Prevention of recurrent affective episodes using extinction training in the reconsolidation window: A testable psychotherapeutic strategy

PSYCHIATRY RESEARCH

卷:249

Review

Post, Robert M.¹  Kegan, Robert² 

[1] George Washington Univ, Sch Med, Bipolar Collaborat Network, 5415 W Cedar Lane Suite 201-B, Bethesda, MD 20814 USA

[2] Harvard Univ, Grad Sch Educ, 205 Longfellow Hall,Appian Way, Cambridge, MA 02138 USA

关键词: Memory;    Reconsolidation window;    Recurrent mood disorders;    Stress;    Habit memory representational memory;    Striatum;    Amygdala;    Cognitive behavior therapy;    Extinction training;    Brain imaging;    Epigenetics;   

DOI  :  10.1016/j.psychres.2017.01.034

来源: Elsevier

【 摘 要 】

Stressors may initially precipitate affective episodes, but with sufficient numbers of recurrences, episodes can occur more autonomously. It is postulated the memory engram for these recurrent depressions moves from the conscious representational memory system to the unconscious habit memory system encoded in the striatum. If this were the case, cognitive behavior therapy targeted toward extinction of habit memories could be an effective maneuver for helping reverse the automaticity of affective episode recurrence. Extinction training in the reconsolidation window (which opens about 5 min to 1 h after active memory recall) can revise, reverse, or eliminate the long term memories associated with PTSD and other anxiety disorders and with drug abuse craving. We hypothesize that similar cognitive behavioral work in the reconsolidation window could inhibit stress -induced and spontaneous affective episodes. Some initial formulations of possible therapeutic strategies are presented and discussed, as well as caveats. It is hoped that preliminary exposition of this theoretical approach to recurrences in the affective disorders based on principles dependent on work in the reconsolidation window will lead to more detailed elaboration of the therapeutic maneuvers most likely to be successful and ones that can be specifically tested for their clinical efficacy.

【 授权许可】

Free