Science of Mindsets for Health & Performance | Dr. Alia Crum

Crum defines mindsets as core beliefs about a domain (e.g., stress, intelligence, food) that orient expectations, explanations, and goals. They simplify complex reality, acting like default settings that shape what we notice, how we interpret events, and what actions feel possible or worthwhile. Critically, these assumptions don’t just influence behavior; they can modulate physiological systems, from hormones to immune responses.

In the milkshake study, participants drank the same ~300-calorie shake on two occasions but were told once that it was an indulgent 620-calorie shake and once that it was a light, sensible diet shake. When they believed it was indulgent, their ghrelin (the “hunger hormone”) dropped threefold more, mimicking the response to having eaten more food. This suggests that constantly thinking in terms of deprivation or “dieting” can leave you physiologically hungrier, whereas feeling you’ve eaten enough and indulgently can promote satiety and potentially a more favorable metabolic response, even when objective calories are the same.

In the hotel housekeepers study, women performing physically demanding cleaning work were objectively exceeding Surgeon General exercise guidelines but mostly believed they weren't exercising. Teaching half of them that their work met exercise guidelines—without changing their behavior—led, over four weeks, to weight loss, a ~10-point drop in systolic blood pressure, and improved self-perceptions. Large-scale correlational work further shows that merely believing you get less exercise than others predicts higher mortality risk, even after controlling for actual activity. The sense of “enoughness” matters.

Most people hold a ‘stress-is-debilitating’ mindset due to public health and cultural messaging, but the research literature shows stress responses can narrow focus, accelerate processing, and trigger physiological “toughening.” In corporate field experiments, brief video interventions framing stress as potentially enhancing—rather than uniformly harmful—shifted employees’ stress mindsets, reduced physical symptoms (e.g., backache, insomnia, racing heart), and improved self-rated performance during layoffs. Among Navy SEAL trainees, a more stress-is-enhancing mindset predicted greater likelihood of completing BUD/S, faster obstacle course times, and better peer ratings.

Nocebo effects occur when negative expectations generate or amplify negative symptoms. Telling patients about long side-effect lists can increase the incidence and salience of those symptoms—sometimes via real physiology, sometimes by shifting attention and attribution. Conversely, in a peanut-allergy desensitization trial, framing side effects as signs the body is learning and getting stronger reduced anxiety, lessened symptoms at higher doses, and even improved immunological markers of tolerance. How clinicians explain side effects can change both experience and efficacy of treatment.