Abstract: Perseverative cognition is that the repeated or chronic activation of the cognitive representation of one or more psychological stressors. Stress is a systemic non-specific adaptive response induced by various internal and external environmental stimuli. Although stress response is an adaptive response help us face the ever-changed ecological demands, the prolonged stress response before and after the stressful event is harmful to our health. Perseverative cognition is an essential factor that causes a prolonged stress response，it usually consist of two types: explicit and implicit. The perseverative cognition can be measured by heart rate variability (HRV) and scales, and can also be induced in the laboratory through standardized procedures. Perseverative cognition can be thought of as a mediator or a pathway by which the stressor exercises its effects on the physical and psychological healthy. The relationship between perseverative cognition and our healthy can be explained in two ways. Firstly, some study found that perseverative cognition plays an important role in the stress–disease process. Both explicit perseverative cognition and implicit perseverative cognition have a negative impact on physical healthy. Secondly, perseverative cognition is regarded as one of the most critical influences on psychological healthy. Some cognitive processes is seriously damaged by perseverative cognition, such as working memory, emotion regulation etc. Previous studies have shown that the critical cognitive mechanism of perseverative cognition is that people cannot recognize safety signals in the environment, which leads to a prolonged stress response. People can actively inhibit stress response when they confirm that safety has been established. While those who fail to recognize a safety signal make undifferentiated stress responses to the threat and neutral stimuli. Perseverative cognition interferes with the recognition of the safety signals, leading to prolonged stress response. This process is associated with brain areas that monitor for potential threats, including the prefrontal cortex, the anterior cingulate gyrus, and the amygdala. The prefrontal cortex monitors external threats, and lift the inhibition of the stress response when external threats are recognized. Perseverative cognition leads to the dysfunction of the prefrontal cortex, people fails to inhibit the stress response in the absence of an apparent threat stimulus. After the stress response and perseverative cognition last for an extended period, the more focal problem is the pathological changes of the brain, such as the larger volume of core Central Autonomic Network (CAN) regions and the weaker connection between the amygdala and prefrontal cortex. The evidence reviewed in the current article suggests that future research needs to systematically investigate the critical influencing factors of perseverative cognition. At the same time, we should focus on the intervention methods of perseverative cognition. The early action on perseverative cognition intervening has not reached the clinical level. Last but not least, we need pay more attention to implicit perseverative cognition. For example, we can adopt a more new research paradigm and cognitive neuroscience technique to explore it. There were pieces of evidence that the implicit perseverative cognition is associated with the impairment of the physical and physiological recovery at night. Those studies, however, failed to demonstrate the harmful effect of the implicit perseverative cognition on the physical and physiological health.

Key words: perseverative cognition, prolonged stress response, physical and psychological health, cognitive mechanisms, neural mechanisms

摘要： 认知固执(Perseverative Cognition, PC)是一种重复或长期的消极认知表征，既能够使用量表测量，也可以通过实验诱发。认知固执会导致持续应激反应，进而影响个体的身心健康。其导致持续应激反应的认知机制体现在个体难以识别安全信号，高认知固执个体会表现出低心率变异性的显著特征；在脑机制方面主要表现为前额叶的抑制控制功能失调、杏仁核与前扣带回的病理性改变以及前额叶-杏仁核的连接减弱。未来研究应深入探讨认知固执的影响因素以及干预措施，同时需要进一步分析内隐认知固执的测量方式及其对个体的影响。

关键词: 认知固执, 持续应激反应, 身心健康, 认知机制, 脑机制