焦虑青少年无意识恐惧的神经机制及干预

doi:10.3724/SP.J.1042.2024.01221

摘要/Abstract

摘要： 焦虑症的患病率在青春期达到顶峰, 对青少年行为和心灵造成严重影响。当前对青少年焦虑发生发展的了解主要依赖于意识层面恐惧加工的相关工作, 忽略了青少年前额叶功能和皮层自上而下的控制功能还不够成熟这一重要事实。因此, 将这种自上而下的干预机制应用于青少年焦虑的临床治疗或许存在一定的局限性。捕捉青少年自动的恐惧加工或许有助于明晰青少年焦虑的病理机制。本研究以健康、焦虑易感以及焦虑障碍青少年为研究对象, 探究1)青少年无意识恐惧加工发生发展规律的认知神经机制及慢性应激激素的影响作用; 2)无意识恐惧加工在青少年焦虑发展中的作用; 3)青少年无意识恐惧的无创干预手段。本研究将为青少年焦虑的预防、识别及干预提供科学支撑, 以促进青少年身心全面健康成长。

关键词: 恐惧, 焦虑障碍, 青少年, 认知神经机制, 恐惧消退

Abstract: Fear plays an important role in the development of anxiety disorders, with abnormalities in conditioned fear—specifically in the aspects of conditioning, generalization, and extinction—being central mechanisms. Neuroimaging evidence suggests that overreactivity of the amygdala and insufficient prefrontal modulation are key factors in the abnormal processing of fear among adolescents. This phenomenon is attributed to the earlier maturation of the amygdala compared to the prefrontal cortex, with the volume of the amygdala peaking during adolescence. Fear can manifest at both conscious and unconscious levels. Unconscious fear is automatic and not directly accessible to introspection. It's closely linked to anxiety-related symptoms because it can trigger physiological and psychological responses without the individual consciously recognizing the source of the threat. Adolescents are particularly sensitive to unconscious fear due to the ongoing development of their brains. Yet, current research on unconscious fear and its neural underpinnings in adolescents is limited. Thus, exploring unconscious fear could shed light on the developmental mechanisms underlying anxiety in adolescents. Traditional CBT focuses on altering maladaptive thought patterns and behaviors associated with anxiety, requiring a level of self-awareness and cognitive maturity that adolescents may not fully possess. Pharmacological treatments, on the other hand, target the biochemical aspects of anxiety but can come with side effects that may affect compliance and overall well-being. Examining the effects of neurofeedback on the unconscious fear in adolescents has the potential to significantly improve the efficacy of anxiety treatments in this age group.
This study aims to investigate the development and cognitive neural mechanisms of unconscious fear in adolescents, uncovering its role in the development of anxiety disorders, and exploring neurofeedback intervention techniques. Study 1 primarily investigates the dynamic change patterns of neural circuits related to unconscious fear processing in adolescents from a developmental perspective. It examines the cognitive neural mechanisms of unconscious fear processing in adolescents, utilizing the Pavlovian conditioning paradigm. Furthermore, it explores the role of chronic stress in the modulation of conditioned fear acquisition, extinction, and generalization. Study 1 aims to provide new insights into why anxiety susceptibility is higher in adolescence and uncover potential reasons for the increased prevalence of anxiety disorders in this age group. Study 2 aims to examine unconscious fear in adolescents with different types of anxiety disorders, highlighting potential differences in brain region activation patterns across these disorders. Together, the two studies offer a comprehensive view of adolescent anxiety, enhancing our understanding and management strategies. We anticipate that the results of Studies 1 and 2 will collectively indicate a pattern of either prefrontal underdevelopment in healthy adolescents or prefrontal underactivation in adolescents with anxiety disorders. Study 3 focuses on the prefrontal neural mechanisms, particularly targeting the vmPFC (ventromedial prefrontal cortex), to investigate the effects of neurofeedback on unconscious fear processing in adolescents. This has significant implications for the optimization of treatment methods for adolescent anxiety disorders.
Considering that the amygdala develops during adolescence, but the prefrontal cortex is still maturing, adolescents are more likely to have stronger unconscious fear responses. Therefore, the current research is expected to offer substantial insights into the psychopathological frameworks that underpin anxiety among adolescents. Furthermore, the capacity of neurofeedback to target the brain's fear circuits directly might offer a faster, more efficient means to reduce anxiety by helping adolescents learn to regulate their own brain activity associated with fear responses. This could help them manage anxiety better and for longer, giving them skills that traditional treatments may not fully realize. The current research could significantly enhance our understanding and treatment of anxiety disorders in adolescents, offering a complementary or alternative option that is both innovative and tailored to their developmental stage.

Key words: fear, anxiety disorders, adolescent, cognitive neural mechanism, fear extinction

中图分类号:

B844
B845

雷怡, 梅颖, 王金霞, 袁子昕. (2024). 焦虑青少年无意识恐惧的神经机制及干预. 心理科学进展 , 32(8), 1221-1232.

LEI Yi, MEI Ying, Wang Jinxia, YUAN Zixin. (2024). Identifying the impact of unconscious fear on adolescent anxiety: Cognitive neural mechanisms and interventions. Advances in Psychological Science, 32(8), 1221-1232.

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