创伤后应激障碍的认知功能缺陷与执行控制——5·12震后创伤恢复的认知基础
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摘要
创伤后应激障碍(Posttraumatic stress disorder,PTSD)患者通常伴随着明显的认知功能损伤。例如,存在注意保持缺陷,对与创伤相关的信息表现出更多的注意偏向和应激反应;并存在对创伤信息的记忆偏向,在陈述性记忆和自传体记忆中表现出一定的缺陷。近年的研究积累了更多类似的证据,表明PTSD的认知损伤可能与执行功能缺陷密切相关,但这一解释是否正确仍有待进一步的研究。本综述对5·12汶川大地震后长期的心理干预工作,尤其是认知功能损伤人群的筛选、恢复以及相关科学研究具有现实意义和理论启发作用。
Posttraumatic stress disorder (PTSD) is often accompanied with cognitive malfunctions, such as deficit in attentional sustain, biased attention towards trauma-related information, biased memory for traumatic events, and impairment in declarative memory and autobiographical memory. More evidences have been accumulated in recent years and these cognitive malfunctions in PTSD are proposed to be related with the deficit in executive control. Though it needs further studies for justifying this uniform explanation, executive function can be a good starting point for filtering and treatment of PTSD in a practical sense.
Posttraumatic stress disorder (PTSD) is often accompanied with cognitive malfunctions, such as deficit in attentional sustain, biased attention towards trauma-related information, biased memory for traumatic events, and impairment in declarative memory and autobiographical memory. More evidences have been accumulated in recent years and these cognitive malfunctions in PTSD are proposed to be related with the deficit in executive control. Though it needs further studies for justifying this uniform explanation, executive function can be a good starting point for filtering and treatment of PTSD in a practical sense.
引文
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Buckley,T.C.,Blanchard,E.B.,&Neill,W.T.(2000).Information processing and PTSD:A review of the empirical literature.Clinical Psychology Review,20(8),1041–1065.
Constans,J.I.,McCloskey,M.S.,Vasterling,J.J.,Brailey,K.,&Mathews,A.(2004).Suppression of attentional bias in PTSD.Journal of Abnormal Psychology,113(2),315–323.
Crowell,T.A.,Kieffer,K.M.,Siders,C.A.,&Vanderploeg,R.D.(2002).Neuropsychological findings in combat-related posttraumatic stress disorders.Clinical Neuropsychologist,16(3),310–321.
Dalgleish,T.,Rolfe,J.,Golden,A.M.,Dunn,B.D.,&Bamard,P.J.(2008).Reduced autobiographical memory specificity and posttraumatic stress:Exploring the contributions of impaired executive control and affect regulation.Journal of Abnormal Psychology,117(1),236–241.
Dalgleish,T.,Williams,J.M.G.,Golden,A.M.J.,Perkins,N.,Barrett,L.F.,Barnard,P.J.,et al.(2007).Reduced specificity of autobiographical memory and depression:The role of executive control.Journal of Experimental Psychology:General,136(1),23–42.
Danckwerts,A.,&Leathem,J.(2003).Questioning the link between PTSD and cognitive dysfunction.Neuropsychology Review,13(4),221–235.
Fan,J.,McCandliss,B.D.,Sommer,T.,Raz,A.,&Posner,M.I.(2002).Testing the efficiency and independence of attentional networks.Journal of Cognitive Neuroscience,14(3),340–347.
Goldstein,L.E.,Rasmusson,A.M.,Bunney,B.S.,&Roth,R.H.(1996).Role of the amygdala in the coordination of behavioral,neuroendocrine,and prefrontal cortical monoamine responses to psychological stress in the rat.Journal of Neuroscience,16(15),4787–4798.
Green,B.(1994).Psychosocial research in traumatic stress:An update.Journal of Traumatic Stress,7,341-360.
Kleim,B.,&Ehlers,A.(2008).Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma.Journal of Consulting and Clinical Psychology,76(2),231–242.
Koso,M.,&Hansen,S.(2006).Executive function and memory in posttraumatic stress disorder:a study of Bosnian war veterans.European Psychiatry,21(3),167–173.
Kulka,R.A.,Schlenger,W.E.,Fairbank,J.A.,Hough,R.L.,Jordan,B.K.,Marmar,C.R.,et al(1990):Trauma and the Vietnam generation:Report of findings from the National Vietnam Veterans Readjustment Study.New York:Brunner/Mazel.
Leskin,L.P.,&White,P.M.(2007).Attentional networks reveal executive function deficits in posttraumatic stress disorder.Neuropsychology,21(3),275–284.
Lezak,M.D.,Howieson,D.B.,&Loring,D.W.(2004).Neuropsychological Assessment(4th ed.).New York:Oxford University Press.
Mirsky,A.F.,Anthony,B.J.,Duncan,C.C.,Ahearn,M.B.,&Kellam,S.G.(1991).Analysis of the elements of attention:A neuropsychological approach.Neuropsychology Review,2,109–145.
Moores,K.A.,Clark,C.R.,McFarlane,A.C.,Brown,G.C.,Puce,A.,&Taylor,D.J.(2008).Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder.Psychiatry Research-Neuroimaging,163(2),156–170.
Moradi,A.R.,Herlihy,J.,Yasseri,G.,Shahraray,M.,Turner,S.,&Dalgleish,T.(2008).Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder(PTSD).Acta Psychologica,127(3),645–653.
Parslow,R.A.,&Jorm,A.F.(2007).Pretrauma and posttrauma neurocognitive functioning and PTSD symptoms in a community sample of young adults.American Journal of Psychiatry,164(3),509–515.
Shucard,J.L.,McCabe,D.C.,&Szymanski,H.(2008).An event-related potential study of attention deficits in posttraumatic stress disorder during auditory and visual Go/NoGo continuous performance tasks.Biological Psychology,79(2),223–233.
Vasterling,J.J.,Brailey,K.,Constans,J.I.,&Sutker,P.B.(1998).Attention and memory dysfunction in posttraumatic stress disorder.Neuropsychology,12(1),125–133.
Vasterling,J.J.,Duke,L.M.,Brailey,K.,Constans,J.I.,Allain,A.N.,&Stuker,P.B.(2002).Attention,learning,and memory performances and intellectual resources in Vietnam veterans:PTSD and no disorder comparisons.Neuropsychology,16(1),5–14.
Williams,J.M.G.,Barnhofer,T.,Crane,C.,Hermans,D.,Raes,F.,Watkins,E.,et al.(2007).Autobiographical memory specificity and emotional disorder.Psychological Bulletin,133(1),122–148.
Williams,J.M.G.,Mathews,A.,&MacLeod,C.(1996).The emotional stroop task and psychopathology.Psychological Bulletin,120(1),3–24.
Young,R.M.,Lawford,B.R.,Noble,E.P.,Kann,B.,Wilkie,A.,Ritchie,T.,et al.(2002).Harmful drinking in military veterans with post-traumatic stress disorder:Association with the D2dopamine receptor A1allele.Alcohol and Alcoholism,37(5),451–456.
Buckley,T.C.,Blanchard,E.B.,&Neill,W.T.(2000).Information processing and PTSD:A review of the empirical literature.Clinical Psychology Review,20(8),1041–1065.
Constans,J.I.,McCloskey,M.S.,Vasterling,J.J.,Brailey,K.,&Mathews,A.(2004).Suppression of attentional bias in PTSD.Journal of Abnormal Psychology,113(2),315–323.
Crowell,T.A.,Kieffer,K.M.,Siders,C.A.,&Vanderploeg,R.D.(2002).Neuropsychological findings in combat-related posttraumatic stress disorders.Clinical Neuropsychologist,16(3),310–321.
Dalgleish,T.,Rolfe,J.,Golden,A.M.,Dunn,B.D.,&Bamard,P.J.(2008).Reduced autobiographical memory specificity and posttraumatic stress:Exploring the contributions of impaired executive control and affect regulation.Journal of Abnormal Psychology,117(1),236–241.
Dalgleish,T.,Williams,J.M.G.,Golden,A.M.J.,Perkins,N.,Barrett,L.F.,Barnard,P.J.,et al.(2007).Reduced specificity of autobiographical memory and depression:The role of executive control.Journal of Experimental Psychology:General,136(1),23–42.
Danckwerts,A.,&Leathem,J.(2003).Questioning the link between PTSD and cognitive dysfunction.Neuropsychology Review,13(4),221–235.
Fan,J.,McCandliss,B.D.,Sommer,T.,Raz,A.,&Posner,M.I.(2002).Testing the efficiency and independence of attentional networks.Journal of Cognitive Neuroscience,14(3),340–347.
Goldstein,L.E.,Rasmusson,A.M.,Bunney,B.S.,&Roth,R.H.(1996).Role of the amygdala in the coordination of behavioral,neuroendocrine,and prefrontal cortical monoamine responses to psychological stress in the rat.Journal of Neuroscience,16(15),4787–4798.
Green,B.(1994).Psychosocial research in traumatic stress:An update.Journal of Traumatic Stress,7,341-360.
Kleim,B.,&Ehlers,A.(2008).Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma.Journal of Consulting and Clinical Psychology,76(2),231–242.
Koso,M.,&Hansen,S.(2006).Executive function and memory in posttraumatic stress disorder:a study of Bosnian war veterans.European Psychiatry,21(3),167–173.
Kulka,R.A.,Schlenger,W.E.,Fairbank,J.A.,Hough,R.L.,Jordan,B.K.,Marmar,C.R.,et al(1990):Trauma and the Vietnam generation:Report of findings from the National Vietnam Veterans Readjustment Study.New York:Brunner/Mazel.
Leskin,L.P.,&White,P.M.(2007).Attentional networks reveal executive function deficits in posttraumatic stress disorder.Neuropsychology,21(3),275–284.
Lezak,M.D.,Howieson,D.B.,&Loring,D.W.(2004).Neuropsychological Assessment(4th ed.).New York:Oxford University Press.
Mirsky,A.F.,Anthony,B.J.,Duncan,C.C.,Ahearn,M.B.,&Kellam,S.G.(1991).Analysis of the elements of attention:A neuropsychological approach.Neuropsychology Review,2,109–145.
Moores,K.A.,Clark,C.R.,McFarlane,A.C.,Brown,G.C.,Puce,A.,&Taylor,D.J.(2008).Abnormal recruitment of working memory updating networks during maintenance of trauma-neutral information in post-traumatic stress disorder.Psychiatry Research-Neuroimaging,163(2),156–170.
Moradi,A.R.,Herlihy,J.,Yasseri,G.,Shahraray,M.,Turner,S.,&Dalgleish,T.(2008).Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder(PTSD).Acta Psychologica,127(3),645–653.
Parslow,R.A.,&Jorm,A.F.(2007).Pretrauma and posttrauma neurocognitive functioning and PTSD symptoms in a community sample of young adults.American Journal of Psychiatry,164(3),509–515.
Shucard,J.L.,McCabe,D.C.,&Szymanski,H.(2008).An event-related potential study of attention deficits in posttraumatic stress disorder during auditory and visual Go/NoGo continuous performance tasks.Biological Psychology,79(2),223–233.
Vasterling,J.J.,Brailey,K.,Constans,J.I.,&Sutker,P.B.(1998).Attention and memory dysfunction in posttraumatic stress disorder.Neuropsychology,12(1),125–133.
Vasterling,J.J.,Duke,L.M.,Brailey,K.,Constans,J.I.,Allain,A.N.,&Stuker,P.B.(2002).Attention,learning,and memory performances and intellectual resources in Vietnam veterans:PTSD and no disorder comparisons.Neuropsychology,16(1),5–14.
Williams,J.M.G.,Barnhofer,T.,Crane,C.,Hermans,D.,Raes,F.,Watkins,E.,et al.(2007).Autobiographical memory specificity and emotional disorder.Psychological Bulletin,133(1),122–148.
Williams,J.M.G.,Mathews,A.,&MacLeod,C.(1996).The emotional stroop task and psychopathology.Psychological Bulletin,120(1),3–24.
Young,R.M.,Lawford,B.R.,Noble,E.P.,Kann,B.,Wilkie,A.,Ritchie,T.,et al.(2002).Harmful drinking in military veterans with post-traumatic stress disorder:Association with the D2dopamine receptor A1allele.Alcohol and Alcoholism,37(5),451–456.
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