跨精神障碍的巴甫洛夫式到工具性条件反射转移：综述。
Pavlovian-to-Instrumental Transfer across Mental Disorders: A Review.
机构信息
Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
Department of Psychiatry, Technische Universität Dresden, Dresden, Germany.
出版信息
Neuropsychobiology. 2022;81(5):418-437. doi: 10.1159/000525579. Epub 2022 Jul 15.
A mechanism known as Pavlovian-to-instrumental transfer (PIT) describes a phenomenon by which the values of environmental cues acquired through Pavlovian conditioning can motivate instrumental behavior. PIT may be one basic mechanism of action control that can characterize mental disorders on a dimensional level beyond current classification systems. Therefore, we review human PIT studies investigating subclinical and clinical mental syndromes. The literature prevails an inhomogeneous picture concerning PIT. While enhanced PIT effects seem to be present in non-substance-related disorders, overweight people, and most studies with AUD patients, no altered PIT effects were reported in tobacco use disorder and obesity. Regarding AUD and relapsing alcohol-dependent patients, there is mixed evidence of enhanced or no PIT effects. Additionally, there is evidence for aberrant corticostriatal activation and genetic risk, e.g., in association with high-risk alcohol consumption and relapse after alcohol detoxification. In patients with anorexia nervosa, stronger PIT effects elicited by low caloric stimuli were associated with increased disease severity. In patients with depression, enhanced aversive PIT effects and a loss of action-specificity associated with poorer treatment outcomes were reported. Schizophrenic patients showed disrupted specific but intact general PIT effects. Patients with chronic back pain showed reduced PIT effects. We provide possible reasons to understand heterogeneity in PIT effects within and across mental disorders. Further, we strengthen the importance of reliable experimental tasks and provide test-retest data of a PIT task showing moderate to good reliability. Finally, we point toward stress as a possible underlying factor that may explain stronger PIT effects in mental disorders, as there is some evidence that stress per se interacts with the impact of environmental cues on behavior by selectively increasing cue-triggered wanting. To conclude, we discuss the results of the literature review in the light of Research Domain Criteria, suggesting future studies that comprehensively assess PIT across psychopathological dimensions.
一种称为条件作用到工具性条件反射转移（PIT）的机制描述了一种现象，即通过条件作用获得的环境线索的价值可以激发工具性行为。PIT 可能是一种基本的行动控制机制，可以在当前分类系统之外的维度上描述精神障碍。因此，我们回顾了人类 PIT 研究，这些研究调查了亚临床和临床精神综合征。关于 PIT，文献呈现出一种不均匀的图景。虽然在非物质相关障碍、超重人群以及大多数酒精使用障碍患者的研究中，增强的 PIT 效应似乎存在，但在烟草使用障碍和肥胖症中，没有报告改变的 PIT 效应。关于酒精使用障碍和复发性酒精依赖患者，有增强或没有 PIT 效应的混合证据。此外，还有皮质纹状体激活和遗传风险的证据，例如，与高危饮酒和酒精解毒后复发有关。在神经性厌食症患者中，由低热量刺激引起的更强的 PIT 效应与疾病严重程度增加有关。在抑郁症患者中，报告了增强的厌恶 PIT 效应和与治疗效果较差相关的行动特异性丧失。精神分裂症患者表现出破坏的特异性但完整的一般性 PIT 效应。慢性背痛患者表现出降低的 PIT 效应。我们提供了理解精神障碍内和跨精神障碍的 PIT 效应异质性的可能原因。此外，我们加强了可靠实验任务的重要性，并提供了 PIT 任务的测试-重测数据，显示出中等至良好的可靠性。最后，我们指出压力可能是精神障碍中更强的 PIT 效应的一个潜在因素，因为有一些证据表明，压力本身通过选择性地增加线索触发的欲望，与环境线索对行为的影响相互作用。总之，我们根据研究领域标准讨论文献综述的结果，建议未来的研究全面评估 across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across across
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