Woodhead Sophie, Robbins Trevor
Clare College, Cambridge, UK,
Psychiatr Danub. 2017 Sep;29(Suppl 3):203-213.
Psychiatric disorders may be caused by underlying imbalances between goal-directed and habit systems in the brain. Numerous studies have aimed to establish whether this is because of a goal-directed system deficit, enhanced habit system, or both. This transdiagnostic approach to studying psychiatric disorders is increasingly popular. Maladaptive habitual behaviour is present in many disorders. It is the principal observation in disorders of compulsivity and is also present in other psychiatric disorders that are not primarily characterised by compulsive behaviour. The psychopathology that causes these disorders might be similar and could be targeted with specific treatment. Traditional categorical classification systems of psychiatric disorders do not reflect similarities in neurobiological dysfunction. The comorbidity and overlap between psychiatric disorders means that a dimensional classifications system based on underlying brain system dysfunction might be more appropriate. In this paper, the neural and neuromodulatory systems that contribute to goal-directed and habit systems are discussed. Account is taken of model-based and model-free computational learning mechanisms that are thought to give rise to goal-directed and habitual control respectively. Different psychiatric disorders that have a deficit in goal-directed behaviour or habit systems are then explored to see if there are similarities in the underlying neural systems despite differences in clinical presentation. It concludes that the relative contribution of goal-directed and habit systems in psychiatric disorders is not evenly distributed. Similar dysfunction of these systems might cause different psychiatric disorders. This neurobiological finding might influence classification systems and research into potential treatments.
精神疾病可能由大脑中目标导向系统和习惯系统之间潜在的失衡所引起。众多研究旨在确定这是由于目标导向系统缺陷、习惯系统增强，还是两者兼而有之。这种研究精神疾病的跨诊断方法越来越受欢迎。适应不良的习惯性行为存在于许多疾病中。它是强迫症的主要表现，也存在于其他并非主要以强迫行为为特征的精神疾病中。导致这些疾病的精神病理学可能相似，并且可以采用特定治疗方法。传统的精神疾病分类系统并不能反映神经生物学功能障碍的相似性。精神疾病之间的共病和重叠意味着基于潜在脑系统功能障碍的维度分类系统可能更合适。本文讨论了对目标导向系统和习惯系统有影响的神经和神经调节系统。考虑了分别被认为产生目标导向控制和习惯性控制的基于模型和无模型的计算学习机制。然后探讨了目标导向行为或习惯系统存在缺陷的不同精神疾病，以查看尽管临床表现不同，但潜在神经系统是否存在相似之处。研究得出结论，目标导向系统和习惯系统在精神疾病中的相对作用分布并不均匀。这些系统的类似功能障碍可能导致不同的精神疾病。这一神经生物学发现可能会影响分类系统以及对潜在治疗方法的研究。
