Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective.
Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective.
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正念的生物行为机制作为慢性压力的治疗方法：RDOC的观点。
DOI：
10.1177/2470547017711912
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Howard MO
中科院分区：
文献类型：
--
作者：
Garland EL;Hanley AW;Baker AK;Howard MO
基于正念的干预措施被认为是缓解慢性压力的有效手段。虽然荟萃分析表明，基于正念的干预措施显着降低了压力的全球措施，但基于正念的干预措施如何调节支持慢性压力的具体机制，如美国国家精神卫生研究所研究领域标准（RDoC）所实施的持续威胁尚未在文献中详细说明。为了解决这一知识缺口，本文旨在（1）审查证据表明，基于正念的干预措施改善了行为失调的10个要素，这些要素通过一系列正念反调节策略来表征持续的威胁;（2）审查证据表明，基于正念的干预措施可以改变与持续威胁有关的生物领域，如下丘脑-垂体-肾上腺轴，以及参与注意功能、边缘反应、习惯行为和默认模式网络的脑回路;（3）将这些发现整合到一个面对压力时正念自我调节的新概念框架--正念意义理论。总而言之，现有的科学证据表明，正念练习增强了一系列与适应性压力应对有关的生物行为因素，并诱导了自我参照的可塑性，从而提高了在逆境中寻找意义的能力。这些机制研究结果可以为治疗开发过程提供信息，以优化下一代基于正念的干预措施，以获得更大的治疗效果。
Mindfulness-based interventions have been heralded as promising means of alleviating chronic stress. While meta-analyses indicate that mindfulness-based interventions significantly reduce global measures of stress, how mindfulness-based interventions modulate the specific mechanisms underpinning chronic stress as operationalized by the National Institute of Mental Health research domain criteria (RDoC) of sustained threat has not yet been detailed in the literature. To address this knowledge gap, this article aims to (1) review evidence that mindfulness-based interventions ameliorate each of the 10 elements of behavioral dysregulation characterizing sustained threat via an array of mindful counter-regulatory strategies; (2) review evidence that mindfulness-based interventions modify biological domains implicated in sustained threat, such as the hypothalamic–pituitary–adrenal axis, as well as brain circuits involved in attentional function, limbic reactivity, habit behavior, and the default mode network; and (3) integrate these findings into a novel conceptual framework of mindful self-regulation in the face of stress—the Mindfulness-to-Meaning Theory. Taken together, the extant body of scientific evidence suggests that the practice of mindfulness enhances a range biobehavioral factors implicated in adaptive stress coping and induces self-referential plasticity, leading to the ability to find meaning in adversity. These mechanistic findings can inform the treatment development process to optimize the next generation of mindfulness-based interventions for greater therapeutic efficacy.