Unleashing the Placebo Effect: Cognitive Connectedness with Placebo Analgesics Predicts Analgesic Outcomes — Evidence from Two Randomized Controlled Studies

Unleashing the Placebo Effect: Cognitive Connectedness with Placebo Analgesics Predicts Analgesic Outcomes — Evidence from Two Randomized Controlled Studies | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Unleashing the Placebo Effect: Cognitive Connectedness with Placebo Analgesics Predicts Analgesic Outcomes — Evidence from Two Randomized Controlled Studies NG Sze Ki, Rose, YEUNG Wai Lan, Victoria, LI Wang On, YAU Eric Kenson This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7975444/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Placebo analgesia has traditionally been understood to require the active administration of treatment. This paper presents two pre-registered studies demonstrating that a strong sense of connectedness with an owned placebo analgesic can enhance analgesia even without active application. In Study 1 ( N = 121), healthy participants were randomized to possess (1) a placebo cream with induced self-object connection, (2) a placebo cream with induced self-object disconnection, (3) a pain-irrelevant cream, or (4) no cream. All participants underwent a cold-pressor-test to experience acute pain. Results indicated that participants in the induced self-object connection condition exhibited significantly higher pain threshold, longer pain tolerance, and a greater likelihood of hand submersion in cold water ( p s < .05) than other conditions. In Study 2 ( N = 66), an Implicit Association Test (IAT) revealed that participants possessing a placebo cream demonstrated stronger self-association, resulting in enhanced analgesic responses ( p s < .05). These findings highlight the significance of cognitive factors in pain modulation. Psychology pain possession placebo analgesia cognitive connection Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryMaterials.docx Study1OSF.xlsx Study 1. De-identified individual data. Study2OSF.xlsx Study 2. De-identified individual data. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7975444","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":536627657,"identity":"9df41671-f0ad-4a4f-b1ce-2ea13e3033da","order_by":0,"name":"NG Sze Ki, Rose","email":"","orcid":"","institution":"Lingnan University","correspondingAuthor":false,"prefix":"","firstName":"Rose","middleName":"NG Sze","lastName":"Ki","suffix":""},{"id":536627658,"identity":"a78f3eec-8180-4628-8799-42bfdcacc02f","order_by":1,"name":"YEUNG Wai Lan, Victoria","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIie2RsQrCMBCGI4FMp1116DsEsorPklBwdhJHQegkzvoODtnE7eSGLmrXjkpnwdFB0LTuMaNgvoPjhvvCf4SxSOQX4a70Zzqg6505Ax6qCB2oNNIHkGGKLHgtr/nQ7JLtnSZsmFrskvQqJJQ2+djs1zdLazZWFnuZ9imDBXA0ORlbnSwBcwOCwgDl5ZTjxSmv70rCgbtgaGy5ZE7BVvEGS7hQUp8zZSshCWSmNgTKe75IqB48pqPUlnStYTZKV8VS9X1KS0e41m/SNM9//ciWZxMRg1YjkUjkD3kD1nZObkM0l8gAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-3479-3198","institution":"Lingnan University","correspondingAuthor":true,"prefix":"","firstName":"Victoria","middleName":"YEUNG Wai","lastName":"Lan","suffix":""},{"id":536627659,"identity":"0a42806b-a3b4-4367-8cf7-762847125a4d","order_by":2,"name":"LI Wang On","email":"","orcid":"","institution":"Hong Kong Shue Yan University","correspondingAuthor":false,"prefix":"","firstName":"LI","middleName":"Wang","lastName":"On","suffix":""},{"id":536627660,"identity":"df31cef2-3108-4718-9fe7-8c68316833e2","order_by":3,"name":"YAU Eric Kenson","email":"","orcid":"","institution":"Lingnan University","correspondingAuthor":false,"prefix":"","firstName":"YAU","middleName":"Eric","lastName":"Kenson","suffix":""}],"badges":[],"createdAt":"2025-10-29 04:34:19","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7975444/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7975444/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95228269,"identity":"9b7e02a3-7faa-42e6-9d5b-a5074d2d6ffe","added_by":"auto","created_at":"2025-11-05 16:33:32","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":531232,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/f61f21a87af660cc3b998386.docx"},{"id":95212264,"identity":"8d4e3b84-752a-4d02-8356-6f1397ccb177","added_by":"auto","created_at":"2025-11-05 14:28:48","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs7975444.json","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/5ee34f48674486e35c7efe41.json"},{"id":95229217,"identity":"83d14016-f665-4b54-8c12-ace780ab2efb","added_by":"auto","created_at":"2025-11-05 16:34:37","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":184787,"visible":true,"origin":"","legend":"","description":"","filename":"rs79754440enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/46c231a2f6cbc87c1937a8f1.xml"},{"id":95212265,"identity":"5d4a6b83-ec47-45f4-9a06-c8795b296d6b","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":62444,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/30f00831c9b56565ad31350a.png"},{"id":95212266,"identity":"f37876d0-12ac-49ff-9d51-db9b83f35188","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":85510,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/cde9e98b4d52be1b65cf717e.png"},{"id":95212291,"identity":"de12458e-e668-48e1-9264-2afb9838393d","added_by":"auto","created_at":"2025-11-05 14:28:58","extension":"jpeg","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":404914,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/a0fe3faa83c49d40134df726.jpeg"},{"id":95212268,"identity":"e1189e74-8c7f-46f1-9e5b-0884f9522a16","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":24240,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/e5ebb8e6bd45e5a6971a5179.png"},{"id":95228208,"identity":"dbb03715-c2dd-415e-9612-e48e05bbba36","added_by":"auto","created_at":"2025-11-05 16:33:28","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14329,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/027891eb0457d91a80e6b62c.png"},{"id":95227835,"identity":"0b26a9b4-a546-42a2-b14a-b50631e6bc3c","added_by":"auto","created_at":"2025-11-05 16:33:01","extension":"jpeg","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":300618,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/3fa4cac872b379a00c08b8bc.jpeg"},{"id":95229038,"identity":"4dac6408-8e76-4bd9-867b-3130b1d4f4e9","added_by":"auto","created_at":"2025-11-05 16:34:23","extension":"png","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":25029,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/b897ec59836cd9db8fe46c96.png"},{"id":95212277,"identity":"62466b33-fd73-4749-9614-3746f64f95ba","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"jpeg","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":234589,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage7.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/3f90f599086e9405e16db206.jpeg"},{"id":95212282,"identity":"3d0da6e4-b797-4ee8-b5ed-5e61d25ddf2b","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"jpeg","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":550352,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage8.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/b852bdbcca1bd54771dd084a.jpeg"},{"id":95212284,"identity":"fe13f21f-dd11-4277-8e5a-da9aabfeec1a","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"jpeg","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":578430,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage9.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/ab56dc46e08012f9d0c2fd8d.jpeg"},{"id":95212281,"identity":"04eef0d4-a178-4b6b-be59-7399ac98061c","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":26057,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/5846dd8d6b2040423db7dd33.png"},{"id":95228055,"identity":"2363dc93-6dec-4f94-81ff-28502514cc07","added_by":"auto","created_at":"2025-11-05 16:33:19","extension":"png","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":20583,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/e0597f0b7cda9a5fb758000d.png"},{"id":95227600,"identity":"7c4963f9-3a00-46b8-83b2-75e4f5269635","added_by":"auto","created_at":"2025-11-05 16:32:38","extension":"png","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":78646,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/aa77e0f0ef24a53b87139e9d.png"},{"id":95212274,"identity":"bc9aac93-7726-480c-81fb-c1a2bf5fae50","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":8533,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/81e724786e6c52119669b053.png"},{"id":95212278,"identity":"65176211-9d52-4733-bead-8d3dfad35479","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":6310,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/0d4dcee0a59c9259e058ba6f.png"},{"id":95228794,"identity":"2cfc463b-a447-4a1e-b021-b5da4ed2143a","added_by":"auto","created_at":"2025-11-05 16:34:08","extension":"png","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":57720,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/7ef0faeed3a5cf8ce41525ad.png"},{"id":95229027,"identity":"b7511113-dbc3-4b6b-8d77-ffcab5544062","added_by":"auto","created_at":"2025-11-05 16:34:22","extension":"png","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":9526,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/2ef23728f631cc9194bcd112.png"},{"id":95212285,"identity":"4cf44dd6-03ae-44e2-a7f4-418859b70150","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":44646,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/ebd41c9beb87813dc975be8d.png"},{"id":95212286,"identity":"3b8ce48f-9381-4417-aedc-3d2bd8ebb508","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":136462,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/6b3bbd405d8f4fa265c029d1.png"},{"id":95227680,"identity":"36a56186-0627-4273-b018-e65628ed9b6d","added_by":"auto","created_at":"2025-11-05 16:32:45","extension":"png","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":143614,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/bf7aefe533d0d4d57666c88f.png"},{"id":95212287,"identity":"c6f39c88-9225-45e8-a6d5-e410cdb60f1f","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"xml","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":177071,"visible":true,"origin":"","legend":"","description":"","filename":"rs79754440structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/3cd92801ad4f6a2cec68ba0e.xml"},{"id":95212288,"identity":"26be180d-b981-44df-8f69-90b9cc86b92b","added_by":"auto","created_at":"2025-11-05 14:28:49","extension":"html","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":203803,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/22a9ee3f1fa2d253b3b8210d.html"},{"id":95312390,"identity":"3ffb7931-4f15-4ffb-ad73-a4cfc25bd7f2","added_by":"auto","created_at":"2025-11-06 15:49:10","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":745559,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1_covered_214041c4-4538-4057-9643-913834cb7635.pdf"},{"id":95229022,"identity":"a63100f4-098d-44e1-9da7-7ced1eae1c48","added_by":"auto","created_at":"2025-11-05 16:34:22","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":194479,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterials.docx","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/6c5ccb775572ddcb1de633fe.docx"},{"id":95228916,"identity":"9a6f2b2e-c574-4d0f-b073-60bfeaea5567","added_by":"auto","created_at":"2025-11-05 16:34:16","extension":"xlsx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":366814,"visible":true,"origin":"","legend":"\u003cp\u003eStudy 1. De-identified individual data.\u003c/p\u003e","description":"","filename":"Study1OSF.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/ac1fa5717ce94a25c9d00340.xlsx"},{"id":95227582,"identity":"f5cdebd8-e8f0-465c-8d19-76e44e3d40ec","added_by":"auto","created_at":"2025-11-05 16:32:38","extension":"xlsx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":212338,"visible":true,"origin":"","legend":"\u003cp\u003eStudy 2. De-identified individual data.\u003c/p\u003e","description":"","filename":"Study2OSF.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-7975444/v1/7cbe2e420ce5ebe897618a72.xlsx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eUnleashing the Placebo Effect: Cognitive Connectedness with Placebo Analgesics Predicts Analgesic Outcomes — Evidence from Two Randomized Controlled Studies\u003c/strong\u003e\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Lingnan University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"pain, possession, placebo, analgesia, cognitive connection","lastPublishedDoi":"10.21203/rs.3.rs-7975444/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7975444/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePlacebo analgesia has traditionally been understood to require the active administration of treatment. This paper presents two pre-registered studies demonstrating that a strong sense of connectedness with an owned placebo analgesic can enhance analgesia even without active application. In Study 1 (\u003cem\u003eN\u003c/em\u003e = 121), healthy participants were randomized to possess (1) a placebo cream with induced self-object connection, (2) a placebo cream with induced self-object disconnection, (3) a pain-irrelevant cream, or (4) no cream. All participants underwent a cold-pressor-test to experience acute pain. Results indicated that participants in the induced self-object connection condition exhibited significantly higher pain threshold, longer pain tolerance, and a greater likelihood of hand submersion in cold water (\u003cem\u003ep\u003c/em\u003es \u0026lt; .05) than other conditions. In Study 2 (\u003cem\u003eN\u003c/em\u003e = 66), an Implicit Association Test (IAT) revealed that participants possessing a placebo cream demonstrated stronger self-association, resulting in enhanced analgesic responses (\u003cem\u003ep\u003c/em\u003es \u0026lt; .05). These findings highlight the significance of cognitive factors in pain modulation.\u003c/p\u003e","manuscriptTitle":"Unleashing the Placebo Effect: Cognitive Connectedness with Placebo Analgesics Predicts Analgesic Outcomes — Evidence from Two Randomized Controlled Studies","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-05 14:28:44","doi":"10.21203/rs.3.rs-7975444/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4ce39ee0-d587-4e08-9564-2c1b5e4df987","owner":[],"postedDate":"November 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":57059861,"name":"Psychology"}],"tags":[],"updatedAt":"2025-11-05T14:28:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-05 14:28:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7975444","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7975444","identity":"rs-7975444","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}