PTSD大学生的认知情绪特征与心理复原

发布时间：2018-06-14 18:25

本文选题：心理创伤 + 心理复原力　；参考：《西南大学》2011年博士论文

【摘要】：从现象学的角度来看,心理复原力(resilience)是指个体在经历困境或创伤后仍然能回复到良好适应状况的现象,其中,重大困境和积极适应是心理复原现象的核心特征。在本研究中,心理复原力是指汶川大地震亲历者在创伤暴露后,没有出现创伤后应激障碍(posttraumatic stress disorder,PTSD),恢复和保持健康的身心状态。当前主要从能力、结果和过程三种角度探讨心理复原力的内涵。从筛选被试的角度来看,探讨与心理复原力相关的的认知神经基础和机制的研究主要存在能力和结果两种取向。能力取向的研究通过心理复原力量表(比如,the resilience scale、the Conner-Davidson scale等),筛选出高特质性和低特质性复原力被试,通过比较两类被试在认知加工过程中的差异,揭示特质性复原力(trait resilience)相关的认知神经基础及其机制。在这一取向的文献中,积极情绪性和情绪调节是特质性复原力认知神经研究的焦点,形成特质性复原力的双重加工理论和情绪灵活性理论。结果取向的学者主张从“积极适应”的角度确定心理复原的标准(比如,社会适应的状况、PTSD症状等),将创伤暴露后有没有罹患病理性障碍作为甄别心理复原和非心理复原个体的依据,通过比较这两组被试在认知加工过程和大脑结构的差异,揭示状态性心理复原(state resilience)的认知神经基础及其机制。在这一取向的文献中,认知加工偏向、创伤性情绪是状态性复原力认知神经研究的热点,并提出状态性心理复原与创伤记忆的表征、认知情绪的调节、积极情绪体验密切相关的理论假设。既往的文献表明,创伤暴露对PTSD和心理复原亲历者的大脑结构和功能都会产生影响；能否从消极情绪中快速恢复决定着创伤亲历者是否能够实现心理复原,而情绪的恢复以及病理性反应的消退与亲历者的积极情绪、认知情绪调节密切相关。尽管以往的研究在能力和结果两种取向下对心理复原力的认知神经机制进行初步探讨,但是还有许多问题尚待解决,比如,在筛选被试的过程中,能力取向与结果取向能否得到兼顾?PTSD和心理复原亲历者对地震相关词(地震灾害词、地震救援词)是否存在认知加工偏向?PTSD和心理复原亲历者是否存在内隐情绪的偏向?在认知情绪调节过程中,PTSD和心理复原亲历者主要的差异体现在哪些方面?哪种调节策略在亲历者实现心理复原的过程中起到关键的作用? 本研究在汶川地震发生2年后,通过问卷调查和ERP技术,对比PTSD组和心理复原组大学生在认知自动加工、内隐情绪以及在认知情绪调节过程中的差异,揭示与心理复原相关的认知和情绪特征。研究一使用问卷法,明确特质性复原力和认知情绪调节策略(认知重评策略、表达抑制策略)分别在地震创伤暴露与亲历者PTSD症状之间的作用机制(研究一b)。在问卷调查之前,对心理复原力量表(RS)进行修订,以确定其在地震灾区大学生中的心理测量学指标(研究一a)。888名汶川地震重灾区大学生参加研究一a的量表修订工作。研究一a的结果显示,地震灾区大学生心理复原力包含可控性、坚持性、效能感、独立性4个方面；各项拟合指数表明,4因素模型具有良好的结构效度；以PTSD、抑郁、焦虑以及神经质、外向性作为效标,心理复原力与PTSD、抑郁、焦虑、神经质呈负相关(p s0.01),而与外向性呈正相关(p0.01)；量表的内部一致性系数为0.94,间隔6个月的重测系数为0.82。这表明,心理复原力量表(中文版)具有良好的心理测量学特性。433名汶川地震重灾区大学生参加研究一b的问卷调查。调查结果显示,在汶川地震发生2年后,创伤恢复的地震亲历大学生在创伤反应上显著轻于PTSD大学生,在消极情感、抑郁情绪和焦虑情绪上显著低于PTSD大学生,而在积极情感上显著高于PTSD大学生；先后按照调节效应、中介效应的检验程序,特质性复原力、认知重评调节策略在地震创伤暴露和灾区大学生PTSD症状之间起到部分中介作用。这表明,心理复原组大学生比PTSD组大学生体验到较少的PTSD症状,更多的积极情绪；筛选心理复原被试应该综合考虑亲历者的特质性复原力和心理复原状态两个方面；认知情绪调节是地震亲历大学生心理复原的重要机制。研究二分别使用情绪Stroop测验、阈下掩蔽启动测验,探讨PTSD组和心理复原组大学生对地震相关词(地震灾害词、地震救援词)的自动加工特征。在情绪Stroop测验(研究二a)中,行为数据显示,PTSD大学生对地震灾难词的反应时明显地长于对无关词的反应时；ERP数据表明,PTSD组比心理复原组大学生诱发了更正的N1成分,同时,在PTSD组大学生中,地震灾害词比无关词诱发一个更负的P2成分,在230-370ms时间窗口地震灾害词比地震救援词、无关词诱发一个更负的ERP波幅。这表明,地震发生2年后,PTSD组大学生仍然对地震灾害词产生注意偏向。在以地震灾害词、地震救援词和地震无关词作为启动词的阈下启动测验(研究二b)中,ERP结果表明,在PTSD组大学生中,地震灾害词比无关词诱发一个更正的P2成分,同时,在300-400ms,地震灾害词比地震救援词、地震无关词诱发一个更负的ERP波幅。结合以往的研究结果,研究二b的结果表明,地震灾害词在无意识层面上激活PTSD组大学生地震情景记忆的提取。研究二的结果表明,地震发生2年后,心理复原组大学生没有对地震相关词产生自动加工偏向。研究三使用问卷和情绪Stroop测验,探讨心理复原组大学生的外显和内隐情绪特征。首先从中文词典和前人的研究中筛选出267个描述情绪状态的情绪形容词,并通过对其进行标准化,建立情绪形容词词库(研究三a)。结果显示,中国大学生是从愉悦度、唤醒度、优势度和熟悉度四个方面对情绪词进行认知的,在愉悦度上分为正性和负性两个维度。在此基础上,使用积极情感和消极情感量表(PANAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)以及情绪Stroop测验考察PTSD组和心理复原组大学生的内隐情绪特征(研究三b)。问卷结果显示,心理复原组比PTSD组大学生体验到更多积极情感,更少的焦虑、抑郁和消极情感；情绪Stroop测验的行为数据表明,心理复原组大学生对正性情绪词的按键反应时短于对负性情绪词的时间；ERP数据显示,在心理复原大学生中,正性情绪词比负性情绪词诱发更正的P2、N2、P360-450成分；溯源分析结果表明,N2、晚期正成分的脑内源,分别位于前扣带回、纹状体的尾状体。研究三的结果表明,心理复原组大学生不仅体验到外显的积极情绪,而且对积极情绪产生内隐偏向。研究四先、后采用内隐联想测验和有意情绪调节范式,分别探讨PTSD组和心理复原组大学生对认知重评、表达抑制策略的内隐态度,以及在有意识进行认知重评、表达抑制调节过程中的差异。内隐态度测验(研究四a)结果显示,相容归类的按键反应时显著短于不相容条件,并且PTSD组和心理复原组大学生在认知重评策略的内隐态度效应量上存在显著的差异。对认知重评策略内隐态度测验的ERP结果显示,与认知重评策略的不相容归类任务相比,相容归类任务使PTSD组大学生诱发了更负的N2和晚期正成分(LPP)；对表达抑制策略内隐态度测验的ERP结果显示,归类任务与组别的主效应、交互效应均不显著。有意情绪调节实验(研究四b)结果显示,心理复原组大学生比PTSD组大学生更倾向于使用认知重评策略；两组被试在情绪调节后对自己情绪愉悦度的评定结果显示,心理复原组大学生只有在表达抑制条件下与观看条件下的差异显著,PTSD组大学生在认知重评、表达抑制条件下与观看条件下的差异显著,而两组被试对自己情绪唤醒度的评定没有显著差异；ERP结果显示,与观看任务相比,认知重评任务、表达抑制任务使PTSD大学生诱发了更负的N2成分,脑内源位于扣带回。研究四的结果表明,心理复原组大学生有效地使用认知重评策略,降低地震情景图片带来的不愉快情绪和认知冲突。综上所述,通过与PTSD组大学生的对比,从心理复原组大学生中概括出与心理复原相关的认知、情绪特征：汶川地震发生2年以后,心理复原大学生对地震相关词语(地震灾害词、地震救援词)自动加工偏向减弱,同时,体验到更多积极情绪和内隐偏向；在认知情绪调节过程中,心理复原大学生更有效地使用认知重评策略调节对地震创伤的认知和情绪加工
[Abstract]:In this study , the psychological recovery force refers to the phenomenon that an individual can still return to a good adaptation condition after experiencing difficulty or trauma . In the present study , the psychological recovery force refers to the psychological recovery from three aspects : ability , result and process .

In the literature of this orientation , positive emotion and mood regulation are the focus of cognitive neuroresearch on the cognitive process and the theory of emotional flexibility .

Previous literature has shown that the brain structure and function of trauma exposure to post - traumatic and psychological recovery will have an impact on the brain structure and function ;
In the process of cognitive emotion regulation , whether the orientation of ability and the orientation of the result can be taken into account ?

After two years of Wenchuan earthquake , the cognitive and emotional characteristics related to psychological recovery were revealed through questionnaires and ERP techniques , compared with the cognitive automatic processing , implicit emotion and cognitive emotion regulation .

In this paper , a questionnaire method was used to determine the mechanism of the action of trait resilience and cognitive emotion regulation strategies ( cognitive reevaluation strategy and expression inhibition strategy ) between the exposure of the earthquake and the symptoms of the relatives of the relatives . The psychological recovery force table ( RS ) was revised to determine the psychometrics of the college students in the earthquake - affected areas ( a ) .
The fitting index shows that the four - factor model has good structural validity .
There was a negative correlation between psychological recovery ( P < 0.01 ) and extroversion ( p0.01 ) .
The internal consistency coefficient of the scale is 0.94 , and the re - test coefficient is 0.82 . This shows that the psychological recovery force meter ( Chinese version ) has good psychometric characteristics .
According to the regulation effect , the intermediate effect test procedure , the characteristic resilience , the cognitive re - evaluation adjustment strategy plays a part mediating effect between the earthquake wound exposure and the symptoms of the college students ' s .
Screening psychological recovery should take into account both the characteristics of the relatives and the state of psychological recovery .
Cognitive emotion regulation is an important mechanism for psychological recovery of college students .

In the Stroop test ( study IIa ) , the behavioral data show that the response to earthquake disaster words is obviously longer than that of unrelated words .
The results of this study indicate that in two years of earthquake disaster words , there is no more negative ERP amplitude induced by earthquake disaster words than that of earthquake rescue words and earthquake - related words .

Based on the study of three questionnaires and emotional Stroop tests , 267 emotional adjectives describing emotional states were selected from four aspects : pleasure , arousal , dominance and familiarity . The results showed that Chinese college students were divided into positive and negative aspects by standardizing them .
The behavioral data of the emotional Stroop test shows that the mental recovery group is shorter than the negative emotion word when the key response of the positive emotion word is responded to ;
ERP data showed that positive emotion words induced correction P2 , N2 , P360 - 450 in psychological recovery college students .
The results of tracing analysis showed that the endogenous brain sources of N2 and advanced positive components were located in the tail of the anterior buckle and the striatum , respectively . The results showed that the psychological recovery group didn ' t only experience the positive emotion , but also the implicit bias to the positive emotion .

In this paper , the implicit attitude test and the intentional emotion regulation model were used to study the implicit attitude of cognitive reevaluation , expression inhibition strategy and the difference of implicit attitude effect in cognitive reevaluation .
The results of ERP showed that students in psychological recovery group tended to use cognitive re - evaluation strategies .
The results showed that the students of psychological recovery group were significantly different from the viewing conditions under the condition of expressing inhibition , and the difference between the two groups was significant under the condition of cognitive review , expression inhibition and viewing conditions , while the two groups had no significant difference in the assessment of their emotional arousal .
The results of ERP showed that compared with the viewing task , the cognitive re - evaluation task and the expression inhibition task caused the university students to induce more negative N2 components and the endogenous brain sources were located in the buckle belt . The results showed that the psychological recovery group college students effectively used the cognitive re - evaluation strategy and reduced the unpleasant emotion and cognitive conflict brought by the pictures of the seismic scene .

In conclusion , the cognitive and emotional characteristics related to psychological recovery are summed up from the psychological recovery group by comparing with the college students in the psychological recovery group . After two years of the Wenchuan earthquake , the psychological recovery college students tend to weaken the automatic processing of the earthquake related words ( earthquake disaster words and earthquake rescue words ) , and meanwhile , experience more positive emotion and implicit bias ;
In the process of cognitive emotion regulation , psychological recovery students use cognitive reevaluation strategies to adjust the cognition and emotional processing of seismic trauma .
【学位授予单位】：西南大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：B844.2

【参考文献】