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运用研究领域标准(RDoC)来界定与成瘾相关的冲动性和强迫性。

Using the research domain criteria (RDoC) to conceptualize impulsivity and compulsivity in relation to addiction.

作者信息

Brooks Samantha J, Lochner Christine, Shoptaw Steve, Stein Dan J

机构信息

University of Cape Town, Cape Town, South Africa; Uppsala University, Uppsala, Sweden.

US/UCT MRC Unit on Anxiety & Stress Disorders, University of Stellenbosch, Stellenbosch, South Africa.

出版信息

Prog Brain Res. 2017;235:177-218. doi: 10.1016/bs.pbr.2017.08.002. Epub 2017 Sep 28.

Abstract

Nomenclature for mental disorder was updated in 2013 with the publication of the fifth edition of the Diagnostic and Statistical Manual (DSM-5). In DSM-5, substance use disorders are framed as more dimensional. First, the distinction between abuse and dependence is replaced by substance use. Second, the addictions section now covers both substances and behavioral addictions. This contemporary move toward dimensionality and transdiagnosis in the addictions and other disorders embrace accumulating cognitive-affective neurobiological evidence that is reflected in the United States' National Institutes of Health Research Domain Criteria (NIH RDoC). The RDoC calls for the further development of transdiagnostic approaches to psychopathy and includes five domains to improve research. Additionally, the RDoC suggests that these domains can be measured in terms of specific units of analysis. In line with these suggestions, recent publications have stimulated updated neurobiological conceptualizations of two transdiagnostic concepts, namely impulsivity and compulsivity and their interactions that are applicable to addictive disorders. However, there has not yet been a review to examine the constructs of impulsivity and compulsivity in relation to addiction in light of the research-oriented RDoC. By doing so it may become clearer as to whether impulsivity and compulsivity function antagonistically, complementarily or in some other way at the behavioral, cognitive, and neural level and how this relationship underpins addiction. Thus, here we consider research into impulsivity and compulsivity in light of the transdiagnostic RDoC to help better understand these concepts and their application to evidence-based clinical intervention for addiction.

摘要

精神障碍的命名法在2013年随着《精神疾病诊断与统计手册》第五版(DSM - 5)的出版而更新。在DSM - 5中,物质使用障碍被构建得更具维度性。首先,滥用和依赖之间的区分被物质使用所取代。其次,成瘾章节现在涵盖了物质成瘾和行为成瘾。成瘾及其他障碍领域中这种向维度性和跨诊断的当代转变,包含了越来越多的认知 - 情感神经生物学证据,这在美国国立卫生研究院研究领域标准(NIH RDoC)中有所体现。RDoC要求进一步发展针对精神变态的跨诊断方法,并包括五个领域以改进研究。此外,RDoC表明这些领域可以根据特定的分析单位来衡量。根据这些建议,近期的出版物激发了对两个跨诊断概念的神经生物学概念更新,即冲动性和强迫性及其相互作用,这些适用于成瘾性障碍。然而,尚未有综述根据以研究为导向的RDoC来审视冲动性和强迫性与成瘾相关的结构。通过这样做,在行为、认知和神经层面上,冲动性和强迫性是拮抗、互补还是以其他方式起作用,以及这种关系如何支撑成瘾可能会变得更加清晰。因此,在这里我们根据跨诊断的RDoC来考虑对冲动性和强迫性的研究,以帮助更好地理解这些概念及其在基于证据的成瘾临床干预中的应用。

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