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基于正念的创伤后应激障碍治疗:治疗文献和神经生物学证据回顾。

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence.

机构信息

From the Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ont., Canada (Boyd); the Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ont., Canada (Boyd, McKinnon); the Homewood Research Institute, Guelph, Ont., Canada (Boyd, Lanius, McKinnon); the Department of Psychiatry, Western University, London, Ont., Canada (Lanius); the Department of Neuroscience, Western University, London, Ont., Canada (Lanius); the Imaging Division, Lawson Health Research Institute, London, Ont., Canada (Lanius); and the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont., Canada (McKinnon).

出版信息

J Psychiatry Neurosci. 2018 Jan;43(1):7-25. doi: 10.1503/jpn.170021. Epub 2017 Oct 2.

Abstract

Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.

摘要

基于正念的创伤后应激障碍(PTSD)治疗方法已成为有前途的辅助或替代干预方法。对 PTSD 治疗研究文献的范围综述,包括基于正念的减压、基于正念的认知疗法和慈爱正念等方法,显示出较低的脱落率和中到大的效果量。我们回顾了 PTSD 的神经生物学模型和正念文献中的神经影像学发现之间的一致性,在这些发现中,正念干预可能针对情绪调节不足和过度,这两者都是 PTSD 症状的关键特征。最近出现的研究工作表明,正念疗法也可能有效地恢复 PTSD 患者大脑网络之间的连接,包括默认模式网络与中央执行网络和突显网络之间的连接。讨论了未来的方向,包括进一步确定 PTSD 患者正念干预的神经生物学机制,并将这些干预与 PTSD 的一线治疗进行直接比较。

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