curative tools, promoted as ameliorating the same symptoms claimed to be caused by wind farms [26]. Thus, infrasound can also be framed in a positive way; as a naturally occurring phenomenon with claimed health benefits.
The experiment was devised to test two hypotheses: (1) that the experience of symptoms and deterioration of mood triggered by negative expectations about exposure to infrasound would be reversed or alleviated by the provision of positive expectations about infrasound exposure; and (2) that the provision of positive expectations about infrasound would provide a buffer against the influence of the later delivery of negative expectations about exposure to infrasound produced by wind farms.
Section snippets
Method
Sixty-four student volunteers, 44 females and 20 males, aged between 17 and 56 years (M = 22.09, SD = 7.03), were recruited by flyer to participate in the experiment, described as an experiment designed to assess the influence of infrasound on symptoms and mood. The experiment took place at the University of Auckland Acoustic Research Centre, a research facility designed for the study of sound, in a listening room constructed to international standards for the execution of subjective listening
Materials
A combination of the Adobe® Audition software package with a Presonus® Firepod audio interface, and a Mackie® HR 150 active studio woofer were used to construct custom-made sound files to produce infrasound at 9 Hz, which was transmitted during listening sessions at 50.4 dB. The audible sound played during listening sessions was transmitted at 43 dB. The sound had been recorded 1 km from a wind farm, and was representative of sound received at the location of a significantly exposed dwelling near
Results
To evaluate whether the later provision of positive expectations reversed nocebo responding, triggered by the earlier delivery of negative expectations, we conducted repeated measures analyses of variance to evaluate differences in symptom and mood reporting in the negative expectation first group at three different time points (baseline, during session one and during session two). There was a significant effect of time of assessment in relation to the number of symptoms reported F(1.47,45.5) =
Discussion
The results of the study indicated that the framing health information about wind farm noise in a positive way can dilute or reverse the effects of negative expectations formed from accessing misinformation about the health effects of such technologies. The data were consistent with an ameliorating effect of receiving positive expectations prior to receiving negative expectations. During negative sessions, positive expectation first participants had fewer symptoms, lower symptom intensity, and
Ethics
The study was approved by the University of Auckland Ethics Committee.
Author contributions
F. Crichton and K.J. Petrie both contributed to the conceptualization and design of the study. F. Crichton collected and analysed the data and wrote the first draft of the manuscript and both authors edited it.
Conflict of interest
The authors declare that they have no conflict of interest.
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