My research focuses on how changes in subjective mindsets - the lenses through which information is perceived, organized, and interpreted - can alter objective reality through behavioral, psychological, and physiological mechanisms. My work is, in part, inspired by research on the placebo effect, a remarkable and consistent demonstration of the ability of the mindset to elicit healing properties in the body. I am interested in understanding how mindsets affect important outcomes outside the realm of medicine, in the domains of behavioral health and organizational behavior. More specifically, I aim to understand how mindsets can be consciously and deliberately changed through intervention to affect organizational and individual performance, physiological and psychological well-being, and interpersonal effectiveness.
AB, Harvard University, Psychology (2005)
PhD, Yale University, Clinical Psychology (2012)
Current Research and Scholarly Interests
Our lab focuses on how subjective mindsets (e.g., thoughts, beliefs and expectations) can alter objective reality through behavioral, psychological, and physiological mechanisms. Our work is, in part, inspired by research on the placebo effect, a robust demonstration of the ability of the mindset to elicit healing properties in the body. We are interested in understanding how mindsets affect important outcomes both within and beyond the realm of medicine, in the domains such as exercise, diet and stress. More specifically, we aim to understand how selective information through modalities such as media, marketing and labeling can inform mindsets, and how mindsets can be consciously and deliberately changed through intervention to affect physiological and psychological health.
Our research draws upon and integrates the psychology of schemas and appraisals within a range of disciplines including the science of the placebo effect, the behavioral economics of framing, and the sociology of valuation. We collaborate with an interdisciplinary web of scholars including psychologists, sociologists, organizational behavior scholars, and neurobiologists and employ a variety of methods, from experimental studies to surveys to field interventions. Though our approach is interdisciplinary and our methods multi-modal, our focus is precise: to bring together related streams of research to a) understand how mindsets shape reality and b) design interventions that can positively change health, performance and wellbeing.
- Independent Studies (4)
Prior Year Courses
- Advanced Studies in Health Psychology
PSYCH 298 (Win)
- Graduate Seminar in Social Psychology Research
PSYCH 258 (Aut, Win, Spr)
- Self and Society: Introduction to Social Psychology
PSYCH 70, SOC 2 (Spr)
- Graduate Seminar in Social Psychology Research
PSYCH 258 (Aut, Win, Spr)
- How Beliefs Create Reality
PSYCH 20N (Aut)
- Self and Society: Introduction to Social Psychology
PSYCH 70 (Spr)
- Advanced Studies in Health Psychology
Changing Patient Mindsets About Non-Life-Threatening Symptoms During Oral Immunotherapy: A Randomized Clinical Trial.
The journal of allergy and clinical immunology. In practice
BACKGROUND: Oral immunotherapy (OIT) can lead to desensitization to food allergens, but patients can experience treatment-related symptoms of allergic reactions that cause anxiety and treatment dropout. Interventions to improve OIT for patients are needed.OBJECTIVE: To determine whether fostering the mindset that non-life-threatening symptoms during OIT can signal desensitization improves treatment experience and outcomes.METHODS: In a randomized, blinded, controlled phase II study, 50 children/adolescents (28% girls, aged 7-17, M=10.82, SD=3.01) completed six-month OIT for peanut allergies. Patients and their parent(s) had monthly clinic visits at the Sean N. Parker Center for Allergy & Asthma Research between 1/5/2017-8/3/2017. All families received identical symptom management training. In a 1:1 approach, 24 patients and their families were informed that non-life-threatening symptoms during OIT were unfortunate side effects of treatment, and 26 patients and their families were informed that non-life-threatening symptoms could signal desensitization. Families participated in activities to reinforce these symptom mindsets.RESULTS: Compared to families informed that symptoms are side effects, families informed that symptoms can signal desensitization were less anxious (B=-0.46, 95% CI (-0.76 to -0.16), p=0.003), less likely to contact staff about symptoms (5/24[9.4%] vs. 27/154[17.5%] instances, p=0.036), experienced fewer non-life-threatening symptoms as doses increased (BInteraction=-0.54(-0.83 to -0.27), p<0.001), less likely to skip/reduce doses (1/26[4%] vs. 5/24[21%] patients, p=0.065), and showed greater increase in patient peanut-specific blood IgG4 levels (BInteraction=0.76(0.36 to 1.17), p<0.001).CONCLUSION: Fostering the mindset that symptoms can signal desensitization improves OIT experience and outcomes. Changing how providers inform patients about non-life-threatening symptoms is a promising avenue for improving treatment.
View details for DOI 10.1016/j.jaip.2019.01.022
View details for PubMedID 30682576
Learning one's genetic risk changes physiology independent of actual genetic risk
Nature Human Behaviour
2019; 3: 48-56
View details for DOI 10.1038/s41562-018-0483-4
Smart food policy for healthy food labeling: Leading with taste, not healthiness, to shift consumption and enjoyment of healthy foods.
Smart food policy models for improving dietary intake recommend tailoring interventions to people's food preferences. Yet, despite people citing tastiness as their leading concern when making food choices, healthy food labels overwhelmingly emphasize health attributes (e.g., low caloric content, reductions in fat or sugar) rather than tastiness. Here we compared the effects of this traditional health-focused labeling approach to a taste-focused labeling approach on adults' selection and enjoyment of healthy foods. Four field studies (total N = 4273) across several dining settings in northern California in 2016-2017 tested whether changing healthy food labels to emphasize taste and satisfaction rather than nutritional properties would encourage more people to choose them (Studies 1-2), sustain healthy purchases over the long-term (Study 3), and improve both the perceived taste of and mindsets about healthy foods (Study 4). Compared to health-focused labeling, taste-focused labeling increased choice of vegetables (OR = 1.73, 95% CI: 1.32, 2.26), salads (OR = 2.06, 95% CI: 1.06, 4.06), and vegetable wraps (OR = 3.09, 95% CI: 1.73, 5.65) in Studies 1-2. In Study 3, taste-focused labeling sustained vegetarian entree purchases over a two-month period, while health-focused labeling led to a 45.1% decrease. In Study 4, taste-focused labeling significantly enhanced post-consumption ratings of vegetable deliciousness and improved mindsets about the deliciousness of healthy foods compared to health-focused labeling. These studies demonstrate that taste-focused labeling is a low-cost strategy that increased healthy food selection by 38% and outperforms health-focused labeling on multiple smart food policy mechanisms.
View details for DOI 10.1016/j.ypmed.2018.11.021
View details for PubMedID 30508553
Beliefs About Stress Attenuate the Relation Among Adverse Life Events, Perceived Distress, and Self-Control.
2018; 89 (6): 2059–69
Prior research has shown that adverse events in the lives of adolescents precipitate psychological distress, which in turn impairs self-control. This study (N=1,343) examined the protective effects of stress mindsets-beliefs about the extent to which stress might be beneficial or strictly detrimental. The results confirmed that increasing the number of adverse life events across the school year predicted rank order increases in perceived distress, which in turn predicted rank order decreases in self-control. Adolescents who believed in the potential benefits of stress were less prone to feeling stressed in the wake of adverse life events. These findings suggest that changing the way adolescents think about stress may help protect them from acting impulsively when confronted with adversity.
View details for DOI 10.1111/cdev.12946
View details for PubMedID 28872676
- Providers' Demeanor Impacts Patient Perceptions of Visit Length. Journal of general internal medicine 2018
- Physician Assurance Reduces Patient Symptoms in US Adults: an Experimental Study. Journal of general internal medicine 2018
Catechol-O-Methyltransferase moderates effect of stress mindset on affect and cognition
2018; 13 (4): e0195883
There is evidence that altering stress mindset-the belief that stress is enhancing vs. debilitating-can change cognitive, affective and physiological responses to stress. However individual differences in responsiveness to stress mindset manipulations have not been explored. Given the previously established role of catecholamines in both placebo effects and stress, we hypothesized that genetic variation in catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines, would moderate responses to an intervention intended to alter participants' mindsets about stress. Participants (N = 107) were exposed to a stress mindset manipulation (videos highlighting either the enhancing or debilitating effects of stress) prior to engaging in a Trier Social Stress task and subsequent cognitive tasks. The associations of the COMT rs4680 polymorphism with the effect of stress mindset video manipulations on cognitive and affective responses were examined. Genetic variation at rs4680 modified the effects of stress mindset on affective and cognitive responses to stress. Individuals homozygous for rs4680 low-activity allele (met/met) were responsive to the stress-is-enhancing mindset manipulation as indicated by greater increases in positive affect, improved cognitive functioning, and happiness bias in response to stress. Conversely, individuals homozygous for the high-activity allele (val/val) were not as responsive to the stress mindset manipulation. These results suggest that responses to stress mindset intervention may vary with COMT genotype. These findings contribute to the understanding of gene by environment interactions for mindset interventions and stress reactivity and therefore warrant further investigations.
View details for DOI 10.1371/journal.pone.0195883
View details for Web of Science ID 000430638900017
View details for PubMedID 29677196
View details for PubMedCentralID PMC5909917
Mindsets Matter: A New Framework for Harnessing the Placebo Effect in Modern Medicine.
International review of neurobiology
2018; 138: 137–60
The clinical utility of the placebo effect has long hinged on physicians deceptively administering an objective placebo treatment to their patients. However, the power of the placebo does not reside in the sham treatment itself; rather, it comes from the psychosocial forces that surround the patient and the treatment. To this end, we propose a new framework for understanding and leveraging the placebo effect in clinical care. In outlining this framework, we first present the placebo effect as a neurobiological effect that is evoked by psychological processes. Next, we argue that along with implicit learning and expectation formation, mindsets are a key psychological process involved in the placebo effect. Finally, we illustrate the critical role of the social environment and treatment context in shaping these psychological processes. In doing so, we offer a guide for how the placebo effect can be understood, harnessed, and leveraged in the practice of modern medicine.
View details for DOI 10.1016/bs.irn.2018.02.002
View details for PubMedID 29681322
Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus
PSYCHOTHERAPY AND PSYCHOSOMATICS
2018; 87 (4): 204–10
Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice.A survey and interdisciplinary expert meeting by invitation was organized as part of the 1st Society for Interdisciplinary Placebo Studies (SIPS) conference in 2017. Twenty-nine internationally recognized placebo researchers participated.There was consensus that maximizing placebo effects and minimizing nocebo effects should lead to better treatment outcomes with fewer side effects. Experts particularly agreed on the importance of informing patients about placebo and nocebo effects and training health professionals in patient-clinician communication to maximize placebo and minimize nocebo effects.The current paper forms a first step towards developing evidence-based and ethical recommendations about the implications of placebo and nocebo research for medical practice, based on the current state of evidence and the consensus of experts. Future research might focus on how to implement these recommendations, including how to optimize conditions for educating patients about placebo and nocebo effects and providing training for the implementation in clinical practice.
View details for DOI 10.1159/000490354
View details for Web of Science ID 000441339300003
View details for PubMedID 29895014
Optimizing stress responses with reappraisal and mindset interventions: an integrated model
ANXIETY STRESS AND COPING
2018; 31 (3): 245–61
The dominant perspective in society is that stress has negative consequences, and not surprisingly, the vast majority of interventions for coping with stress focus on reducing the frequency or severity of stressors. However, the effectiveness of stress attenuation is limited because it is often not possible to avoid stressors, and avoiding or minimizing stress can lead individuals to miss opportunities for performance and growth. Thus, during stressful situations, a more efficacious approach is to optimize stress responses (i.e., promote adaptive, approach-motivated responses). Objectives and Conclusions: In this review, we demonstrate how stress appraisals (e.g., [Jamieson, J. P., Nock, M. K., & Mendes, W. B. (2012). Mind over matter: reappraising arousal improves cardiovascular and cognitive responses to stress. Journal of Experimental Psychology: General, 141(3), 417-422. doi: 10.1037/a0025719 ]) and stress mindsets (e.g., [Crum, A. J., Salovey, P., & Achor, S. (2013). Rethinking stress: The role of mindsets in determining the stress response. Journal of Personality and Social Psychology, 104(4), 716-733. doi: 10.1037/a0031201 ]) can be used as regulatory tools to optimize stress responses, facilitate performance, and promote active coping. Respectively, these interventions invite individuals to (a) perceive stress responses as functional and adaptive, and (b) see the opportunity inherent in stress. We then propose a novel integration of reappraisal and mindset models to maximize the utility and effectiveness of stress optimization. Additionally, we discuss future directions with regard to how stress responses unfold over time and between people to impact outcomes in the domains of education, organizations, and clinical science.
View details for DOI 10.1080/10615806.2018.1442615
View details for Web of Science ID 000428806800001
View details for PubMedID 29471669
- Selection Does Not Equate Consumption Reply JAMA INTERNAL MEDICINE 2017; 177 (12): 1875–76
- Making mindset matter. BMJ (Clinical research ed.) 2017; 356: j674-?
The role of stress mindset in shaping cognitive, emotional, and physiological responses to challenging and threatening stress.
Anxiety, stress, and coping
Prior research suggests that altering situation-specific evaluations of stress as challenging versus threatening can improve responses to stress. The aim of the current study was to explore whether cognitive, physiological and affective stress responses can be altered independent of situation-specific evaluations by changing individuals' mindsets about the nature of stress in general.Using a 2 × 2 design, we experimentally manipulated stress mindset using multi-media film clips orienting participants (N = 113) to either the enhancing or debilitating nature of stress. We also manipulated challenge and threat evaluations by providing positive or negative feedback to participants during a social stress test.Results revealed that under both threat and challenge stress evaluations, a stress-is-enhancing mindset produced sharper increases in anabolic ("growth") hormones relative to a stress-is-debilitating mindset. Furthermore, when the stress was evaluated as a challenge, a stress-is-enhancing mindset produced sharper increases in positive affect, heightened attentional bias towards positive stimuli, and greater cognitive flexibility, whereas a stress-is-debilitating mindset produced worse cognitive and affective outcomes.These findings advance stress management theory and practice by demonstrating that a short manipulation designed to generate a stress-is-enhancing mindset can improve responses to both challenging and threatening stress.
View details for DOI 10.1080/10615806.2016.1275585
View details for PubMedID 28120622
- Association Between Indulgent Descriptions and Vegetable Consumption: Twisted Carrots and Dynamite Beets. JAMA internal medicine 2017
Adaptive Appraisals of Anxiety Moderate the Association between Cortisol Reactivity and Performance in Salary Negotiations
2016; 11 (12)
Prior research suggests that stress can be harmful in high-stakes contexts such as negotiations. However, few studies actually measure stress physiologically during negotiations, nor do studies offer interventions to combat the potential negative effects of heightened physiological responses in negotiation contexts. In the current research, we offer evidence that the negative effects of cortisol increases on negotiation performance can be reduced through a reappraisal of anxiety manipulation. We experimentally induced adaptive appraisals by randomly assigning 97 male and female participants to receive either instructions to appraise their anxiety as beneficial to the negotiation or no specific instructions on how to appraise the situation. We also measured participants' cortisol responses prior to and following the negotiation. Results revealed that cortisol increases were positively related to negotiation performance for participants who were told to view anxiety as beneficial, and not detrimental, for negotiation performance (appraisal condition). In contrast, cortisol increases were negatively related to negotiation performance for participants given no instructions on appraising their anxiety (control condition). These findings offer a means through which to combat the potentially deleterious effects of heightened cortisol reactivity on negotiation outcomes.
View details for DOI 10.1371/journal.pone.0167977
View details for Web of Science ID 000392758000019
View details for PubMedID 27992484
View details for PubMedCentralID PMC5161466
Transforming Water: Social Influence Moderates Psychological, Physiological, and Functional Response to a Placebo Product
2016; 11 (11)
This paper investigates how social influence can alter physiological, psychological, and functional responses to a placebo product and how such responses influence the ultimate endorsement of the product. Participants consumed a product, "AquaCharge Energy Water," falsely-labeled as containing 200 mg of caffeine but which was actually plain spring water, in one of three conditions: a no social influence condition, a disconfirming social influence condition, and a confirming social influence condition. Results demonstrated that the effect of the product labeling on physiological alertness (systolic blood pressure), psychological alertness (self-reported alertness), functional alertness (cognitive interference), and product endorsement was moderated by social influence: participants experienced more subjective, physiological and functional alertness and stronger product endorsement when they consumed the product in the confirming social influence condition than when they consumed the product in the disconfirming social influence condition. These results suggest that social influence can alter subjective, physiological, and functional responses to a faux product, in this case transforming the effects of plain water.
View details for DOI 10.1371/journal.pone.0167121
View details for Web of Science ID 000388886000052
View details for PubMedID 27875567
View details for PubMedCentralID PMC5119827
- Self-Fulfilling Prophesies, Placebo Effects, and the Social-Psychological Creation of Reality Emerging Trends in the Social and Behavioral Sciences John Wiley & Sons, Inc. 2015
Rethinking Stress: The Role of Mindsets in Determining the Stress Response
JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY
2013; 104 (4): 716-733
This article describes 3 studies that explore the role of mindsets in the context of stress. In Study 1, we present data supporting the reliability and validity of an 8-item instrument, the Stress Mindset Measure (SMM), designed to assess the extent to which an individual believes that the effects of stress are either enhancing or debilitating. In Study 2, we demonstrate that stress mindsets can be altered by watching short, multimedia film clips presenting factual information biased toward defining the nature of stress in 1 of 2 ways (stress-is-enhancing vs. stress-is-debilitating). In Study 3, we demonstrate the effect of stress mindset on physiological and behavioral outcomes, showing that a stress-is-enhancing mindset is associated with moderate cortisol reactivity and high desire for feedback under stress. Together, these 3 studies suggest that stress mindset is a distinct and meaningful variable in determining the stress response.
View details for DOI 10.1037/a0031201
View details for Web of Science ID 000316620300007
View details for PubMedID 23437923
Mind Over Milkshakes: Mindsets, Not Just Nutrients, Determine Ghrelin Response
2011; 30 (4): 424-429
To test whether physiological satiation as measured by the gut peptide ghrelin may vary depending on the mindset in which one approaches consumption of food.On 2 separate occasions, participants (n = 46) consumed a 380-calorie milkshake under the pretense that it was either a 620-calorie "indulgent" shake or a 140-calorie "sensible" shake. Ghrelin was measured via intravenous blood samples at 3 time points: baseline (20 min), anticipatory (60 min), and postconsumption (90 min). During the first interval (between 20 and 60 min) participants were asked to view and rate the (misleading) label of the shake. During the second interval (between 60 and 90 min) participants were asked to drink and rate the milkshake.The mindset of indulgence produced a dramatically steeper decline in ghrelin after consuming the shake, whereas the mindset of sensibility produced a relatively flat ghrelin response. Participants' satiety was consistent with what they believed they were consuming rather than the actual nutritional value of what they consumed.The effect of food consumption on ghrelin may be psychologically mediated, and mindset meaningfully affects physiological responses to food.
View details for DOI 10.1037/a0023467
View details for Web of Science ID 000292809100006
View details for PubMedID 21574706
Mind-set matters: Exercise and the placebo effect
2007; 18 (2): 165-171
In a study testing whether the relationship between exercise and health is moderated by one's mind-set, 84 female room attendants working in seven different hotels were measured on physiological health variables affected by exercise. Those in the informed condition were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General's recommendations for an active lifestyle. Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.
View details for Web of Science ID 000245157900014
View details for PubMedID 17425538