Dai Qin, Smith Graeme D
Department of Medical Psychology, Army Medical University, Chongqing, China.
School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, Hong Kong SAR, China.
Front Psychiatry. 2023 Feb 14;14:1071859. doi: 10.3389/fpsyt.2023.1071859. eCollection 2023.
From the vulnerability perspective, we often ask the question "why someone suffers from depression?" Despite outstanding achievements along this line, we still face high occurrence or recurrence and unsatisfied therapeutic efficacy of depression, suggesting that solely focusing on vulnerability perspective is insufficient to prevent and cure depression. Importantly, although experiencing same adversity, most people do not suffer from depression but manifest certain resilience, which could be used to prevent and cure depression, however, the systematic review is still lack. Here, we propose the concept "resilience to depression" to emphasize resilient diathesis against depression, by asking the question "why someone is exempted from depression?" Research evidence of resilience to depression has been reviewed systematically: positive cognitive style (clear purpose in life, hopefulness, et al.), positive emotion (emotional stability, et al.), adaptive behavior (extraversion, internal self-control, et al.), strong social interaction (gratitude and love, et al.), and neural foundation (dopamine circuit, et al.). Inspired by these evidence, "psychological vaccination" could be achieved by well-known real-world natural-stress vaccination (mild, controllable, and adaptive of stress, with help from parents or leaders) or newly developed "clinical vaccination" (positive activity intervention for current depression, preventive cognitive therapy for remitted depression, et al.), both of which aim to enhance the resilient psychological diathesis against depression, through events or training. Potential neural circuit vaccination was further discussed. This review calls for directing attention to resilient diathesis against depression, which offers a new thinking "psychological vaccination" in both prevention and therapy of depression.
从易感性角度来看，我们常常会问“为什么有些人会患抑郁症？”尽管在这方面已经取得了显著成就，但我们仍然面临着抑郁症的高发病率或复发率以及不尽人意的治疗效果，这表明仅关注易感性角度不足以预防和治愈抑郁症。重要的是，尽管经历相同的逆境，但大多数人不会患抑郁症，而是表现出一定的复原力，这种复原力可用于预防和治愈抑郁症，然而，目前仍缺乏系统的综述。在此，我们提出“抗抑郁复原力”这一概念，通过询问“为什么有些人不会患抑郁症？”来强调抵御抑郁症的复原素质。我们对抑郁症复原力的研究证据进行了系统综述：积极的认知风格（生活目标明确、充满希望等）、积极情绪（情绪稳定等）、适应性行为（外向、内在自我控制等）、强大的社会互动（感恩和爱等）以及神经基础（多巴胺回路等）。受这些证据的启发，“心理疫苗接种”可以通过著名的现实世界自然应激疫苗接种（轻度、可控且适应性的应激，在父母或领导的帮助下）或新开发的“临床疫苗接种”（对当前抑郁症进行积极活动干预、对缓解期抑郁症进行预防性认知治疗等）来实现，这两种方式都旨在通过事件或训练增强抵御抑郁症的复原心理素质。我们还进一步讨论了潜在的神经回路疫苗接种。这篇综述呼吁关注抵御抑郁症的复原素质，它在抑郁症的预防和治疗方面提供了一种“心理疫苗接种”的新思路。
