Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado 80309.
Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755.
Annu Rev Clin Psychol. 2017 May 8;13:73-98. doi: 10.1146/annurev-clinpsy-021815-093015. Epub 2017 Mar 27.
Placebos are sham medical treatments. Nonetheless, they can have substantial effects on clinical outcomes. Placebos depend on a person's psychological and brain responses to the treatment context, which influence appraisals of future well-being. Appraisals are flexible cognitive evaluations of the personal meaning of events and situations that can directly impact symptoms and physiology. They also shape associative learning processes by guiding what is learned from experience. Appraisals are supported by a core network of brain regions associated with the default mode network involved in self-generated emotion, self-evaluation, thinking about the future, social cognition, and valuation of rewards and punishment. Placebo treatments for acute pain and a range of clinical conditions engage this same network of regions, suggesting that placebos affect behavior and physiology by changing how a person evaluates their future well-being and the personal significance of their symptoms.
安慰剂是虚假的医疗处理方法。尽管如此，它们对临床结果仍有显著影响。安慰剂取决于一个人对治疗环境的心理和大脑反应，这些反应会影响对未来幸福感的评估。评估是对事件和情况的个人意义的灵活认知评价，这些评价会直接影响症状和生理。它们还通过指导从经验中学习的内容来塑造联想学习过程。评估由与默认模式网络相关的大脑区域的核心网络支持，该网络涉及自我产生的情绪、自我评估、对未来的思考、社会认知以及对奖励和惩罚的估值。针对急性疼痛和一系列临床病症的安慰剂治疗会涉及到这个相同的区域网络，这表明安慰剂通过改变一个人对未来幸福感的评估以及对其症状的个人意义来影响行为和生理。
