Nair Akshay, Rutledge Robb B, Mason Liam
Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom.
Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany.
Front Psychiatry. 2020 Mar 18;11:140. doi: 10.3389/fpsyt.2020.00140. eCollection 2020.
Psychological therapies, such as CBT, are an important part of the treatment of a range of psychiatric disorders such as depression and anxiety. There is a growing desire to understand the mechanisms by which such therapies effect change so as to improve treatment outcomes. Here we argue that adopting a computational framework may be one such approach. Computational psychiatry aims to provide a theoretical framework for moving between higher-level psychological states (like emotions, decisions and beliefs) to neural circuits, by modeling these constructs mathematically. These models are explicit hypotheses that contain quantifiable variables and parameters derived from each individual's behavior. This approach has two advantages. Firstly, some of the variables described by these models appears to reflect the neural activity of specific brain regions. Secondly, the parameters estimated by these models may offer a unique description of a patient's symptoms which can be used to both tailor therapy and track its effect. In doing so this approach may offer some additional granularity in understanding how psychological therapies, such as CBT, are working. Although this field shows significant promise, we also highlight several of the key hurdles that must first be overcome before clinical translation of computational insights can be realized.
心理疗法，如认知行为疗法（CBT），是治疗一系列精神疾病（如抑郁症和焦虑症）的重要组成部分。人们越来越渴望了解这些疗法产生变化的机制，以便改善治疗效果。在此我们认为，采用计算框架可能是一种途径。计算精神病学旨在通过对这些结构进行数学建模，提供一个从高级心理状态（如情绪、决策和信念）到神经回路的理论框架。这些模型是明确的假设，包含从每个个体行为中得出的可量化变量和参数。这种方法有两个优点。首先，这些模型描述的一些变量似乎反映了特定脑区的神经活动。其次，这些模型估计的参数可能会对患者的症状提供独特的描述，可用于定制治疗方案并跟踪其效果。这样做，这种方法可能会在理解诸如CBT等心理疗法如何起作用方面提供一些额外的细节。尽管这个领域显示出巨大的前景，但我们也强调了在实现计算见解的临床转化之前必须首先克服的几个关键障碍。
