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社交焦虑障碍:回顾与展望。

Social anxiety disorder: looking back and moving forward.

机构信息

School of Psychology, Curtin University,Kent Street, Bentley, Western Australia, 6021,Australia.

出版信息

Psychol Med. 2018 Sep;48(12):1937-1944. doi: 10.1017/S0033291717003816. Epub 2018 Jan 11.

Abstract

Fifty years have passed since social anxiety disorder (SAD) was first differentiated from other phobias. In the years since research has largely aligned with the zeitgeist of categorical classificatory frameworks, and has spanned identifying causes, maintenance factors and innovative interventions. Despite significant advances in the field, the capacity to conceptualise SAD as an independent entity is limited given the heterogeneity and dimensionality of diagnostic criteria, high rates of comorbidity, and non-specificity of aetiological mechanisms, maintaining factors and approaches to treatment. The Research Domain Criteria (RDoC) initiative was developed in an effort to overcome the inherent limitations posed by descriptive diagnostic systems - particularly in terms of reliability and validity - and in doing so seeks to facilitate research into underlying pathophysiological and behavioural mechanisms that cut across traditional diagnostic boundaries. The RDoC framework is furnished with a 'matrix', which in essence corresponds to a set of research principles that attempt to reconcile neuroscience and psychopathology. This review outlines a rationale for integrating SAD research with the RDoC approach, and offers examples of how future studies may wish to frame hypotheses and design experiments as the field moves towards classifying dimensions of psychopathology through a mechanistic understanding of underlying neurobiological and behavioural processes.

摘要

自社交焦虑障碍(SAD)首次与其他恐惧症区分开来以来,已经过去了五十年。自那时以来,研究在很大程度上与分类框架的时代精神保持一致,并涵盖了确定病因、维持因素和创新干预措施。尽管该领域取得了重大进展,但鉴于诊断标准的异质性和多维性、高共病率以及病因机制、维持因素和治疗方法的非特异性,将 SAD 概念化为独立实体的能力有限。研究领域标准(RDoC)倡议的制定是为了克服描述性诊断系统固有的局限性 - 特别是在可靠性和有效性方面 - 并以此为契机,促进对跨越传统诊断边界的潜在病理生理和行为机制的研究。RDoC 框架配备了一个“矩阵”,实质上对应于一套试图调和神经科学和精神病理学的研究原则。这篇综述概述了将 SAD 研究与 RDoC 方法相结合的基本原理,并提供了一些示例,说明随着该领域通过对潜在神经生物学和行为过程的机制理解来对精神病理学的维度进行分类,未来的研究可能希望构建假设和设计实验。

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