替代药物治疗焦虑的安慰剂效应:虚假的希望还是治愈的潜力?

IF 4.1 3区 医学 Q2 CLINICAL NEUROLOGY
Álex Escolà-Gascón, Neil Dagnall, Kenneth Drinkwater, Abdrew Denovan, Julián Benito-León
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引用次数: 0

摘要

目的:研究愈合晶体导致的焦虑减少是否反映了由条件反射和信念相关偏见驱动的安慰剂反应,而不是特定的治疗效果。方法:在一项随机对照研究中,138名成年人被分为相信水晶疗效或不相信水晶疗效的两组,并被分配使用玫瑰石英(实验性)或视觉上匹配的安慰剂。参与者遵循标准化的14天方案。用贝克焦虑量表和西班牙科威特大学焦虑量表评估干预前后的焦虑。使用多水平方差分析(ANOVA)和贝叶斯模型来评估主要效应、相互作用和治疗特异性的证据。结果:焦虑减少只发生在信徒中,与水晶分配无关。各组之间的主要结果没有发现差异,并且改善的程度没有超过安慰剂反应的典型程度。贝叶斯估计倾向于对特定治疗效果的零假设。既存信念强有力地预测了感知到的疗效和症状变化,这与由条件反射机制形成的因果幻觉一致。非信徒没有表现出可靠的改善。结论:愈合晶体没有表现出比安慰剂更强的抗焦虑作用。症状变化是由期望和条件作用介导的,特别是在倾向于直觉或神奇思维的个体中。尽管非特异性的、环境相关的因素(如治疗联盟的元素)可能会在临床环境中增强安慰剂的反应性,但这些发现并不支持将晶体的固有治疗价值归因于此。未来的工作应该描述期望、医患关系和相关变量如何相互作用以形成安慰剂反应,以及这些机制如何在不促进伪科学实践的情况下在伦理上加强循证护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Placebo effects in alternative medical treatments for anxiety: false hope or healing potential?

Objective: To investigate whether anxiety reductions attributed to healing crystals reflect placebo responses driven by conditioning and belief-related biases rather than specific therapeutic effects.

Methods: In a randomized, controlled study, 138 adults were classified as believers or nonbelievers in crystal efficacy and assigned to rose quartz (experimental) or a visually matched placebo. Participants followed a standardized 14-day protocol. Anxiety was assessed pre- and post-intervention with the Beck Anxiety Inventory and the Spanish Kuwait University Anxiety Scale. Multilevel analyses of variance (ANOVA) and Bayesian models were used to evaluate main effects, interactions, and evidence for treatment specificity.

Results: Anxiety reductions occurred only among believers, regardless of crystal assignment. No differences were detected between groups in primary outcomes, and improvements did not exceed the magnitudes typically associated with placebo responses. Bayesian estimates favored the null hypothesis for specific treatment effects. Preexisting belief strongly predicted perceived efficacy and symptom change, consistent with causal illusions plausibly shaped by conditioning mechanisms. Nonbelievers showed no reliable improvement.

Conclusion: Healing crystals did not demonstrate anxiolytic effects beyond those of the placebo. Symptom change was mediated by expectancy and conditioning, particularly in individuals inclined toward intuitive or magical thinking. Although nonspecific, context-dependent factors-such as elements of the therapeutic alliance-may amplify placebo responsiveness in clinical settings, these findings do not support attributing inherent therapeutic value to crystals. Future work should delineate how expectations, clinician-patient rapport, and related variables interact to shape placebo response and how such mechanisms might be ethically leveraged to enhance evidence-based care without promoting pseudoscientific practices.

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来源期刊
CNS Spectrums
CNS Spectrums 医学-精神病学
CiteScore
6.20
自引率
6.10%
发文量
239
审稿时长
>12 weeks
期刊介绍: CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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