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精神病患者威胁评估的认知和神经模型:理论整合。

Cognitive and neural models of threat appraisal in psychosis: A theoretical integration.

机构信息

King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, UK.

King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, UK; National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust, UK.

出版信息

Psychiatry Res. 2016 May 30;239:131-8. doi: 10.1016/j.psychres.2016.03.016. Epub 2016 Mar 9.

Abstract

Cognitive models of psychosis propose that maladaptive appraisals of anomalous experiences contribute to distress and disability in psychosis. Attentional, attributional and reasoning biases are hypothesised to drive these threat-based appraisals. Experimental and self-report data have provided support for the presence of these biases in psychosis populations, but recently there have been calls for neurobiological data to be integrated into these findings. Currently, little investigation has been conducted into the neural correlates of maladaptive appraisals. Experimental and neuroimaging research in social cognition employing threatening stimuli provide the closest equivalent of maladaptive appraisal in psychosis. Consequently, a rapprochement of these two literatures was attempted in order to identify neural networks relevant to threat appraisal in psychosis. This revealed overlapping models of aberrant emotion processing in anxiety and schizophrenia, encompassing the amygdala, insula, hippocampus, anterior cingulate cortex, and prefrontal cortex. These models posit that aberrant activity in these systems relates to altered emotional significance detection and affect regulation, providing a conceptual overlap with threat appraisal in psychosis, specifically attentional and attributional biases towards threat. It remains to be seen if direct examination of these biases using neuroimaging paradigms supports the theoretical integration of extant models of emotion processing and maladaptive appraisals in psychosis.

摘要

精神病认知模型提出,异常体验的适应不良评价会导致精神病患者的痛苦和残疾。注意力、归因和推理偏差被假设为驱动这些基于威胁的评价。实验和自我报告数据为精神病患者群体中存在这些偏差提供了支持,但最近有人呼吁将神经生物学数据纳入这些发现。目前,对适应不良评价的神经相关性研究很少。采用威胁性刺激的社会认知的实验和神经影像学研究为精神病中的适应不良评价提供了最接近的等效物。因此,尝试将这两种文献结合起来,以确定与精神病中威胁评价相关的神经网络。这揭示了焦虑症和精神分裂症中异常情绪处理的重叠模型,包括杏仁核、脑岛、海马体、前扣带皮层和前额叶皮层。这些模型假设,这些系统的异常活动与情绪意义检测和情绪调节的改变有关,与精神病中的威胁评价具有概念上的重叠,特别是对威胁的注意力和归因偏差。使用神经影像学范式直接检查这些偏差是否支持精神病中现有情绪处理和适应不良评价模型的理论整合,还有待观察。

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