目的:患者和治疗师的期望被认为是影响实验和治疗环境中安慰剂反应的重要因素。然而,尚未研究促进治疗疗效的常见神经促进剂的安慰剂效应.在本研究中,我们检查了患者的估计,治疗师,和工作人员,关于它们的治疗类型,并评估了它们对催产素促进作用的影响。
方法:患者(N=87)被随机和双盲分配接受催产素或安慰剂,每天两次,为期四周,作为更大的随机化的一部分,双盲,安慰剂对照试验。病人,治疗师和工作人员的期望是根据他们对治疗类型(药物或安慰剂)的估计进行评估。多水平建模和单变量和多元回归分析,以评估患者的影响,治疗师,以及工作人员对治疗结果的估计,超出了治疗类型的影响。
结果:员工,治疗师,患者的估计与治疗结果显著相关。然而,只有治疗师和患者的估计显着预测超过实际管理的改善,治疗师和患者的估计与特质焦虑的改善相关(STAI-T,B=-1.80,p<.05,B=-2.02,p<.05);治疗师的估计与一般痛苦的改善有关(OQ-45,B=-3.71,p<.05),和患者的估计与症状缓解相关(HSCL-11,B=-0.13,p<.05)。总的来说,患者的估计对治疗成功有更高的相对贡献,各尺度的标准化系数范围为-0.06至-0.26。
结论:促进治疗成功的神经生物学因素也受患者和治疗师期望的影响。未来的研究在检查其在住院环境中的影响时应该考虑这些影响。
OBJECTIVE: Patient\'s and therapist\'s expectations are considered an important factor influencing placebo response in experimental and therapeutic settings. Nevertheless, the placebo effects of common neurological facilitators that promote treatment efficacy have not been explored. In the present study we examined the estimations of patients, therapists, and staff members, regarding their treatment type and assessed their influence on the facilitating effects of oxytocin.
METHODS: Patients (N = 87) were randomized and double-blindly allocated to receive either oxytocin or placebo, twice daily for a period of four weeks, as part of a larger randomized, double-blind, placebo-controlled trial. Patient\'s, therapist\'s and staff\'s expectations were assessed based on their estimation of treatment type (agent or placebo). Multilevel modeling and univariate and multivariate regression analysis were performed to assess the effects of patient\'s, therapist\'s, and staff\'s estimations on treatment outcome beyond the effects of treatment type.
RESULTS: Staff\'s, therapist\'s, and patient\'s estimations were significantly associated with treatment outcomes. Nevertheless, only therapist\'s and patient\'s estimations significantly predicted improvement beyond actual administration, with therapist\'s and patient\'s estimations associated with improvement in trait anxiety (STAI-T, B=-1.80, p < .05, and B=-2.02, p < .05, respectively); therapist\'s estimations were associated with improvement in general distress (OQ-45, B=-3.71, p < .05), and patient\'s estimations were associated with symptom relief (HSCL-11, B=-0.13, p < .05). Overall, patient\'s estimations had a higher relative contribution to treatment success, with standardized coefficients across scales ranging from - 0.06 to -0.26.
CONCLUSIONS: The neurobiological factors that promote treatment success are also influenced by patient\'s and therapist\'s expectations. Future studies should consider these effects when examining their impact in inpatient settings.