TREATMENT FOR ANHEDONIA: A NEUROSCIENCE DRIVEN APPROACH
TREATMENT FOR ANHEDONIA: A NEUROSCIENCE DRIVEN APPROACH
复制标题
DOI：
10.1002/da.22490
复制
发表时间：
2016-10-01
影响因子：
7.4
通讯作者：
Dour, Halina J.
中科院分区：
文献类型：
--
作者：
Craske, Michelle G.;Meuret, Alicia E.;Dour, Halina J.
快感缺失，或对日常活动失去兴趣或乐趣，是抑郁症，某些类型的焦虑，以及药物滥用和精神分裂症的特征。快感缺失是不良长期结局的预测因子，包括自杀和不良治疗反应。由于现有的心理和药物治疗对快感缺乏相对无效，因此对这种高危症状的治疗需求尚未得到满足。目前，焦虑和抑郁的心理和药物治疗主要集中在减少过度的负面影响，而不是改善积极影响的不足。情感神经科学的最新进展表明，快感缺乏与食欲奖赏系统的缺陷有关，特别是对奖赏的预期、消费和学习。在本文中，我们回顾了积极情绪作为一个症状群的证据，及其神经基础，并介绍了一种新的心理治疗焦虑和抑郁症的目标食欲反应。首先，我们回顾了快感缺乏与积极和消极的效价系统和目前的治疗方法。其次，我们讨论了证据连接快感缺乏的奖励子系统中的生物，经验和行为缺陷。第三，我们描述了积极情感治疗（PAT）的治疗方法，这是一种专门针对奖励敏感性缺陷的干预措施。(C)2016 Wiley Periodicals，Inc.
Anhedonia, or loss of interest or pleasure in usual activities, is characteristic of depression, some types of anxiety, as well as substance abuse and schizophrenia. Anhedonia is a predictor of poor long-term outcomes, including suicide, and poor treatment response. Because extant psychological and pharmacological treatments are relatively ineffective for anhedonia, there is an unmet therapeutic need for this high-risk symptom. Current psychological and drug treatments for anxiety and depression focus largely on reducing excesses in negative affect rather than improving deficits in positive affect. Recent advances in affective neuroscience posit that anhedonia is associated with deficits in the appetitive reward system, specifically the anticipation, consumption, and learning of reward. In this paper, we review the evidence for positive affect as a symptom cluster, and its neural underpinnings, and introduce a novel psychological treatment for anxiety and depression that targets appetitive responding. First, we review anhedonia in relation to positive and negative valence systems and current treatment approaches. Second, we discuss the evidence linking anhedonia to biological, experiential, and behavioral deficits in the reward subsystems. Third, we describe the therapeutic approach for Positive Affect Treatment (PAT), an intervention designed to specifically target deficits in reward sensitivity. (C) 2016 Wiley Periodicals, Inc.