幻觉心理治疗后对波动性的预期:一项随机临床试验
Julia M Sheffield1, Ali F Sloan2, Philip R Corlett3
1Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA network open
|June 24, 2025
概括
计算神经科学模型表明,在患有迫害妄想的患者中,挥发性先验和尾状核激活可以改变. 这些发现表明,不稳定性先验可能是精神病干预的新治疗目标.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 计算精神病学是一种计算精神病学.
背景情况:
- 迫害妄想是精神疾病中常见的,令人痛苦和具有挑战性的症状.
- 计算神经科学通过建模潜在的认知机制,为妄想提供了潜在的新治疗目标.
研究的目的:
- 调查幻觉严重程度的变化与波动先验和大脑激活的相应变化之间的关联.
- 探索针对波动性先验的潜力,作为对精神病的干预.
主要方法:
- 一项随机临床试验将精神病认知行为疗法 (CBTp) 与精神分裂症谱或妄想障碍的成年人友疗法进行了比较.
- 在8周的干预之前和之后,测量了先前的波动性,错觉严重程度 (使用PSYRATS) 和大脑激活 (fMRI).
- 分析了波动先验变化,临床结果和神经激活之间的关联.
主要成果:
- 无论是CBTp还是友疗法,都导致两组患者的波动性先验和妄想严重程度都降低了.
- 之前的波动性降低与错觉严重性的临床改善没有直接关联.
- 尾状核激活的减少与前期挥发性降低有关,独立于抗精神病药物治疗.
结论:
- 在患有迫害妄想的个体中,升高的波动性先验和相关的尾状核激活是可修改的.
- 波动性先验代表了一种潜在的新型治疗目标,用于治疗精神病的干预.
- 需要进一步的研究来探索在精神病治疗中准波动性先验的临床实用性.
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