우울 및 불안 장애에서의 인지적 처리와 정서조절 고찰: 신경인지 연결망을 중심으로
A Study on the Relationship between Cognitive Processes and Emotion Regulations in Depression and Anxiety Disorder: Focused on the Neurocognitive Networks
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
본고는 인지적 과제를 수행하는 동안 우울 및 불안 환자의 정신병리적 과정과 이의 치료접근 방식에 대한 통합적 이해를 위해 최근 제시된 신경인지 연결망을 토대로 인지과정 및 정서조절의 비정상적 기능 연결성을 재해석 할 수 있는 모델을 제안하고자 하였다. 재구성된 우울과 불안장애 신경인지 연결망 모델을 통해, 우울증은 불이행방식 연결망(default mode network; DMN)의 과다 활성화에 기인하는 ‘자기참조적 사고로의 과몰입’으로, 불안장애는 불이행방식 연결망의 과소 활성화에 기인하는 ‘자기참조적 사고와의 단절’로 규정해 볼 수 있음을 확인하였다. 신경인지 연결망 중 자기의식 및 투사와 관련되는 자기참조 처리가 주요 기능인 DMN의 비정상적 활성화와 병리적 기능의 체계적 연결시도는 우울와 불안에 대한 통합적 해석과 치료적 접근에 시사점을 줄 수 있는 또 다른 출발점이 될 수 있을 것이다.
Abstract
This review aims to propose a model that can reinterpret the abnormal and functional connections between cognitive processes and emotional regulations based on the neurocognitive networks for a comprehensive understanding of pathologic processes and treatment approach of depression and anxiety disorder. Through the processes of rebuilding the network model for depression and anxiety disorder, it was confirmed that depression can be said to be ‘over-immersion in self-referencing’ due to hyper-activation of default mode network (DMN), and anxiety disorders to be ‘disconnection with self-referencing’ due to hypo-activation of DMN. The attempts to link up between abnormal activation and pathological function of DMN which is thought to be involved in self-referential processing associated with self-consciousness and projection among neurocognitive networks may be another starting point that can afford to be suggestive in integrated interpretation and therapeutic approach to depression and anxiety disorder.
참고문헌 (39)
- David Watson, "Positive and negative affectivity and their relation to anxiety and depressive disorders.", Journal of Abnormal Psychology, 97(3), pp.346~353 (1988), American Psychological Association (APA)[DOI]
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders", American Psychiatric Association, ~ (1994)
- Sidney H. Kennedy, "Differences in Brain Glucose Metabolism Between Responders to CBT and Venlafaxine in a 16-Week Randomized Controlled Trial", American Journal of Psychiatry, 164(5), pp.778~788 (2007), American Psychiatric Association Publishing[DOI]
- M. C. Neale, "Models of comorbidity for multifactorial disorders", The American Journal of Human Genetics, 57(4), pp.935~953 (1995)
- Lisa M. Shin, "Resting Metabolic Activity in the Cingulate Cortex and Vulnerability to Posttraumatic Stress Disorder", Archives of General Psychiatry, 66(10), pp.1099~ (2009), American Medical Association (AMA)[DOI]
- J. Alonso, "12-Month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Men-tal Disorders(ESEMeD) project", Acta psychiatrica Scandinavica, 7(Supplementum), pp.28~37 (2004)
- 백대업, "주요우울장애 환자와 범불안장애 환자의 성격 특성 비교 연구", 생물치료정신의학, 9(1), pp.106~111 (2003), 대한생물치료정신의학회
- Anton J.L.M. van Balkom, "Comorbid depression, but not comorbid anxiety disorders, predicts poor outcome in anxiety disorders", Depression and Anxiety, 25(5), pp.408~415 (2008), Wiley[DOI]
- D. S. Cha, "Cognitive impairment as measured by the THINC-integrated tool(THINC-it) : the association with self-reported anxiety in major depressive disorder", Journal of Affective Disorders, 238, pp.228~232 (2018)
- H-U. Wittchen, "Why do people with anxiety disorders become depressed? A prospective-longitudinal community study", Acta Psychiatrica Scandinavica, 102, pp.14~23 (2000), Wiley[DOI]
- L. J. Cozolino, "The Neuroscience of psychotherapy, Healing the social brain" (2017), W. W. Norton & Company through EYA
- T. M. Field, "Infants of dejpressed mothers show"depressed"behavior even with nondepressed adults", Child Development, 59(6), pp.1569~1579 (1988)
- S. L. Rauch, "Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography", Archives of General Psychiatry, 5, pp.62~70 (1994)
- E. David Klonsky, "The relationship between nonsuicidal self-injury and attempted suicide: Converging evidence from four samples.", Journal of Abnormal Psychology, 122(1), pp.231~237 (2013), American Psychological Association (APA)[DOI]
- T. M. Field, "Infants of dejpressed mothers show"depressed"behavior even with nondepressed adults", Child Development, 59(6), pp.1569~1579 (1988)
- I. H. Gotlib, "Construct accessibility and clinical depression: A longitudinal investigation", Journal of Abnormal Psychology, 96(3), pp.199~204 (1987)
- Brendan P. Bradley, "Attentional biases for negative information in induced and naturally occurring dysphoria", Behaviour Research and Therapy, 35(10), pp.911~927 (1997), Elsevier BV[DOI]
- Kirsten I. Stordal, "Impairment across executive functions in recurrent major depression", Nordic Journal of Psychiatry, 58(1), pp.41~47 (2009), Informa UK Limited[DOI]
- 조현주, "신경계 질환자들의 우울 수준 및 우울 요인과 신경인지기능과의 관계성", 한국심리학회지: 건강, 13(2), pp.445~459 (2008), 한국건강심리학회[DOI]
- Katie M. Douglas, "Longitudinal Assessment of Neuropsychological Function in Major Depression", Australian & New Zealand Journal of Psychiatry, 43(12), pp.1105~1117 (2009), SAGE Publications[DOI]
- Florian Ferreri, "Current research on cognitive aspects of anxiety disorders", Current Opinion in Psychiatry, 24(1), pp.49~54 (2011), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Timothy A. Salthouse, "How general are the effects of trait anxiety and depressive symptoms on cognitive functioning?", Emotion, 12(5), pp.1075~1084 (2012), American Psychological Association (APA)[DOI]
- K. S. Kee, "Perception of emotion and neurocognitive functioning in Schizophrenia : What’s the link", Psychiatry Research, 81, pp.57~65 (1998)
- F. Schneider, "Emotion processing in Schizophrenia : Neurobehavioral probes in relation to psychopathology", Schizophrenia Research, 17, pp.67~75 (1995)
- G. Bryson, "Affect recognition in Schizophrenia : A function of global impairment or a specific cognitive deficit", Psychiatry Research, 71, pp.105~113 (1997)
- Elizabeth A. Phelps, "Emotion and Cognition: Insights from Studies of the Human Amygdala", Annual Review of Psychology, 57(1), pp.27~53 (2006), Annual Reviews[DOI]
- Vinod Menon, "Saliency, switching, attention and control: a network model of insula function", Brain Structure and Function, 214(5-6), pp.655~667 (2010), Springer Science and Business Media LLC[DOI]
- Vinod Menon, "Large-scale brain networks and psychopathology: a unifying triple network model", Trends in Cognitive Sciences, 15(10), pp.483~506 (2011), Elsevier BV[DOI]
- Nico U.F. Dosenbach, "A Core System for the Implementation of Task Sets", Neuron, 50(5), pp.799~812 (2006), Elsevier BV[DOI]
- Irit Weissman-Fogel, "Cognitive and default-mode resting state networks: Do male and female brains “rest” differently?", Human Brain Mapping, 31(11), pp.1713~1726 (2010), Wiley[DOI]
- A. M. Morcom, "Does the brain gave a baseline? Why we should be resisting a rest", NeuroImage, 37(4), pp.1073~1082 (2007)
- Michelle Hampson, "Detection of functional connectivity using temporal correlations in MR images", Human Brain Mapping, 15(4), pp.247~262 (2002), Wiley[DOI]
- Michael Greicius, "Resting-state functional connectivity in neuropsychiatric disorders", Current Opinion in Neurology, 21(4), pp.424~430 (2008), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Roberto Cabeza, "Aging Gracefully: Compensatory Brain Activity in High-Performing Older Adults", NeuroImage, 17(3), pp.1394~1402 (2002), Elsevier BV[DOI]
- D. Mantini, "Default Mode of Brain Function in Monkeys", Journal of Neuroscience, 31(36), pp.12954~12962 (2011), Society for Neuroscience[DOI]
- Roberto Cabeza, "Functional neuroimaging of autobiographical memory", Trends in Cognitive Sciences, 11(5), pp.219~227 (2007), Elsevier BV[DOI]
- Wanqing Li, "The default mode network and social understanding of others: what do brain connectivity studies tell us", Frontiers in Human Neuroscience, 8, pp.1~15 (2014), Frontiers Media SA[DOI]
- Simone Grimm, "Reduced negative BOLD responses in the default-mode network and increased self-focus in depression", The World Journal of Biological Psychiatry, 12(8), pp.627~637 (2011), Informa UK Limited[DOI]
- R. A. Lanius, "Brain activation dur-ing script-driven imagery induced dissociative responses in PTSD : a functional magnetic resonance imaging investigation", Biological Psychiatry, 52, pp.305~311 (2010)
