Weng Lingling, Peerdeman Kaya J, van Laarhoven Antoinette I M, Evers Andrea W M
School of Psychology, Shenzhen University, Shenzhen, China.
Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands.
Eur J Pain. 2025 Jul;29(6):e70018. doi: 10.1002/ejp.70018.
Placebo and nocebo effects are beneficial or adverse treatment outcomes upon administration of inert treatment components. These effects have been frequently studied on pain. It remains unclear to what extent generalisation occurs in these effects on pain and other somatic sensations. This review outlines the current knowledge on stimulus generalisation (i.e., generalisation over various stimuli) and response generalisation (i.e., generalisation over various responses) of placebo and nocebo effects on prevalent somatic sensations (i.e., pain, itch, dyspnea, nausea and fatigue).
The databases PubMed, Web of Science and PsycINFO were systematically searched for peer-reviewed articles reporting on experimental studies in humans of the induction and generalisation of placebo and nocebo effects on prevalent somatic sensations.
Of 2025 records identified, 23 studies were included. These studies indicated that placebo and nocebo effects can generalise over stimuli (at perceptual, categorical and treatment levels) and over responses within modalities. Most studies investigated pain; fewer studies investigated itch, dyspnea, nausea and fatigue. Generalisation effects tend to be larger when the generalisation stimuli and responses more closely resemble the initial stimulus or response. Generalisation was more likely if a combination of verbal suggestion and conditioning was employed to induce placebo or nocebo effects than if either suggestion or conditioning was employed alone. Response generalisation across modalities remains unclear.
Placebo and nocebo effects can generalise over stimuli and responses. More experimental and clinical research is warranted to address carryover effects of placebo and nocebo effects.
The current review provides an overview of the literature on the generalisation of placebo and nocebo effects to diverse stimuli and responses. This can ultimately benefit healthcare providers to prevent carryover effects of treatment failure and harness carryover effects of treatment success.
安慰剂和反安慰剂效应是在给予惰性治疗成分时产生的有益或不良治疗结果。这些效应在疼痛方面已得到广泛研究。目前尚不清楚这些效应在疼痛和其他躯体感觉上的泛化程度。本综述概述了关于安慰剂和反安慰剂效应在常见躯体感觉（即疼痛、瘙痒、呼吸困难、恶心和疲劳）上的刺激泛化（即对各种刺激的泛化）和反应泛化（即对各种反应的泛化）的现有知识。
系统检索了PubMed、Web of Science和PsycINFO数据库，以查找关于安慰剂和反安慰剂效应在常见躯体感觉上的诱导和泛化的人体实验研究的同行评审文章。
在识别出的2025条记录中，纳入了23项研究。这些研究表明，安慰剂和反安慰剂效应可以在刺激（在感知、类别和治疗水平）以及模态内反应上进行泛化。大多数研究调查了疼痛；较少研究调查了瘙痒、呼吸困难、恶心和疲劳。当泛化刺激和反应与初始刺激或反应更相似时，泛化效应往往更大。与单独使用言语暗示或条件作用相比，联合使用言语暗示和条件作用来诱导安慰剂或反安慰剂效应时，泛化更有可能发生。跨模态的反应泛化仍不明确。
安慰剂和反安慰剂效应可以在刺激和反应上进行泛化。需要更多的实验和临床研究来解决安慰剂和反安慰剂效应的遗留效应。
本综述提供了关于安慰剂和反安慰剂效应向不同刺激和反应泛化的文献综述。这最终可以使医疗保健提供者受益，以预防治疗失败的遗留效应并利用治疗成功的遗留效应。
