Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA.
Transl Psychiatry. 2019 Feb 14;9(1):88. doi: 10.1038/s41398-019-0424-7.
In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind-body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD.
与传统的韧性观点（韧性是一种稳定的、特质性的特征）相反，现在人们认识到，韧性是一种多维的、动态的能力，受到内部和环境资源之间终身相互作用的影响。我们回顾了与老年抑郁症（LLD）的韧性相关的心理社会和神经生物学因素。最近的研究已经确定了与 LLD 风险升高相关的心理社会特征（例如，不安全依恋、神经质）和可能是有用的干预目标的心理社会过程（例如，自我效能感、目标感、应对行为、社会支持）。心理生物学因素包括多种内分泌、遗传、炎症、代谢、神经和心血管过程，它们相互作用，双向影响 LLD 发病和疾病过程的风险。几种增强韧性的干预方式显示出预防和治疗 LLD 的潜力，包括认知/心理或身心（积极心理学；心理治疗；心率变异性生物反馈；冥想）、运动（有氧运动；瑜伽；太极）和生物学方法（药物治疗、电惊厥治疗）。需要进一步研究来阐明影响 LLD 风险和病程的心理社会和生物学因素。此外，研究确定预测对各种干预措施的不同治疗反应的心理生物学因素，对于开发更个体化和有效的预防和治疗 LLD 的方法至关重要。
