Cognitive Control in Pediatric Obsessive-Compulsive and Anxiety Disorders: Brain-Behavioral Targets for Early Intervention.
Cognitive Control in Pediatric Obsessive-Compulsive and Anxiety Disorders: Brain-Behavioral Targets for Early Intervention.
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DOI：
10.1016/j.biopsych.2020.11.012
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发表时间：
2021-04-01
影响因子：
10.6
通讯作者：
Marsh R
中科院分区：
文献类型：
--
作者：
Fitzgerald KD;Schroder HS;Marsh R
DSM为强迫症和各种类型的焦虑症提供了不同的标准，但现象上的重叠、高比例的合并症和早期发病表明了共同的潜在机制。认知行为疗法（CBT）和5 -羟色胺再摄取抑制剂药物——用于治疗临床环境中的强迫症（OCD）和非强迫症焦虑症——进一步支持了这一观点。虽然这些黄金标准疗法被推荐用于儿童强迫症和焦虑症的早期干预，但年轻患者往往在治疗后仍有症状。为了指导新的、机械的靶向治疗的发展，以更好地解决强迫症和焦虑症状，已经推荐识别神经回路，这些神经回路是心理结构的基础，具有跨障碍的相关性。一个可能与理解儿童强迫症和焦虑症相关的概念是认知控制，考虑到年轻患者在排除强迫、强迫和担忧方面遇到的困难，尽管他们认识到这些症状是过度和不合理的。在这篇综述中，我们研究了越来越多的涉及儿童强迫症和焦虑症认知控制的脑行为标记的文献，包括治疗前后。我们的结论是，旨在增强认知控制下的任务控制回路功能的干预措施可能促进大脑成熟，帮助受影响的青少年克服症状。
The DSM provides distinct criteria for obsessive compulsive and various types of anxiety disorders, but phenomenological overlap, high rates of comorbidity, and early onset suggest common underlying mechanisms. This notion is further supported by use of the same treatments – cognitive behavioral therapy (CBT) and serotonin reuptake inhibitor medication – for managing both obsessive compulsive disorder (OCD) and non-OCD anxiety disorders in clinical settings. While early intervention with these gold standard treatments is recommended for pediatric OCD and anxiety disorders, young patients often remain symptomatic even after treatment. To guide the development of novel, mechanistically targeted treatments to better resolve OCD and anxiety symptoms, the identification of neural circuits underlying psychological constructs with relevance across disorders has been recommended. One construct that may be relevant for understanding pediatric OCD and anxiety disorders is cognitive control, given the difficulty that young patients experience in dismissing obsessions, compulsions and worry despite recognition that these symptoms are excessive and unreasonable. In this review, we examine findings from a growing body of literature implicating brain-behavioral markers of cognitive control in pediatric OCD and anxiety disorders, including before and after treatment. We conclude by suggesting that interventions designed to enhance the functioning of the task control circuits underlying cognitive control may facilitate brain maturation to help affected youth overcome symptoms.
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