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精神分裂症的社交障碍:治疗持续性问题的新方法。

Social impairment in schizophrenia: new approaches for treating a persistent problem.

作者信息

Dodell-Feder David, Tully Laura M, Hooker Christine I

机构信息

Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.

出版信息

Curr Opin Psychiatry. 2015 May;28(3):236-42. doi: 10.1097/YCO.0000000000000154.

Abstract

PURPOSE OF REVIEW

Deficits in social cognition are an important determinant of social functioning in schizophrenia, a core feature of the illness that persists despite treatment. Recent research in neuroplasticity-based therapeutics shows that neural systems supporting core cognitive skills improve after targeted cognitive training, suggesting that social cognition, and concomitant social functioning, may be improved by targeting the neural systems supporting social cognition. However, the success of this approach depends on the extent to which the social brain is malleable. We review the neural effects of training programs focused on improving social cognition in healthy, schizophrenia, and other clinical samples.

RECENT FINDINGS

The current literature suggests that the neural mechanisms underlying social cognition show neuroplastic changes after behavioral training and these neural changes confer concomitant benefits to social cognition and social behavior. Most research in schizophrenia has focused on emotion recognition, and although emotion recognition training has behavioral and neural benefits for schizophrenia, more advanced social cognitive processes need to be examined.

SUMMARY

The data suggest that targeting neural systems underlying social cognition through socially focused behavioral interventions may improve social functioning impairments in schizophrenia. Questions remain regarding how to optimize training, which should be addressed in future work.

摘要

综述目的

社会认知缺陷是精神分裂症社会功能的重要决定因素,是该疾病的核心特征,即便经过治疗仍会持续存在。基于神经可塑性的治疗方法的最新研究表明,支持核心认知技能的神经系统在经过有针对性的认知训练后会得到改善,这表明通过针对支持社会认知的神经系统,社会认知以及随之而来的社会功能可能会得到改善。然而,这种方法的成功程度取决于社会脑的可塑性程度。我们综述了针对健康人群、精神分裂症患者及其他临床样本开展的旨在改善社会认知的训练项目所产生的神经效应。

最新发现

当前文献表明,社会认知背后的神经机制在行为训练后会出现神经可塑性变化,这些神经变化会给社会认知和社会行为带来相应益处。精神分裂症方面的大多数研究都集中在情绪识别上,尽管情绪识别训练对精神分裂症患者有行为和神经方面的益处,但更高级的社会认知过程仍有待研究。

总结

数据表明,通过以社会为导向的行为干预针对社会认知背后的神经系统,可能会改善精神分裂症患者的社会功能障碍。关于如何优化训练仍存在问题,未来的研究工作应予以解决。

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