Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA; email:
Annu Rev Clin Psychol. 2022 May 9;18:443-469. doi: 10.1146/annurev-clinpsy-081219-111203.
A basic survival need is the ability to respond to, and persevere in the midst of, experiential challenges. Mechanisms of neuroplasticity permit this responsivity via functional adaptations (flexibility), as well as more substantial structural modifications following chronic stress or injury. This review focuses on prefrontally based flexibility, expressed throughout large-scale neuronal networks through the actions of excitatory and inhibitory neurotransmitters and neuromodulators. With substance use disorders and stress-related internalizing disorders as exemplars, we review human behavioral and neuroimaging data, considering whether executive control, particularly cognitive flexibility, is impaired premorbidly, enduringly compromised with illness progression, or both. We conclude that deviations in control processes are consistently expressed in the context of active illness but operate through different mechanisms and with distinct longitudinal patterns in externalizing versus internalizing conditions.
基本的生存需求是能够应对和坚持体验挑战的能力。神经可塑性的机制通过功能适应性（灵活性）以及慢性应激或损伤后的更实质性的结构改变来实现这种反应能力。本综述重点关注基于前额叶的灵活性，通过兴奋性和抑制性神经递质和神经调质的作用在整个大规模神经元网络中表达。以物质使用障碍和与应激相关的内化障碍为例，我们回顾了人类行为和神经影像学数据，考虑到执行控制，特别是认知灵活性，是否在疾病发生前就已经受损，是否随着疾病的进展而持续受损，或者两者兼而有之。我们得出结论，在活跃疾病的情况下，控制过程的偏差始终表现出来，但在外显和内化条件下，它们通过不同的机制和不同的纵向模式发挥作用。
