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Once considered nuisance variance in clinical trials, placebo effects and nocebo effects are now widely recognized as important and mutable psychobiological contributors to mental and physical health. Psychological theory explaining these effects emphasizes associative learning and conscious expectations. It has long been suggested, however, that affective states such as moods, emotions, and distress could play a significant role. In this paper, we draw together and review the empirical data linking affective states to placebo and nocebo effects. To organize this disparate literature, three questions are addressed: (1) Does pre‐existing state and trait affect modulate placebo and nocebo effects? (2) Does administering placebo and nocebo treatments change affective states, and if so, does the resulting affect causally influence placebo and nocebo effects? Finally, (3) Can placebo treatments be successfully employed as a regulation strategy to modulate different affective states? In reviewing the evidence in relation to these three questions, it is clear that affect does play a key role in placebo and nocebo effects in many circumstances, and further, there may be a reciprocal dynamic at play between a treatment event, affect, and placebo/nocebo effects. The paper concludes by discussing implications for theory and intervention and recommends future research priorities.

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Handwashing is important in preventing infectious diseases like COVID-19. The current public health emergency has required rapid implementation of increased handwashing in the general public; however, rapidly changing health behavior, especially on this scale, is difficult. This study considers attitudes and affective responses to handwashing as possible factors predicting COVID-19 related changes to handwashing behavior, future intentions, and readiness to change during the early stages of the pandemic in the United States. Income was explored as a potential moderator to these relationships. To explore these issues, data from 344 community participants were analyzed. Results indicate that stronger affective responses toward handwashing relate to increases in handwashing since the outbreak of COVID-19, and both attitudes and affect uniquely predict handwashing intentions. Income significantly moderated the relationship between affect and readiness to change. Those with low income were more influenced by both affective responses and attitudes. These results suggest messages targeting both cognitions and affective responses are needed to increase the handwashing behavior during a global pandemic and these variables are critical in increasing readiness to change in low-income individuals.

Background Vaccines are being administered worldwide to combat the COVID-19 pandemic. Vaccine boosters are essential for maintaining immunity and protecting against virus variants. The side effects of the primary COVID-19 vaccine (e.g., headache, nausea), however, could reduce intentions to repeat the vaccination experience, thereby hindering global inoculation efforts. Purpose The aim of this research was to test whether side effects of a primary COVID-19 vaccine relate to reduced intentions to receive a COVID-19 booster. The secondary aim was to test whether psychological and demographic factors predict booster intentions. Methods Secondary data analyses were conducted on a U.S. national sample of 551 individuals recruited through the online platform Prolific. Key measures in the dataset were side effects reported from a primary COVID-19 vaccination and subsequent intentions to receive a booster vaccine. Psychological and demographic variables that predicted primary vaccination intentions in prior studies were also measured. Results Booster intentions were high. COVID-19 booster vaccine intentions were uncorrelated with the number of side effects, intensity of side effects, or occurrence of an intense side effect from the primary COVID-19 vaccine. Correlational and regression analyses indicated intentions for a booster vaccination increased with positive vaccination attitudes, trust in vaccine development, worry about the COVID-19 pandemic, low concern over vaccine side effects, and democratic political party affiliation. Conclusions Side effects of a primary COVID-19 vaccine were not directly associated with lower intentions to receive a booster of the COVID-19 vaccine early in the pandemic. However, many variables that predict primary vaccination intentions also predict booster intentions.