Brain Mechanisms of the Placebo Effect: An Affective Appraisal Account
Brain Mechanisms of the Placebo Effect: An Affective Appraisal Account
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DOI：
10.1146/annurev-clinpsy-021815-093015
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发表时间：
2017-01-01
期刊：
影响因子：
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通讯作者：
Wager, Tor D.
中科院分区：
文献类型：
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作者：
Ashar, Yoni K.;Chang, Luke J.;Wager, Tor D.
安慰剂是虚假的医学治疗。尽管如此，它们仍然可以对临床结果产生重大影响。安慰剂取决于一个人对治疗环境的心理和大脑反应，这会影响对未来幸福感的评估。评估是对可直接影响症状和生理的事件和情况的个人意义的灵活认知评估。他们还通过指导从经验中学到的知识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核心网络支持，这些默认模式网络涉及自我产生的情感、自我评价、对未来的思考、社会认知以及奖励和惩罚的评价。用于治疗急性疼痛和一系列临床病症的安慰剂治疗也涉及相同的区域网络，这表明安慰剂通过改变一个人评估其未来健康状况及其症状的个人意义的方式来影响行为和生理学。
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.