The role of outcome expectancies for a training program consisting of meditation, breathing exercises, and cold exposure on the response to endotoxin administration: a proof-of-principle study

Clin Rheumatol. 2016 Apr;35(4):1081-5. doi: 10.1007/s10067-015-3009-8. Epub 2015 Jul 21.


Expectancies play a major role for the treatment outcome of a broad variety of immune-mediated conditions and may strengthen or mimic the effects of regular long-term therapies. This study adds to a recently published study of Kox et al. (PNAS 111:7379-7384, 2014) on the ability to voluntarily influence the physiological stress response in healthy men after a training program consisting of meditation, breathing techniques, and exposure to cold, which found highly promising results on the clinical, autonomic, and immune response to experimentally induced inflammation (using the experimental human endotoxemia model). Within this project, a number of variables were included to assess the role of generalized (optimism, neuroticism) and specific outcome expectancies (related to the effects of the training on health) on the response to endotoxin administration after training. Indications were found that especially the generalized outcome expectancy optimism is a potential determinant of the autonomic (epinephrine: rho = 0.76, p < .01) and immune response (interleukin-10: rho = 0.60, p < .05) to induced inflammation after training, whereas more specific expectations with regard to the effects of the training could be especially relevant for the clinical symptom report (flu-like symptoms: rho = -0.71, p < .01). This proof-of-principle study provides first indications for potential innovative treatments to change immune-modulating responses by means of psychological mechanisms. If replicated, these findings may be used for predicting training responses and potentiate their effects by means of optimism-inducing interventions in patients with immune-mediated rheumatic conditions.

Keywords: Cytokines; Expectancies; Inflammation; Optimism; Proof-of-principle study; Psychology.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticipation, Psychological*
  • Autonomic Nervous System
  • Cold Temperature*
  • Endotoxemia / psychology*
  • Endotoxemia / therapy*
  • Endotoxins / administration & dosage*
  • Healthy Volunteers
  • Humans
  • Immune System
  • Inflammation
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Male
  • Meditation / methods*
  • Optimism
  • Research Design
  • Respiration*
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood
  • Young Adult


  • CXCL8 protein, human
  • Endotoxins
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Interleukin-10