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焦虑、回避与顺序评估。

Anxiety, avoidance, and sequential evaluation.

作者信息

Zorowitz Samuel, Momennejad Ida, Daw Nathaniel D

机构信息

Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08540.

Department of Biomedical Engineering, Columbia University, New York, NY 10027.

出版信息

Comput Psychiatr. 2020;4. doi: 10.1162/cpsy_a_00026. Epub 2020 Mar 1.

Abstract

Anxiety disorders are characterized by a range of aberrations in the processing of and response to threat, but there is little clarity what core pathogenesis might underlie these symptoms. Here we propose that a particular set of unrealistically pessimistic assumptions can distort an agent's behavior and underlie a host of seemingly disparate anxiety symptoms. We formalize this hypothesis in a decision theoretic analysis of maladaptive avoidance and a reinforcement learning model, which shows how a localized bias in beliefs can formally explain a range of phenomena related to anxiety. The core observation, implicit in standard decision theoretic accounts of sequential evaluation, is that the potential for avoidance should be protective: if danger can be avoided later, it poses less threat now. We show how a violation of this assumption - via a pessimistic, false belief that later avoidance will be unsuccessful - leads to a characteristic, excessive propagation of fear and avoidance to situations far antecedent of threat. This single deviation can explain a range of features of anxious behavior, including exaggerated threat appraisals, fear generalization, and persistent avoidance. Simulations of the model reproduce laboratory demonstrations of abnormal decision making in anxiety, including in situations of approach-avoid conflict and planning to avoid losses. The model also ties together a number of other seemingly disjoint phenomena in anxious disorders. For instance, learning under the pessimistic bias captures a hypothesis about the role of anxiety in the later development of depression. The bias itself offers a new formalization of classic insights from the psychiatric literature about the central role of maladaptive beliefs about control and self-efficacy in anxiety. This perspective also extends previous computational accounts of beliefs about control in mood disorders, which neglected the sequential aspects of choice.

摘要

焦虑症的特征是在对威胁的处理和反应方面存在一系列异常,但对于这些症状背后的核心发病机制却知之甚少。在此,我们提出一组特定的不切实际的悲观假设会扭曲个体的行为,并构成一系列看似不同的焦虑症状的基础。我们在对适应不良性回避的决策理论分析和强化学习模型中对这一假设进行了形式化,该模型展示了信念中的局部偏差如何从形式上解释一系列与焦虑相关的现象。在标准的序列评估决策理论解释中隐含的核心观察结果是,回避的可能性应该具有保护作用:如果稍后可以避免危险,那么它现在构成的威胁就较小。我们展示了违反这一假设——通过一种悲观的错误信念,即稍后的回避将不会成功——如何导致恐惧和回避过度传播到远在威胁之前的情境中。这一单一偏差可以解释焦虑行为的一系列特征,包括夸大的威胁评估、恐惧泛化和持续回避。该模型的模拟重现了焦虑症中异常决策的实验室演示,包括在接近 - 回避冲突和计划避免损失的情境中。该模型还将焦虑症中的许多其他看似不相关的现象联系在一起。例如,在悲观偏差下的学习捕捉到了一个关于焦虑在抑郁症后期发展中作用的假设。这种偏差本身为精神病学文献中关于适应不良的控制和自我效能信念在焦虑中的核心作用的经典见解提供了一种新的形式化。这一观点还扩展了先前关于情绪障碍中控制信念的计算解释,后者忽略了选择的序列方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/857b/8143038/58af3a1ed2b9/nihms-1694304-f0001.jpg

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