Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface.
Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface.
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DOI：
10.3389/fpsyt.2013.00173
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发表时间：
2014-01-10
影响因子：
4.7
通讯作者：
Howard MO
中科院分区：
文献类型：
--
作者：
Garland EL;Froeliger B;Howard MO
突出的神经科学模型表明，成瘾行为发生时，环境压力和药物相关的线索激活认知，情感和心理生理机制的循环，包括自下而上和自上而下的神经过程之间的失调相互作用，迫使用户寻找和使用药物。基于正念的干预（MBIs）针对连接压力和成瘾的风险链的致病机制。这篇综述介绍了MBIs如何在注意-评价-情绪界面靶向成瘾的神经认知机制。MBIs通过增强对一些关键过程的认知调节来改善成瘾，包括：澄清认知评价和调节负性情绪以减少持续认知和情绪唤醒;增强元认知意识以调节药物使用行为图式和减少成瘾注意偏差;促进消退学习以将药物使用触发与条件性食欲反应分离;降低线索反应性并增加对渴望的认知控制;通过副交感神经激活减弱生理应激反应性;以及增加品味以恢复自然奖励处理。我们的神经认知框架的治疗和研究意义。最后，我们通过一个假设的案例研究，提供了一个时间序列的描述MBIs针对神经认知过程。我们的神经认知框架对MBIs成瘾治疗的优化有影响。
Prominent neuroscience models suggest that addictive behavior occurs when environmental stressors and drug-relevant cues activate a cycle of cognitive, affective, and psychophysiological mechanisms, including dysregulated interactions between bottom-up and top-down neural processes, that compel the user to seek out and use drugs. Mindfulness-based interventions (MBIs) target pathogenic mechanisms of the risk chain linking stress and addiction. This review describes how MBIs may target neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface. Empirical evidence is presented suggesting that MBIs ameliorate addiction by enhancing cognitive regulation of a number of key processes, including: clarifying cognitive appraisal and modulating negative emotions to reduce perseverative cognition and emotional arousal; enhancing metacognitive awareness to regulate drug-use action schema and decrease addiction attentional bias; promoting extinction learning to uncouple drug-use triggers from conditioned appetitive responses; reducing cue-reactivity and increasing cognitive control over craving; attenuating physiological stress reactivity through parasympathetic activation; and increasing savoring to restore natural reward processing. Treatment and research implications of our neurocognitive framework are presented. We conclude by offering a temporally sequenced description of neurocognitive processes targeted by MBIs through a hypothetical case study. Our neurocognitive framework has implications for the optimization of addiction treatment with MBIs.
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