Tafet Gustavo E, Ortiz Alonso Tomas
Department of Psychiatry and Behavioral Sciences, Texas A&M University, College Station, TX, United States.
Universidad Complutense de Madrid, Madrid, Spain.
Front Psychiatry. 2025 Aug 26;16:1600165. doi: 10.3389/fpsyt.2025.1600165. eCollection 2025.
The sustained and prolonged exposure to environmental stressors may provoke different reactions, depending on the subjective perception of control. Repeated perception of lack of control may lead to learned helplessness, which has been linked to the development of depression. It has been shown that learned helplessness is associated with increased activation of the serotonergic dorsal raphe nucleus (DRN) and the amygdala, as well as the decreased activation in certain regions of the prefrontal cortex (PFC), such as the dorsolateral (DL-PFC) and the ventromedial prefrontal cortex (VM-PFC). Perception of control has been associated with increased activation of the DL-PFC and the VM-PFC, decreased activation of the DRN and the amygdala, as well as increased activation of the serotonergic medial raphe nucleus (MRN). It is also associated with decreased activation of the ventral hippocampus and increased activation of the ventral striatum, including the nucleus accumbens (NAc). Functionally, perception of control promotes the implementation of active coping strategies, characterized by efficient cognitive-emotional processing, effective decision making, and goal directed actions, that in turn may lead to lower anxiety, greater tolerance of adverse events, emotional stability, and increased resilience. Just as it has been demonstrated that helplessness may result from a learning process, it could be hypothesized that controllability may also be trained and learned. If so, learned controllability could be taught to enhance resilience and provide invaluable resources ultimately reducing depressive symptoms and improving overall well-being. By fostering a sense of controllability, where individuals learn to associate their actions with desired outcomes, it may be possible to counteract the consequences of "learned helplessness" aspects of depression. This could provide direction in development of novel interventions aimed at promoting skill acquisition, problem-solving strategies, and adaptive decision-making, thereby restoring a sense of agency and resilience in the face of adversity.
持续且长期暴露于环境应激源可能会引发不同的反应，这取决于对控制的主观认知。反复感知到缺乏控制可能会导致习得性无助，而这与抑郁症的发展有关。研究表明，习得性无助与血清素能背侧中缝核（DRN）和杏仁核的激活增加以及前额叶皮质（PFC）某些区域（如背外侧前额叶皮质（DL-PFC）和腹内侧前额叶皮质（VM-PFC））的激活减少有关。对控制的认知与DL-PFC和VM-PFC的激活增加、DRN和杏仁核的激活减少以及血清素能中缝内侧核（MRN）的激活增加有关。它还与腹侧海马体的激活减少和腹侧纹状体（包括伏隔核（NAc））的激活增加有关。在功能上，对控制的认知促进了积极应对策略的实施，其特征是高效的认知-情绪处理、有效的决策和目标导向的行动，这反过来可能导致更低的焦虑、对不良事件的更大耐受性、情绪稳定性和更强的恢复力。正如已经证明无助可能源于学习过程一样，可以假设可控性也可以被训练和学习。如果是这样，习得的可控性可以被传授以增强恢复力并提供宝贵的资源，最终减轻抑郁症状并改善整体幸福感。通过培养可控感，让个体学会将自己的行动与期望的结果联系起来，有可能抵消抑郁症“习得性无助”方面的后果。这可以为开发旨在促进技能习得、问题解决策略和适应性决策的新型干预措施提供指导，从而在面对逆境时恢复自主感和恢复力。
