关于安慰剂效应的研究

安慰剂效应是指由安慰剂所引起的可观察的行为.本文讨论了安慰剂效应的确切定义,安慰剂效应的强度差异,以及临床背景、患者的人格特质、安慰剂的特征和医患关系等因素对安慰剂效应的影响.目前研究者普遍认为安慰剂效应通过期待和条件作用产生.近期的一个研究热点是疼痛和帕金森氏症背景下期待引起的安慰剂效应的神经机制.     

安慰剂效应研究实验设计的历史和发展

安慰剂处理从最初作为研究某种真实治疗效应的控制条件, 已演变为研究者直接关注的研究目标, 其实验范式也发生了相应变化。双盲随机设计关注真实的治疗是否优于安慰剂处理; 欺骗设计直接比较安慰剂处理效应和自然历史效应的差异, 关注安慰剂效应本身; 公开隐藏设计通过计算公开治疗效应和隐藏治疗效应之差来估计安慰剂效应的大小; 平衡范式可同时观察安慰剂效应和真实治疗效应; 强化范式通过条件性强化获得加强的安慰剂效应, 是研究其作用机制的优化方案; 本课题组建立的迁移强化范式, 研究安慰剂效应从痛觉到情绪的迁移, 是强化范式的重要补充。     

希望的代际传递效应:教养方式的中介作用

为探索希望在父母与学前儿童之间的代际传递效应,以及父母教养方式在其中的中介作用,使用成人特质希望量表、儿童希望量表(他评版)及教养方式问卷对1034名学前儿童的家长进行了调查。结果表明,父母希望显著正向预测儿童希望,教养方式在其中起部分中介作用,且这一中介模型对于父亲和母亲完全等价。说明希望存在代际传递性;希望水平高的父母更倾向于采取积极的教养方式,进而提升学前儿童的希望水平;并且父亲和母亲以相同的模式将希望通过教养方式的中介作用传递给儿童。     

临床工作中应重视“安慰剂”效应

目前我国临床工作中对“安慰剂”效应重视不够。“安慰剂”效应建立在患者对医生的信任之上。生物医学模式重视疾病的生物学意义而忽视社会、心理因素的影响,导致医生对患者态度冷漠,患者对医生缺乏信任,已成为我国医患关系恶化的重要原因,继而弱化了医疗的“安慰剂”效应。推行生物-心理-社会医学模式,提倡临床工作以人为本而非以疾病为主,建立医患共赢的医疗体制,改善医疗环境,有利于产生和加强临床工作的“安慰剂”效应,切实促进医疗和谐。     

临床工作中应重视"安慰剂"效应

目前我国临床工作中对"安慰剂"效应重视不够."安慰剂"效应建立在患者对医生的信任之上.生物医学模式重视疾病的生物学意义而忽视社会、心理因素的影响,导致医生对患者态度冷漠,患者对医生缺乏信任,已成为我国医患关系恶化的重要原因,继而弱化了医疗的"安慰剂"效应.推行生物-心理-社会医学模式,提倡临床工作以人为本而非以疾病为主,建立医患共赢的医疗体制,改善医疗环境,有利于产生和加强临床工作的"安慰剂"效应,切实促进医疗和谐.     

The structure of the State Hope Scale

The present research aimed to examine the factorial structure of the State Hope Scale (SHS). In Study 1, using confirmatory factorial analyses, two factorial structures were contrasted: a single-factor mode (representing a general hope construct) and a second-order factor model (with general hope characterized by agency and pathways). Results revealed that the two-factor model was more likely to be replicated. Furthermore, invariance analyses revealed that the two-factor structure applied equally across age groups and gender. In Study 2, the factorial structure of the SHS was evaluated again. Once more, results confirmed the superiority of the two-factor model. In addition, hope was positively linked to mental health.     

The Dark Night of Hope

This essay discusses the nature of hope and despair, and the difficulties of responding to the aged who have nothing left .. to hope for. Based in pan on the writings of Gabriel Marcel, it suggests that one can hope when reasons for doing so are insufficient or lacking. It characterizes this kind of hope, absolute or unconditional hope, as a mystery, and suggests that to respond to the failing aged we must put aside efforts to find reasons to hope in order to participate in its mystery. The essay challenges the idea that hope is a private, isolated act of the will and insists that it always occurs between persons.     

The Science and Ethics of Placebo in Pediatric Psychopharmacology

Pediatric psychopharmacology is a relatively new science. Although the use of psychotropic medications in children has risen in the past decade, there are few standard treatments for serious psychiatric or developmental disorders of childhood. The relative absence of standard treatments is further complicated by the fact that many of the agents used in pediatric psychopharmacology have been adapted from other fields. Therefore, investigators have a responsibility to make incremental progress from concept through pilot studies and large-scale, multisite efficacy and safety trials. Thus, although there is a pressing need to conduct medication trials that can guide clinical practice, there are scientific and ethical considerations to bear in mind when designing clinical trials in pediatric psychopharmacology. This article reviews essential ethical and scientific issues that are relevant to designing clinical trials in children with psychiatric and developmental disorders. Using examples from recently published literature, the article describes the challenges and pitfalls of various clinical trial study designs. The application of sound ethical and scientific principles is necessary to ensure that clinical trials are properly conducted and to guard against ambiguous results that can not guide practice.     

音乐对希望感的影响

过去的研究发现,在经历挫折后,相比于不听音乐,听积极音乐能提升人们的希望感。然而,研究者并不清楚积极音乐和消极音乐在提升希望感上是否存在差异,也不清楚这种差异是否由于两种音乐在诱发的积极情绪或消极情绪的差异造成的。文章通过三个实验来考察这些问题。实验一发现,在无挫折的情况下,积极音乐相比消极音乐诱发了更强的希望感。实验二发现,这种效应同样存在于人们回忆挫折之后,并且是积极情绪在其中起中介作用。实验三则通过设置控制组进一步发现,这种效应是由积极音乐对希望感的提升作用和消极音乐对希望感的降低作用共同引起的。文末讨论了该发现的意义。     

Placebo and criminal law

This article considers issues concerning cases where the use of placebo is lawful or is not lawful under aspects of German criminal law. It will differentiate between cases of individual therapy and cases of supervised experiments within the scope of medical tests. Thereby, it reveals that a medication of placebo with regard to an individual patient seems to be lawful if there is no alternative possibility of a better treatment using a chemically effective medicine and if the limits of presumed consent are complied with. On the other hand, in the context of the supervised experiment, the assignment of a patient to a group treated with placebo is only lawful if the patient has been fully informed about the possibilities of a treatment and if the patient has given consent to it. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003. The author’s interests include International Criminal Law, Comparative Criminal Law and Philosophy of Law.     

Raising Hope: Hope Inducement and Voter Turnout

Politicians routinely invoke hope on the campaign trail, presumably because they believe that inducements of hope attract supporters and impel citizens to the polls. Social psychologists and political scientists similarly posit that activating positive emotions like hope and other powerful psychological mechanisms has the capacity to stimulate prosocial behavior, like voting in elections. In this study, I subject these claims to empirical scrutiny by designing and implementing a series of randomized field experiments to examine whether inducing hope raises electoral participation. Overall, I find little evidence that hope affects voting behavior, but I acknowledge the null effects may reflect the [im]potency of the treatment.     

Hope Against Hope in Cancer at the End of Life

Hope has many facets to it in the context of cancer. This article outlines an instrumental case study for a patient with aggressive lymphoma who rapidly deteriorated to the point of dying. How her and her family’s hope was managed is outlined here from various perspectives. Interviews were carried out with the patient’s family, medical consultant-in-charge (attending physician) and nurses caring for her at the end of life. The findings outline the transition from hope for cure to hope for a good death and the role that the patient and family’s Christian hope played in this. Religiosity and spirituality of hope in terms of Christian hope is explored from the theological perspective. Practical aspects of care in the face of changing hope are discussed. Conclusions are drawn about reframing hope in a changing clinical situation with reference to theories of hope. The importance of acknowledging hope, coping, spirituality and religiosity, especially at end of life, is emphasised.     

“尚未存在”与“希望哲学”

批判传统的形而上学,是现代西方哲学的主要任务之一.然而,不同的哲学派别及其哲学家都提出了自己的批判理由.比如,分析哲学用“证实原则”来拒斥形而上学,海德格尔用“有根的存在论”来声讨“无根的本体论”.本文所论述的布洛赫的“希望哲学”,则是从“尚未存在”出发指责传统哲学的停滞和保守.作为一个典型的理想主义哲学家,布洛赫力图伸张哲学思考的未来向度,用以证明实现人类自由王国的可能性.     

The Neural Bases of Placebo Effects in Pain

Abstract— Placebo effects are beneficial effects of treatment caused not by the biological action of the treatment but by one's response to the treatment process itself. One possible mechanism of placebo treatments is that they create positive expectations, which change one's appraisal of the situation and may thereby shape sensory and emotional processing. Recent brain-imaging evidence suggests that placebo-induced expectations of analgesia increase activity in the prefrontal cortex in anticipation of pain and decrease the brain's response to painful stimulation. These findings suggest that placebo treatments can alter experience, not just alter what participants are willing to report about pain. To the extent that they involve neural systems mediating expectancy and appraisal, placebo effects in pain may share common circuitry with placebo effects in depression, Parkinson's disease, and other disorders.     

The Great Black Hope: Hope and Its Relation to Suicide Risk among African Americans

Positive psychology has garnered considerable scholarly interest recently and has been suggested to hold promise in the application to suicide research and prevention; however, empirical research has lagged behind these suggestions. This is the first study to examine the relationship between hope and a specific theory of suicide in African Americans. It was hypothesized that (1) hope would negatively predict the interpersonal suicide risk factors of burdensomeness and thwarted belongingness; and positively predict acquired capability to enact suicide; (2) hope would negatively predict suicidal ideation; and (3) the interpersonal suicide risk factors would predict suicidal ideation. Results were primarily as predicted. Implications for hope theory and Joiner's theory of suicidal behavior are discussed, as well as implications for clinical practice.