Maren Stephen, Chang Chun-hui
Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109-1043, USA.
Proc Natl Acad Sci U S A. 2006 Nov 21;103(47):18020-5. doi: 10.1073/pnas.0608398103. Epub 2006 Nov 7.
In some individuals, fearful experiences (e.g., combat) yield persistent and debilitating psychological disturbances, including posttraumatic stress disorder (PTSD). Early intervention (e.g., debriefing) after psychological trauma is widely practiced and argued to be an effective strategy for limiting subsequent psychopathology, although there has been considerable debate on this point. Here we show in an animal model of traumatic fear that early intervention shortly after an aversive experience yields poor long-term fear reduction. Extinction trials administered minutes after aversive fear conditioning in rats suppressed fear acutely, but fear suppression was not maintained the next day. In contrast, delivering extinction trials 1 day after fear conditioning produced an enduring suppression of fear memory. We further show that the recent experience of an aversive event, not the timing of the extinction intervention per se, inhibits the development of long-term fear extinction. These results reveal that the level of fear present at the time of intervention is a critical factor in the efficacy of extinction. Importantly, our work suggests that early intervention may not yield optimal outcomes in reducing posttraumatic stress, particularly after severe trauma.
在一些个体中,恐惧经历(如战斗)会产生持续且使人衰弱的心理障碍,包括创伤后应激障碍(PTSD)。心理创伤后的早期干预(如汇报)被广泛应用,并被认为是限制后续精神病理学发展的有效策略,尽管在这一点上存在相当多的争论。在此,我们在创伤性恐惧的动物模型中表明,厌恶经历后不久进行早期干预,长期恐惧减轻效果不佳。在大鼠厌恶恐惧条件反射后几分钟进行消退试验,能急性抑制恐惧,但第二天恐惧抑制效果无法维持。相比之下,在恐惧条件反射后1天进行消退试验,则能持久抑制恐惧记忆。我们进一步表明,厌恶事件的近期经历,而非消退干预本身的时间,会抑制长期恐惧消退的发展。这些结果表明,干预时的恐惧水平是消退效果的关键因素。重要的是,我们的研究表明早期干预在减轻创伤后应激方面可能无法产生最佳效果,尤其是在严重创伤后。