Miller Christopher W T
University of Maryland School of Medicine, 701 W. Pratt St., 4th Floor, Baltimore, MD 21201, USA.
Psychiatry J. 2017;2017:5491812. doi: 10.1155/2017/5491812. Epub 2017 May 25.
The science behind psychotherapy has garnered considerable interest, as objective measures are being developed to map the patient's subjective change over the course of treatment. Prenatal and early life influences have a lasting impact on how genes are expressed and the manner in which neural circuits are consolidated. Transgenerationally transmitted epigenetic markers as well as templates of enhanced thought flexibility versus evasion can be passed down from parent to child. This influences gene expression/repression (impacting neuroplasticity) and kindling of neurocircuitry which can perpetuate maladaptive cognitive processing seen in a number of psychiatric conditions. Importantly, genetic factors and the compounding effects of early life adversity do not inexorably lead to certain fated outcomes. The concepts of vulnerability and resilience are becoming more integrated into the framework of "differential susceptibility," speaking to how corrective environmental factors may promote epigenetic change and reconfigure neural templates, allowing for symptomatic improvement. Psychotherapy is one such factor, and this review will focus on our current knowledge of its epigenetic and neurocircuitry impact.
心理治疗背后的科学已引起了相当大的兴趣，因为正在开发客观测量方法来描绘患者在治疗过程中的主观变化。产前和生命早期的影响对基因表达的方式以及神经回路的巩固方式具有持久影响。跨代传递的表观遗传标记以及增强思维灵活性与逃避的模板可以从父母传给孩子。这会影响基因表达/抑制（影响神经可塑性）和神经回路的点燃，这可能会使在许多精神疾病中出现的适应不良认知过程永久化。重要的是，遗传因素和早期生活逆境的复合效应并不会不可避免地导致某些注定的结果。易感性和复原力的概念正越来越多地融入“差异易感性”框架，这说明了纠正性环境因素如何促进表观遗传变化并重新配置神经模板，从而实现症状改善。心理治疗就是这样一个因素，本综述将聚焦于我们目前对其表观遗传和神经回路影响的认识。
