新的元分析挖了负面情绪会导致癌症之神话的墙角
作者: Tomasz Witkowski / 2368次阅读 时间: 2017年5月02日
来源: 陈明 译
www.psychspace.com心理学空间网
New meta-analysis undermines the myth that negative emotions can cause cancer
新的元分析挖了负面情绪会导致癌症之神话的墙角

Tomasz Witkowski

At least one in four readers of this post will die of cancer. This is a simple statistic that leads rationally thinking people to treat the possibility as very likely. And this is what many do: they try to adopt a lifestyle that minimises the risk to some degree. But how do we know what minimises and what increases this risk? Of course, by listening to experts, the best of whom are scientists who research these things. However, whenever there is disquiet brought about by uncertainty, self-titled experts come out of the woodwork. Discussion of factors increasing the risk of cancer is today not only the domain of medical doctors and psycho-oncologists, but is also engaged in by some alternative medicine proponents, pseudopsychologists, and fringe psychotherapists, whose opinions are disseminated by journalists, some more thorough than others (see myth #26 in 50 Great Myths of Popular Psychology for more background).

这篇文章的读者中至少至少有四分之一会死于癌症。这是一个简单的统计,导致了人们对非常有可能的可能性的理性思考。很多人知道:他们试图采取一种最大程度的减少风险程度的生活方式。但是我们怎么知道是什么增加或减少这种风险呢?当然,可以通过听取专家、最好的研究这些事情的科学家的意见。然而,每当有不确定性带来不安时,自封的专家就从阴暗的角落出现了。如今对增加癌症风险因素的讨论不仅是医生和心理医生的领域,而且也是一些从事替代医学的支持者,伪心理学家,外围精神科医生从事的领域,他们的意见通过新闻工作者传播,更多是通过他人传播。

Among these opinions is the common claim that negative thinking, pessimism, and stress create the conditions for the cells in our body to run amok, and for cancer to develop. Similar declarations accompany therapeutic propositions for changing our way of thinking into a more positive one that will protect us from cancer, or even cure us of the disease. Should you, therefore, begin to fear the possibility of cancer if you are not prone to optimism, or – even worse – have bouts of depression?

在这些观点中较为普遍的是消极的思想,悲观主义的主张,压力为我们身体中的细胞横行和癌症的发展创造了条件。类似的声称伴随着治疗学的主张,将我们的思维方式转变成更积极的方式,以此来保护我们远离癌症,甚至治愈我们的疾病。因此,如果你不容易乐观,或者更糟的是有过几次抑郁,那么你应该开始害怕罹患癌症的可能性吗?

In a paper published recently in Psycho-Oncology, four Korean scholars have attempted to provide answers to this question by way of meta-analysis. The first difficulty they encountered was the heterogeneity of the assessment of depression in the published literature. To clarify the mixed findings, they limited data to articles that used a reliable method of defining depression based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and/or the International Classification of Disease (ICD). Only nine studies fulfilled their criteria.

最近在心理肿瘤学出版的一篇文章中,四个韩国学者试图通过元分析的方法来回答这个问题。他们遇到的第一个困难是在出版的文献中评估抑郁症的异质性。为了澄清混合的调查结果,他们将数据限制在基于精神疾病的诊断和统计手册(DSM)和/或国际疾病分类(ICD)中的标准来定义抑郁症的文章之中。只有九项研究满足他们的标准。

What are the results? Although some low-quality studies found that patients with depressive disorder were at increased risk for cancer, overall the meta-analysis did not demonstrate that patients with clinically diagnosed depressive disorder had an increased risk of developing cancer relative to the general population.

结果是什么?尽管一些低质量的研究发现患有抑郁障碍的患者患癌症的风险增加,但总的元分析并没有说明临床上被诊断为抑郁症的患者相对于一般人群患癌症的风险增加。

So should readers with depressive tendencies breathe a sigh of relief? In the researchers’ cautious opinion, it is possible that some epidemiological biases affecting the diagnosis of depressive disorder or cancer could have affected their findings, thus concealing a depression-cancer link. Another limitation of their study was the narrow research database: most existing findings were obtained from Western societies and cannot be generalized to other cultures. Additionally, cancer detection depends on screening programmes and the application of new technologies, which vary across countries. Antidepressant medication is also a potential confounder for the relationship between depression and cancer. Furthermore, in the researchers’ opinion too much difference between studies causes a potential problem when interpreting the combined results. Finally, they think that possible publication bias may have affected their review, with negative results (a lack of an association between depression and cancer) less likely to see the light of day.

那么,抑郁倾向的读者应该松一口气吗?在研究者的谨慎观点中,一些流行病学偏见可能影响了他们对抑郁症或癌症诊断,或者可能是癌症影响了他们的发现,进而隐盖了抑郁和癌症的关系。他们的研究的另一个局限性是有限的研究数据库:大多数现有的研究结果来自于西方社会,不能推广到其他文化。此外,癌症检测取决于筛查方案和新技术的应用,这在各个国家是不同的。抗抑郁药物也是抑郁症和癌症之间的关系的一个潜在的混杂因素。此外,在研究者看来,在解释合并后的结果时,研究结果之间的太大差异导致一个潜在的问题。最后,他们认为合理的出版偏见可能影响了他们的评论,有着阴性的结果(缺乏抑郁症和癌症之间的关联)不太可能看到曙光。

Scientists write articles which are most often read by other scientists. The careful wording of conclusions is, in this context, essential. However, when cautious words of authors aware of the limitations facing their work are confronted with the arrogant declarations of healers and falsehoods spread via the Internet and other media, there is reason to fear that the former will be drowned out. The meta-analysis of the Korean scholars delivers data that are in agreement with a robust body of research. Many studies have shown that such factors as positive vs. negative attitudes, mood, emotions and stress have nothing to do with cancer (for example, see here and here and here). Moreover, some of these studies demonstrated that the relationship could even be the reverse of what is expected: depressed people and those who experienced more stress were less likely to get cancer than those who were positive and did not suffer from stress.

科学家写的文章最常见的读者是其他科学家。在此背景下,重要的是结论的谨慎措辞。然而,当作者意识到他们工作的局限性的谨慎措辞遭遇到疗愈者和瞎话通过互联网等媒介传播的傲慢的声明时,我们有理由担心,前者将被淹没。韩国学者的元分析交付的数据和强大的研究机构是一致的。许多研究表明,正面和负面的态度,情绪,情绪和压力等因素与癌症无关(例如,看这里和这里和这里)。此外,一些研究表明,这种关系甚至可能和预期是相反的:抑郁的人和那些经历了更多的压力的人患癌症的可能性比那些积极的,没有受到压力的人来的少。

The conviction that positive thinking and emotions prevent the development of cancer, or can even cure it, is consistent with our need for control. We prefer to live with the conviction that we have control over something rather than it being out of our hands. Unfortunately, as a matter of fact, we are powerless to influence the overwhelming majority of cancer-inducing factors, and there are still others which simply remain unknown.

确信积极的思考和情绪阻止癌症的发展,甚至可以治愈癌症,与我们对控制的需要是一致的。我们宁愿生活在这样一种信念中,那就是我们能够控制某件事,而不是失去控制。不幸的是,事实上,我们无力影响绝大多数的癌症诱发因素,而且,还有一些诱发因素仍然是未知的。

https://digest.bps.org.uk/2017/04/20/ 

—Risk of cancer among patients with depressive disorder: a meta-analysis and implications

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