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强迫症的心理生物学:厌恶情绪的作用有多重要?

The psychobiology of obsessive-compulsive disorder: how important is the role of disgust?

作者信息

Stein D J, Liu Y, Shapira N A, Goodman W K

机构信息

Medical Research Council Unit on Anxiety Disorders, University of Stellenbosch, Cape Town, South Africa.

出版信息

Curr Psychiatry Rep. 2001 Aug;3(4):281-7. doi: 10.1007/s11920-001-0020-3.

Abstract

Psychobiologic models of obsessive-compulsive disorder (OCD) have focused on cortico-striatal-thalamic-cortical (CTSC) circuits, noting normal function in cognitive and motoric procedural strategies. Such models have relied on the classification of OCD as an anxiety disorder, seldom exploring other relevant emotions. Based on the hypothesis that a central emotion in OCD is disgust, the authors review the literature on its psychobiology and its relevance to current models of OCD. There are important parallels between the psychobiology of OCD and that of disgust. Obsessive- compulsive disorder may be conceptualized in terms of a false contamination alarm in which disgust plays a crucial organizing or embodying role, not only at a basic brain level, but also in terms of the psychosocial aspects of the disorder. Just as psychobiologic models of panic disorder and post- traumatic stress disorder have been strengthened by the inclusion of preclinical work on amygdala-mediated fear conditioning, so findings on disgust and its mediating CSTC circuits may generate useful hypotheses for OCD research.

摘要

强迫症(OCD)的心理生物学模型聚焦于皮质-纹状体-丘脑-皮质(CTSC)回路,指出其在认知和运动程序策略方面的正常功能。此类模型一直将强迫症归类为焦虑症,很少探究其他相关情绪。基于强迫症的核心情绪是厌恶这一假设,作者回顾了关于其心理生物学及其与当前强迫症模型相关性的文献。强迫症的心理生物学与厌恶的心理生物学之间存在重要的相似之处。强迫症可从错误的污染警报角度来理解,其中厌恶不仅在基本的大脑层面,而且在该疾病的社会心理方面都发挥着关键的组织或体现作用。正如恐慌症和创伤后应激障碍的心理生物学模型因纳入杏仁核介导的恐惧条件作用的临床前研究而得到加强一样,关于厌恶及其介导的CTSC回路的研究结果可能会为强迫症研究产生有用的假设。

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