疼痛恐惧的神经机制及其消退

疼痛恐惧是疼痛基础和临床研究中的一个重要课题。个体对疼痛信息产生过度警觉,诱发不恰当的回避行为,扰乱机体的正常功能,加剧疼痛的现象即为疼痛恐惧。疼痛恐惧可影响个体的疼痛感知以及疼痛相关的注意和回避行为,且在慢性疼痛(如慢性肌骨骼疼痛)的发展、维持个体正常生理功能的丧失中起着重要作用。疼痛恐惧的形成与表达涉及杏仁核、海马、背侧前扣带回皮层、和前额叶皮层等脑区的参与。当前的疼痛恐惧消退的心理-行为干预方法可在疼痛恐惧加工的不同阶段(巩固、再巩固和消退)消退个体的疼痛恐惧。然而,由于恐惧记忆形成过程较为复杂并受多种因素影响,疼痛恐惧记忆消退方法效果较不稳定,其基础研究与临床应用之间仍存在较大的鸿沟。将来研究有必要考虑到疼痛恐惧形成环境的差异以及个体人格特质/心理状态的差异,逐步完善相关消退方法并将其引入临床镇痛,以期帮助患者弱化、擦除甚至改写困扰他们的疼痛恐惧,从而缓解甚至消除病患的疼痛。     

Fearing shades of grey: individual differences in fear responding towards generalisation stimuli

Individual differences in fear generalisation have been proposed to play a role in the aetiology and/or maintenance of anxiety disorders, but few data are available to directly support that claim. The research that is available has focused mostly on generalisation of peripheral and central physiological fear responses. Far less is known about the generalisation of avoidance, the behavioural component of fear. In two experiments, we evaluated how neuroticism, a known vulnerability factor for anxiety, modulates an array of fear responses, including avoidance tendencies, towards generalisation stimuli (GS). Participants underwent differential fear conditioning, in which one conditioned stimulus (CS+) was repeatedly paired with an aversive outcome (shock; unconditioned stimulus, US), whereas another was not (CS?). Fear generalisation was observed across measures in Experiment 1 (US expectancy and evaluative ratings) and Experiment 2 (US expectancy, evaluative ratings, skin conductance, startle responses, safety behaviours), with overall highest responding to the CS+, lowest to the CS? and intermediate responding to the GSs. Neuroticism had very little impact on fear generalisation (but did affect GS recognition rates in Experiment 1), in line with the idea that fear generalisation is largely an adaptive process.     

All in the first glance: first fixation predicts individual differences in valence bias*

Surprised expressions are interpreted as negative by some people, and as positive by others. When compared to fearful expressions, which are consistently rated as negative, surprise and fear share similar morphological structures (e.g. widened eyes), but these similarities are primarily in the upper part of the face (eyes). We hypothesised, then, that individuals would be more likely to interpret surprise positively when fixating faster to the lower part of the face (mouth). Participants rated surprised and fearful faces as either positive or negative while eye movements were recorded. Positive ratings of surprise were associated with longer fixation on the mouth than negative ratings. There were also individual differences in fixation patterns, with individuals who fixated the mouth earlier exhibiting increased positive ratings. These findings suggest that there are meaningful individual differences in how people process faces.     

Fear and avoidance of driving among drivers involved in a road traffic crash. The role of traumatic fear and driving cognitions

Fear and avoidance of driving are possible consequences of involvement in road traffic crashes (RTCs). Few studies have assessed the factors associated with fear and avoidance of driving after an RTC. The aim of this present study is to investigate the relations among trauma appraisals of fear, negative driving cognitions, fear and avoidance of driving in a sample of people who experienced vehicle crashes. Further, the mediating role of negative driving cognitions in the relation between trauma appraisals, fear of driving and avoidance of driving was assessed. The sample was comprised of 116 drivers who had been involved in an RTC in the past two years. Negative driving cognitions positively predicted fear of driving and avoidance of driving. Moreover, negative driving cognitions mediated the relation among trauma appraisals of fear with fear of driving and avoidance of driving. The theoretical and practical implications of these results are discussed.     

预期错误在恐惧记忆更新中的作用与机制

依据错误驱动的学习理论,行为预期结果与实际结果之间的不匹配即预期错误(Predictionerror,PE)是学习产生的驱动因素。作为显著性信息中的一种,预期错误和物理显著性、惊讶、新异性等存在信息加工阶段的不同,与记忆更新的关系也有差异。近年来,记忆再巩固干预范式(reconsolidation interference)被证明可用于人类条件性恐惧记忆的更新,其中记忆提取激活阶段所包含的预期错误起到了引发记忆“去稳定”、开启记忆再巩固的关键作用。在促进恐惧记忆更新的行为机制上,PE被认为是记忆去稳定的必要非充分条件。记忆提取必须包含适量的PE,但其引发的是记忆去稳定、消退还是中间状态,还需结合记忆本身性质确定。在促进恐惧记忆更新的神经机制上,杏仁核、导水管周围灰质(PAG)、海马均在PE探测和计算过程中具有重要作用;前额叶皮层(PFC)及其亚区在PE开启记忆再巩固过程中扮演了重要角色。上述过程又受到神经系统中特定神经递质的重要调节,尤其是多巴胺能和谷氨酸能。未来研究应进一步探索基于PE计算模型的量化研究,整合PE与其他边界条件的交互作用,考察不同类型显著性在记忆再巩固中的作用等;并亟...     

条件性恐惧大鼠边缘下区Cdk5激酶活性、caspase-3表达以及突触结构的变化

探讨条件性恐惧大鼠内侧前额叶皮层边缘下区(IL区)Cdk5激酶活性、凋亡因子caspase-3表达和突触结构的变化。采用声音结合足底电击的方法对大鼠建立条件性恐惧模型后, 在不同时间点测定IL区Cdk5激活剂P35和P25的蛋白表达水平、Cdk5激酶活性、caspase-3的阳性细胞数, 并观察突触结构的变化。结果发现, 大鼠在条件性恐惧建立后第2、4和8天, IL区的P25蛋白表达和Cdk5激酶活性均明显高于正常; caspase-3的免疫反应阳性细胞数在3个时间点也均多于正常; 透射电镜下观察到：在恐惧建立后的第8天, IL区突触的突触后致密物质(PSD)厚度变薄, 在恐惧建立后第22天突触数密度减少、PSD厚度仍小于正常。推测条件性恐惧的建立, 使大鼠IL区的P25水平和Cdk5活性高于正常, 引起IL区的突触结构发生改变, 导致大鼠的恐惧反应持续存在。     

Cognitive Links Between Fear Of Failure And Perfectionism

This study investigated links between three forms of perfectionism and beliefs associated with fear of failure (FF). College students (N = 372) enrolled in physical activity classes completed the Multidimensional Perfectionism Scale and Performance Failure Appraisal Inventory in a single session. After controlling for other forms of perfectionism, only socially prescribed perfectionism (SPP) was strongly associated with beliefs that failure led to aversive interpersonal consequences (i.e., important others losing interest, upsetting important others). Other-oriented perfectionism (OOP) exhibited a weak negative relation with beliefs that failure would lead to devaluation of one’s self-estimate; individuals who held the highest standards for others’ behavior had the weakest beliefs that failure would lead to them devaluing their self-estimate. Self-oriented perfectionism (SOP) was not associated with any beliefs that failure led to aversive consequences; however, when SOP and OOP were simultaneously elevated, they contributed positively to fears of experiencing shame and embarrassment (above and beyond main effects of SPP). Collectively these findings indicated that FF was not ubiquitous with all forms of perfectionism because the specific beliefs about the consequences of failure that underlie different forms of perfectionism varied tremendously. This research was supported in part by a grant from the College of Health & Human Development, The Pennsylvania State University.     

Diagnostic Features,Symptom Severity,and Help-Seeking in a Media-Recruited Sample of Women with Driving Fear

This paper examines the clinical features, symptom severity, diagnostic profile, and help-seeking behaviour of a media-recruited sample of driving-fearful women. Results support previous findings of the primary foci of fear as motor vehicle accidents as well as specific driving situations and conditions. Consistent with prior research, there was difficulty relating the foci of fear to current diagnostic concepts. Social concerns were identified as having a role in driving fear for some individuals. Fearful participants exhibited high levels of fear and symptom severity according to various diagnostic and self-report measures, although most reported that they would be unlikely to seek professional psychological help or driving instruction. Assessment of cognitions indicated a range of errors likely to maintain anxiety and fear reactions that would be a target of treatment. There were no group differences in number of major recent accidents, although fearful drivers learnt to drive later than controls, suggesting early fearfulness.

The Role of Morphology and Short Vowelization in Reading Arabic among Normal and Dyslexic Readers in Grades 3, 6, 9, and 12

This study was an investigation of several Arabic reading measures among dyslexics and normal Arabic readers across different ages (grades 3, 6, 9, and 12): the role of morphology, short vowelization (phonological and syntactic skills), spelling, reading isolated words, and reading comprehension. The results of the one-way ANOVAs indicated clear differences between the dyslexic readers and the normal readers on all reading measures. However, the stepwise regression analysis revealed consistent “orthographic” results: morphology (identification and/or production) and spelling were generally the most powerful predictors of both reading accuracy and reading comprehension among dyslexic and normal readers across these different age groups. The results are discussed in terms of the characteristics of the Arabic orthography and the heavy reliance of readers at all levels and ages on “orthographic” factors in reading.     

Driving fear and driving skills: comparison between fearful and control samples using standardised on-road assessment

The present study explores driving skills in a group of 50 media-recruited driving-fearful and 50 control drivers, all of whom were women. Participants completed an on-road practical driving assessment with a professional driving instructor. Diagnostic as well as pre-post self-report and instructor driving assessments were conducted. Fearful drivers made more errors on the driving assessment than controls. However, the pattern of errors was identical for both groups, indicating that fear and anxiety may be associated with the number rather than the type of driving errors made. These differences remained when factors such as driving history, current driving frequency, and diagnosis were controlled using case selection. More research is needed to replicate the findings in more diverse samples. Additional work should also aim to clarify the specific role of driving skills in driving fear, which will facilitate treatment planning for exposure-based treatments and help identify cases where driving skills assessment may be appropriate.