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十,安慰劑效應似乎在增強
奇怪的是,近年來安慰劑效應似乎有增強的趨勢,這一點在抗精神病葯[24]、抗抑鬱葯[25]和鎮痛劑[26]上都有表現。
其中鎮痛劑的安慰劑效應只是在美國變強。研究組長傑弗里·莫吉拉(Jeffrey Mogil)對《自然新聞》表示:「發現這個效應,我們都驚呆了。」具體來說,在90年代,他們發現服用有效藥物的被試報告疼痛緩解的比例比服用安慰劑的被試高出27%,但是到了2013年,這個差距已經縮小到了9%。一個解釋是新葯試驗變得規模更大更精細,尤其是在美國,因此服用安慰劑的被試也體驗到了更多戲劇性和緊張感。
另一種可能是,公眾對於安慰劑效應更了解了,也知道了它真的可以影響癥狀(比如減少和疼痛有關的腦活動),而不僅僅是錯覺。去年的《疼痛》期刊上,麻醉學家蓋瑞·本內特(Gary Bennett)就提出了這個觀點[27]。他甚至主張,鑒於「安慰劑」這三個字會引起如此強烈的安慰劑效應,藥物試驗中應不再使用,給病人的說明和指導文字中應一律避免「安慰劑」的說法。
沒準成本更低而效果更好。|Chris Madden
無論如何,安慰劑效應將繼續存在,不管我們多麼努力地控制、隱藏和理解它。在未來很長的時間裡,它肯定會繼續使我們既困惑又驚奇。(編輯:游識猷)
參考資料
Kaptchuk, T. J., Friedlander, E., Kelley, J. M., Sanchez, M. N., Kokkotou, E., Singer, J. P., … Lembo, A. J. (2010). Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE, 5(12), e15591. https://doi.org/10.1371/journal.pone.0015591
Carvalho, C., Caetano, J. M., Cunha, L., Rebouta, P., Kaptchuk, T. J., & Kirsch, I. (2016). Open-label placebo treatment in chronic low back pain. PAIN, 157(12), 2766–2772. https://doi.org/10.1097/j.pain.0000000000000700
Schaefer, M., Sahin, T., & Berstecher, B. (2018). Why do open-label placebos work? A randomized controlled trial of an open-label placebo induction with and without extended information about the placebo effect in allergic rhinitis. PLOS ONE, 13(3), e0192758. https://doi.org/10.1371/journal.pone.0192758
Mathur, A., Jarrett, P., Broadbent, E., & Petrie, K. J. (2018). Open-label Placebos for Wound Healing: A Randomized Controlled Trial. Annals of Behavioral Medicine, 52(10), 902–908. https://doi.org/10.1093/abm/kax057
Bannuru, R. R., McAlindon, T. E., Sullivan, M. C., Wong, J. B., Kent, D. M., & Schmid, C. H. (2015). Effectiveness and Implications of Alternative Placebo Treatments. Annals of Internal Medicine, 163(5), 365. https://doi.org/10.7326/m15-0623
Blackwell, B., Bloomfield, S., & Buncher, C. R. (1972). DEMONSTRATION TO MEDICAL STUDENTS OF PLACEBO RESPONSES AND NON-DRUG FACTORS. The Lancet, 299(7763), 1279–1282. https://doi.org/10.1016/s0140-6736(72)90996-8
Faasse, K., Martin, L., Grey, A., Gamble, G., & Petrie, K. (2015). Impact of Brand or Generic Labeling on Medication Effectiveness and Side Effects. Health Psychology DOI: 10.1037/hea0000282
McRae, C., Cherin, E., Yamazaki, T. G., Diem, G., Vo, A. H., Russell, D., … Freed, C. R. (2004). Effects of perceived treatment on quality of life and medical outcomes in a double-blind placebo surgery trial. Archives of General Psychiatry, 61(4), 412–20. https://doi.org/10.1001/archpsyc.61.4.412
Geers, A. L., Wellman, J. A., Fowler, S. L., Helfer, S. G., & France, C. R. (2010). Dispositional optimism predicts placebo analgesia. The Journal of Pain : Official Journal of the American Pain Society, 11(11), 1165–71. https://doi.org/10.1016/j.jpain.2010.02.014
Peciña, M., Azhar, H., Love, T., Lu, T., Fredrickson, B., Stohler, C., and Zubieta, J. (2012). Personality Trait Predictors of Placebo Analgesia and Neurobiological Correlates Neuropsychopharmacology DOI: 10.1038/npp.2012.227
Darragh, M., Booth, R. J., & Consedine, N. S. (2014). Investigating the 『placebo personality』 outside the pain paradigm. Journal of Psychosomatic Research, 76(5), 414–421. https://doi.org/10.1016/j.jpsychores.2014.02.011
Howe, L. C., Goyer, J. P., & Crum, A. J. (2017). Harnessing the placebo effect: Exploring the influence of physician characteristics on placebo response. Health Psychology, 36(11), 1074-1082.http://dx.doi.org/10.1037/hea0000499
Losin, E. A. R., Anderson, S. R., & Wager, T. D. (2017). Feelings of Clinician-Patient Similarity and Trust Influence Pain: Evidence From Simulated Clinical Interactions. The Journal of Pain, 18(7), 787–799. https://doi.org/10.1016/j.jpain.2017.02.428
Morton, R. H. (2009). Deception by manipulating the clock calibration influences cycle ergometer endurance time in males. Journal of Science and Medicine in Sport, 12(2), 332–337. https://doi.org/10.1016/j.jsams.2007.11.006
Rozenkrantz, L., Mayo, A. E., Ilan, T., Hart, Y., Noy, L., & Alon, U. (2017). Placebo can enhance creativity. PLOS ONE, 12(9), e0182466. https://doi.org/10.1371/journal.pone.0182466
Turi, Z., Bjørkedal, E., Gunkel, L., Antal, A., Paulus, W., & Mittner, M. (2018). Evidence for Cognitive Placebo and Nocebo Effects in Healthy Individuals. Scientific Reports, 8(1). https://doi.org/10.1038/s41598-018-35124-w
Draganich C, and Erdal K (2014). Placebo Sleep Affects Cognitive Functioning. Journal of experimental psychology. Learning, memory, and cognition PMID: 24417326
Crum, A.J. & Langer, E.J. (2007). Mind-set matters. Exercise and the placebo effect. Psychological Science, 18, 165-171.
Zahrt, O. H., & Crum, A. J. (2017). Perceived physical activity and mortality: Evidence from three nationally representative U.S. samples. Health Psychology, 36(11), 1017-1025. http://dx.doi.org/10.1037/hea0000531
Keller, A., Akintola, T., & Colloca, L. (2018). Placebo Analgesia in Rodents: Current and Future Research. International Review of Neurobiology, 1–15. https://doi.org/10.1016/bs.irn.2018.02.001
Petersen, G. L., Finnerup, N. B., Colloca, L., Amanzio, M., Price, D. D., Jensen, T. S., & Vase, L. (2014). The magnitude of nocebo effects in pain: a meta-analysis. PAIN, 155(8), 1426-1434.
Bingel, U., Wanigasekera, V., Wiech, K., Ni Mhuircheartaigh, R., Lee, M. C., Ploner, M., & Tracey, I. (2011). The effect of treatment expectation on drug efficacy: imaging the analgesic benefit of the opioid remifentanil. Science Translational Medicine, 3(70), 70ra14. https://doi.org/10.1126/scitranslmed.3001244
Boot, W. R., Simons, D. J., Stothart, C., & Stutts, C. (2013). The pervasive problem with placebos in psychology: Why active control groups are not sufficient to rule out placebo effects. Perspectives on Psychological Science, 8(4), 445-454.
Leucht, S., Arbter, D., Engel, R. R., Kissling, W., & Davis, J. M. (2008). How effective are second-generation antipsychotic drugs? A meta-analysis of placebo-controlled trials. Molecular Psychiatry, 14(4), 429–447. https://doi.org/10.1038/sj.mp.4002136
Dunlop, B. W., Thase, M. E., Wun, C.-C., Fayyad, R., Guico-Pabia, C. J., Musgnung, J., & Ninan, P. T. (2012). A meta-analysis of factors impacting detection of antidepressant efficacy in clinical trials: the importance of academic sites. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 37(13), 2830–6. https://doi.org/10.1038/npp.2012.153
Tuttle, A. H., Tohyama, S., Ramsay, T., Kimmelman, J., Schweinhardt, P., Bennett, G. J., & Mogil, J. S. (2015). Increasing placebo responses over time in U.S. clinical trials of neuropathic pain. Pain, 156(12), 2616–26. https://doi.org/10.1097/j.pain.0000000000000333
Bennett, G. J. (2018). Does the word 「placebo」 evoke a placebo response? PAIN, 159(10), 1928–1931. https://doi.org/10.1097/j.pain.0000000000001269
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