创伤后应激障碍的暴露疗法:成功受限的因素及可能的替代治疗方法

Exposure Therapy for Post-Traumatic Stress Disorder: Factors of Limited Success and Possible Alternative Treatment.

作者信息

Markowitz Sara, Fanselow Michael

机构信息

Psychology Department, University of California, Los Angeles, Los Angeles, CA 90095, USA.

出版信息

Brain Sci. 2020 Mar 13;10(3):167. doi: 10.3390/brainsci10030167.

Abstract

Recent research indicates that there is mixed success in using exposure therapies on patients with post-traumatic stress disorder (PTSD). Our study argues that there are two major reasons for this: The first is that there are nonassociative aspects of PTSD, such as hyperactive amygdala activity, that cannot be attenuated using the exposure therapy; The second is that exposure therapy is conceptualized from the theoretical framework of Pavlovian fear extinction, which we know is heavily context dependent. Thus, reducing fear response in a therapist's office does not guarantee reduced response in other situations. This study also discusses work relating to the role of the hippocampus in context encoding, and how these findings can be beneficial for improving exposure therapies.

摘要

最近的研究表明,在对创伤后应激障碍(PTSD)患者使用暴露疗法时,效果不一。我们的研究认为,造成这种情况有两个主要原因:第一个原因是PTSD存在非联想性方面,比如杏仁核活动过度活跃,而暴露疗法无法减弱这种情况;第二个原因是暴露疗法是从巴甫洛夫式恐惧消退的理论框架中概念化而来的,我们知道这在很大程度上依赖于情境。因此,在治疗师办公室减少恐惧反应并不能保证在其他情况下反应也会减少。这项研究还讨论了与海马体在情境编码中的作用相关的工作,以及这些发现如何有助于改进暴露疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8792/7139336/a092a844aaeb/brainsci-10-00167-g001.jpg

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