关联恐惧和回避学习在焦虑障碍中的作用：未来研究的差距和方向。
The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research.
机构信息
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany.
Department of Psychology, University of California, Los Angeles, CA, 90095-1563, United States.
出版信息
Neurosci Biobehav Rev. 2018 May;88:117-140. doi: 10.1016/j.neubiorev.2018.03.015. Epub 2018 Mar 14.
Anxiety disorders are the most common mental disorders and are often chronic and disabling. Although exposure-based treatments are effective, a substantial number of individuals fail to fully remit or experience a return of symptoms after treatment. Understanding the critical processes underlying the development and treatment of anxiety disorders will help identify individuals at risk and optimize treatments. Aversive associative learning offers explanatory pathways through which fear and anxiety emerge, spread, persist, and resurge. This narrative review examines the advances made in our understanding of associative fear and avoidance learning in anxiety disorders. Overall, the extant literature supports a key role of aversive associative learning in the development and treatment of anxiety disorders. However, research targeting specific mechanisms such as extinction generalization and avoidance, the fragility of extinction, and moderating influences of individual differences pertinent to anxiety disorders (e.g., age, sex, depression) is needed. We discuss the need for more ecological valid and complex paradigms to model ambiguity and conflict as well as for clinical translation studies to optimize treatment.
焦虑障碍是最常见的精神障碍，往往具有慢性和致残性。尽管暴露疗法有效，但仍有相当数量的个体在治疗后未能完全缓解或出现症状复发。了解焦虑障碍发生和治疗的关键过程将有助于识别高危人群并优化治疗。厌恶联想学习提供了可以解释恐惧和焦虑出现、传播、持续和复发的途径。本综述探讨了我们在理解焦虑障碍中的联想恐惧和回避学习方面取得的进展。总的来说，现有文献支持厌恶联想学习在焦虑障碍的发生和治疗中的关键作用。然而，需要针对特定机制（如消退泛化和回避、消退的脆弱性，以及与焦虑障碍相关的个体差异的调节影响（例如年龄、性别、抑郁）开展研究。我们讨论了需要更具生态有效性和更复杂的范式来模拟模糊性和冲突，以及开展临床转化研究以优化治疗。
Zotero 插件