重新认识复杂的创伤后应激障碍:机制和干预的预测处理框架

IF 7.5 1区 医学 Q1 BEHAVIORAL SCIENCES
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引用次数: 0

摘要

在本文中,我们将介绍一个通过预测处理来解释复杂创伤后应激障碍(C-PTSD)的框架。预测处理是一个神经科学概念,用于解释大脑对感官信息的解释和预测。复杂创伤后应激障碍与创伤后应激障碍密切相关,但它还包括以自我组织紊乱(DSO)为特征的其他症状群,如消极的自我概念、情感失调和关系障碍,这些症状群通常是由长期的创伤应激源引起的。我们的模型利用了计算精神病学和神经科学的进步,通过说明长期创伤如何扰乱大脑的预测处理,为这些症状提供了机理解释。具体来说,预测机制的改变导致了C-创伤后应激障碍的症状,重点是DSO:(1)消极的自我概念产生于适应不良的先验,这种先验使感知偏向于自我批评,从而使预期的和实际的感知间状态错位;(2)预测的和实际的感知间信号错位导致情感失调,对身体线索敏感;以及(3)人际关系挑战产生于偏斜的社交预测错误,从而导致不信任和退缩。这种以精确性为重点的方法揭示了C-创伤后应激障碍的动力学基础,并突出了旨在重新校准预测处理系统的潜在干预目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reconceptualizing complex posttraumatic stress disorder: A predictive processing framework for mechanisms and intervention

In this article, we introduce a framework for interpreting Complex Posttraumatic Stress Disorder (C-PTSD) through predictive processing, a neuroscience concept explaining the brain’s interpretation and prediction of sensory information. While closely related to PTSD, C-PTSD encompasses additional symptom clusters marked by disturbances in self-organization (DSO), such as negative self-concept, affect dysregulation, and relational difficulties, typically resulting from prolonged traumatic stressors. Our model leverages advances in computational psychiatry and neuroscience, offering a mechanistic explanation for these symptoms by illustrating how prolonged trauma disrupts the brain's predictive processing. Specifically, altered predictive mechanisms contribute to C-PTSD's symptomatology, focusing on DSO: (1) Negative self-concept emerges from maladaptive priors that bias perception towards self-criticism, misaligning expected and actual interoceptive states; (2) Misalignment between predicted and actual interoceptive signals leads to affect dysregulation, with sensitivity to bodily cues; and (3) Relationship challenges arise from skewed social prediction errors, fostering mistrust and withdrawal. This precision-focused approach sheds light on the dynamics underpinning C-PTSD and highlights potential intervention targets aimed at recalibrating the predictive processing system.

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来源期刊
CiteScore
14.20
自引率
3.70%
发文量
466
审稿时长
6 months
期刊介绍: The official journal of the International Behavioral Neuroscience Society publishes original and significant review articles that explore the intersection between neuroscience and the study of psychological processes and behavior. The journal also welcomes articles that primarily focus on psychological processes and behavior, as long as they have relevance to one or more areas of neuroscience.
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