It’s all in how you look at it. According to a new study from Italian researchers, an asthma patient’s mental outlook could improve their symptom control or worsen it. The study, “Illness Expectations and Asthma Symptoms: A 6-Month Longitudinal Study,” was recently published in the journal, Health Expectations.
Researchers looked at patient expectations for how they believed the chronic disease would progress. The study followed 310 asthma patients over six months and found that negative expectations about illness progression were linked to worse asthma symptoms and reduced lung function. The study is among the first to examine both explicit (conscious) and implicit (unconscious) illness expectations (IEs) and their impact on chronic respiratory disease.
Additional key findings from the study indicated that implicit expectations did not show a statistically significant effect, though researchers cautioned that current tools may not fully capture their influence. The study used validated tools like the Asthma Control Test (ACT) and spirometry to track outcomes, alongside psychological assessments of expectations and emotional well-being.
Positive and negative thinking about an illness can shape an asthma patient’s health trajectory, researchers noted — a conclusion that echoes broader research on the mind-body connection. Researchers said these findings could have major implications for asthma care, where psychological and behavioral factors are often overlooked.
Researchers underscored the role clinicians play in helping patients cope with and manage their condition. Among their suggestions, they encouraged clinicians to:
- Assess patient expectations for asthma management.
- Provide interventions aimed at shifting negative expectations to improve symptom control and treatment adherence.
- Be mindful of how their communication may shape patient expectations — positively or negatively.
The research team noted that the study faced challenges due to the COVID-19 pandemic, including high dropout rates and limited access to spirometry testing. Still, the results were statistically significant and point to a need for further research, especially on implicit expectations and their role in chronic disease. The group also called for broader studies across other chronic conditions, like diabetes and cardiovascular disease, to explore whether similar patterns hold.
