Garland Eric L
Center on Mindfulness and Integrative Health Intervention Development, University of Utah, USA.
College of Social Work, University of Utah, USA.
Curr Opin Behav Sci. 2021 Jun;39:168-177. doi: 10.1016/j.cobeha.2021.03.019. Epub 2021 Apr 24.
Chronic drug use is theorized to induce cortico-striatal neuroplasticity, driving an allostatic process marked by increased sensitivity to drug-related cues and decreased sensitivity to natural rewards that results in anhedonia and a dearth of positive affect. As such, positive emotion regulation represents a key mechanistic target for addictions treatment. This paper provides a conceptual model detailing how mindfulness may synergize a range of positive affective mechanisms to reduce addictive behavior, from savoring the hedonic pleasure derived from natural rewards, to self-generating interoceptive reward responses, and ultimately to cultivating self-transcendent meaning. These therapeutic processes may restructure reward processing from over-valuation of drug-related rewards back to valuation of natural rewards, and hypothetically, "reset" the default mode network dysfunction that undergirds addiction.
长期使用药物被认为会诱发皮质-纹状体神经可塑性,驱动一种非稳态过程,其特征是对与药物相关线索的敏感性增加,而对自然奖励的敏感性降低,从而导致快感缺失和积极情感匮乏。因此,积极情绪调节是成瘾治疗的一个关键机制靶点。本文提供了一个概念模型,详细阐述了正念如何与一系列积极情感机制协同作用,以减少成瘾行为,从品味自然奖励带来的享乐愉悦,到自我产生内感受性奖励反应,最终培养自我超越的意义。这些治疗过程可能会将奖励处理从对与药物相关奖励的过度重视重新调整为对自然奖励的重视,并假设“重置”支撑成瘾的默认模式网络功能障碍。