情绪障碍和精神分裂症的奖赏加工:一个神经发育框架

IF 17.8 1区 心理学 Q1 PSYCHOLOGY
Robin Nusslock, Vijay A. Mittal, Lauren B. Alloy
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引用次数: 0

摘要

重度抑郁症(MDD)、双相情感障碍和精神分裂症都涉及对奖励刺激的处理中断。在这篇综述中,我们提出在情绪障碍与精神分裂症之间存在不同的机制途径,并强调了解这些差异对于开发个性化治疗的重要性。我们总结的证据表明,情绪障碍的奖励处理异常是由失调的动机系统驱动的;重度抑郁症的特点是对奖励线索的反应迟钝,而双相情感障碍的特点是反应增强。相反,我们认为精神分裂症的奖励处理中断并不反映动机或享乐体验的异常;相反,它们反映了对过去和未来奖励的认知表征的损伤,以及对无关刺激的错误注意力。为了整合这些发现,我们提出了情绪和精神障碍发病的神经发育框架,并探讨了正常大脑发育的中断如何影响其病理生理学、时间和发病。此外,我们超越了将这些条件视为同质障碍,并讨论了奖励处理概况如何与特定症状维度相一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reward Processing in Mood Disorders and Schizophrenia: A Neurodevelopmental Framework
Major depressive disorder (MDD), bipolar disorder, and schizophrenia involve disruptions in processing rewarding stimuli. In this review, we propose that distinct mechanistic pathways underlie these disruptions in mood disorders versus schizophrenia, and we highlight the importance of understanding these differences for developing personalized treatments. We summarize evidence suggesting that reward processing abnormalities in mood disorders are driven by dysregulated motivational systems; MDD is characterized by blunted responses to reward cues, and bipolar disorder is characterized by heightened responses. In contrast, we argue that reward processing disruptions in schizophrenia do not reflect abnormalities in motivation or hedonic experience; rather, they reflect impairments in the cognitive representation of past and future rewards as well as misdirected attention to irrelevant stimuli. To integrate these findings, we present a neurodevelopmental framework for the onset of mood and psychotic disorders and explore how disruptions in normative brain development contribute to their pathophysiology, timing, and onset. Additionally, we move beyond viewing these conditions as homogeneous disorders and discuss how reward processing profiles may align with specific symptom dimensions.
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来源期刊
CiteScore
31.50
自引率
0.50%
发文量
24
期刊介绍: The Annual Review of Clinical Psychology is a publication that has been available since 2005. It offers comprehensive reviews on significant developments in the field of clinical psychology and psychiatry. The journal covers various aspects including research, theory, and the application of psychological principles to address recognized disorders such as schizophrenia, mood, anxiety, childhood, substance use, cognitive, and personality disorders. Additionally, the articles also touch upon broader issues that cut across the field, such as diagnosis, treatment, social policy, and cross-cultural and legal issues. Recently, the current volume of this journal has transitioned from a gated access model to an open access format through the Annual Reviews' Subscribe to Open program. All articles published in this volume are now available under a Creative Commons Attribution License (CC BY), allowing for widespread distribution and use. The journal is also abstracted and indexed in various databases including Scopus, Science Citation Index Expanded, MEDLINE, EMBASE, CINAHL, PsycINFO, and Academic Search, among others.
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