Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland.
Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA.
Sci Rep. 2019 Feb 5;9(1):1421. doi: 10.1038/s41598-018-37945-1.
In recent years, placebos have evolved from a mean to control for 'therapeutic chaff' to something that has clinically relevant effects with biological underpinning and that is considered to have clinical as well as scientific potential. However, the wealth of scientific placebo research is conceptualized in a biomedical context, i.e. based on placebos provided with a biomedical treatment rationale, whereas little is known about effects and mechanisms of placebos provided with a psychological treatment rationale. This has important repercussions not only on placebo research, but also on attempts to establish specificity of psychological interventions, such as psychotherapy. Therefore, we set out to assess the effects and possible components of placebos provided with a psychological treatment rationale in three experiments on healthy subjects. We show that placebos provided with a psychological treatment rationale are effective in short- as well as mid-term, but only when provided by a trustworthy, friendly and empathetic experimenter. These findings indicate that placebos are effective outside the medical context and thus need be controlled for in non-medical trials. Furthermore, it highlights and confirms the importance of a plausible psychological treatment rationale in the context of a therapeutic alliance for psychological interventions, such as psychotherapy.
近年来，安慰剂已经从一种控制“治疗性废话”的手段演变为具有临床相关效应的物质，其具有生物学基础，并被认为具有临床和科学潜力。然而，大量的科学安慰剂研究是在生物医学背景下进行概念化的，即基于具有生物医学治疗原理的安慰剂，而对于具有心理治疗原理的安慰剂的作用和机制知之甚少。这不仅对安慰剂研究有重要影响，而且对试图建立心理干预（如心理治疗）的特异性也有重要影响。因此，我们着手在三项针对健康受试者的实验中评估具有心理治疗原理的安慰剂的效果和可能成分。我们发现，当由值得信赖、友好和富有同理心的实验者提供时，具有心理治疗原理的安慰剂在短期和中期都有效。这些发现表明，安慰剂在医学环境之外是有效的，因此在非医学试验中需要加以控制。此外，这突出并证实了在治疗联盟背景下，对于心理干预（如心理治疗）具有合理的心理治疗原理的重要性。
