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老年人抑郁和焦虑障碍中的情绪加工:系统评价

Emotion processing in depression and anxiety disorders in older adults: systematic review.

作者信息

Gray Vanessa, Douglas Katie M, Porter Richard J

机构信息

Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.

Department of Psychological Medicine, University of Otago; and Canterbury District Health Board, Christchurch, New Zealand.

出版信息

BJPsych Open. 2020 Dec 3;7(1):e7. doi: 10.1192/bjo.2020.143.

Abstract

BACKGROUND

Emotional cognition and effective interpretation of affective information is an important factor in social interactions and everyday functioning, and difficulties in these areas may contribute to aetiology and maintenance of mental health conditions. In younger people with depression and anxiety, research suggests significant alterations in behavioural and brain activation aspects of emotion processing, with a tendency to appraise neutral stimuli as negative and attend preferentially to negative stimuli. However, in ageing, research suggests that emotion processing becomes subject to a 'positivity effect', whereby older people attend more to positive than negative stimuli.

AIMS

This review examines data from studies of emotion processing in Late-Life Depression and Late-Life Anxiety to attempt to understand the significance of emotion processing variations in these conditions, and their interaction with changes in emotion processing that occur with ageing.

METHOD

We conducted a systematic review following PRISMA guidelines. Articles that used an emotion-based processing task, examined older persons with depression or an anxiety disorder and included a healthy control group were included.

RESULTS

In Late-Life Depression, there is little consistent behavioural evidence of impaired emotion processing, but there is evidence of altered brain circuitry during these processes. In Late-Life Anxiety and Post-Traumatic Stress disorder, there is evidence of interference with processing of negative or threat-related words.

CONCLUSIONS

How these findings fit with the positivity bias of ageing is not clear. Future research is required in larger groups, further examining the interaction between illness and age and the significance of age at disease onset.

摘要

背景

情感认知以及对情感信息的有效解读是社交互动和日常功能中的一个重要因素,这些方面的困难可能导致心理健康状况的病因及维持。对于患有抑郁症和焦虑症的年轻人,研究表明在情绪加工的行为和大脑激活方面存在显著改变,倾向于将中性刺激评估为负面,并优先关注负面刺激。然而,在老龄化过程中,研究表明情绪加工会受到“积极效应”的影响,即老年人对积极刺激的关注多于负面刺激。

目的

本综述考察了老年期抑郁症和老年期焦虑症情绪加工研究的数据,试图了解这些情况下情绪加工变化的意义,以及它们与老龄化过程中情绪加工变化的相互作用。

方法

我们按照PRISMA指南进行了系统综述。纳入了使用基于情绪的加工任务、研究患有抑郁症或焦虑症的老年人且包括健康对照组的文章。

结果

在老年期抑郁症中,几乎没有一致的行为证据表明情绪加工受损,但有证据表明在这些过程中大脑回路发生了改变。在老年期焦虑症和创伤后应激障碍中,有证据表明对负面或与威胁相关词语的加工受到干扰。

结论

这些发现如何与老龄化的积极偏差相契合尚不清楚。未来需要在更大的群体中进行研究,进一步考察疾病与年龄之间的相互作用以及疾病发病时年龄的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fe3/7791559/d02728e8a680/S205647242000143X_fig1.jpg

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