A return to the psychiatric dark ages with a two-system framework for fear
A return to the psychiatric dark ages with a two-system framework for fear
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DOI：
10.1016/j.brat.2017.10.012
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发表时间：
2018-01-01
影响因子：
4.1
通讯作者：
Pennington, Zachary T.
中科院分区：
文献类型：
--
作者：
Fanselow, Michael S.;Pennington, Zachary T.
在过去的几十年里，我们对恐惧和焦虑的神经生物学的理解取得了长足的进步。这些进展是由恐惧的设想推动的，恐惧来自大脑和行为系统的协调激活，这些系统的进化是为了防御环境危险。最近，这一观点的前支持者约瑟夫·勒道克斯发表了一系列论文，对这一方法的价值提出了质疑。作为另一种选择，他和他的同事们提出，研究对威胁的反应的“两系统”框架将加快恐惧障碍的医疗治疗的进步。这一观点表明，一种系统用于自主和行为反应，另一种系统用于主观恐惧感觉。他们认为，这两个系统相互垂直运行，因此无法从生理和行为测量中收集有关恐惧情绪的推论；混淆这些系统阻碍了对恐惧障碍的机械性理解和治疗。与这种观点将推动科学进步的说法相反，它蕴含着可怕的含义，即我们应该将对恐惧的研究减少到主观报告。在这里，我们概述了为什么我们认为恐惧最好被认为是对危险的综合自主、行为和认知情绪反应，这些反应来自中央恐惧生成器，其进化上保守的功能是防御。此外，我们认为，尽管恐惧反应的组成部分可以被独立地调节和研究，但大脑共同的上游区域决定了它们的起源，因此可以从每种区域的测量中得出关于中枢恐惧状态的推断。
The past several decades has seen considerable progress in our understanding of the neurobiology of fear and anxiety. These advancements were spurred on by envisioning fear as emerging from the coordinated activation of brain and behavioral systems that evolved for the purpose of defense from environmental dangers. Recently, Joseph LeDoux, a previous proponent of this view, published a series of papers in which he challenges the value of this approach. As an alternative, he and colleagues propose that a 'two-system' framework for the study of responses to threat will expedite the advancement of medical treatments for fear disorders. This view suggests one system for autonomic and behavioral responses and a second for the subjective feeling of fear. They argue that these two systems operate orthogonally and thus inferences concerning the emotion of fear cannot be gleaned from physiological and behavioral measures; confounding these systems has impeded the mechanistic understanding and treatment of fear disorders. Counter to the claim that this view will advance scientific progress, it carries the frightening implication that we ought to reduce the study of fear to subjective report. Here, we outline why we believe that fear is best considered an integrated autonomic, behavioral, and cognitive emotional response to danger emerging from a central fear generator whose evolutionarily conserved function is that of defense. Furthermore, we argue that although components of the fear response can be independently modulated and studied, common upstream brain regions dictate their genesis, and therefore inferences about a central fear state can be garnered from measures of each.