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基于价值的认知与药物依赖。

Value-based cognition and drug dependency.

机构信息

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Addict Behav. 2021 Dec;123:107070. doi: 10.1016/j.addbeh.2021.107070. Epub 2021 Jul 28.

Abstract

Value-based decision-making is thought to play an important role in drug dependency. Achieving elevated levels of euphoria or ameliorating dysphoria/pain may motivate goal-directed drug consumption in both drug-naïve and long-time users. In other words, drugs become viewed as the preferred means of attaining a desired internal state. The bias towards choosing drugs may affect one's cognition. Observed biases in learning, attention and memory systems within the brain gradually focus one's cognitive functions towards drugs and related cues to the exclusion of other stimuli. In this narrative review, the effects of drug use on learning, attention and memory are discussed with a particular focus on changes across brain-wide functional networks and the subsequent impact on behaviour. These cognitive changes are then incorporated into the cycle of addiction, an established model outlining the transition from casual drug use to chronic dependency. If drug use results in the elevated salience of drugs and their cues, the studies highlighted in this review strongly suggest that this salience biases cognitive systems towards the motivated pursuit of addictive drugs. This bias is observed throughout the cycle of addiction, possibly contributing to the persistent hold that addictive drugs have over the dependent. Taken together, the excessive valuation of drugs as the preferred means of achieving a desired internal state affects more than just decision-making, but also learning, attentional and mnemonic systems. This eventually narrows the focus of one's thoughts towards the pursuit and consumption of addictive drugs.

摘要

基于价值的决策被认为在药物依赖中起着重要作用。在药物依赖者和长期使用者中,获得更高水平的欣快感或减轻烦躁/疼痛可能会促使他们有目标地使用药物。换句话说,药物成为了人们获得理想内在状态的首选手段。这种对药物的偏好可能会影响人们的认知。在大脑中观察到的学习、注意力和记忆系统的偏差逐渐使人们的认知功能集中在药物和相关线索上,而排除其他刺激。在这篇叙述性综述中,讨论了药物使用对学习、注意力和记忆的影响,特别关注大脑广泛的功能网络的变化及其对行为的后续影响。然后,这些认知变化被纳入成瘾循环中,该模型概述了从偶然使用药物到慢性依赖的转变。如果药物使用导致药物及其线索的显著增加,那么本综述中强调的研究强烈表明,这种显著偏差会使认知系统倾向于追求成瘾药物。这种偏差在成瘾循环的各个阶段都存在,可能导致成瘾药物对依赖者的持续影响。总之,将药物作为获得理想内在状态的首选手段的过度评估不仅会影响决策,还会影响学习、注意力和记忆系统。这最终会使人们的思维集中在追求和使用成瘾药物上。

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