Learning models of PTSD: Theoretical accounts and psychobiological evidence.
Learning models of PTSD: Theoretical accounts and psychobiological evidence.
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DOI：
10.1016/j.ijpsycho.2014.11.006
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发表时间：
2015-12
期刊：
影响因子：
--
通讯作者：
van Meurs B
中科院分区：
文献类型：
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作者：
Lissek S;van Meurs B
长期以来，学习异常一直被认为与创伤后精神病理有关。事实上，在所有焦虑症中，创伤后应激障碍可能最明显地归因于离散的、令人厌恶的学习事件。在创伤后应激障碍中，这种学习是在创伤性遭遇中获得的，表现为对与事件相关的刺激的条理性恐惧，以及更普遍的过度反应——或无法适应强烈的、新颖的或与恐惧相关的刺激。创伤后应激障碍与这些基本的、进化上古老的条件反射、敏化和习惯化的学习过程之间的相对直接的联系，提供了创伤后应激障碍的模型，包括基本的、实验上可处理的学习机制，这些机制已经在包括人类在内的各种哺乳动物物种中得到了很好的表征。尽管这种学习机制在创伤心理适应不良的解释模型中占有显著地位至少90年，但这些模型的许多实证检验仅在过去二十年中才出现。当前的综述描述了形成长期以来基于学习的创伤后应激障碍模型的各种理论，详细介绍了这些模型的经验证据，试图对这些文献的结果进行综合解释，并详细说明了测试创伤后应激障碍学习模型的研究的局限性和未来方向。
Learning abnormalities have long been centrally implicated in posttraumatic psychopathology. Indeed of all anxiety disorders, PTSD may be most clearly attributable to discrete, aversive learning events. In PTSD, such learning is acquired during the traumatic encounter and is expressed as both conditioned fear to stimuli associated with the event and more general over-reactivity—or failure to adapt—to intense, novel, or fear-related stimuli. The relatively straightforward link between PTSD and these basic, evolutionarily old, learning processes of conditioning, sensitization, and habituation affords models of PTSD comprised of fundamental, experimentally tractable mechanisms of learning that have been well characterized across a variety of mammalian species including humans. Though such learning mechanisms have featured prominently in explanatory models of psychological maladjustment to trauma for at least 90 years, much of the empirical testing of these models has occurred only in the past two decades. The current review delineates the variety of theories forming this longstanding tradition of learning-based models of PTSD, details empirical evidence for such models, attempts an integrative account of results from this literature, and specifies limitations of, and future directions for, studies testing learning models of PTSD.