科學(xué)家揭示了減緩焦慮發(fā)作的潛在技巧

科學(xué)家揭示了減緩焦慮發(fā)作的潛在技巧

In the last year, an estimated one-in-five adults living in the US will experience a form of anxiety, the effects of which can be debilitating for those who experience an anxiety attack characterized by sweaty palms, rapid breathing, trembling, and shaking that's then topped off by a surge of overwhelming panic.

去年,估計(jì)有五分之一的成年人生活在美國(guó)將經(jīng)歷一種焦慮,會(huì)讓人感到非常虛弱的影響對(duì)于那些經(jīng)歷一個(gè)焦慮發(fā)作特點(diǎn)是手心出汗,快速的呼吸,然后是頭部的顫抖,顫抖的壓倒性的恐慌。

For the half of anxiety sufferers who do not find relief in traditional treatments such as cognitive behavioral therapy and antidepressants, scientists have revealed a possible way to slow down an anxiety attack: safety signals. When life events trigger the crushing fear associated with an anxiety attack, turning to a symbol or sound not associated with adverse effects can relieve anxiety by activating a different brain network in both mice and human subjects.

對(duì)于那些無(wú)法從認(rèn)知行為療法和抗抑郁藥等傳統(tǒng)療法中得到緩解的焦慮患者，科學(xué)家們發(fā)現(xiàn)了一種減緩焦慮發(fā)作的可能方法:安全信號(hào)。當(dāng)生活事件引發(fā)與焦慮發(fā)作相關(guān)的極度恐懼時(shí)，轉(zhuǎn)向與副作用無(wú)關(guān)的符號(hào)或聲音可以通過(guò)激活小鼠和人類(lèi)的不同大腦網(wǎng)絡(luò)來(lái)緩解焦慮。

“A safety signal could be a musical piece, a person, or even an item like a stuffed animal that represents the absence of threat,” said Paola Odriozola, a PhD candidate in psychology at Yale and co-first author, in a statement.

“安全信號(hào)可以是一件音樂(lè)作品，一個(gè)人，甚至是一個(gè)像填充玩具動(dòng)物一樣的物品，代表沒(méi)有威脅，”耶魯大學(xué)(Yale)心理學(xué)博士候選人、第一作者之一保拉·奧德里奧佐拉(Paola Odriozola)在一份聲明中說(shuō)。

Study participants were shown a shape associated with a threatening outcome, followed by both the threatening shape and a secondary non-threatening shape (For mice, researchers used different tones). Brain imaging revealed that a different neural network was activated than in exposure therapy, a treatment that gradually exposes a patient to a perceived threat in order to lessen the level of associated anxiety. The second shape, or “safety signal”, suppressed the subject’s fear compared to the threatening shape. In particular, the Yale University researchers found that the ventral hippocampus, a part of the brain that responds to perceived threats, was activated and may be key to inhibiting fear response in animals.

研究人員向參與者展示了一種與威脅性結(jié)果相關(guān)的形狀，接著是威脅性形狀和第二種不具威脅性的形狀(對(duì)于老鼠，研究人員使用了不同的聲調(diào))。腦成像顯示，激活的神經(jīng)網(wǎng)絡(luò)與暴露療法不同。暴露療法是指逐漸將患者暴露在可感知的威脅中，以減輕相關(guān)焦慮水平。第二種形狀，或“安全信號(hào)”，與威脅性形狀相比，能抑制受試者的恐懼。特別是，耶魯大學(xué)的研究人員發(fā)現(xiàn)，大腦中對(duì)感知到的威脅做出反應(yīng)的部分——腹側(cè)海馬體被激活了，這可能是抑制動(dòng)物恐懼反應(yīng)的關(guān)鍵。

Behavioral therapy gradually exposes patients to the source of their fear over time, eventually reteaching the brain to respond differently to once-perceived threats. For those who don’t respond to CBT, safety signals may be an effective method to reduce the threat response and prevent anxiety attacks in the future.

隨著時(shí)間的推移，行為療法逐漸讓患者接觸到恐懼的源頭，最終重新教會(huì)大腦對(duì)曾經(jīng)感知到的威脅做出不同的反應(yīng)。對(duì)于那些對(duì)CBT沒(méi)有反應(yīng)的人來(lái)說(shuō)，安全信號(hào)可能是一種減少威脅反應(yīng)和預(yù)防未來(lái)焦慮發(fā)作的有效方法。

“Exposure-based therapy relies on fear extinction, and although a safety memory is formed during therapy, it is always competing with the previous threat memory,” explained Dylan Gee, assistant professor of psychology at Yale and co-senior author. “This competition makes current therapies subject to the relapse of fear – but there is never a threat memory associated with safety signals.”

耶魯大學(xué)心理學(xué)助理教授迪倫·吉(Dylan Gee)解釋說(shuō):“暴露療法依賴(lài)于恐懼消退，盡管在治療過(guò)程中形成了一種安全記憶，但它總是在與之前的威脅記憶競(jìng)爭(zhēng)。”“這種競(jìng)爭(zhēng)使得目前的治療方法容易使恐懼復(fù)發(fā)——但從來(lái)沒(méi)有與安全信號(hào)相關(guān)的威脅記憶。”

Importantly, the study was conducted with individuals who do not have anxiety disorders, leaving much to be studied in terms of how safety signals function in adults and children diagnosed with anxiety disorders, added Gee. Furthermore, safety signals in daily life may be more complex than during an experiment and may interfere at times with treatment or serve as a “crutch”.

重要的是，這項(xiàng)研究是在沒(méi)有焦慮癥的個(gè)體中進(jìn)行的，對(duì)于安全信號(hào)在被診斷為焦慮癥的成人和兒童中的作用，還有很多需要研究的地方，Gee補(bǔ)充說(shuō)。此外，日常生活中的安全信號(hào)可能比實(shí)驗(yàn)中更復(fù)雜，有時(shí)可能干擾治療或充當(dāng)“拐杖”。

There is much more research needed to understand how, when, and for whom safety signals might be helpful, but we think that judiciously incorporating safety signals into treatment could be helpful for individuals who have not benefited sufficiently from existing interventions or at particular developmental stages, said Gee.

吉說(shuō):“需要進(jìn)行更多的研究來(lái)了解安全信號(hào)如何、何時(shí)以及對(duì)誰(shuí)有幫助，但是我們認(rèn)為，明智地將安全信號(hào)納入治療可能對(duì)那些沒(méi)有從現(xiàn)有干預(yù)措施或處于特定發(fā)展階段的人有幫助。”

Regardless, the researchers write in the journal Proceedings of the National Academy of Sciences that their work presents a potential solution to enhance current treatments for anxiety disorders by targeting neural circuits through safety signaling.

無(wú)論如何，研究人員在《美國(guó)國(guó)家科學(xué)院院刊》(Proceedings of the National Academy of Sciences)雜志上撰文稱(chēng)，他們的工作提出了一種潛在的解決方案，可以通過(guò)安全信號(hào)傳導(dǎo)瞄準(zhǔn)神經(jīng)回路，加強(qiáng)目前對(duì)焦慮癥的治療。