Persistent and maladaptive drug-related memories represent a key component in drug addiction.Converging evidence from both preclinical and clinical studies has demonstrated the potential efficacy of the memory reconso...Persistent and maladaptive drug-related memories represent a key component in drug addiction.Converging evidence from both preclinical and clinical studies has demonstrated the potential efficacy of the memory reconsolidation updating procedure(MRUP),a non-pharmacological strategy intertwining two distinct memory processes:reconsolidation and extinction—alternatively termed“the memory retrieval-extinction procedure”.This procedure presents a promising approach to attenuate,if not erase,entrenched drug memories and prevent relapse.The present review delineates the applications,molecular underpinnings,and operational boundaries of MRUP in the context of various forms of substance dependence.Furthermore,we critically examine the methodological limitations of MRUP,postulating potential refinement to optimize its therapeutic efficacy.In addition,we also look at the potential integration of MRUP and neurostimulation treatments in the domain of substance addiction.Overall,existing studies underscore the significant potential of MRUP,suggesting that interventions predicated on it could herald a promising avenue to enhance clinical outcomes in substance addiction therapy.展开更多
A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic conditions.Implementing mental health care in physical care service...A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic conditions.Implementing mental health care in physical care services is still insufficient.Thus,interdisciplinary communication across treatment providers is essential.The standardized language provided by the diagnostic statistical manual favors a clear conceptualization.However,this approach might not focus on the individual,as thinking in categories might impede recognizing the continuum from healthy to diseased.Psychoanalytic theory is concerned with an individual’s unconscious conflictual wishes and motivations,manifested through enactments like psychic symptoms or(maladaptive)behavior with long-term consequences if not considered.Such modifiable internal and external factors often are inadequately treated.However,together with the physical chronic condition constraints,these factors determine degrees of freedom for a self-determined existence.The effect of therapeutic interventions,and especially therapy adherence,relies on a solid therapeutic relationship.Outcome and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment problems.This article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research.A clinical example is discussed.Additionally,further directions for research are given.The theoretical frame in psychoanalytic therapies is the affect-cognitive interface.Subliminal affect-perception is enabled via awareness of subjective meanings in oneself and the other;shaping this awareness is the main intervention point.The interactional ingredients,the patient’s inherent bioenvironmental history meeting the clinician,are relevant variables.Several intrinsic,subliminal parameters relevant for changing behavior are observed.Therapeutic interventions aim at supporting the internalization of the superego’s functions and at making this ability available in moments of self-reflection.By supporting mentalization abilities,a better understanding of oneself and higher selfregulation(including emotional regulation)can lead to better judgments(application of formal logic and abstract thinking).Thus,this facilitates enduring behavior change with presumably positive effects on mental and physical health.展开更多
Fear memory underlies anxiety-related disorders, including posttraumatic stress disorder(PTSD). PTSD is a fear-based disorder,characterized by difficulties in extinguishing the learned fear response and maintaining ex...Fear memory underlies anxiety-related disorders, including posttraumatic stress disorder(PTSD). PTSD is a fear-based disorder,characterized by difficulties in extinguishing the learned fear response and maintaining extinction. Currently, the first-line treatment for PTSD is exposure therapy, which forms an extinction memory to compete with the original fear memory. However,the extinguished fear often returns under numerous circumstances, suggesting that novel methods are needed to eliminate fear memory or facilitate extinction memory. This review discusses research that targeted extinction and reconsolidation to manipulate fear memory. Recent studies indicate that sleep is an active state that can regulate memory processes. We also discuss the influence of sleep on fear memory. For each manipulation, we briefly summarize the neural mechanisms that have been identified in human studies. Finally, we highlight potential limitations and future directions in the field to better translate existing interventions to clinical settings.展开更多
基金supported by the National Natural Science Foundation of China(82071498,81871046,and 32161143022)STI2030-Major Projects(2022ZD0214500).
文摘Persistent and maladaptive drug-related memories represent a key component in drug addiction.Converging evidence from both preclinical and clinical studies has demonstrated the potential efficacy of the memory reconsolidation updating procedure(MRUP),a non-pharmacological strategy intertwining two distinct memory processes:reconsolidation and extinction—alternatively termed“the memory retrieval-extinction procedure”.This procedure presents a promising approach to attenuate,if not erase,entrenched drug memories and prevent relapse.The present review delineates the applications,molecular underpinnings,and operational boundaries of MRUP in the context of various forms of substance dependence.Furthermore,we critically examine the methodological limitations of MRUP,postulating potential refinement to optimize its therapeutic efficacy.In addition,we also look at the potential integration of MRUP and neurostimulation treatments in the domain of substance addiction.Overall,existing studies underscore the significant potential of MRUP,suggesting that interventions predicated on it could herald a promising avenue to enhance clinical outcomes in substance addiction therapy.
文摘A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic conditions.Implementing mental health care in physical care services is still insufficient.Thus,interdisciplinary communication across treatment providers is essential.The standardized language provided by the diagnostic statistical manual favors a clear conceptualization.However,this approach might not focus on the individual,as thinking in categories might impede recognizing the continuum from healthy to diseased.Psychoanalytic theory is concerned with an individual’s unconscious conflictual wishes and motivations,manifested through enactments like psychic symptoms or(maladaptive)behavior with long-term consequences if not considered.Such modifiable internal and external factors often are inadequately treated.However,together with the physical chronic condition constraints,these factors determine degrees of freedom for a self-determined existence.The effect of therapeutic interventions,and especially therapy adherence,relies on a solid therapeutic relationship.Outcome and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment problems.This article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research.A clinical example is discussed.Additionally,further directions for research are given.The theoretical frame in psychoanalytic therapies is the affect-cognitive interface.Subliminal affect-perception is enabled via awareness of subjective meanings in oneself and the other;shaping this awareness is the main intervention point.The interactional ingredients,the patient’s inherent bioenvironmental history meeting the clinician,are relevant variables.Several intrinsic,subliminal parameters relevant for changing behavior are observed.Therapeutic interventions aim at supporting the internalization of the superego’s functions and at making this ability available in moments of self-reflection.By supporting mentalization abilities,a better understanding of oneself and higher selfregulation(including emotional regulation)can lead to better judgments(application of formal logic and abstract thinking).Thus,this facilitates enduring behavior change with presumably positive effects on mental and physical health.
基金supported by the National Key Technology Research and Development Program of the Ministry of Science and Technology of China(2015BAI13B01)
文摘Fear memory underlies anxiety-related disorders, including posttraumatic stress disorder(PTSD). PTSD is a fear-based disorder,characterized by difficulties in extinguishing the learned fear response and maintaining extinction. Currently, the first-line treatment for PTSD is exposure therapy, which forms an extinction memory to compete with the original fear memory. However,the extinguished fear often returns under numerous circumstances, suggesting that novel methods are needed to eliminate fear memory or facilitate extinction memory. This review discusses research that targeted extinction and reconsolidation to manipulate fear memory. Recent studies indicate that sleep is an active state that can regulate memory processes. We also discuss the influence of sleep on fear memory. For each manipulation, we briefly summarize the neural mechanisms that have been identified in human studies. Finally, we highlight potential limitations and future directions in the field to better translate existing interventions to clinical settings.
