Norbury Agnes, Brinkman Hannah, Kowalchyk Mary, Monti Elisa, Pietrzak Robert H, Schiller Daniela, Feder Adriana
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Psychol Med. 2021 Mar 8:1-12. doi: 10.1017/S0033291721000647.
Problems in learning that sights, sounds, or situations that were once associated with danger have become safe (extinction learning) may explain why some individuals suffer prolonged psychological distress following traumatic experiences. Although simple learning models have been unable to provide a convincing account of why this learning fails, it has recently been proposed that this may be explained by individual differences in beliefs about the causal structure of the environment.
Here, we tested two competing hypotheses as to how differences in causal inference might be related to trauma-related psychopathology, using extinction learning data collected from clinically well-characterised individuals with varying degrees of post-traumatic stress (N = 56). Model parameters describing individual differences in causal inference were related to multiple post-traumatic stress disorder (PTSD) and depression symptom dimensions via network analysis.
Individuals with more severe PTSD were more likely to assign observations from conditioning and extinction stages to a single underlying cause. Specifically, greater re-experiencing symptom severity was associated with a lower likelihood of inferring that multiple causes were active in the environment.
We interpret these results as providing evidence of a primary deficit in discriminative learning in participants with more severe PTSD. Specifically, a tendency to attribute a greater diversity of stimulus configurations to the same underlying cause resulted in greater uncertainty about stimulus-outcome associations, impeding learning both that certain stimuli were safe, and that certain stimuli were no longer dangerous. In the future, better understanding of the role of causal inference in trauma-related psychopathology may help refine cognitive therapies for these disorders.
曾经与危险相关的视觉、声音或情境已变得安全(消退学习),但学习过程中出现的问题可能解释了为何一些人在经历创伤后会长期遭受心理困扰。尽管简单的学习模型无法令人信服地解释这种学习为何失败,但最近有人提出,这可能是由个体对环境因果结构的信念差异所致。
在此,我们使用从具有不同程度创伤后应激的临床特征明确的个体(N = 56)收集的消退学习数据,测试了关于因果推理差异如何与创伤相关精神病理学相关的两种相互竞争的假设。通过网络分析,描述因果推理个体差异的模型参数与多种创伤后应激障碍(PTSD)和抑郁症状维度相关。
PTSD更严重的个体更有可能将条件作用和消退阶段的观察结果归因于单一潜在原因。具体而言,更高的重新体验症状严重程度与推断环境中存在多种活跃原因的可能性较低相关。
我们将这些结果解释为更严重PTSD参与者在辨别学习中存在主要缺陷的证据。具体而言,将更多样化的刺激配置归因于同一潜在原因的倾向导致刺激 - 结果关联的不确定性增加,阻碍了学习某些刺激是安全的以及某些刺激不再危险的能力。未来,更好地理解因果推理在创伤相关精神病理学中的作用可能有助于完善针对这些疾病的认知疗法。