CAJ | 학술논문

心理预期是具有方向性的,可分为正性（积极的）和负性（消极的）预期,它们相互对立,并对人的身心状况产生不同的影响。在长久以来的临床实践中,预期对疾病治疗和某些生理体验的强大调节作用逐渐为人们所知,并根据其调节方向的不同催生出两个重要概念,即安慰剂与反安慰剂效应。目前关于安慰剂与反安慰剂的研究主要集中在疼痛领域。出人意料的是,尽管二者在疼痛调节上具有相似的心理机制,其内在神经基础并不完全相同：安慰剂效应与反安慰剂效应分别由阿片肽系统和胆囊收缩素系统所介导;在影像学研究中,疼痛加工系统和脊髓在安慰剂/反安慰剂的调节下呈现相反的激活模式,而海马在反安慰剂中的活动具有特异性。
심리예기시구유방향성적,가분위정성（적겁적）화부성（소겁적）예기,타문상호대립,병대인적신심상황산생불동적영향。재장구이래적림상실천중,예기대질병치료화모사생리체험적강대조절작용축점위인문소지,병근거기조절방향적불동최생출량개중요개념,즉안위제여반안위제효응。목전관우안위제여반안위제적연구주요집중재동통영역。출인의료적시,진관이자재동통조절상구유상사적심리궤제,기내재신경기출병불완전상동：안위제효응여반안위제효응분별유아편태계통화담낭수축소계통소개도;재영상학연구중,동통가공계통화척수재안위제/반안위제적조절하정현상반적격활모식,이해마재반안위제중적활동구유특이성。
Expectation can bidirectionally regulate diseases or sensory experiences. In terms of pain field, positive expectation alleviates pain （i.e., placebo effect）; while negative expectation makes it worse （i.e., nocebo effect）. So far, most of researches on placebo and nocebo effect mainly come from the field of pain. Interestingly, although placebo and nocebo share similar psychological processes in modulating pain, the neurophysiological mechanisms underlying the placebo and nocebo are different. Placebo analgesia might be involved with endogenous opioids system. On the contrary, the nocebo effect is considered to be mediated by cholecystokinin （CCK）. In addition, brain imaging researches suggested that placebo and nocebo could lead to contrary activation patterns in pain-related networks. Some areas such as the hippocampus were specifically activated in nocebo condition.