安全学习与焦虑障碍:三阶段神经机制框架OACHSSCD

Safety learning refers to an adaptive mechanism through which individuals suppress fear by identifying safety signals—cues that predict the absence of threat—and impairments in this process are closely associated with the emergence of anxiety and related disorders.Based on existing evidence,the present work seeks to propose a three-stage neurobiological framework of safety learning,comprising safety perception and appraisal,safety acquisition,and safety behavioral expression.This framework emphasizes that individuals with anxiety disorders exhibit stage-specific neural abnormalities across the three phases of safety learning.Specifically,during the perception and appraisal stage,abnormalities in circuits centered on the insula and perceptual cortices impair the effective identification of safety cues;during the acquisition stage,dysfunctions in midbrain-striatal circuits hinder the formation of safety associations and the acquisition of positive emotional experiences;and during the behavioral expression stage,functional abnormalities in hippocampus-centered inhibitory circuits make it difficult to retrieve safety memories to suppress fear responses.Future research should employ paradigms and measurement approaches with higher ecological validity to characterize stage-specific abnormalities in safety learning among anxious individuals,thereby facilitating the translational application of safety learning in clinical interventions.