essay on impact of advertisement

Essay On Advertisement

500 words essay on advertisement.

We all are living in the age of advertisements. When you step out, just take a quick look around and you will lay eyes upon at least one advertisement in whichever form. In today’s modern world of trade and business, advertisement plays an essential role. All traders, big and small, make use of it to advertise their goods and services. Through essay on advertisement, we will go through the advantages and ways of advertisements.

The Various Ways Of Advertisement

Advertisements help people become aware of any product or service through the use of commercial methods. This kind of publicity helps to endorse a specific interest of a person for product sale.

As the world is becoming more competitive now, everyone wants to be ahead in the competition. Thus, the advertisement also comes under the same category. Advertising is done in a lot of ways.

There is an employment column which lists down job vacancies that is beneficial for unemployed candidates. Similarly, matrimonial advertisement help people find a bride or groom for marriageable prospects.

Further, advertising also happens to find lost people, shops, plots, good and more. Through this, people get to know about a nearby shop is on sale or the availability of a new tutor or coaching centre.

Nowadays, advertisements have evolved from newspapers to the internet. Earlier there were advertisements in movie theatres, magazines, building walls. But now, we have the television and internet which advertises goods and services.

As a large section of society spends a lot of time on the internet, people are targeting their ads towards it. A single ad posting on the internet reaches to millions of people within a matter of few seconds. Thus, advertising in any form is effective.

Benefits of Advertisements

As advertisements are everywhere, for some magazines and newspapers, it is their main source of income generation. It not only benefit the producer but also the consumer. It is because producers get sales and consumer gets the right product.

Moreover, the models who act in the advertisements also earn a handsome amount of money . When we look at technology, we learn that advertising is critical for establishing contact between seller and buyer.

This medium helps the customers to learn about the existence and use of such goods which are ready to avail in the market. Moreover, advertisement manages to reach the nooks and corners of the world to target their potential customers.

Therefore, it benefits a lot of people. Through advertising, people also become aware of the price difference and quality in the market. This allows them to make good choices and not fall to scams.

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Conclusion of Essay On Advertisement

All in all, advertisements are very useful but they can also be damaging. Thus, it is upon us to use them with sense and ensure they are entertaining and educative. None of us can escape advertisements as we are already at this age. But, what we can do is use our intelligence for weeding out the bad ones and benefitting from the right ones.

FAQ on Essay On Advertisement

Question 1: What is the importance of advertisement in our life?

Answer 1: Advertising is the best way to communicate with customers. It helps informs the customers about the brands available in the market and the variety of products which can be useful to them.

Question 2: What are the advantages of advertising?

Answer 2: The advantages of advertising are that firstly, it introduces a new product in the market. Thus, it helps in expanding the market. As a result, sales also increase. Consumers become aware of and receive better quality products.

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Advertising Makes Us Unhappy

• Nicole Torres

The more a country spends on ads, the less satisfied its citizens are.

The University of Warwick’s Andrew Oswald and his team compared survey data on the life satisfaction of more than 900,000 citizens of 27 European countries from 1980 to 2011 with data on annual advertising spending in those nations over the same period. The researchers found an inverse connection between the two. The higher a country’s ad spend was in one year, the less satisfied its citizens were a year or two later. Their conclusion: Advertising makes us unhappy.

• Nicole Torres is a former senior editor at Harvard Business Review.

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Essay on the impact of advertisement on society |essay.

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Essay on the Impact of Advertisement on Society!

The advertising has deep impact into the minds of the viewers especially among the children. Hence the ad makers must be aware of the social consequences of the ads.

For example, some advertisements like Mountain Dew show daring stunt actions where the statutory warning is either not written or written in very small illegible fonts. The kids getting motivated by seeing this ad may rehearse then same action with dire consequences. Some other ads unnecessarily use female models and sexually explicit scenes like Euro briefs or Aristocrat apple juice ads, which create unhealthy impression among the minors.

Some advertisements show precocious children advising their parents on various issues. Consider Chabaaza ad where a little boy peers into the tonsil and epiglottis of a man until he (the child) is so pleased with what he finds that he suggests that the man give his Chabaaza to his father too. Just visualising this scene in your home; doesn’t it seem irritating to you? Or consider Fair & Lovely cream ad produced by Lowe, where the parents are worried about their dark skinned girl and express their frustration of having a son to take care of them.

The girl eventually gains fair complexion by using the cream and becomes professionally successful. Don’t you think this ad so rudely used the agony of dark complexion and gender biases? Hence, the ad agencies must be more careful and conscious of the ads they make. We can discuss two more such examples, the first of which had to be withdrawn and in second case, ASCI directed to modify the ad.

Surf Kidstains Challenge:

This ad created by Lowe showed a child throwing ketchup on another’s shirt and asking “tumhare ghar mein Surf hain?” (Do you have Surf at your home?) The major argument against this ad was that deliberately soiling someone else’s dresses with a coloured food is a form of insulting and embarrassing, which could give rise to quarrels and fights among children

Super Nirma detergent cake:

This ad created by Purnima Advertising depicted a child washing stains on his shirt and having succeeded in doing that, he kissed the detergent cake in appreciation and joy. But domg so the wet detergent cake can leave a residue on the lips, which could possibly enter the mouth. This practice could have a dangerous and fatal outcome, as the detergents are skin irritants with toxicity potent.

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2020 Theses Doctoral

Essays on Advertising

Choi, Woohyun

According to eMarketer, the total advertising spend in US alone was estimated to be over $238 billion. Firms invest large amounts of money in advertising to promote and inform consumers about their products and services, as well as to persuade them to purchase. The broad theme of advertising has been examined from many different angles in the marketing literature, ranging from empirically measuring effects of TV ads on sales to analytically characterizing the key economic forces stemming from enhanced targetability in online advertising. The purpose of my dissertation is to study some of the key questions which remain unaddressed in the advertising literature. In the first essay, I examine firms' choices of advertising content in a competitive setting. I demonstrate that competitive forces sometimes induces firms to choose advertising content that shifts consumers' perception of product quality. While this strategy hurts firms in a monopoly setting, it increases their profits under competition because it may increase the utility of their offering in comparison with the competing offering. In the second essay, I investigate the optimal mechanism for selling online ads in a learning environment. Specifically, I show that when ad sellers, such as Google, design their ad auctions, it is optimal for them to favor new advertisers in the auction in order to expedite learning their ad performance. In the third essay, I study the impact of tracking consumers' Internet activities on the online advertising ecosystem in the presence of regulations that, motivated by privacy concerns, endow consumers with the choice to have their online activity be tracked or not. I find that when ad effectiveness is intermediate, fewer ads are shown to opt-in consumers, who can be tracked and have their funnel stages inferred by advertisers, than to opt-out consumers, who cannot be tracked. In this case, consumers trade-off the benefit of seeing fewer ads by opting-in to tracking (positive instrumental value of privacy) with the disutility they feel from giving up their privacy (intrinsic cost of privacy). Overall, these findings shed light on novel strategic forces that provide guidance for marketers' advertising decisions in three distinct contexts.

Geographic Areas

• United States
• Internet marketing
• Internet advertising
• Television advertising
• Competition
• Google (Firm)

More About This Work

• DOI Copy DOI to clipboard

9.2 The Influence of Advertising

Learning objectives.

By the end of this section, you will be able to:

• Discuss how social media has altered the advertising landscape
• Explain the influence of advertising on consumers
• Analyze the potential for subliminal advertising

The advertising industry revolves around creating commercial messages urging the purchase of new or improved products or services in a variety of media: print, online, digital, television, radio, and outdoor. Because as consumers we need and want to be informed, this feature of advertising is to the good. Yet some advertising is intended to lead to the purchase of goods and services we do not need. Some ads may make claims containing only the thinnest slice of truth or exaggerate and distort what the goods and services can actually deliver. All these tactics raise serious ethical concerns that we will consider here.

The Rise of Social Media

Relevant to any discussion of the influence and ethics of advertising is the emergence and dominance of social media , which now serve as the format within which many people most often encounter ads. Kelly Jensen, a digital-marketing consultant, observed that we inhabit a “Digital Era” in which “the internet is arguably the single most influential factor of our culture—transforming the way we view communication, relationships, and even ourselves. Social media platforms have evolved to symbolize the status of both individuals and businesses alike. . . Today, using social media to create brand awareness, drive revenue, engage current customers, and attract new ones isn’t optional anymore. Now it is an absolute ‘must.’” 11

These are bold claims—as are the claims of some advertising—but Jensen argues convincingly that social media platforms reach many consumers, especially younger ones, who simply cannot be captured by conventional advertising schemes. For those who derive most of the significant information that shapes their lives solely through electronic sources, nothing other than social media–based appeals stands much chance of influencing their purchasing decisions.

This upending of conventional modes of advertising has begun to change the content of ads dramatically. It certainly presents a new stage on which people as young as their teens increasingly rely for help in choosing what to buy. Many marketers have come to appreciate that if they are not spreading the word about their products and services via an electronic source, many millennials will ignore it. 12

Undeniably, a digital environment for advertising, selling, and delivering products and services functions as a two-edged sword for business. It provides lightning-quick access to potential customers, but it also opens pathways for sensitive corporate and consumer data to be hacked on an alarming scale. It offers astute companies nearly unlimited capacity to brand themselves positively in the minds of purchasers, but it simultaneously offers a platform for disgruntled stakeholders to assail companies for both legitimate and self-serving reasons.

Paul A. Argenti, who has taught business communication for many years at the Tuck School of Business at Dartmouth University, has studied this dilemma. As he put it, “mobile apps have created a new playground for cyber-thieves.” 13 And consumer advocates and purchasers alike “now use technology to rally together and fuel or escalate a crisis—posing additional challenges for the corporation” in the crosshairs of criticism. Finally, “the proliferation of online blogs and social networking sites has greatly increased the visibility and reach of all current events, not excluding large corporate” 14 bungling.

Regardless of the delivery platform, however, any threat that the advertising of unnecessary or harmful products may pose to our autonomy as consumers is complicated by the fact that sometimes we willingly choose to buy goods or services we may not necessarily require. Sometimes we even buy things that have been proven to be harmful to us, such as cigarettes and sugary drinks. Yet we may desire these products even if we do not need them. If we have the disposable income to make these discretionary purchases, why should we not do so, and why should advertisers not advise us of their availability?

Does Advertising Drive Us to Unnecessary Purchases?

By definition, advertising aims to persuade consumers to buy goods and services, many of which are nonessential. Although consumers have long been encouraged to heed the warning caveat emptor (let the buyer beware), it is a valid question whether advertisers have any ethical obligation to rein in the oft-exaggerated claims of their marketing pitches. Most consumers emphatically would agree that they do.

The award-winning Harvard University economist John Kenneth Galbraith directly addressed this issue in The Affluent Society , first published in 1958. In what he depicted as the “the dependence effect,” Galbraith bemoaned the power of corporations to harness wide-ranging advertising strategies, marketing efforts, and sales pitches to influence consumer purchasing decisions. 15 He asked whether it is possible for a sophisticated advertising campaign to create a demand for a product whose benefits are frivolous at best. If so, is there anything inherently wrong with that? Or are informed consumers themselves responsible for resisting tempting—though misleading—advertising claims and exercising their own best judgment about whether to buy a product that might be successful, not because it deserves to be but simply because of the marketing hype behind it? These questions remain fundamental to the manager’s task of creating ethical advertising campaigns in which truthful content is prioritized over inducing wasteful consumption.

Psychological appeals form the basis of the most successful ads. Going beyond the standard ad pitch about the product’s advantages, psychological appeal s try to reach our self-esteem and persuade us that we will feel better about ourselves if we use certain products. If advertising frames the purchase of a popular toy as the act of a loving parent rather than an extravagance, for instance, consumers may buy it not because their child needs it but because it makes them feel good about what generous parents they are. This is how psychological appeals become successful, and when they do work, this often constitutes a victory for the power of psychological persuasion at the expense of ethical truthfulness.

Purchases are also affected by our notion of what constitutes a necessity versus a luxury, and that perception often differs across generations. Older consumers today can probably remember when a cell phone was considered a luxury, for instance, rather than a necessity for every schoolchild. On the other hand, many younger consumers consider the purchase of a landline unnecessary, whereas some older people still use a conventional phone as their main or even preferred means of communication. The cars and suburban homes that were once considered essential purchases for every young family are slowly becoming luxuries, replaced, for many millennials, by travel. Generational differences like these are carefully studied by advertisers who are anxious to make use of psychological appeals in their campaigns.

A consumer craze based on little more than novelty—or, at least, not on necessity or luxury in the conventional sense—is the Pet Rock, a recurring phenomenon that began in 1977. Pet Rocks have been purchased by the millions over the years, despite being nothing more than rocks. During the 2017 holiday shopping season, they retailed at $19.95. 16 Is this a harmless fad, or a rip-off of gullible consumers who are persuaded it can satisfy a real need? In the annals of marketing, the Pet Rock craze denotes one of the most successful campaigns—still unfolding today, though in subdued fashion—in support of so dubious a product.

As long as marketers refrain from breaking the law or engaging in outright lies, are they still acting ethically in undertaking influential advertising campaigns that may drive gullible consumers to purchase products with minimal usefulness? Is this simply the free market in operation? In other words, are manufacturers just supplying a product, promoting it, and then seeing whether customers respond positively to it? Or are savvy marketing campaigns exerting too much influence on consumers ill prepared to resist them? Many people have long asked exactly these questions, and we still have arrived at no clear consensus as to how to answer them. Yet it remains an obligation of each new generation of marketers to reflect on these points and, at the very least, establish their convictions about them.

A second ethical question is how we should expect reasonable people to respond to an avalanche of marketing schemes deliberately intended to separate them from their hard-earned cash. Are consumers obligated to sift through all the messages and ultimately make purchasing decisions in their own best interest? For example, does a perceived “deal” on an unhealthy food option justify the purchase ( Figure 9.3 )? These questions have no consensus answers, but they underlie any discussion of the point at which sophisticated advertising runs headlong into people’s obligation to take responsibility for the wisdom of their purchases.

No one would argue that children are particularly susceptible to the ads commercial television rains over them regularly. Generally, young children have not developed sufficient judgment to know what advertised products are good for them and which ones have little or no benefit or perhaps can even harm. Research has even shown that very young children have difficulty separating what is real on television from what is not. This is especially so as it pertains to advertising for junk food. Savvy marketers take advantage of the fact that young children (those younger than age seven or eight years) view advertising in the same manner they do information from trustworthy adults—that is, as very credible—and so marketers hone pitches for junk food directly to these children. 17

What restrictions could we reasonably impose on those who gear their ads toward children? We could argue that they should take special care that ads targeting children make absolutely no exaggerated claims, because children are less capable of seeing through the usual puffery that most of us ignore. Children are more literal, and once they gain the ability to understand messages directed toward them, especially when voiced by adult authority figures, they typically accept these as truthful statements.

When adults make poor consumer choices, who is responsible? Is it ourselves? Is it our society and culture, which permit the barrage of marketing to influence us in ways we often come to regret? Is it the persuasive power of marketers, which we should rein in through law? Do adults have the right to some assistance from marketers as they attempt to carry out their responsibility to protect children from manipulative ads? We have no easy answers to these questions, though they have taken on special urgency as technology has expanded the range of advertising even to our smartphones.

Is Subliminal Advertising Real?

It may be possible for marketing to be unfairly persuasive in ways that overwhelm the better judgment of consumers. Whether it is the consumers’ responsibility to resist or marketers’ to tone down their appeals, or both, will continue to be debated. Yet the question of where responsibility lies when consumers are steered to make choices certainly has ethical ramifications.

Some psychologists and educational specialists claim that the very old and the very young are particularly ill prepared to exercise good judgment in the face of subliminal advertising , that is, embedded words or images that allegedly reach us only beneath the level of our consciousness. Other experts, however, disagree and insist that subliminal advertising is an urban myth that no current technology could create or sustain.

A U.S. journalist, Vance Packard, published The Hidden Persuaders in 1957, contending that subliminal messaging had already been introduced into some U.S. cinemas to sell more refreshments at the theaters’ snack bars. Alarms sounded at the prospect, but it turned out that any data on which Packard was relying came from James Vicary, a U.S. market researcher who insisted he had engineered the feat in a cinema in New Jersey. No other substantiation was provided, and Vicary’s claim was eventually dismissed as self-promotion, which he seemed to concede in an interview five years later. Although the immediate threat of subliminal advertising receded, some people remain concerned that such persuasion might indeed be possible, especially with the advent of better technologies, like virtual reality, to implement it. 18

A 2015 study at the University of South Carolina found that thirsty test subjects placed in the role of shoppers in a simulated grocery store could be subliminally influenced in their choice of beverages if they were primed by images of various beverage brands within fifteen minutes of acknowledging being thirsty. After that window of time passed, however, any impact of subliminal messaging receded. 19

So the scientific evidence establishing any real phenomenon of subliminal advertising is inconclusive. Put another way, the evidence to this point does not definitively demonstrate the existence of a current technology making subliminal marketing pitches possible. Given this, it cannot be clearly determined whether such a technology, if it did exist, would be effective. Another question is whether virtual reality and augmented reality might eventually make subliminal advertising viable. Real subliminal persuasion might render children, the elderly, and those with developmental disabilities more vulnerable to falling prey. Could even the most skeptical viewer resist a message so powerfully enhanced that the product can be sampled without leaving home? Would you be in favor of federal government regulation to prevent such ads? What sort of ethical imperatives would you be willing to request of or impose on sophisticated marketers?

Link to Learning

Is subliminal messaging real? Watch this video where BBC Earth Lab investigates a bit whimsically what truth might lie in the claim that subliminal advertising is real to learn more.

Advertising plays a useful role in informing consumers of new or modified products and services in the marketplace, and wise purchasers will pay attention to it but with a discerning eye. Even the exaggerated claims that often accompany ads can serve a purpose as long as we do not unquestioningly accept every pitch as true.

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Introduction

Advertising is an essential element of any business's marketing strategy. It is a means of promoting products and services and creating awareness among consumers. However, advertising not only informs and influences consumers but also affects their behaviour. Understanding the impact of advertising on consumer behaviour is crucial to ensure effective advertising efforts. In this article, we will discuss the significance of comprehending the influence of ads on consumers.

The impact of advertising on consumer behaviour

• Advertising influences consumers' purchasing decisions: Advertising plays a significant role in shaping consumers' buying behaviour. Ads are designed to create a sense of urgency, need, or desire in the minds of consumers, which can persuade them to buy a product or service.
• Advertising affects consumers' perception of a brand: Advertising can impact how consumers perceive a brand. A well-crafted ad campaign can create a positive brand image in the minds of customers, while a poorly executed campaign can tarnish a brand's image.
• Advertising creates brand loyalty: Consistent advertising efforts can create brand loyalty among consumers. When a consumer repeatedly sees an ad for a particular brand, they develop trust in the brand and are more likely to remain loyal to it.
• Advertising shapes consumers' preferences and attitudes: Advertising can shape consumers' attitudes towards a particular product, service or brand. It can influence how they perceive a brand's value, quality, and benefits, influencing their preferences.

It is crucial for businesses to understand the impact of advertising on consumer behaviour to use it effectively to promote their products and services. Proper analysis of advertising campaigns can help businesses develop a better understanding of their target audience and how they respond to advertising efforts, allowing them to refine their advertising strategies.

The Science of Advertising

Advertising is the art of persuading people to buy a product or service. But how do advertisers get into the minds of consumers to convince them to make a purchase? This is where the science of advertising comes in.

The Role of Consumer Psychology in Advertising

Consumer psychology plays a crucial role in advertising. Advertisers need to understand what motivates consumers to make a purchase, and what factors influence their decision-making process.

Some of the factors that advertisers need to consider include:

• The consumer's needs and desires
• The consumer's values and beliefs
• The consumer's social and cultural background

By understanding these factors, advertisers can create ads that are more effective in persuading consumers to make a purchase.

How Ads Manipulate and Persuade

Ads use a variety of techniques to manipulate and persuade consumers. These techniques include emotional appeals, social cues, and cognitive biases.

Emotional appeals are one of the most effective ways to persuade consumers. Ads that use emotional appeals tap into the consumer's emotions, triggering feelings of happiness, fear, or sadness. This can lead the consumer to make a purchase based on their emotional response, rather than a rational decision.

Social cues are another way that ads manipulate consumers. Ads may feature social cues, such as celebrities or popular products, to make the consumer feel like they are part of a group. This can create a sense of belonging, making the consumer more likely to make a purchase.

Cognitive biases are another technique used by advertisers. Cognitive biases are mental shortcuts that our brains take when we make decisions. Ads may use cognitive biases to influence the consumer's decision-making process, such as by framing the product in a positive light, using scarcity to create a sense of urgency, or offering a discount.

Overall, the science of advertising is a complex field that requires a deep understanding of human psychology. By using techniques such as emotional appeals, social cues, and cognitive biases, advertisers can create ads that are more effective in persuading consumers to make a purchase.

Impact on Purchasing Habits

Advertising can have a significant effect on consumer behavior, influencing their purchasing habits, creating desire, and guiding decision-making processes. Here’s how:

Creating Desire

Advertisements create a sense of desire among consumers by showcasing the benefits and features of a particular product or service. They use persuasive language, appealing visuals, and emotional appeals to stimulate the consumer's senses and make them crave the product. For example, the famous Coca-Cola Christmas ads create a sense of warmth and togetherness that makes people want to share a bottle of Coke with their loved ones during the festive season.

Influencing Preferences

Advertising plays a significant role in shaping consumer preferences. Brand positioning, brand image, and brand recognition are all achieved through advertising. Consumers are likely to choose brands that resonate with them and match their values. Advertising helps to create and reinforce brand image, making a lasting impression on consumer's minds. For example, Apple's "Think Different" campaign positioned the company as an innovative, cutting-edge brand that resonates with people who value creativity and originality.

Guiding Decision-Making Processes

Advertisements guide the consumer decision-making process by providing information about the product or service, offering comparisons with competitors, and highlighting the unique selling points. Consumers often turn to ads to learn about new products or to compare prices, features, and benefits. For example, online display ads for hotels that promote amenities like free breakfast, free Wi-Fi, and pet-friendly policies can influence consumers' decisions when booking their accommodation.

Examples and Statistics

• Research has shown that advertising has a positive impact on sales, with brands spending around $180 billion globally on advertising in 2020 alone. (Source: Statista)
• A study found that 70% of consumers are more likely to purchase from a brand that they follow on social media. (Source: Forbes)
• Advertising has been found to influence children's snack preferences, with those exposed to food ads more likely to choose unhealthy snacks. (Source: Pediatrics Journal)

Overall, advertising plays a crucial role in influencing consumer behavior and guiding their purchasing habits. By creating desire, influencing preferences, and guiding decision-making processes, ads can have a significant impact on sales and brand success.

Brand Perception

Brand perception is the way consumers view and interpret a brand. It is shaped by various factors such as advertising, product quality, customer service, and social media presence. Advertising plays a vital role in shaping consumer perceptions of brands by creating certain associations, establishing credibility, and cultivating loyalty.

Associations

Advertisements create associations between a brand and certain aspects such as quality, reliability, and value. For example, ad campaigns that emphasize a brand's affordability and value can create the association of the brand being budget-friendly. Similarly, ads that showcase a brand's commitment to quality can build an association of trust and reliability.

Credibility

Ads can also establish a brand's credibility. By highlighting a brand's unique features, awards, and customer testimonials, ads create a perception of expertise and authenticity. For instance, an ad campaign that touts a brand's innovative technology can establish its credibility as a cutting-edge industry leader.

Finally, advertisements can cultivate loyalty among consumers by creating an emotional connection with the brand. Ads that showcase a brand's values, such as sustainability or social responsibility, can appeal to consumers who share those same values. Moreover, ad campaigns that build a brand persona are likely to create a loyal fan base that feels a personal connection with the brand.

Overall, advertising plays a crucial role in shaping consumer perceptions of brands. It can create positive associations, establish credibility, and cultivate loyalty. For instance, a study found that after viewing a brand's ads, consumers were 70% more likely to purchase the brand's products or services. Therefore, it is essential for brands to invest in effective advertising campaigns that help shape the desired consumer perception.

The Future of Advertising

In today's digital age, advertising has become an essential component of businesses. With the advancements in technology and changing consumer preferences, advertising is evolving at a rapid pace, challenging businesses to keep up with the latest trends and adapt to new strategies.

Advancements in Technology

The integration of artificial intelligence, machine learning, and data analytics has transformed the advertising industry. Brands are now using data to develop more targeted marketing campaigns and personalized communication with their customers. Emerging technologies such as augmented reality, virtual reality, and voice-activated assistants are also changing the way advertisements are being delivered to consumers.

Changing Consumer Preferences

As the power of information has shifted from the advertisers to the consumers, they are becoming more conscious of the advertising messages they receive. Brands are now focusing on creating authentic and engaging content to build lasting connections with their customers. Social media and influencers are playing a vital role in shaping consumer preferences, where customers are looking for authenticity, transparency, and personalized experiences.

Ethical Considerations and Potential Implications

With the increasing reliance on technology and data, there are ethical concerns surrounding data privacy and security. Consumers are now more aware of how their data is being used and expecting businesses to handle it responsibly. Additionally, the rise of deep fake technology, which can create realistic but false content, raises questions about the authenticity of advertisements and the potential implications it can have on society.

• Advancements in technology are changing the way advertisements are delivered.
• Changing consumer preferences require brands to create engaging and authentic content.
• Ethical considerations around data privacy and deep fake technology demand responsible advertising practices.

As businesses navigate the ever-changing landscape of advertising, understanding these trends and their implications is crucial to stay ahead of the game in the future of advertising.

Advertising has a significant impact on consumer behaviour, as it influences their decision-making processes and purchasing choices. In this article, we have highlighted some of the key points that demonstrate the influence of ads on consumer behaviour. We have seen how ads can create brand awareness, shape attitudes, and affect people's emotions towards a product or service. We have also discussed the role of advertising in influencing consumer preferences and driving sales.

It is important for consumers to become more aware of the influence of advertising and make informed decisions. By being more critical of the messages conveyed in ads, consumers can avoid falling prey to marketing strategies that are designed to manipulate their behaviour.

Key Takeaways:

• Advertising plays a crucial role in shaping consumer behaviour.
• Ads create brand awareness and influence consumer attitudes and emotions.
• Advertising drives sales and can affect consumer preferences.

As consumers, it is important to be mindful of the impact that advertising has on our behaviour. By questioning the messages conveyed in ads and making informed decisions, we can avoid being influenced by marketing strategies that are designed to manipulate our choices.

Take action now: Become more aware of the influence of ads by critically evaluating the messages conveyed in marketing campaigns. Research the product or service before making a purchase decision and seek out recommendations from trusted sources.

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Home — Essay Samples — Business — Advertisement — The Impact Of Advertisement On Youth

The Impact of Advertisement on Youth

• Categories: Advertisement Social Media Youth

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Words: 1539 |

Published: Mar 3, 2020

Words: 1539 | Pages: 3 | 8 min read

Table of contents

Introduction, literature review.

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Essay on Importance of Advertisement

Students are often asked to write an essay on Importance of Advertisement in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Importance of Advertisement

Introduction.

Advertisements play a crucial role in today’s world. They are a bridge between producers and consumers, providing valuable information about products and services.

Role in Economy

Advertisements stimulate economic growth. They encourage competition, leading to better products and lower prices.

Consumer Awareness

Advertisements educate consumers, helping them make informed decisions. They provide details about product features, benefits, and prices.

Supporting Media

Advertisements fund many free-to-use platforms like newspapers and websites. Without ads, these services might not exist.

In conclusion, advertisements are essential for a thriving economy, informed consumers, and free media. They are an indispensable part of our daily lives.

250 Words Essay on Importance of Advertisement

Advertisements are an indispensable part of modern commerce and industry. They serve as the bridge between producers and consumers, acting as a powerful tool for businesses to promote their products and services.

Driving Economic Growth

Advertisements stimulate economic growth by increasing demand. They educate consumers about new products, triggering a desire to purchase. This demand prompts businesses to produce more, thereby boosting economic activity.

Facilitating Informed Decisions

Advertisements provide valuable information that helps consumers make informed decisions. They contain details about product features, prices, and comparisons, empowering consumers to choose what best suits their needs and budget.

Enhancing Brand Image

Advertisements play a crucial role in building and reinforcing a brand’s image. They help businesses communicate their values and mission, shaping public perception and fostering customer loyalty.

Supporting Media and Entertainment

Advertisements fund many forms of media and entertainment. They provide revenue for television, radio, print, and digital platforms, enabling them to deliver content to audiences at low or no cost.

In conclusion, the importance of advertisement is multi-faceted. It drives economic growth, enables informed consumer decisions, enhances brand image, and supports media and entertainment. In an increasingly competitive market, the role of advertisement is likely to become more significant, making it a critical field of study and understanding for future business leaders.

500 Words Essay on Importance of Advertisement

Introduction to advertisement.

Advertising is an essential component of modern trade and business, making it a crucial part of our economic system. It is a powerful tool used by businesses to inform, persuade, and remind consumers about their products or services. In essence, advertising is a communication bridge between the producer and the consumer.

Advertising plays a pivotal role in stimulating economic growth. By promoting a product or service, it creates awareness among consumers, thereby generating demand. This increased demand leads to higher production levels, contributing to economies of scale and fostering economic development. Moreover, advertising is a significant source of revenue for numerous sectors such as media, design, and marketing, indirectly supporting economic growth.

Creating Informed Consumers

Advertisements are not just promotional tools but also informative platforms. They educate consumers about various products, their uses, prices, and availability. This information allows consumers to make informed decisions, compare different products, and choose the one that best suits their needs. In this way, advertising enhances consumer welfare and ensures market transparency.

Enhancing Brand Image and Value

Advertising is instrumental in building a brand’s image and value. By conveying the brand’s message, values, and vision through creative and compelling advertisements, businesses can establish a strong brand identity. This identity helps differentiate the brand from its competitors, creating a unique position in the market. Furthermore, effective advertising can lead to brand loyalty, ensuring long-term profitability for businesses.

Facilitating Market Competition

Advertising fosters healthy competition in the market. It offers a platform for businesses to showcase their unique selling propositions, encouraging innovation and improvement in product quality. This competition benefits consumers as they get access to better products and services at competitive prices.

Challenges and Ethical Considerations

While advertising has numerous benefits, it also poses some challenges and ethical considerations. Misleading advertisements can distort consumers’ perceptions and lead to uninformed decisions. Therefore, it is crucial for businesses to maintain truthfulness and transparency in their advertising practices. Regulatory bodies and ethical guidelines are put in place to ensure this.

In conclusion, advertising plays a vital role in today’s economic structure. It drives economic growth, creates informed consumers, enhances brand value, and facilitates market competition. However, it is important to consider the ethical implications of advertising practices to ensure consumer protection. As future business leaders, college students must understand the importance of advertising and its impact on society, economics, and consumer behavior. The power of advertising, when harnessed correctly, can lead to business success and societal benefits.

That’s it! I hope the essay helped you.

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Unfolding Concepts.

Impact of Advertisements on the Younger Generation

Advertisements have become a part of the daily life of the youngsters and they have gotten used to being bombarded with several advertisements during the course of their day. 

AUTHOR : SREEJITA KARMAKAR

Introduction

Advertising is a means of marketing communication with the users of a product or service, or the general public in order to promote or sell a product, service, or idea. Sponsors of advertising are generally businesses wishing to promote their products or services. In advertising, the advertiser pays for and has control over the message. Advertising is distributed and communicated through various mass media. Including traditional media like newspapers, flyers, magazines, television, radio, and news media. Such as search results, blogs, social media, text messages, or websites. Commercial ads seek to induce increased consumption of their products or services through “branding”. Which associates a product name or image with certain qualities in the minds of the consumers. 

Advertisements and the Youth 

The advertisement industry has a massive impact on the younger generation. In the modern world, with the widespread impact of social media among the youth, advertisements are at an all-time high reaching equally high to the audience. Advertisements have become a part of the daily life of the youngsters and they have gotten used to being bombarded with several advertisements during the course of their day. 

Advertisements have become so common for them that they do not even realize that they are viewing or hearing them. They certainly have a persuasive influence on the youth. In the ever-expanding world of consumerism and advertising, companies are always looking for multiple new ways to sell their products to the youngsters by making their commercials and campaigns more memorable, which would leave an impact on their minds. 

The younger generation has become the prime target of the advertisers. Because they have more spending power than ever before, as well as having increased avenues at their disposal. Therefore companies spend tremendous amounts of money to rope in popular film stars, sportspersons, musicians, etc. to endorse their products. These famous people are usually in such an influential position that their fans follow their lifestyles and their famous personas leave impressions on the lives of their fans too. Especially the younger ones – who mostly follow the footsteps of their idols from deciding what to wear to choosing what to eat and drink. 

Advertisement using Famous Personality

These advertisements using famous people not only help to ensure popularity but also early brand loyalty. In the last decade, many superbrands have looked towards new and outrageous ways to lure young audiences. Through appealing campaigns as these youngsters are cognitively and psychologically quite defenceless against advertisements. These prove that advertisements represent ‘big business’ and have a significant role in the lives of young people. Who need to be educated about the effects of advertising, that is, media literacy. This will prove effective in mitigating the harmful effects of advertisements on youngsters.

These days, Cristiano Ronaldo – the renowned Portuguese footballer and health fanatic is being talked about because he removed two Coca-Cola bottles during a press conference at the European Championship. He held up a bottle of water before declaring in Portuguese: “Agua!”, thereby encouraging people to choose that instead. This caused a $4bn fall in the share price of the drinks company. Coca-cola, which is one of the official sponsors of Euro 2020, saw the drop of its company’s share price from $56.10 to $55.22 almost immediately after Ronaldo’s gesture, a 1.6% dip. The market value of Coca-Cola went from $242bn to $238bn. This responsible gesture from an impactful man like Cristiano Ronaldo is truly commendable. It shows he knows his influence on the lives of his fans and he cares about them.

Although advertisements can be informative and help one make an informed choice, they may have certain effects on the youth and go as far as influencing their decisions, lifestyle, and personality, in some cases. Advertisements can have both positive and negative effects on the minds of the younger generation. 

Positive Effects of Advertisements

⦁ They can be a source of information as certain advertisements, especially public service announcements present innovations and technological milestones. Which can offer knowledge and a good learning opportunity to the youth, besides educating them about new products on the market.

⦁ Healthy food choices advertised the right way can influence the youngsters to opt for a more balanced diet.

⦁ Advertisements can also have motivating content that can encourage children and youngsters to choose a profession or chase a specific dream. They can help develop a passion for the same and make the youth work towards making it true.

⦁ Certain advertisements about hygiene or cleanliness can inculcate good habits in youngsters.

⦁ Advertisements that present other youngsters of a similar age engaging in activities like helping out with household chores and saving can persuade kids to do the same.

Negative Impacts of Advertisements

⦁ As advertisements can be persuasive, youngsters may want to purchase a product because ads are generally aimed at the youth. A stubborn youngster might demand products shown in advertisements.

⦁ The portrayal of stunts in advertisements can be very dangerous. Although they do come with statutory warnings, they may be ignored at times and the kids may attempt the stunts.

⦁ A large portion of food or drinks advertised are junk food and can be very visually appealing. These can have an impact on the eating habits of the youth and promote an unhealthy lifestyle.

⦁ The sexual objectification of people in certain advertisements is a cause for concern. As the youth grow up to think this is the norm.

⦁ The visual portrayal of some inappropriate acts such as lying or cheating can make someone vulnerable believe such types of behaviours are acceptable. 

There can be some tips given to stop the negative influences of advertisements from spreading among the youth. Like cutting down the screen time or trying to download television programs to avoid watching advertisements and more. But in a world full of innovative advertisements, it is very hard to ignore all of them. Advertisements appear almost everywhere, from newspapers to billboards, from television to luggage tags. The best way to eliminate the negativity surrounding advertisements is by educating the youth. Regarding the finer concepts of the marketing world.

Bibliography

https://parenting.firstcry.com/articles/effects-of-advertising-on-children/

https://www.theguardian.com/football/2021/jun/16/cristiano-ronaldo-snubs-coca-cola-billions-wiped-off-drink-giants-market-value

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• Open access
• Published: 29 November 2021

A systematic review of the effects of psychiatric medications on social cognition

• Zoë Haime   ORCID: orcid.org/0000-0001-6599-2176 1 ,
• Andrew J. Watson 2 ,
• Nadia Crellin 1 ,
• Louise Marston 3 ,
• Eileen Joyce 2 &
• Joanna Moncrieff 1  

BMC Psychiatry volume  21 , Article number:  597 ( 2021 ) Cite this article

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Introduction

Social cognition is an important area of mental functioning relevant to psychiatric disorders and social functioning, that may be affected by psychiatric drug treatments. The aim of this review was to investigate the effects of medications with sedative properties, on social cognition.

This systematic review included experimental and neuroimaging studies investigating drug effects on social cognition. Data quality was assessed using a modified Downs and Black checklist (Trac et al. CMAJ 188: E120-E129, 2016). The review used narrative synthesis to analyse the data.

40 papers were identified for inclusion, 11 papers investigating benzodiazepine effects, and 29 investigating antipsychotic effects, on social cognition.

Narrative synthesis showed that diazepam impairs healthy volunteer’s emotion recognition, with supporting neuroimaging studies showing benzodiazepines attenuate amygdala activity. Studies of antipsychotic effects on social cognition gave variable results. However, many of these studies were in patients already taking medication, and potential practice effects were identified due to short-term follow-ups.

Healthy volunteer studies suggest that diazepam reduces emotional processing ability. The effects of benzodiazepines on other aspects of social cognition, as well as the effects of antipsychotics, remain unclear. Interpretations of the papers in this review were limited by variability in measures, small sample sizes, and lack of randomisation. More robust studies are necessary to evaluate the impact of these medications on social cognition.

Peer Review reports

Introduction (narrative synthesis element 1: theory development)

What is social cognition.

Social cognition is defined as the mental processes which underlie the ability to understand and act on the thoughts, intentions, and behaviours of others [ 1 ]. Deficits in social cognition have been found in psychiatric disorders including depression, schizophrenia and bipolar disorder [ 2 , 3 , 4 ] and can lead to the faulty interpretation of others’ intentions and thinking, as well as inaccuracies in identifying others’ emotions [ 5 ].

Social cognition can be separated into individual testable domains. However, many of these domains overlap, and there is no consistent agreement between cognitive scientists as to which are the most important. In psychiatry research the domains most frequently studied tend to reflect those identified by the National Institute of Mental Health (NIMH) at their meeting to define social cognition in schizophrenia in 2006 [ 6 , 7 ]. These domains can be seen in Fig.  1 , and include: Theory of mind (ToM) - the ability to ‘infer intentions, dispositions, and beliefs of others’ [ 8 ] ; emotion processing - the ability to perceive emotions and interpret them appropriately [ 9 ] ; social perception - the ability to process social cues and context to decipher social situations [ 10 ]; attributional bias - how people interpret the causes of events, which may be positive or negative in nature [ 11 ]; and social knowledge – how mental schemas of social situations guide behaviour [ 12 ]. Additional domains of social cognition tested in research include emotional intelligence, prejudice and stereotyping, and empathy [ 6 ].

Social Cognition Domains identified by the NIMH

Social functioning deficits are a core feature of most psychiatric diagnoses and considered an integral treatment target for many conditions, in order to promote recovery [ 13 , 14 ]. Social cognition deficits have been associated with poor social functioning in several psychiatric disorders including schizophrenia, bipolar disorder, anorexia, Alzheimer’s disorder, and depression [ 2 , 3 , 15 , 16 , 17 ]. Additionally, in schizophrenia better social cognitive ability has been linked to better social functioning outcomes [ 18 ]. This makes social cognition a potential target for treatment interventions across psychiatric care.

Psychiatric medications

The existing studies showing social cognition deficits in psychiatric disorders often involve people who are currently taking psychiatric medication [ 19 ]. However, it is unclear how these medications might affect social cognition. Many psychiatric medications have sedative effects, including benzodiazepines, antipsychotics (to varying degrees) and drugs used as mood stabilisers (22), and evidence suggests these drugs impair neurocognitive functioning in volunteers [ 20 , 21 , 22 , 23 ]. Antipsychotics also impair cognitive functioning in people with Alzheimer’s disease [ 24 ], but evidence on the effects of antipsychotics in people diagnosed with schizophrenia is inconclusive. Some evidence suggests that antipsychotics improve neurocognitive functioning [ 25 , 26 ] and some that they impair it [ 27 , 28 ].

Along with sedative effects, psychiatric medications affect emotion and motivation. Antipsychotics, for example, reduce motivation and suppress emotions in volunteers [ 29 ], effects which are also reported by patients [ 30 ], and these effects may impact on social cognition. On the other hand, psychiatric drugs may improve social cognition by alleviating symptoms that impair social interaction, such as psychotic symptoms and anxiety. Moreover, different agents within the same class may have different effects on social cognition, depending on their sedative profile and other effects [ 31 ].

Therefore, there is good reason to believe that psychiatric medications may influence social cognition, especially those with sedative actions that are known to impair neurocognitive functioning in volunteers. Clarifying these effects is important in order to understand the nature of social cognitive deficits in psychiatric disorders, and to evaluate the effects of treatment on social cognition and associated outcomes, such as social functioning. A previous review highlighted the paucity of evidence on the effects of antipsychotic treatment, but it did not explore the use of other medications or effects in volunteers [ 31 ]. Volunteer studies help to distinguish those effects that occur in the absence of symptoms of psychiatric disorders from those that are related to the disorder itself, or to the interaction of the treatment with the disorder. They can help with the interpretation of studies with patients who are taking medication, and ultimately improve our understanding of this complex area.

Neuroimaging

The realisation that social disability may be linked to cognitive dysfunction has led to the employment of neuroimaging techniques to study this phenomenon in psychiatric populations, including the use of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). EEG can identify temporal changes in brain activity in response to specific tasks via event-related potentials (ERP), and fMRI is used to detect the location of changes in brain activity via variations in blood-oxygen-level-dependence (BOLD) [ 32 , 33 ]. ERPs typically associated with social cognitive emotional stimuli are the P300-P400 potentials, where the brain shows activations 300-400 ms post-stimulus [ 34 ]. In fMRI, a social cognitive brain network has been identified and includes consistent activation of regions, including the temporo-parietal junction (TPJ), anterior cingulate cortex (ACC), superior temporal sulcus (STS), ventral and dorsal medial prefrontal cortex (VMPFC and DMPFC), precuneus, and inferior frontal gyrus (IFG) [ 35 ]. Neuroimaging studies investigating the effects of sedative medications on social cognition will help to identify any temporal or spatial neural changes in social cognitive brain regions, as a result of medication effects. This research is important in allowing researchers to assess the biological impact of psychiatric pharmaceutical treatments. In studies where patients have been using psychiatric medications with sedative effects long-term, permanent changes to structural and functional brain systems may inhibit the identification of medication effects on social cognition, Therefore, healthy volunteer and drug-naïve patient studies will be integral to our understanding of medication effects on social cognition in neuroimaging studies.

Despite evidence of effects on neurocognitive functioning, there has been little consideration of how psychiatric medications affect social cognition. We hypothesised that psychiatric medications that produce sedative effects might affect social cognition, and we conducted a systematic review of the literature in this area. We included research on healthy volunteers as well as research conducted with patients with diagnosed psychiatric disorders.

An additional aim of this review was to explore any temporal or spatial brain differences between healthy volunteers and clinical populations with psychiatric diagnoses conducting social cognition tasks after administration of psychiatric medication using neuroimaging technology. Notable differences in brain activity may reflect the effects of medication on social cognitive processing.

The review will help to clarify the nature of any underlying deficits in social cognition in people diagnosed with psychiatric disorders, and this will help in the development of targeted treatments for social cognition, which may also improve social functioning and general outcomes [ 28 ].

Protocol and registration

This review follows the PRISMA guidelines for reporting systematic reviews [ 36 ]. The review protocol is available on the PROSPERO registry, ID: CRD42018092883.

Narrative synthesis

The scope of our narrative synthesis was to examine the effects of sedative medications on social cognition. Following guidance from Popay et al. [ 37 ] we used four iterative elements shown in Fig.  2 . As the first point suggests, we conducted an initial scoping of the literature to summarise the current research in the field, and in order to construct our search strategy. To address point two, we reported our findings in the results section and summarised relevant data from the included papers in a table (Table  1 ). In our discussion we critically explored relationships between the reported studies and went on to discuss the strengths and limitations of the current review, to address points three and four.

The four iterative elements of narrative synthesis [ 37 ]

Search strategy

We searched the following major databases: MEDLINE (OViD), Embase, Psychinfo, Web of Science, Lilacs, and Scopus as well as grey literature through greylit.org and opengrey.eu. Database-specific search terms included the keywords ‘social cognition’, ‘mental disorder’, ‘neuroleptic agents’, ‘sedatives’, and ‘tranquilisers’ with intervention-specific terms (including names of drug classes, and individual agents in classes that were not included as a whole, e.g., some sedative antidepressants), diagnosis-specific terms, outcome-specific subtypes and synonyms (see Additional file 1 : Appendix A for full list of search terms and search strategy). An attempt to find additional studies was made through a backward reference search and contacting experts in the field.

Inclusion/exclusion criteria

• a We included all antipsychotics, benzodiazepines, Z-drugs, and barbiturates. Tricyclic antidepressants, mirtazapine and trazadone were also included, and pregabalin. Drugs that are prescribed for mental disorders but predominantly used for physical health complaints, such as gabapentin and beta-blockers, were excluded

Citations were imported to Mendeley and all duplicates were removed. ZH independently screened all citation titles for their applicability [ 77 ]. Titles that did not meet eligibility criteria were removed. Full-text papers were then screened and any uncertainties about inclusion were discussed with a second reviewer (AJW).

Quality of assessment of studies

Study quality was evaluated using the Downs and Black checklist [ 78 ] as it allows for assessment of both randomised and non-randomised studies. The checklist evaluates papers on reporting, external validity, and internal validity (bias and confounding). It consists of 27 items scored with 0 points for ‘no/unable to determine’, or 1 point for a ‘yes’ response. Item 5 is scored differently with 0 points for a ‘no’ response, 1 point for a ‘partially’ response, or 2 points for a ‘yes’ response. The last item on the checklist regarding power was altered in concordance with a previous review conducted by Trac et al. [ 79 ] to rate whether a power analysis was calculated (1 point), or not (0 points). The maximum score for the checklist was 28, with the scoring ranges being (< 14) poor quality, (15–19) fair quality, (20–25) good quality, and (26–28) excellent quality.

Results (narrative synthesis element 2: developing a preliminary synthesis)

Search results.

The search identified 2931 papers fitting the eligibility criteria, with 2681 remaining after de-duplication. The abstracts and titles of those records were then screened and 2511 were excluded due to not meeting the inclusion criteria. This resulted in 170 papers for full-paper screening. A further 130 papers were excluded during this stage, for reasons shown in Fig.  3 . The remaining 40 full-text papers were used in the narrative synthesis. Data from these papers including study design, sample, medication (name, dosage), pre-intervention treatment, placebo (yes/no), social cognitive domains tested, social cognition measures, follow-up timepoints, key findings, and study limitations, were extracted and can be viewed in Table 1 . Notably there were no studies of mood stabilisers, barbiturates, pregabalin or any sedative antidepressants.

PRISMA flow diagram [ 36 ]

Data quality was rated by ZH on all 40 full-text papers and AJW on 20% randomly selected papers. An interrater reliability score Cohens Kappa Coefficient of 0.85 was calculated [ 80 ], indicating good agreement between authors. Of the 40 included papers, 11 were rated poor and 20 were rated fair. Only 9 total papers were rated good, and none were rated excellent. Scores for each paper are reported in Table 1 .

Benzodiazepine studies

Four benzodiazepine studies conducted in healthy volunteers showed significant impairments in emotion recognition social cognition tasks following diazepam administration [ 39 , 41 , 44 , 81 ], suggesting that sedative medication at a therapeutic dose impairs emotion processing. One of these papers also incidentally investigated the effects of Metropolol, a beta-blocker with mild sedative effects, and found no significant effect of the drug on emotion recognition [ 41 ]. A further study [ 42 ] showed a selective effect of diazepam on recognition of angry expressions only. This result may be due to using a small dose in comparison to other studies. One benzodiazepine study using oxazepam showed no effect on a measure of empathy [ 38 ].

One study was conducted in patients with schizophrenia, which looked at the effects of benzodiazepine withdrawal. Patients who were in the process of withdrawing from benzodiazepines were significantly impaired in recognising negative emotions compared to healthy volunteers, in contrast to patients who had already withdrawn, who were not. However, all patients were likely to have been on other medications [ 81 ].

Neuroimaging studies of benzodiazepines and social cognition

All neuroimaging studies compared social cognition before and immediately after administration of the experimental drug. Del-Ben et al. [ 43 ] showed that a single dose of diazepam in healthy volunteers resulted in attenuated activation of the right amygdala when responding to fearful faces, although no evidence was found for this interaction when participants viewed angry faces. In another healthy volunteer study, Paulus et al. [ 82 ] showed that lorazepam attenuated activation in the amygdala and insula, and that the activation was significantly lower after 1 mg compared to 0.25 mg, suggesting a dose-dependent reaction in emotional processing regions. However, a study by Olofsson et al. [ 45 ] found no interaction between benzodiazepines and EEG activity during response to an affective processing task.

A study investigating benzodiazepine effects on patients with ‘catatonic’ schizophrenia and patients with bipolar disorder found that lorazepam induced BOLD signal decreases in the occipital cortex and medial prefrontal cortex (MPFC) in patients with schizophrenia when undertaking a negative emotion recognition task. This resulted in BOLD patterns resembling those of healthy volunteers taking a placebo drug during the same emotion recognition tasks [ 46 ]. However, at the time of the fMRI task all patients were taking either antipsychotic or antidepressant medications in addition to the administered lorazepam .

Antipsychotic studies

Healthy volunteers.

Only two studies tested the effects of antipsychotics on social cognition in healthy volunteers. A small crossover study by Lawrence et al. [ 47 ] ( N  = 14) found that recognition of angry facial expressions was reduced in participants taking sulpiride, but recognition of other expressions was not affected. In addition, a larger randomised parallel group trial of quetiapine versus placebo by Rock et al. [ 48 ] ( N  = 27) found no effect of the medication on facial expression recognition, though dropout rates were high (25%) in the quetiapine arm, which may have obscured an effect.

Patient studies

All studies comparing patients with schizophrenia and healthy volunteers found patients performed less well on social cognition tasks whether or not they were taking antipsychotics at baseline [ 49 , 50 , 51 , 52 , 53 , 54 , 56 , 61 , 63 , 68 ]. This included one study with patients who were drug naïve [ 61 ], two studies with patients who were drug-free at study commencement [ 53 , 68 ], studies including participants with a mixture of drug-naïve, drug-free, and previous treatment for under 4 weeks [ 50 , 51 , 52 , 54 , 57 , 72 ], and one study with patients stable on an antipsychotic [ 58 ]. Most longitudinal studies involving people with schizophrenia taking antipsychotics showed improvements in performance on social cognition tasks at follow-up compared to baseline [ 50 , 51 , 52 , 55 , 56 , 59 , 61 , 63 , 64 , 66 , 70 ], although some found no effect [ 49 , 53 , 54 , 58 , 60 , 62 , 65 , 67 ] and one showed a decline [ 68 ].

When studies were classified by the prior medication status of participants, two longitudinal studies involved patients who were previously drug naïve. One of these studies detected improvements on an emotional processing task at follow-up [ 61 ], the other study involved an attributional style task, and found no effects of the medication [ 49 ]. Studies that involved patients who had a prior drug-free period, mostly found improvements in emotion processing tasks [ 50 , 52 , 53 , 70 ], and one in a theory of mind task [ 56 ]. Some studies specified that participants were taking an antipsychotic at baseline prior to switching to another [ 51 , 54 , 55 , 58 , 59 , 60 , 62 , 63 , 64 , 65 , 67 , 68 ] and one did not describe the prior treatment status of participants [ 66 ]. In studies in which people were already taking antipsychotic treatment, results reflect effects of changing the type of antipsychotic rather than starting treatment.

One study tested healthy volunteers at baseline and follow-up to control for practice effects [ 50 ]. It found that patients with schizophrenia treated with antipsychotics (a mixture of people who were previously drug naïve ( n  = 11) or drug free ( n  = 12)) showed significant improvements in emotion recognition at 6 months compared to healthy volunteers.

One longitudinal study involving 29 people with schizophrenia and 28 with bipolar disorder explored dose-response relationships [ 68 ]. Findings showed that patients with schizophrenia who were taking higher doses of antipsychotic medication had more difficulty recognising sad and neutral facial expressions compared to those taking lower doses at follow-up. In bipolar patients, antipsychotic dose was unrelated to the accuracy of performance in judging emotions.

Studies comparing different antipsychotics produced inconsistent results. Some found that patients treated with second-generation drugs did better than those taking first-generation antipsychotics [ 55 , 59 , 66 , 69 , 70 ], but there was no consistent pattern to the results. Others found no difference between different agents or types of agent [ 57 , 60 , 62 , 65 , 67 , 72 ]. The largest study by Penn et al. [ 64 ] showed improvements in all treatment groups (except for ziprasidone) on an emotion processing task, with no difference between individual second-generation drugs or between first- and second-generation drugs.

One study involving participants with Huntingdon’s disease showed poorer performance on facial recognition tests in those taking antipsychotics compared to those who were not, after controlling for the stage of the disease [ 71 ].

In this review, several studies were conducted by authors who received funding from pharmaceutical companies for research purposes or consulting. One study had a pharmaceutical company provide the medication for the research [ 65 ]. Studies that were conducted by authors who received pharmaceutical company funding found either improvements in social cognition after antipsychotic administration [ 55 , 64 , 73 ], or no effect of the drug on performance [ 60 , 63 , 65 ]. However, improvements were also shown in studies that did not rely on pharmaceutical funding [ 50 , 51 , 52 , 56 , 61 , 66 ].

Neuroimaging studies of patients and social cognition

A study by Sumiyoshi et al. [ 73 ] investigated the effect of the antipsychotic, perospirone, on social perception in schizophrenia patients. They found an increase in the P300 ERP activation in the left pre-frontal cortex (PFC), as well as improvements in the social cognitive script task, after 6 months treatment compared to baseline.

A study investigating the effect of sultopride on emotion processing in healthy volunteers found decreased BOLD responses in the amygdala when viewing negatively valenced stimuli compared to before sultopride administration [ 74 ]. There was also increased activation in the PFC identified during positron emission tomography (PET) scans. However, behaviourally they found minimal changes to performance on social cognition tasks. Additionally, a crossover EEG study by Franken et al. [ 75 ] with healthy volunteers, found that both the dopamine agonist bromocriptine, and antipsychotic haloperidol produced no significant difference in emotion-related ERPs (P300-P400) compared to before drug administration. This study used low doses of medication, however, and some participants were also prescribed domperidone to treat nausea.

Discussion (narrative synthesis element 3: exploring the relationships within and between the studies)

Clarifying the effects of prescribed medication on social cognitive ability is important since social cognition appears to be impaired in people across psychiatric diagnoses, and this impairment may be related to deficits in social functioning that represent a significant disability. Hypothetically, psychiatric drugs may impair social cognition due to their sedative effects, or may, through improving psychiatric symptoms, benefit social cognition.

The findings suggest that psychiatric drugs with sedative properties, such as benzodiazepines, can impair emotion recognition in healthy volunteers [ 39 , 41 , 42 , 44 , 81 ]. Findings were most consistent for emotion processing following the use of diazepam, however few studies were conducted using other benzodiazepines or measures of social cognition. Two neuroimaging studies investigating lorazepam found decreased activation in the social cognitive neural network during emotion processing [ 46 , 82 ]. These findings suggest sedative effects of lorazepam may be altering brain processes required for emotion recognition, although neither study used a behavioural measure to confirm the effects on social cognitive ability. In contrast effects of antipsychotics on healthy volunteers were inconsistent, but only two studies were identified. As antipsychotics have different pharmacological profiles and cause varying levels of sedation, different agents may have different effects. Further research is required to clarify effects of antipsychotics on social cognition in volunteers, especially considering the evidence that antipsychotics impair neurocognitive performance and their reported effects on emotional reactivity.

Results of studies with patient populations found that antipsychotic treatment improves or has no effect on social cognition in patients with schizophrenia. The studies suffered from several important methodological limitations, however. First, practice effects in cognitive tasks are common [ 76 ], and as most studies in this review had short follow-up time windows (averaging 3.2 months) it is expected that improvements would be caused by task memory from earlier sessions. Only one study controlled for practice effects by including a healthy volunteer control group. The study identified practice effects, but also showed an additional improvement in social cognition that was independent of practice effects [ 51 ]. Second, studies did not distinguish the effects of the medication from the effects of changes in symptoms. Symptom improvement may occur as a result of antipsychotic treatment but may also occur spontaneously. One of the present studies detected a correlation between psychotic symptoms and social cognition [ 53 ], but ultimately, placebo-controlled comparisons are needed to reliably detect treatment-specific effects.

In contrast to studies showing improvement in social cognition with antipsychotics, one study on emotion processing identified a negative effect with a dose-response relationship, such that higher doses of antipsychotics related to higher levels of social cognitive impairment in patients with schizophrenia, but this was only found in people diagnosed with schizophrenia and not with bipolar disorder. The study with patients with Huntingdon’s disease also found worse facial recognition performance associated with antipsychotic use, even after adjusting for disease severity [ 71 ]. This is consistent with the evidence of reduced neurocognitive functioning in people with Alzheimer’s following antipsychotic use, but further studies are required to clarify the effects of drugs in other psychiatric conditions.

Patients who experience psychiatric disorders are likely to experience neurocognitive deficits such as poor attention and decision-making skills due to the nature of their symptoms [ 83 ], which may directly prevent successful social cognitive ability [ 27 ]. In addition to this, some research has found that patients with a mental health diagnosis are more likely to have poorer intellectual abilities than the healthy population [ 84 ], which could result in difficulties with language and communication skills. These difficulties may make individuals less experienced or confident in a social environment and have a negative influence on social cognition as a result. The studies examined here confirmed that there is an impairment of social cognition in people experiencing a psychotic episode, even before drug treatment is started. However, the research base is currently not adequate to unravel whether there are additional positive or negative effects associated with the use of psychiatric drugs.

Neuroimaging findings suggest that medication may be affecting brain processes that have been found to be associated with social cognitive ability. Sumiyoshi et al. [ 73 ] found an increase in the P300 ERP during a social perception task in patients with schizophrenia after antipsychotic administration, which was positively correlated with their task performance. However, only 7 of 20 participants started the study drug-free, and 8 participants dropped out after the baseline assessment, making it difficult to make firm conclusions. Takahashi et al’s [ 74 ] study on an affective processing task showed decreased BOLD responses in the amygdala and greater activations in the PFC following antipsychotic administration in healthy volunteers. This was noteworthy as the PFC is known to attenuate amygdala activation during emotional processing [ 85 ]. Therefore, it is possible antipsychotic medication is working directly on the PFC, and decreased amygdala signals are secondary to this.

Strengths and limitations (narrative synthesis element 4: assessment of the robustness of the synthesis)

One of the most important strengths of this review was establishing the current literature on the effects of sedative psychiatric medications on social cognition using a rigorous search strategy of published and unpublished work.

We included all psychiatric populations, and healthy volunteer studies in our search. However, in our review we found the research was largely limited to studies of benzodiazepine effects in healthy volunteers, and studies of antipsychotics in patients with schizophrenia with one study of patients with the neuropsychiatric disorder, Huntingdon’s disease [ 86 ]. Research on neurocognitive function suggests that antipsychotics, in particular, may have specifically detrimental effects in people with psychiatric disorders, such as Alzheimer’s, and further research on their effects on social cognition in people with these disorders would be valuable.

We made efforts to also include all prescribed psychiatric medications with sedative effects in our search, but we may have omitted some medications that are not commonly used. We also excluded drugs that are prescribed for mental disorders but are predominantly used for non-psychiatric indications, such as gabapentin or beta-blockers. We also did not include drugs with sedative effects that are routinely used for physical disorders, such as opiate anaesthetics, for example, and we also did not include recreational sedatives such as alcohol or heroin in our search. The review focused on prescribed psychiatric medication in order to clarify the effects of these medications in people with diagnoses of mental disorders, but recreational drugs are commonly used amongst patients with a mental health diagnosis [ 87 ], and their sedative effects may also influence social cognitive ability. Therefore, this should be an important consideration for future research in the area.

An integral strength of our search for this review was the inclusion of all known terminology for social cognitive domains and measures. However, this was difficult due to the use of interchangeable terms for similar items, exposing a feature of the social cognition field that needs to be addressed.

A limitation of the current review was the poor quality of available studies. Our data quality analysis tool allowed us to identify several deficiencies with current papers available in the field, such as small sample sizes, non-randomised designs, and few adherence to medication measures. Only four of the studies found conducted power analysis to qualify their sample size. This resulted in many of the included studies having small numbers of recruits, undermining the internal and external validity of the research findings. During quality analysis, researchers also found only three of the longitudinal studies included were recording medication adherence. In addition to this, very few studies considered the influence of practice effects, which have an important influence on the results of longitudinal studies of cognitive performance, and there were few randomised placebo-controlled studies that would allow conclusions about whether changes in patients taking antipsychotics were attributable to specific medication effects, or whether they were the result of unrelated symptom improvement or of practice effects. Additionally, only one study of antipsychotics, and no benzodiazepine studies, looked at dose-dependent effects. This variability in studies also restricted analysis of the papers included, making a meaningful meta-analysis impossible to conduct.

One other major limitation of this review was that 80% of the included studies explored emotion processing tasks, leaving the other domains of social cognition largely ignored in the literature. Resultingly, our review is more of an insight into the effects of sedative medications on emotion processing, rather than the broader area of social cognition as a whole.

Finally, benzodiazepines have reasonably consistent effects, but antipsychotics vary widely in their receptor targets, pharmacological actions and sedative profiles [ 47 , 48 ]. The studies examined did not enable a comprehensive comparison of the effects of different agents within any class of drugs. In addition, no studies were found that assessed effects of other prescribed psychiatric drugs with sedative properties, such as mood stabilisers, sedative antidepressants or pregabalin.

Further research

We suggest that further research of higher quality is needed to clarify the effects of sedative medications on social cognition in healthy volunteers and patients with psychiatric diagnoses.

Further studies conducted with neuroimaging techniques will allow better insight into structural or functional brain changes resulting from administration of psychiatric medication with sedative effects. Conducting these studies with a behavioural performance element will also allow researchers to identify if brain changes are consistent with changes in social cognitive ability.

Further studies also need to control for practice effects, and studies involving patients should include placebo or no treatment control groups in order to distinguish the effects of medication from the natural evolution of psychiatric symptoms. Studies should be conducted across a range of social cognition domains, to ensure we are getting an accurate picture of complete social cognitive ability. Additionally, studies should be conducted across a range of psychiatric medications with sedative properties, to ensure we are able to identify any significant differences between drugs, and in different psychiatric diagnoses to clarify the effects of medication across conditions.

Notably, recent research in the field of social cognition and psychiatry has focused on the potential benefits of non- pharmacological interventions, such as social cognition and interaction training (SCIT), metacognitive reflection and insight therapy (MRIT), and metacognitive training. A review in 2009 by Choi and colleagues [ 88 ] found that five intervention studies showed promising results for social cognitive improvements in patients with schizophrenia, and a comprehensive review by Kurtz et al. [ 89 ] showed large effect sizes for training on facial affect recognition, moderate effect sizes on theory of mind, and small effect sizes on attribution bias for patients with schizophrenia. Although some studies included in these reviews used control groups, the majority of studies failed to control for potential medication effects in participants with schizophrenia. Psychiatric medication use alongside a social cognitive training intervention may cause improvements or deficits in participant outcomes, which we consider an important clinical implication in treatment implementation. Therefore, we suggest future research in this area accounts for psychiatric medication use in the analysis of intervention effectiveness.

Deficits in social cognition have been identified in people with psychiatric diagnoses, and are associated with impaired social functioning, yet we remain uncertain to what extent these are attributable to the effects of the disorder or the effects of its treatment. A number of healthy volunteer studies suggest that diazepam and lorazepam can impair emotion processing abilities. Studies on antipsychotics were inconclusive and suffered from methodological limitations. There were no studies on any other drugs with recognised sedative properties, and studies focused mainly on the emotion processing domain of social cognition. Better data on the ability of drugs to affect social cognition will help to improve our understanding of the nature of social cognitive deficits in mental disorders, and the effects of treatment. Optimising the treatment of social cognition could potentially lead to better social functioning outcomes.

Availability of data and materials

Not Applicable.

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EMJ is supported by the UCLH/UCL NIHR Biomedical Research Centre.

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Haime, Z., Watson, A.J., Crellin, N. et al. A systematic review of the effects of psychiatric medications on social cognition. BMC Psychiatry 21 , 597 (2021). https://doi.org/10.1186/s12888-021-03545-z

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The Effects of Advertisement for Children Essay

Advertising has had a significant role on people and especially on children. Their young and developing mind is very influential and everything they see is considered to be real and true. Television has become a great part of every child’s life, not to mention the internet and the extreme amount of ads that can be found there. Often, children are suscepted to uncontrollable TV and internet usage and so, great care should be applied when allowing children to watch TV (Metroka-Kirkham 30). Commercials and different advertisements can prove to be harmful but at the same time, there are things that are very positive and mind stimulating. Lego is one of such things; it is a toy, a puzzle that allows children to use their imagination. The building blocks of the constructor can be compared to the building blocks in the mind that develop in the process of child’s play. It has been proven by numerous studies that play and games are an important and crucial part in the development of a healthy individual. Pretend play and toys are a large part of children’s life and childhood.

The paper/study will focus on the effects of Lego and other toy’s advertisement on the desire of children to receive the above products. The specific focus on Lego will examine the type of toy and the benefits that it might have for the children, as well as some disadvantages. The advertisement also has to have specific qualities in order to attract potential customers, so a close look at the parameters of advertisements will also be analyzed. The advertisement industry is familiar with the effects it has on children and it is used by manipulating colors, voices, themes, products, presence of other children or already known characters that children will respond to.

The method of the study will be a close look at the qualities and details of the advertisement. One of the criteria will be the story or theme that is being used in the advertisement. For example, if it is Lego with a pirate theme then it is mostly directed towards boys. The same is true if there are cars, fire trucks, tanks, soldiers and other male related themes. If it is a Lego playhouse with dolls, natural scenes and other female preferred pretend play scenarios then the difference will be obvious. This means that the advertisements should be developed with a gender orientation in planning. Another factor is the age of the child. If it is a simple and small amount of blocks then it can be used by younger children. A more complex Lego set with moving parts and potentially remote controls; it is directed towards an older audience. Some Lego toys are not to be used by children under 3 years of age because of the small parts that can become dangerous and even lethal in case they are used without supervision and care. Thus, it is important to determine the relationship between parental control and children’s Lego use because parents are the ones who will be acquiring the toy for their children (Gunter 81).

The academic articles analyzing the amount of advertisements watched with a correlation to the number of Lego toys that a child has will be consulted. A susception towards advertisements definitely has an effect on a child’s mind but there is also a dependence on the personality and upbringing of the child. The articles will examine the quality and quantity of parental control—the number of hours a child is allowed to watch TV, what channels and at what time of the day (Macklin 146). Parental views and the type of guardians are also important. If a child is being raised by parent, they are more current in the modern views. Children raised by other relatives or grandparents, will have a different outlook on the toys and the types of advertisements a child watches (Moore 60). A specific look at the Lego commercials and development of the toy will be looked at. The history of Lego goes back to 1932-1949 and the amount of advertisements has greatly increased since then. There was a period when interest in Lego decreased but the company was able to manage a comeback with new and exciting toys (Dibb 64).

This study will be extremely relevant to the course because the amount of advertisements that people are receiving is rather large. As a child’s mind is very sensitive to the outside stimuli, it is important what information they obtain from the ads. Any deception in the advertisements will create false beliefs, which will make it harder for parents to communicate with the child and explain why certain things are not allowed or unacceptable. Whereas TV is better controlled by parents, internet can have a devastating influence. False information and manipulation can damage the child’s mind and understanding of the world and concepts (Thorson 352). Childhood is the most important stage in the development of a child. This is the time when children receive the basic knowledge about the world and their character and individuality is forming in a major way. Developmental psychologists have theorized that a child will develop their character by age 5 and this means that the types of things they hear and see on TV will be potentially imprinted on their mind.

Works Cited

Dibb , Sally. The Marketing Casebook: Cases and Concepts, New York, United States: Cengage Learning EMEA, 2001. Print.

Gunter , Barrie. Advertising to Children on TV: Content, Impact, and Regulation, Mahwah, United States: Routledge, 2005. Print.

Macklin, Carole. Advertising to Children: Concepts and Controversies , Thousand Oaks, United States: SAGE, 1999. Print.

Metroka-Kirkham , Kari. The Children’s Television Act and Program-length Commercials , Ann Arbor, United States: ProQuest, 2008. Print.

Moore , Nana. Parental Attitudes Toward Children’s Television Advertising , Ann Arbor, United States: ProQuest, 2007. Print.

Thorson, Esther. Internet Advertising: Theory And Research , Mahwah, United States: Routledge 2007. Print.

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Guest Essay

The Spectacle of the Ambani Wedding Event Reveals India’s Inequality

By Sonia Faleiro

Ms. Faleiro is an author from India.

Rihanna, Mark Zuckerberg, bejeweled elephants and 5,500 drones. Those were some of the highlights of what is likely the most ostentatious pre-wedding ceremony the modern world has ever seen.

On a long weekend in early March, members of the global elite gathered to celebrate the impending nuptials of the billionaire business titan Mukesh Ambani’s youngest son, Anant, and Radhika Merchant. Monarchs, politicians and the ultrawealthy, including Bill Gates and Ivanka Trump, descended on an oil refinery city in the western Indian state of Gujarat for an event so extravagant, you’d be forgiven for thinking it was, well, a wedding. But that will take place in July. For the long windup to the big day, some of Bollywood’s biggest stars, though invited as guests, took to the stage to sing and dance in what amounted to a bending of the knee to India’s most powerful family.

Watching the event, I couldn’t help thinking of the 1911 durbar, or royal reception, when King George V was proclaimed emperor of India. Once India won its independence from Britain in 1947, it committed itself to becoming a democratic welfare state — an audacious experiment that resulted in what is now the world’s largest democracy. But in advance of this year’s general election, expected to begin in April, the Ambani-Merchant matrimonial extravaganza shows us where true power in India now lies: with a handful of people whose untrammeled wealth and influence have elevated them to the position of India’s shadow leaders.

It’s difficult to imagine the Ambani-Merchant wedding event in an India that isn’t ruled by Prime Minister Narendra Modi. It’s true that the Ambanis have been wealthy for years now and that accusations of favorable treatment from government authorities are not unique to this family or the Modi government. But no other prime minister in India’s history has been so openly aligned with big business, and never before has the concentration of wealth been more apparent. India’s richest 1 percent now own more than 40 percent of the country’s wealth, according to Oxfam. The country has the world’s largest number of poor, at 228.9 million . And according to a newly published study looking at 92 low- and middle-income countries, India had the third-highest percentage of “zero food” children — babies between 6 months and 23 months old who had gone a day or more without food other than breast milk at the time they were surveyed. Oxfam has described this new India as the “survival of the richest.”

For the uberwealthy, this presents a no-holds-barred opportunity to exert their power and influence. In 2017, Mr. Modi introduced a fund-raising mechanism called electoral bonds to allow unlimited anonymous donations to political parties. In the five years that followed, the prime minister’s Bharatiya Janata Party received $635 million in contributions through such bonds, 5.5 times as much as its closest rival, the Congress Party. The 2019 Indian general elections cost $8.6 billion, surpassing the estimated $6.5 billion spent on the 2016 U.S. presidential and congressional elections.

Analysis by three independent media organizations in India published on March 14 revealed that a company called Qwik Supply Chains purchased bonds in the scheme worth $50 million. One of the company’s three directors, reporters later uncovered, is also a director at several subsidiaries of Reliance, Mukesh Ambani’s megacompany. A spokesperson for Reliance said that Qwik is not a Reliance subsidiary and did not respond to further questioning from Reuters . The Indian Supreme Court has since struck down the electoral bond mechanism, calling it unconstitutional , but the delay in addressing the matter has most likely come too late to change the outcome of the forthcoming election, which is widely considered all but certain to go in Mr. Modi’s favor.

And judging by the omnipresence of Mr. Modi’s image — the state-funded publicity exercises focused on exalting him, the constant advertisements in newspapers and on TV, his image plastered on billboards and life-size cutouts everywhere from train stations to public parks — even those who wish to vote for other candidates might be forgiven for thinking there are none. With the help of a small group of business tycoons, led by Mr. Ambani, the prime minister has dominated the Indian media landscape. Since Mr. Modi came to power, Mr. Ambani has invested heavily in the media and now owns more than 70 outlets, including India’s biggest media conglomerate, which are followed by 800 million weekly viewers. Many of these outlets have been trumpeting Mr. Modi’s credentials and heaping praise on him.

Mr. Ambani has been relentless in expressing his gratitude to Mr. Modi for working in step with Reliance. In January, Mr. Ambani hailed Mr. Modi as the “most successful prime minister in India’s history.” Later that month, the tycoon’s family traveled to Ayodhya for the inauguration of the Ram Mandir temple complex, which is being built on the highly contentious grounds of a functioning mosque that was destroyed by a Hindu mob in 1992. The construction of the Ram Mandir is the epitome of Mr. Modi’s tenure, which has been defined by a violent and divisive Hindu majoritarianism. Mr. Ambani donated $300,000 toward the temple costs.

Mr. Modi was reportedly not present during the Ambani wedding event, leading to speculation on social media that he wanted to avoid further accusations of cronyism in an election year. But his hand was evident. Anant Ambani told the press that he in part chose his family’s hometown Jamnagar as his pre-wedding venue to honor the prime minister’s “Wed in India” call for young Indians to marry at home rather than abroad. Jamnagar is the location of Mukesh Ambani’s oil refinery, which is the largest in the world. And in a brazen misuse of public resources, the government temporarily turned the city’s small domestic airport into a designated international airport, clearing the way for guests to land their private aircraft. The government airport was expanded, staff numbers were increased , and the Indian Air Force deployed additional military personnel — all in the service of one event for one family.

Some Indians viewed the arrival of the world’s elite on their shores as a sign of their country’s growing prominence in the world. The occasion was treated as a national event, with “breaking news” and live feeds of the arrival and then departure of every celebrity, of the more than 1,000 guests who stayed in luxury tents and were provided with makeup artists and sari drapers and were reportedly served 2,500 dishes and of the lion-shaped diamond brooch on Anant Ambani’s suit and his Richard Mille wristwatch, worth an estimated $1 million, which even Mr. Zuckerberg appeared to covet .

But what viewers saw that long weekend in March wasn’t India at all but the playground of an oligarch. The festivities took place weeks before a national election, at a time when India’s democracy is teetering on an edge. Violence against Muslims, Christians and Dalits has been normalized. The harassment of journalists, the incarceration of human rights activists and police violence against protesters have all but wrenched the country from the path chosen by its founding leaders, who wished the people of India to enjoy a “sovereign, socialist, secular, democratic republic.” In 2022, Freedom House, the nonprofit organization that tracks democratic governance, downgraded India from “free” to “partly free.” This status remains unchanged.

The Ambanis are entitled to spend their money on whatever they want (except, perhaps, on electoral bonds). And this latest celebration, while lavish, wasn’t entirely atypical in India, where weddings are viewed as an opportunity to demonstrate status. The giddy young couple at the center of the spectacle are charming: Ms. Merchant is a trained classical dancer; her fiancé is fond of animals. It would be churlish not to celebrate their happiness.

But if the 1911 Delhi durbar was a symbol of British imperial power, then the Ambani pre-wedding event in Jamnagar symbolized the rise of Mr. Modi’s oligarchs. And if these few are thriving in their symbiotic relationship with the Indian prime minister, it comes at the cost of the nation’s experiment with building a democratic welfare state. That’s nothing to celebrate.

Sonia Faleiro is a writer and the founder of the literary mentorship program South Asia Speaks. Her most recent book is “The Good Girls: An Ordinary Killing.”

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Research Article

Does the Wim Hof Method have a beneficial impact on physiological and psychological outcomes in healthy and non-healthy participants? A systematic review

Roles Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Warwick Medical School, University of Warwick, Coventry, United Kingdom

Roles Writing – review & editing

• Omar Almahayni, 
• Lucy Hammond

• Published: March 13, 2024
• https://doi.org/10.1371/journal.pone.0286933
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Introduction

Wim Hof, also known as the iceman, developed a method called Wim Hof Method (WHM) which he claims to have several benefits on physical and mental health. The aim of this systematic review is to identify and synthesise the results of the studies conducted on WHM on physiological and psychological health-related outcomes.

Materials and methods

This systematic review followed the PRISMA guidelines for systematic reviews. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42022333209. Medline and Web of Science were searched and included studies from January 1, 2014, to July 4, 2022. Studies were included if they met the predetermined inclusion/exclusion criteria. Inclusion criteria included RCTs and cohort studies published in peer-reviewed journals, studies conducted on healthy individuals and people with pre-existing medical conditions (adolescents and adults over the age of 14), studies that included all three pillars (breathing, cold exposure, and commitment) of the WHM, and studies that only focused on Wim Hof breathing method (WHBM). Exclusion criteria included studies that discussed WHM but are not original experimental research or are not peer-reviewed, studies that included children under the age of 14, and studies that used methods similar to WHM, but not actually WHM, such as tummo meditation. The articles were assessed for risk of bias using RoB 2.0 and Scottish Intercollegiate Guidelines Network (SIGN) tools. The effects of WHM were categorised into physiological or psychological related outcomes and narrative synthesis was conducted.

Nine papers were included in this review which consisted of eight individual trials. The findings suggest that the WHM may reduce inflammation in healthy and non-healthy participants as it increases epinephrine levels, causing an increase in interleukin-10 and a decrease in pro-inflammatory cytokines. Additionally, effect of WHBM on exercise performance showed mixed findings. Effects on respiratory parameters of minute ventilation, tidal volume, and breathing frequency were mixed following bouts of exercise.

Taken together, the findings of this review show promising use of WHM in the inflammatory response category. The focus of future studies should further investigate the benefits of WHM in non-healthy participants with inflammatory disorders and explore the use of Wim Hof breathing method to enhance exercise performance.

Citation: Almahayni O, Hammond L (2024) Does the Wim Hof Method have a beneficial impact on physiological and psychological outcomes in healthy and non-healthy participants? A systematic review. PLoS ONE 19(3): e0286933. https://doi.org/10.1371/journal.pone.0286933

Editor: Hidetaka Hamasaki, Hamasaki Clinic, JAPAN

Received: May 25, 2023; Accepted: December 26, 2023; Published: March 13, 2024

Copyright: © 2024 Almahayni, Hammond. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

The Wim Hof Method (WHM) is a lifestyle change that claims to enhance a person’s quality of life which consists of three pillars: Wim Hof breathing method (WHBM), cold therapy, and commitment. According to Wim Hof, the creator of this method, a combination of these three pillars enhances a person’s autonomic nervous and immune systems, thus strengthening a person’s health and mentality.

Wim Hof is recognized for his ability to resist extreme cold temperatures. He holds 21 Guinness World Records for some of his remarkable human achievements, including climbing Mount Kilimanjaro while wearing shorts, swimming 66 metres beneath ice, standing for two hours in a container filled with ice cubes, and running a half marathon over the Arctic Circle, only wearing shorts and barefoot [ 1 ]. Wim Hof credits his achievements to the WHM.

The first pillar of the WHM is WHBM which consists of hyperventilation 30–40 times then holding the breath voluntarily at low lung volume [ 2 ]. Secondly, cold therapy involves taking daily cold showers or sitting in an ice bath [ 3 ]. The final pillar, which is commitment, is the foundation of the other two pillars; mastering both mindful breathing and cold exposure takes patience and persistence [ 4 ]. To support his claims, Wim Hof has submitted his method and himself for research. Many studies, including case studies, randomised control trials (RCTs), and observational trials have been conducted on him and his method [ 5 – 16 ].

To identify some of the benefits people are experiencing, Wim Hof collaborated with RMIT University by conducting a survey inquiring about the impact WHM had on an individual’s health and well-being [ 17 ]. Over 3,200 people answered the survey, and the majority of the answers were positive. Respondents reported a good mix of physical and mental benefits such as an increase in their tolerance to resist cold, as well as an increase in energy, mood, mental focus, and general health. The survey findings also claimed that the WHM had benefits for specific conditions such as stress, tiredness and fatigue, anxiety, depression, back pain, insomnia, arthritis, and chronic pain [ 17 ].

Collectively, these findings suggest that the WHM may be of importance to healthy and non-healthy individuals and that the WHM approach may be given consideration in the public health and lifestyle medicine fields. The notion of lifestyle medicine refers to the study of how actions and habits affect illness prevention and treatment [ 18 ]. However, caution should be applied insofar as the aforementioned survey [ 17 ] has not been peer-reviewed or published, and Wim Hof’s own involvement in this study and others [ 5 , 9 ] may give rise to conflicts of interest in the pursuit of both an evidence base and a commercial opportunity. Wim Hof has attained a level of celebrity as a result of his achievements, method and associated media career. Due to all his remarkable achievements, his charisma, and authenticity, Wim Hof might be considered to be both achieved and micro celebrity [ 19 ], where achieved celebrity refers to the attainment of fame based on recognized talent, achievement, or ability and micro celebrity describes an individual that achieves status and social media presence by self-broadcasting about niche subjects to a small community of followers. Wim Hof is an example of a celebrity that embodies the para-social relationship, exchanging the allure of intimacy, integrity, and authenticity. The growing number of celebrities giving lifestyle and health advice and scientific knowledge to the public indicates the need to critically examine such advice [ 20 ]. Nunan et al . urge caution for the potential of “the unintended consequences of uncritical endorsement and application of lifestyle medicine including the infiltration of pseudoscience, profiteering, and the potential for widening health inequalities by a continued focus on the ‘individual’” (p229) [ 21 ]. Therefore, an independent, systematic synthesis of this evidence is warranted to evaluate the positive health claims of the WHM.

A systematic review has not yet been conducted on the WHM body of evidence. Therefore, an independent, systematic synthesis of this evidence is warranted to evaluate the positive health claims of the WHM. Hence, this review aims to identify and synthesise the results of the studies conducted on WHM on physiological and psychological health-related outcomes.

This systematic review followed the PRISMA guidelines for systematic reviews [ 22 ]. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42022333209.

Literature search

MEDLINE and Web of Science databases were used to search for published studies for potential inclusion in this systematic review. The following search phrases were used in combination: Wim Hof; breathing exercise OR breathing technique; meditation OR commitment; cold temperature OR cold exposure OR ice bath OR cold shower. The filters English language, year = "2014—July 4, 2022", and journal articles or observational studies or randomised controlled trials (RCTs) were applied. A filter for the year was applied because the first study performed on WHM was in 2014 [ 10 ].

Study selection

Duplicates were deleted before abstracts were screened. The screening of titles, abstracts and full texts was conducted by two independent reviewers, with any disagreements resolved by consensus. Screening was performed in Covidence (title and abstract screening, full text review, and extraction of the chosen articles). Studies were included according to the predetermined inclusion/exclusion criteria. Inclusion criteria included RCTs and cohort studies published in peer-reviewed journals, studies conducted on healthy individuals and people with pre-existing medical conditions (adolescents and adults over the age of 14), studies that included all three pillars (breathing, cold exposure, and commitment) of the WHM as defined above, and studies that only focused on WHBM. Articles just covering WHBM were permitted as it has been deemed more important and studied more frequently than other pillars. Furthermore, exclusion criteria included studies that discussed WHM but are not original experimental research or are not peer-reviewed, studies that included children under the age of 14, and studies that used methods similar to WHM, but not actually WHM, such as Tummo meditation. Both WHM and Tummo methods allow for the controlment of body temperature, and both have similar breathing techniques, however Tummo meditation consists of breathing and visualisation techniques which are intended to summon spiritual insight, whereas WHM is not religious [ 23 ]. After deciding on the included studies, the reference lists were hand-searched for other relevant articles.

Data extraction comprised the name of the study, place where the study was conducted, research design, participant demographics, study context, description of intervention and control, and key findings. One reviewer completed the extraction while a second reviewer checked it for accuracy. Furthermore, study quality was assessed using the RoB 2.0 risk bias tool [ 24 ] for RCTs and the Scottish Intercollegiate Guidelines Network (SIGN) risk bias tool [ 25 ] for cohort studies. Two reviewers independently evaluated the possibility of bias. The answers were then compared, and any disagreement was discussed between the reviewers.

Data synthesis

A narrative synthesis of the findings from the studies was included by providing a description and comparison between the different studies. This comprised a discussion of the contexts in which the studies have been undertaken, and the effects of WHM thematically grouped into physiological or psychological related outcomes. In each thematic grouping, different sets of outcomes were included. The data were not suitable for meta-analysis as there were various unrelated outcome measures resulting in heterogeneity across studies.

Study characteristics

Nine papers, seen in Fig 1 , published between 2014 and July 4, 2022, were identified that examined the WHM. One of these articles was identified from hand-searching the included studies’ reference lists [ 6 ]. Two of these articles [ 13 , 16 ] were further analyses of a study [ 10 ]. Table 1 summarises the characteristics of the listed studies. Of the nine papers included, there were eight individual trials. Four of the trials performed the full WHM [ 7 , 10 , 12 , 15 ] and four did only WHBM [ 6 , 8 , 11 , 15 ]. The application of WHBM differed between studies as some studies had one breathing exercise [ 6 , 8 , 11 , 12 ] while others had two breathing exercises [ 7 , 10 , 13 , 15 , 16 ]. The first breathing exercise was common in all studies. Cold exposure was conducted according to what was accessible to each study. However, all studies agreed on daily exposure to the cold through having cold showers, but the duration of exposure under the shower differed across studies. The meditation technique was the least focused component of the WHM. All studies had the same description of the meditation technique except for Petraskova Touskova et al . [ 12 ]. All the authors described it as visualisations meant to promote complete relaxation, while Petraskova Touskova et al . described it as a form of focusing to obtain self-awareness and will-power. Out of the nine papers, five conducted a randomised controlled trial (RCT) design [ 10 , 11 , 13 , 15 , 16 ], three conducted a crossover RCT design [ 6 – 8 ], and one conducted a prospective cohort design [ 12 ].

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Study quality

For the RCT studies, the RoB 2.0 overall risk of bias judgement was ‘high concerns’ for all studies except one study which was judged as ‘some concerns’ [ 8 ] ( Table 2 ). Most of the articles were judged as high concern due to the difficulty in blinding the participants and researchers to the intervention. For the cohort study [ 12 ], the SIGN tool was used. The cohort study was scored ‘unacceptable’ as it was not able to reduce the possibility of bias or confounding. An explanation of the results of the SIGN tool can be found in the S2 Table .

https://doi.org/10.1371/journal.pone.0286933.t002

Table 3 summarises the WHM description, key findings, and quality assessment. The outcomes were separated into physiological or psychological outcomes. The physiological outcome has six categories: stress response, pro-inflammatory/anti-inflammatory response, metabolites response, respiratory parameters, blood gas measurements, and reporting of symptoms, while psychological outcome has one category: psychological response. The stress response included outcomes such as epinephrine, norepinephrine, dopamine, cortisol, and heart rate (HR) whereas pro-inflammatory/anti-inflammatory response included tumour necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), erythrocyte sedimentation rate (ESR), Ankylosing Spondylitis Disease Activity Score C-reactive protein (ASDAS-CRP), calprotectin, high-sensitivity C-reactive protein (hs-CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Additionally, metabolites response contained lactate and pyruvate while respiratory parameters looked at minute ventilation (V E ), tidal volume (V T ), and breathing frequency (BF). The blood gas measurements category included carbon dioxide partial pressure (pCO 2 ), pH, and oxygen saturation outcomes and the psychological response category contained expectancy, optimism, neuroticism, short-form 36 (SF-36), EuroQol-5D (EQ-5D), Borg Rating of Perceived Exertion (RPE) scale, and customised questionnaire. Finally, the reporting of symptoms investigated flu-like, self-reported, and depressive symptoms, and Trauma Symptom Checklist-40 (TSC-40).

https://doi.org/10.1371/journal.pone.0286933.t003

Stress response

Two trials investigated epinephrine levels during the endotoxemia experiment [ 10 , 15 ] and one trial studied epinephrine levels during WHBM [ 15 ]. Baseline epinephrine levels in WHM-trained participants were significantly higher compared to non-trained participants (p = 0.007). After starting WHBM, epinephrine levels increased further in this group and peaked just before endotoxemia administration and remained elevated until WHBM was stopped [ 10 ]. Additionally, in Zwaag et al . endotoxemia study [ 15 ], participants had no variations in epinephrine levels throughout the experiment (p = 0.48) in both participants exposed to cold (CEX) and participants not performing the WHM (CON). However, an increase in epinephrine levels began much earlier and was significantly greater in both the cold exposure with breathing exercise without retention (CBR) (p = 0.01) and breathing exercise without retention (BRT) (p = 0.04) compared to the CEX and CON groups [ 15 ]. Furthermore, in Zwaag et al . breathing exercises study [ 15 ], both breathing exercises (WHBM with/without retention) raised epinephrine levels, which were unaffected by training duration (short vs extensive training: p = 0.71) or the trainer (independent trainer vs Wim Hof: p = 0.46). However, epinephrine was slightly more sustained in participants performing WHBM with retention compared to without retention (p = 0.003) [ 15 ]. Moreover, Kox et al . [ 10 ] explored norepinephrine and dopamine levels during the endotoxemia trial and found them to be within the reference range throughout the experiment [ 10 ].

The associations of cortisol with WHM was also explored. In Petraskova Touskova et al . study [ 12 ], the group not practising WHM had higher, but statistically non-significant cortisol levels at the end of the expedition (p = 0.327) compared to WHM-trained participants [ 12 ]. Whereas Kox et al . [ 10 ] found no variations in serum cortisol levels between the WHM-trained and non-trained groups. The serum cortisol levels were drawn before and throughout the period of WHM training. The only variation between the two groups was that serum cortisol levels normalised faster in WHM-trained participants [ 10 ]. The difference in the results could be due to the different collection procedures for cortisol. Kox et al . [ 10 ] collected cortisol from blood while Petraskova Touskova et al . [ 12 ] collected hair cortisol.

Four trials examined HR recordings [ 6 , 8 , 10 , 15 ]. Kox et al . [ 10 ] showed an increase in HR after starting WHBM which normalised faster in WHM-trained group compared to non-trained group [ 10 ]. Furthermore, Bahenský et al . [ 6 ] reported that HR tended to be lower after WHBM compared to no WHBM [ 6 ]. Citherlet et al . [ 8 ] also found HR significantly increased during hyperventilation (HV) and significantly decreased during breath hold in participants practising WHBM when compared to resting values [ 8 ]. Similarly, Zwaag et al . [ 15 ] observed a significant increase in HR in both CBR (p<0.001) and BRT (p<0.001) groups, during the first hyperventilation cycle, compared to the CON group. No changes in HR responses between CEX and CON groups (p = 0.89) were found during the endotoxemia experiment. The HR measurements of BRT and CBR groups were comparable to those of CEX and CON groups when WHBM was stopped [ 15 ]. In conclusion, HR was increased when WHBM was initiated and decreased when WHBM was stopped compared to control group.

Pro-inflammatory/anti-inflammatory responses

Two trials investigated cytokines levels during endotoxemia experiment [ 10 , 15 ]. In Kox et al . study [ 10 ], TNF-α, interleukin-6, and interleukin-8 levels were significantly lower in WHM-trained participants, whilst interleukin-10 levels were significantly higher (TNF-α, interleukin-6 and interleukin-8 levels were 53%, 57%, and 51% lower respectively; interleukin-10 levels were 194% higher) compared to non-trained group [ 10 ]. Similarly, Zwaag et al . endotoxemia study [ 15 ], found TNF-α (p = 0.03), interleukin-6 (p = 0.03), and interleukin-8 (p<0.001) levels significantly lower, whereas interleukin-10 levels significantly higher (p = 0.02) in CBR group than CON group. However, similar but less pronounced effects on cytokine levels were found when comparing BRT group to CON group for interleukin-6 (p = 0.04) and interleukin-8 (p = 0.02), but not for interleukin-10 (p = 0.17). Additionally, CEX group did not show any significant changes in TNF-α (p = 0.93), interleukin-6 (p = 0.73), interleukin-8 (p = 0.99), and interleukin-10 (p = 0.44) levels compared to CON [ 15 ]. Both studies found similar results although there was a difference in WHBM. Kox et al . [ 10 ] performed WHBM with retention, while Zwaag et al . endotoxemia study [ 15 ] performed WHBM without retention.

Inflammation outcomes were also measured in participants with axial spondyloarthritis. During the 8-week WHM training, ESR, median BASDAI, ASDAS-CRP, and serum calprotectin decreased significantly (p = 0.040, p = 0.012, p = 0.044, p = 0.064 respectively) compared to participants not receiving WHM training. However, no statistical significance was found in hs-CRP between both groups (p = 0.103) [ 7 ].

Metabolites response

Zwaag et al . [ 16 ] showed that lactate and pyruvate play an important role in the anti-inflammatory response in WHM-trained participants. High pyruvate concentration, but not lactate concentration, increased endotoxemia-induced interleukin-10 production, and the combination of both metabolites resulted in an even more prominent and statistically robust increase. Although these two metabolites were highly intercorrelated (p<0.0001), they were not associated with the highly elevated epinephrine levels at any of the examined time points (p-values>0.15). Additionally, pyruvate reduced the production of interleukin-6. Lactate, pyruvate, and the two metabolites combined also tended to reduce endotoxemia-induced TNF-α production; however, significance was not achieved [ 16 ]. In Kox et al . study [ 10 ], lactate levels were significantly higher but not to a clinically relevant level in WHM-trained compared to non-trained participants [ 10 ].

Respiratory parameters

Three papers measured V E [ 6 , 8 , 11 ] and two of them also measured V T and BF [ 6 , 11 ]. All three papers were investigating whether performing WHBM before an exercise will improve performance. Bahenský et al . [ 6 ] found the difference in mean values at each load to be significant for V E [ 6 ] and Citherlet et al . [ 8 ] found a significant difference (p = 0.039) between participants performing spontaneous breathing (SB) and WHBM at rest, but the mean difference was not statistically significant after performing an exercise (p>0.05) [ 8 ]. Additionally, Marko et al . [ 11 ] showed that at each load stage, V E depicted statistical insignificance between WHBM and normal breathing (p = 0.138, p = 0.825, p = 0.479, p = 0.489) [ 11 ]. Furthermore, for V T and BF measurements, Bahenský et al . [ 6 ] found the difference in mean values at each load to be significant (p<0.001, p<0.001) [ 6 ]; however, Marko et al . [ 11 ] showed no statistical significance between WHBM participants and normal breathing at any load stage (V T : p = 0.630, p = 0.377, p = 0.688, p = 0.087; BF: p = 0.794, p = 0.917, p = 0.956, p = 0.296) [ 11 ].

Blood gas measurements

Two trials examined blood gas measurements [ 10 , 15 ]. In Kox et al . study [ 10 ], starting the WHBM resulted in an immediate and profound decrease in pCO 2 and an increase in pH, but it was not stated if these changes were statistically significant. Furthermore, during WHBM training, the trained group’s oxygen saturation decreased significantly [ 10 ]. In contrast, Zwaag et al . endotoxemia study [ 15 ], found pH and oxygen saturation levels significantly higher in the groups performing WHBM (BRT: p<0.01, p<0.001; CBR: p<0.01, p<0.001 respectively) when compared to CON. Whereas, pCO 2 was significantly lower in the same groups (BRT: p<0.001; CBR: p<0.001) when compared to CON [ 15 ]. In Zwaag et al . breathing exercises study [ 15 ], oxygen saturation significantly decreased at the end of each retention phase, only when WHBM is performed with retention (p<0.001) compared to without retention. While pH and pCO 2 were similar in both WHBM exercises, except for a small but statistically significant difference at the final measurement time point (pH: p<0.001; pCO 2 : p<0.001) [ 15 ].

Psychological response

One paper [ 13 ] investigated the effect of optimism and neuroticism on WHM. It found that a higher level of expectancy and optimism helped significantly potentiate the effect of WHM while a decrease in neuroticism level was not found to significantly help. Participants in the training group were overall relatively optimistic and low in neuroticism. A higher level of optimism was associated with higher interleukin-10 levels (p<0.05) and epinephrine levels (p<0.01). Neuroticism was not found to be a significant predictor of endotoxin response. Participants’ expectations to overcome the endotoxemia experiment significantly increased from before WHM training to after the endotoxemia experiment (p = 0.003) [ 13 ].

Another paper [ 7 ] explored the quality of life of participants and found that SF-36 physical and mental component scores significantly increased over the WHM-training period (p = 0.004, p = 0.004 respectively) compared to the non-trained group. While EQ-5D and EQ-5D visual analogue scale did not experience a significant change between the WHM-trained and non-trained groups (EQ-5D: p = 0.933, p = 0.102; EQ-5D visual analogue scale: p = 0.090, p = 0.674) [ 7 ].

The last paper [ 8 ] reported the results of a customised questionnaire, used for the subjective examination of the three sessions, and Borg RPE scale. Positive effects of increased energy, less fatigue, and improved breathing were reported by 87% of the participants. Almost half of the participants (47%) also said they would think about incorporating the WHBM into their own practices in the future. Additionally, when the experiment was performed using the WHBM, 66.7% of participants rated it the best method in terms of perceived performance compared to 13.3% for SB and 20% for HV. Likewise, 73.3% of participants judged the WHBM to be the best method to perform, while 53.3% judged SB as the worst. However, 33% of the participants using WHBM reported negative effects of deafness and heaviness [ 8 ]. Moreover, Borg RPE score was found significantly lower in Bahenský et al . (p<0.001) [ 6 ] and Citherlet et al . (WHBM compared to HV (p = 0.008) and SB (p = 0.017)) [ 8 ], meaning that the perceived intensity of a training session is less when WHM is being used [ 6 , 8 ].

Reporting of symptoms

Three papers reported experience of flu-like symptoms following endotoxemia administration [ 10 , 13 , 15 ]. Kox et al . [ 10 ] reported lower flu-like and self-reported symptoms and faster recovery from fever in participants performing WHM [ 10 ]. Similarly, Middendorp et al . [ 13 ] showed that a higher expectation of the training’s effects was associated with lower flu-like clinical symptoms (p<0.01) compared to non-trained group [ 13 ]. Likewise, Zwaag et al . endotoxemia study [ 15 ] results showed that only CEX group had significantly lower flu-like symptoms (p = 0.017) compared to CON group. All other groups had comparable peak symptom scores to CON group (BRT: (p = 0.70); CBR: (p = 0.21)). Additionally, when compared to the CON group, symptoms disappeared considerably faster in all three intervention groups (BRT: p<0.001; CEX: p = 0.01; CBR: p = 0.002) [ 15 ]. Overall all participants reported flu-like symptoms but it was significantly lower in participants practising WHM or any one of its pillars such as CEX. The flu-like symptoms also disappeared faster in these participants.

Two papers also reported depressive symptoms [ 7 , 12 ]. Petraskova Touskova et al . [ 12 ] found that at the end of the expedition, depressive symptoms were significantly lower in the WHM-trained group compared to non-trained group (p = 0.03), while TSC-40 scores, which measures stess-related symptoms, were higher in the non-trained group, but not significantly [ 12 ]. Additionally, Buijze et al . [ 7 ] found no significant effect on depressive symptoms between WHM-trained and non-trained groups [ 7 ].

This is the first systematic review conducted on WHM. The findings of this review suggest that WHM may affect the reduction of inflammation in healthy and non-healthy participants. In addition, there are currently mixed findings on the effect of WHBM and exercise performance. Despite the statistical significance observed in some studies, it must be noted that the quality of the studies is very low, meaning that all the results must be interpreted with caution. Additionally, the low sample size (15–48 individuals per study) and large proportion of males in the studies (86.4%) make the results non-generalizable to the public. Consideration should also be given that participants might experience the placebo effect, where improvements in patients’ symptoms are due to their participation in the therapeutic encounter, with its rituals, symbols, and interactions [ 27 ]. For example, Middendorp et al . [ 13 ] found that a higher level of expectancy and optimism helped significantly potentiate the effect of WHM [ 13 ]. However, Zwaag et al . [ 15 ] who queried the so-called ‘guru effect’ [ 28 ] and whether it is necessary to be trained by the creator of the intervention to influence symptomatology [ 15 ], found that observed physiological and immunological effects are independent from the individual who provides the WHM treatment intervention.

Out of all the categories, WHM appears to have the most benefit in the stress and pro-inflammatory/anti-inflammatory response categories. Inflammation, especially when chronic, can cause severe complications such as cardiovascular diseases, cancer, diabetes, rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, alzheimer, chronic kidney disease, and inflammatory bowel disease, therefore, reducing inflammation is beneficial [ 29 ]. The WHM reduces inflammation using a different mechanism of action (MOA) than other anti-inflammatory interventions. The closest MOA to that of WHM is corticosteroids’ MOA as they both increase interleukin-10 production. WHM increases epinephrine, causing an increase in interleukin-10 which leads to a reduction in pro-inflammatory cytokines [ 10 , 15 ]. Whereas corticosteroids activate anti-inflammatory genes, including interleukin-10 gene, and inactivate multiple inflammatory genes by inhibiting histone acetyltransferase and recruiting histone deacetylase-2 activity to the inflammatory gene transcriptional complex [ 30 ]. The findings of this review suggest that WHM may provide some benefits in healthy and non-healthy people as it was suggested to be safe and might decrease inflammation, unlike corticosteroids, which are only given to non-healthy people due to having many side effects.

WHBM effect on exercise performance category showed mixed results. Although it is too early to decide whether WHBM enhances the performance or not, WHBM could have other potential applications in the physical exertion category. For example, a published letter suggests that WHBM may be helpful in preventing and reversing symptoms of acute mountain sickness (AMS) [ 31 ]. Wim Hof and a combination of healthy and non-healthy participants climbed a mountain using the WHBM in 2 days instead of the usual 4–7 days and none of the participants suffered from severe AMS. These findings suggest that a trial on this topic may be of importance, especially for the rescue teams that must ascend quickly [ 31 ]. However, although this letter was published in a journal, it was not peer-reviewed and there was no control group; hence the results should be interpreted with caution. Further studies on the effect of WHBM and physical exertion must be conducted before drawing a conclusion.

There are three pillars to WHM: cold exposure, WHBM, and meditation. The latter is a foundation of the other two pillars, thus there were no studies testing it by itself. In this review, cold exposure alone was suggested to have an insignificant effect on epinephrine and cytokine levels [ 15 ]. Similarly, the wider literature agrees with this finding. For example, cold water immersion (CWI) did activate the immune system and alter systematic inflammation but not significantly [ 32 – 35 ]. Only one study found CWI helpful in reducing inflammation in rock climbers by reducing vessel permeability toward the site of inflammation [ 36 ]. Furthermore, in this review, WHBM alone was claimed to significantly increase epinephrine levels, regardless of the duration of training or trainer, and that increase was more prolonged in participants performing WHBM with retention [ 15 ]. On the other hand, cytokine levels were only measured in participants performing WHBM without retention. There were no trials comparing WHBM with retention alone on cytokine levels. When WHBM was performed without retention, pro-inflammatory cytokines significantly decreased, but interleukin-10 levels were not increased significantly [ 15 ]. This might be because hypoxia improves interleukin-10 release and reduces the pro-inflammatory response via improved adenosine release [ 37 ]. Thus, it would be interesting for future trials to investigate the effects of WHBM with retention alone on cytokine levels. Nevertheless, when cold exposure was combined with WHBM, regardless of whether it was with retention or without, statistical significance was achieved on epinephrine and cytokine levels [ 10 , 15 ]. Therefore, it is probably best to perform all the pillars of WHM to achieve a significant improvement in immunomodulatory effects. Future trials should investigate whether there is a significant difference between performing WHBM with retention and cold exposure compared to WHBM without retention and cold exposure on epinephrine and cytokine levels.

This review suffers from several limitations. Firstly, only two bibiographic databases were searched to identify suitable papers for this review. Including the database EMBASE, as recommended for inclusion in systematic reviews by Bramer et al . [ 38 ] may have increased the reach of the search and identified further relevant papers on this topic. Secondly, the search strategy keywords used such as breathing exercise, breathing technique, cold temperature, cold exposure, and cold shower may have excluded studies that used words combined with breathing and cold other than these words. Using breathing and cold as search words alone may have identified further relevant studies. Thirdly, the outcomes were very heterogeneous as many unrelated outcomes are included. This review could have focused on synthesising specific outcomes such as only focusing on outcomes related to stress and inflammation. Fourthly, all the trials had a very high risk of bias. This was due to the lack of a prior published protocol, small sample size, and complexity of blinding the participants and outcome assessors to the intervention. Furthermore, some outcomes such as psychological outcomes were difficult to measure as they are subjective measures usually assessed using a questionnaire. Since the participants were not blinded, it was very difficult to ensure that the answers were honest and valid to the experience. Lastly, the sample size was very small, sometimes affecting the results as any error in measurement or a loss of follow-up can significantly shift the trial results. More evidence needs to be synthesised about WHM before being recommended to the public. An intervention like WHM presents a challenge for rigorous experimental research as participants cannot be blinded to a WHM intervention, therefore the gold standard approach of a double-blinded RCT is not possible. It does appear to offer benefits in attenuating inflammation with minimal serious adverse events and good positive effects of increased energy, less fatigue, and improved breathing [ 7 , 8 , 10 , 15 ]. Thus, WHM can probably be used within lifestyle medicine to decrease inflammation in people suffering from inflammatory disorders. However, to be able to recommend WHM in an unwell population, future trials should publish a protocol outlining their experiment before starting the trial, increase the sample size, and make sure to account for loss to follow-up. Additionally, researchers should make sure to blind outcome assessors, and ensure that the outcomes assessed are objective and not subjective.

Considering all the studies, the WHM may produce promising immunomodulatory effects but more research of higher quality is needed to substantiate this finding. The combination of cold exposure and WHBM appeared to most effectively reduce the inflammatory response. Hence, all the pillars of the WHM are important to extract the benefits. The focus of future studies should further investigate the benefits of WHM in preventing or treating diseases, such as inflammatory disorders, in non-healthy participants and explore the use of WHBM in enhancing exercise performance. Studies about WHM have not yet investigated all the beneficial claims the WHM states to have. Future studies may provide valuable insights about WHM as there is still much to explore.

Supporting information

S1 checklist. prisma 2009 checklist..

https://doi.org/10.1371/journal.pone.0286933.s001

S1 Table. SIGN tool assessment.

https://doi.org/10.1371/journal.pone.0286933.s002

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