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拢合与拆分:走向安慰剂及相关效应的分类学。

Lumping and Splitting: Toward a Taxonomy of Placebo and Related Effects.

机构信息

Distinguished Professor of Psychology, Endicott College, Beverly, MA, United States; Deputy Director, Program in Placebo Studies, Harvard Medical School, Boston, MA, United States.

出版信息

Int Rev Neurobiol. 2018;139:29-48. doi: 10.1016/bs.irn.2018.07.011. Epub 2018 Aug 2.

Abstract

The placebo effect is closely related to many other constructs, including most prominently, conditioning and expectancy, but also natural history, regression to the mean, priming, mindset, context effects, the meaning response, specific and non-specific clinical effects, placebo-related effects, the patient-clinician relationship, and the common factors in psychotherapy. How are these various terms related to one another? To what degree do they overlap, and to what degree do they diverge? To form a better theoretical understanding of these constructs and to foster improved empirical research, is it better to lump these terms together in some fashion? Or will progress best be served by maintaining the splits between the constructs? Or would it perhaps be most effective to employ some mixture of lumping and splitting? I will address these and related questions with two major goals: (1) to delineate and clarify the relationship between these various terms and (2) to suggest some possible re-alignments in the way in which we conceptualize the relationships among these constructs that might prove useful in fostering research on placebo and related effects. In addition, clarifying the interconnections between the placebo effect and other related terms has the potential to spark innovative cross-fertilizations between related areas of research.

摘要

安慰剂效应与许多其他结构密切相关,包括最突出的条件作用和期望,但也包括自然史、均值回归、启动、思维模式、情境效应、意义反应、特定和非特定临床效应、安慰剂相关效应、医患关系以及心理治疗中的共同因素。这些不同的术语之间是如何相互关联的?它们在多大程度上重叠,又在多大程度上相去甚远?为了更好地从理论上理解这些结构,并促进更好的实证研究,最好将这些术语以某种方式合并在一起?还是将这些结构之间的分裂保持下去会取得更好的进展?或者采用合并和分裂的混合方式可能最有效?我将以两个主要目标来解决这些问题和相关问题:(1) 阐明和澄清这些不同术语之间的关系;(2) 提出一些可能的重新调整方式,以概念化这些结构之间的关系,这可能有助于促进安慰剂和相关效应的研究。此外,澄清安慰剂效应与其他相关术语之间的相互联系,有可能在相关研究领域之间引发创新的交叉融合。

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