Could repetitive negative thinking interfere with corrective learning? The example of anorexia nervosa
Could repetitive negative thinking interfere with corrective learning? The example of anorexia nervosa
复制标题
DOI：
10.1002/eat.22997
复制
发表时间：
2019-01-01
影响因子：
5.5
通讯作者：
Kaye, Walter H.
中科院分区：
文献类型：
--
作者：
Reilly, Erin E.;Lavender, Jason M.;Kaye, Walter H.
识别在神经性厌食症（AN）治疗过程中可能干扰矫正学习的过程可能有助于提高现有干预措施的有效性。我们认为，AN气质的某些认知过程特征可能有助于解释先前在AN中发现的难以更新先前学习过的关联和从反馈中学习的结果。具体来说，我们假设重复性消极思维（RNT）的参与，包括担心和沉思，可能会干扰对行为治疗成功至关重要的纠正学习。在此过程中，我们从焦虑和情绪障碍的现有工作中得出结论，将RNT与症状的维持和对认知行为治疗的不良反应联系起来。接下来，我们概述了在暴露于厌恶刺激之前、期间和之后参与RNT可能干扰AN学习的假设机制。然后，我们就如何在未来的研究中测试这些假设的关联提供了建议。虽然先前的工作表明RNT过程在AN患者中很常见，但这项工作主要是描述性的。我们建议通过直接检查积极参与RNT对纠正性学习的影响来扩展这项工作，这有助于确定可以明确针对治疗的AN维持过程。
Identifying processes that may interfere with corrective learning during treatments for anorexia nervosa (AN) may help to improve the effectiveness of existing interventions. We propose that certain cognitive processes characteristic of the AN temperament may help explain previous findings in AN suggesting difficulty updating previously learned associations and learning from feedback. Specifically, we hypothesize that engagement in repetitive negative thinking (RNT), including worry and rumination, could interfere with corrective learning that is critical to the success of behavioral treatments. In doing so, we draw from existing work in anxiety and mood disorders linking RNT to the maintenance of symptoms and poorer response to cognitive-behavioral treatments. Next, we outline hypothesized mechanisms through which engagement in RNT before, during, and after exposure to aversive stimuli could interfere with learning in AN. We then provide recommendations for how these hypothesized associations could be tested in future research. Although prior work has suggested that RNT processes are common among individuals with AN, this work has been primarily descriptive in nature. We propose that extending this work through direct examination of the impact of active engagement in RNT on corrective learning could aid in identifying AN maintenance processes that could be explicitly targeted in treatment.