Service de Psychiatrie et de Psychologie Médicale, Hôpital Saint-Antoine, UPMC, Sorbonne Universités, Paris, France.
Curr Opin Psychiatry. 2011 Jan;24(1):49-54. doi: 10.1097/YCO.0b013e32833f5585.
Cognitive dysfunction is frequently reported in anxiety disorders. Our aim is to describe recent advances concerning these cognitive aspects.
Cognitive dysfunction in anxiety disorders can be classified into four domains. The first concerns executive functions, mainly attentional processes. The second concerns memory, including deficits in working, episodic, and autobiographical memory. The third encompasses maladaptive cognitions, or thoughts and beliefs. Finally, a burgeoning area of research (mainly in obsessive-compulsive disorder and posttraumatic stress disorder) concerns metacognitions, or thoughts and beliefs about one's own thoughts and beliefs. All of these dysfunctions may contribute to maintain or aggravate anxiety disorders. When developing and implementing interventions, researchers and clinicians alike must consider these cognitive aspects, and may need to tailor their approaches accordingly.
Advances have clearly been made in the elucidation of the cognitive functioning associated with anxiety disorders. It remains unclear if particular cognitive profiles can help to distinguish anxiety disorders from one another, although emerging evidence suggests this may be the case. Further clarification will add to our understanding of the development and maintenance of these disorders, and may provide targets for future therapy and endophenotypes.
焦虑障碍常伴有认知功能障碍。本综述旨在描述该领域的最新进展。
焦虑障碍患者的认知功能障碍可分为四个领域。第一是执行功能,主要为注意力过程。第二是记忆,包括工作记忆、情景记忆和自传体记忆受损。第三是适应不良认知,即对自身想法和信念的错误认知。最后,元认知领域(主要在强迫症和创伤后应激障碍中)的研究方兴未艾,元认知是指对自身想法和信念的想法和信念。所有这些功能障碍都可能导致或加重焦虑障碍。在开发和实施干预措施时,研究人员和临床医生都必须考虑这些认知方面,并可能需要相应地调整他们的方法。
焦虑障碍相关认知功能的阐明已经取得了明显进展。目前尚不清楚特定的认知特征是否有助于区分不同的焦虑障碍,但新出现的证据表明情况可能如此。进一步的澄清将有助于我们理解这些疾病的发展和维持,并可能为未来的治疗和内表型提供靶点。