影响应激障碍治疗方案确立的临床特征

急性应激障碍和创伤后应激障碍是近些年创伤后研究的重要内容.为了更加全面地评估遭遇创伤事件患者的情况,本文将从年龄、性别、种族和文化因素、生理与心理共病、过去受伤史、攻击行为、自伤和自杀行为7个方面阐述影响应激障碍的因素,以期在影响应激治疗因素层面为临床治疗提供依据.     

催产素调控心理韧性:基于对海马的作用机制

心理韧性指个体面对逆境、挫折或重大威胁等应激情境下的有效且灵活适应的能力, 促进机体恢复正常的生理和心理功能。研究表明海马是调控心理韧性的重要脑区, 且催产素可能通过作用于海马增强心理韧性。海马内部环路内嗅皮层-齿状回-CA3可能调节恐惧记忆的泛化和消退以增强心理韧性; 海马外部环路齿状回-杏仁核-伏隔核及海马-伏隔核环路调节情绪, 可能分别通过促进奖赏和带来厌恶进而增强或降低心理韧性。催产素作用于海马增强心理韧性的可能途径有:催产素促进海马神经发生, 降低海马腹侧成熟神经元对应激的敏感性, 提高海马“模式分离”功能, 降低应激记忆泛化; 催产素恢复海马谢弗侧枝-CA1突触长时程增强, 促进机体适应应激; 催产素降低海马糖皮质激素受体水平, 重新建立机体稳态。     

父母感知的家庭压力对儿童问题行为的影响：父母心理攻击和儿童应激下皮质醇反应的中介作用

儿童问题行为受到环境与个体因素的协同影响。研究以北京150名五、六年级儿童及其家长为被试,探究心理攻击和应激下皮质醇反应在父母感知的家庭压力与儿童问题行为间的中介作用。采用儿童版特里尔社会应激测试测量儿童应激下皮质醇反应,并由家长报告感知的家庭压力、对儿童的心理攻击及儿童的问题行为。结果发现：(1)父母感知的家庭压力可正向预测儿童问题行为;(2)心理攻击在父母感知的家庭压力与儿童问题行为间起中介作用;(3)心理攻击和儿童应激下皮质醇反应在父母感知的家庭压力与儿童问题行为之间起链式中介作用。研究揭示了父母感知压力对儿童问题行为影响的心理和生理机制,从父母和儿童角度为减少儿童问题行为提供了参考。     

急性心理应激致免疫改变的影响因素研究进展

自塞里提出应激理论以来 ,研究者对应激影响身心健康的生理、心理机制做了大量研究。近年来 ,许多学者把视角转向急性应激影响机体神经内分泌和免疫系统的研究[1] ,已有许多研究表明 ,无论是实验室诱发的急性应激或生活中的急性事件应激 ,均可影响机体免疫系统功能 ,而且机体免疫改变受到多种心理因素的影响[2 ] 。因此 ,探讨急性应激引起免疫反应的影响因素及其相关程度 ,对研究应激致病的中介机制、并进一步设计干预措施有重要的实际意义。1　急性应激致免疫改变的机制　　目前认为 ,机体保持内稳态的平衡 ,主要依赖于中枢神经系统 (ｃｅ…     

石杉碱甲对应激诱导的吗啡行为敏感化表达的影响

为探讨石杉碱甲对应激诱导的吗啡行为敏感化表达的影响, 将40只动物随机分为5组: 盐水组、石杉碱甲组、吗啡组、应激组、石杉碱甲+应激组。实验发现, 急性/慢性空瓶应激都能够激发吗啡行为敏感化的表达, 而石杉碱甲能够显著抑制空瓶应激的这种激发作用。经过吗啡点燃后, 急性空瓶应激并不能显著影响动物的行为敏感化, 提示与成瘾性药物的再现相比, 空瓶应激对动物的影响力度较小。研究结果表明, 石杉碱甲能够抑制急性/慢性空瓶应激诱导的吗啡行为敏感化表达, 表明这类胆碱酯酶抑制剂有可能成为治疗药物依赖的潜在药物。     

应激心向对女性急性应激条件下工作记忆的影响

为了探讨急性应激对工作记忆的影响,本研究引入应激心向的概念。实验1验证了社会性评价冷压测试的可靠性以及应激对工作记忆的影响,并探讨了急性应激条件下一般性应激心向与工作记忆的关系,结果发现,在急性应激条件下,女性的一般性应激心向不影响工作记忆的表现。实验2通过视频诱发被试的情境性应激心向,发现应激有利心向组比应激有害心向组在工作记忆任务中的表现更好,且应激心向得分与任务的准确率成正相关。研究表明女性在应激条件下的工作记忆表现会受具体应激心向的影响。     

应激环境下亲社会性的增加：来自不同类型的亲社会偏好的研究证据

人们面临对生理或者心理产生威胁的应激事件时并不一定表现出敌意和攻击, 也可能表现出更强的亲社会性。研究发现, 基于利他动机、规则动机、策略性动机的或者基于自我报告的亲社会偏好在应激环境下都可能增强, 这可能和应激环境下直觉增强、共情提升和亲社会行为有助于改善负面情绪方面的机制有关。未来研究可以从应激的性质、诱发方式、影响机制、个体差异和发展特征等方面去理解应激增加亲社会性的条件, 从而提高群体韧性。     

急性应激障碍（ASD）研究述评

急性应激障碍是个体在亲历、目击或面临一个对自己或他人具有死亡威胁、严重伤害的创伤事件后的2天至4周内所表现的应激反应。急性应激障碍的症状主要表现为分离、再历、回避和过度警觉。文章回顾了以往的相关研究,从急性应激障碍的测评方法、发生率、与创伤后应激障碍和创伤记忆的关系、心理治疗和干预等方面进行了综述。最后对未来可能的研究方向提出了展望     

急性应激对威胁刺激注意定向和注意解除的影响:认知神经机制研究

急性应激和注意偏向是焦虑障碍和创伤后应激障碍发生和症状保持的两个重要因素。急性应激导致交感神经系统激活以及儿茶酚胺和糖皮质激素分泌增加,因而影响对威胁刺激的注意偏向。但是急性应激如何影响注意偏向中的注意定向和注意解除尚不清楚。本项目采用点探测任务、威胁线索空间提示任务,结合恐惧条件反射、眼动和事件相关电位技术,研究急性应激对注意定向和注意解除影响的认知神经机制。研究结果可为治疗焦虑和创伤后应激障碍提供支持,为公共卫生管理政策的制定提供建议。     

急性情绪应激对大鼠行为和脑神经颗粒素磷酸化水平的影响

为探讨急性情绪应激对大鼠旷场行为的影响,以及脑神经颗粒素（Neuroganin,NG）变化与应激性行为效应之间的相互关系。以急性不确定性空瓶刺激,建立情绪应激动物模型。将40只雄性SD大鼠随机分为情绪应激组1（ES1,接受情绪应激和旷场测试）、情绪应激组2（ES2,只接受情绪应激）、正常对照组1（C1,无情绪应激,但接受旷场测试）和正常对照组（C2,无情绪应激,也无旷场测试）（n=10）。以旷场行为和高架十字迷宫任务来评定大鼠应激后的行为变化,Western印迹杂交法（Western blotting）测定海马和前脑皮层中的NG含量和磷酸化水平。结果表明：（1） 应激后ES1组的水平活动增加,与C1组比较,差异有显著性, p<0.01;（2）ES1组海马和前脑皮层的NG磷酸化水平高于C1和C2组,差异有显著性, 均为p<0.05; ES2组的前脑皮层NG的磷酸化水平高于C1组,差异有显著性,为p<0.05;（3） 海马的NG磷酸化水平与水平活动之间的相关达显著水平。提示急性情绪应激能导致动物明显的行为改变如焦虑,这种行为改变可能与脑内NG磷酸化水平的变化有关。水平活动可能是反映急性情绪应激的较敏感行为指标,海马NG磷酸化水平可能是预测急性情绪应激所致焦虑或抑郁行为的较敏感生物学指标     

Habituation to repeated stress: get used to it

Habituation, as described in the landmark paper by Thompson et al. [Thompson, R. F., & Spencer, W. A. (1966). Habituation: A model phenomenon for the study of neuronal substrates of behavior. Psychological Review, 73(1), 16–43], is a form of simple, nonassociative learning in which the magnitude of the response to a specific stimulus decreases with repeated exposure to that stimulus. A variety of neuronal and behavioral responses have been shown to be subject to habituation based on the criteria presented in that paper. It has been known for several decades that the magnitude of hypothalamic–pituitary–adrenal (HPA) activation occurring in response to a stressor declines with repeated exposure to that same stressor. For some time this decline has been referred to as “habituation” in the stress neurobiology literature. However, how this usage compares to the definition proposed by Thompson and Spencer has not been systematically addressed. For this special issue, we review the stress neurobiology literature and examine the support available for considering declines in HPA response to repeated stress to be response habituation in the sense defined by Thompson and Spencer. We conclude that habituation of HPA activity meets many, but not all, important criteria for response habituation, supporting the use of this term within the context of repeated stress. However, we also propose that response habituation can, at best, only partially explain the phenomenon of HPA habituation, which also involves well-known negative feedback mechanisms, activation of broad stress-related neural circuitry and potentially more complex associative learning mechanisms.     

Oxytocin Receptor Gene Relates to Theory of Mind and Prosocial Behavior in Children

Individual social differences have been addressed in recent studies, and the oxytocin receptor gene (OXTR) is the major candidate in explaining various social phenotypes. To study the association between a well-known haplotype (rs53576) of OXTR and children's prosocial behavior and its relationship with theory of mind (ToM) ability, 87 children (aged 3 to 5 years old) participated in 3 prosocial tasks and ToM performance experiments. Participants who were homozygous for the G allele (GG) exhibited more prosocial behaviors than did those with 1 or 2 copies of the A allele (AA), and GG carriers also displayed better ToM ability than did AA individuals. Further tests showed differences between genotypes in helping and comforting, albeit not in sharing. The results demonstrated that OXTR rs53576 was related to individual differences in ToM and was associated with prosocial behavior.     

Acute exposure to a novel stressor further reduces the habituated corticosterone response to restraint in rats

The present study sought to identify dishabituation of the hypothalamic-pituitary-adrenal(HPA) axis response to different psychological stressors. Young adult male Sprague Dawley rats were exposed to five, 1 h sessions of restraint stress on five consecutive days. On the sixth day, and 2 h before additional exposure to restraint, animals were subjected to 30 min of a small (27cm square), elevated open field stressor (pedestal), which served as the dishabituating stimulus. We predicted HPA axis response dishabituation in chronically restrained rats exposed to the novel pedestal. Rats which underwent five days of restraint stress showed significantly blunted plasma corticosterone levels to restraint (habituation) as compared to restraint-nai've rats. However, rats which underwent five sessions of restraint responded with an enhanced habituation response when confronted with restraint shortly after exposure to the novel pedestal. Instead of HPA axis response dishabituation, we observed enhanced habituation. Subsequent experiments determined that a 1.25 mgkg corticosterone injection could substitute for pedestal exposure to produce enhanced restraint habituation.Combined treatment with both the glucocorticoid receptor antagonist RU40555 (30 mgkg)and the mineralocorticoid receptor antagonist RU283 18 (50 mgkg) blocked the expression of enhanced habituation after pedestal exposure. Thus, the delayed corticosterone negative feedback produced by novel stress led to enhanced expression of corticosterone response habituation.     

The neurogenetics of nice: receptor genes for oxytocin and vasopressin interact with threat to predict prosocial behavior

Oxytocin, vasopressin, and their receptor genes influence prosocial behavior in the laboratory and in the context of close relationships. These peptides may also promote social engagement following threat. However, the scope of their prosocial effects is unknown. We examined oxytocin receptor (OXTR) polymorphism rs53576, as well as vasopressin receptor 1a (AVPR1a) polymorphisms rs1 and rs3 in a national sample of U.S. residents (n = 348). These polymorphisms interacted with perceived threat to predict engagement in volunteer work or charitable activities and commitment to civic duty. Specifically, greater perceived threat predicted engagement in fewer charitable activities for individuals with A/A and A/G genotypes of OXTR rs53576, but not for G/G individuals. Similarly, greater perceived threat predicted lower commitment to civic duty for individuals with one or two short alleles for AVPR1a rs1, but not for individuals with only long alleles. Oxytocin, vasopressin, and their receptor genes may significantly influence prosocial behavior and may lie at the core of the caregiving behavioral system.     

Ignorance is no excuse: moral judgments are influenced by a genetic variation on the oxytocin receptor gene

Perspective-taking has become a main focus of studies on moral judgments. Recent fMRI studies have demonstrated that individual differences in brain activation predict moral decision making. In particular, pharmacological studies highlighted the crucial role for the neuropeptide oxytocin in social behavior and emotional perception. In the present study N=154 participants were genotyped for a functional polymorphism (rs2268498) in the promoter region of the OXTR gene. We found a significant difference between carriers and non-carriers of the C-allele in exculpating agents for accidental harms (F((1,152))=11.49, p=.001, η(2)=.07) indicating that carriers of the C-allele rated accidentally committed harm as significantly more blameworthy than non-carriers. This is the first study providing evidence for a genetic contribution to moral judgments.     

Aggression is suppressed by acute stress but induced by chronic stress: Immobilization effects on aggression, hormones, and cortical 5-HT1B/ striatal dopamine D2 receptor density

Although it has been established by a number of investigators that a variety of stressors are associated with the induction of aggressive behavior, two specific issues remain unanswered. First, it is unclear whether the contexts surrounding stressors (e.g., stressor length and chance of winning over opponents) change outcomes regarding aggressive behavior. Second, if a relationship exists between stress and aggressive behavior, altered levels of stress-related hormone (e.g., corticosterone [CORT]), as well as aggression-related biomarkers (e.g., testosterone [T], density of prefronto-cortical 5-HT(1B) receptor and striatal dopamine D(2) receptor [D2r]) may contribute to changes in aggressive behavior. Thus, we examined how immobilization (with a 1-, 5-, or 10-day exposure) would impact (1) a longitudinal course of aggression toward different-sized opponents, (2) levels of CORT and T, and (3) densities of 5-HT(1B) receptor (5-HT1Br) in the prefrontal cortex (PFC) and D2r in the striatum. It was found that, regardless of small or large opponents, a single 2-h exposure to immobilization reduced aggressive behavior (stress-suppressed aggression) over time, whereas repeated (10-day) exposure to immobilization escalated aggressive behavior (stress-induced aggression). These stress effects persisted up to 1 week of recovery from immobilization stress. Moreover, immobilized rats demonstrated elevated levels of T, but not CORT, as compared with controls. Finally, acute immobilization altered D2r densities in the shell of the nucleus accumbens, and chronic immobilization changed 5-HT1Br in the PFC, including the downregulation of 5-HT1Br densities in the right prelimbic and orbitolateral cortices. The potential relationships among stress, aggression, and 5-HT1Br/D2r roles are discussed.     

特里尔社会应激测验对儿童皮质醇分泌的影响

研究以32名小学儿童（平均年龄10.47岁,男生16人）为被试,采用唾液皮质醇为应激测验的客观指标、以被试主观紧张度为主观指标,考察特里尔社会应激测验对中国儿童皮质醇分泌的影响。结果表明：（1）社会应激测验任务引发儿童皮质醇浓度和主观紧张度的显著上升,任务后的恢复期皮质醇浓度和主观紧张度能够恢复到任务前的水平。（2）社会应激测验任务引发的男生皮质醇水平变化显著高于女生,但是引发的主观紧张度水平变化不存在显著性别差异。社会应激测验中文修订版能够有效引发儿童的压力应激变化,可以用其开展儿童社会应激的相关研究。     

催产素及受体基因与社会适应行为

作为一种在哺乳动物分娩和泌乳中起神经调节作用的激素, 催产素(oxytocin, OT)在人类的母婴关系和社会关系中也发挥着重要作用。研究发现催产素及其受体基因与人类的社会适应行为关系密切。催产素会影响亲子依恋和父母教养行为, 也能促进人际信任及慷慨行为; 同时, 不同催产素受体(oxytocin receptor, OXTR)基因型的个体, 在亲子关系和一些亲社会行为方面都表现出了差异。来自于激素和基因水平的研究提示我们, 催产素及其受体基因可能是通过促进社会识别、调节共情以及降低恐惧、减缓焦虑来影响人类一系列的社会适应行为。未来的研究应考虑结合分子遗传学和神经科学的研究方法, 从基因－激素－行为三个层面系统的研究催产素影响社会行为的分子过程和认知神经过程。     

Habituation to a stressor predicts adolescents' adiposity

Background and Objectives: Stress is associated with gains in adiposity. One factor that determines how much stress is experienced is how quickly an adolescent reduces responding (habituates) across repeated stressors. The purpose of this study was to determine the association of body mass index (BMI) percentile and the rate of habituation to a stressor. Design: Thirty-four adolescents completed anthropometric measures and a habituation protocol using a within study design. Methods: The habituation protocol measured the rate of decline in perceived stress and heart rate (HR) across four, two-minute serial subtraction trials. Results: Multivariate linear regression revealed the habituation rate of the HR predicted BMI percentile after adjusting for gender, socioeconomic status, and initial HR (β?=?17.2, p?Conclusions: Slower habituation to a laboratory stressor was associated with greater BMI percentiles in adolescents.     

Better not to deal with two tasks at the same time when stressed? Acute psychosocial stress reduces task shielding in dual-task performance

A major control demand in successful dual-task performance is the task-specific separation of task-goal representations and of the related stimulus-response translation processes. In the present study, we investigated how these cognitive control processes of task shielding are affected by acute psychosocial stress. Fifty-six healthy participants were exposed to either an acute psychosocial stressor (the Trier Social Stress Test) or a standardized control situation prior to a dual task. Task shielding was assessed by analyzing the interference of Task 2 processing on prioritized Task 1 performance. Following successful stress induction, as indicated by increases in salivary α-amylase (sAA) and cortisol that reflect increases in sympathetic nervous system and hypothalamus-pituitary-adrenal (HPA) axis activity, respectively, stressed individuals displayed reduced task shielding relative to controls. This result was further substantiated by a correlation between treatment-related increase in cortisol, but not sAA, and between-task interference, suggesting a potential role of the HPA stress response for the development of the observed effects. As an additional finding, when the volunteers were categorized with regard to their action-state orientation, their orientation did not interact with stress but did reveal generally increased between-task interference, and thus inferior task shielding, for state-oriented as compared to action-oriented individuals.