单双相抑郁患者发作期的认知重评策略比较分析

发布时间：2018-03-19 15:53

本文选题：情绪调节　切入点：认知重评　出处：《深圳大学》2017年硕士论文　论文类型：学位论文

【摘要】：良好的情绪调节能力是适应社会的重要条件,而双相抑郁患者和抑郁障碍患者存在明显的持续性情绪低落,在情绪的加工和调节上存在困难。已有的研究多关注于疾病的鉴别诊断和治疗方面,较少关注单双相抑郁障碍患者社会认知方面,尤其是情绪调节能力。认知重评作为一种使用广泛的情绪调节策略,在众多研究中表现出良好的情绪调节能力和社会适应性,有必要对单双相抑郁发作患者使用认知重评的情况进行探索。本研究采用问卷调查对单双相抑郁患者常用的情绪调节策略进行比较,使用认知重评范式对被试在主观情绪评定和近红外脑功能成像(Near-infrared spectroscopy,NIRS)方面的结果进行对比,探究其能否帮助患者进行有效的情绪调节,并通过影像学方面的比较以期为两者鉴别诊断提供神经生理学依据。使用情绪调节量表(ERS)对19名双相抑郁患者、25名抑郁障碍患者和22名对照组进行测量,比较三组被试在惯用情绪调节策略上的差异。结果显示,单双相抑郁患者在表达抑制的使用上与对照组没有显著差异,但在认知重评策略的使用上显著少于对照组。说明相比于正常人群,抑郁发作的患者使用认知重评这种适应性的情绪调节策略频率更少。采用3×3×2的设计对被试在认知重评任务下的行为学(主观情绪等级评分)和NIRS数据进行分析,其中组别为组间变量,情绪类型和实验操作为组内变量。三组被试在认知重评条件下对负性情绪刺激的主观评分显著高于自然观看时,双相组在认知重评后的主观评分显著高于之前;单相组在认知重评前后的主观评分没有显著差异,但都显著低于对照组。表明认知重评对负性情绪有良好的调节作用,双相患者认知重评作用显著。NIRS分析结果显示,单相组在进行认知重评时通道6、14、16的脑活动变化显著,通道16上两组患者的活动差异显著,通道13、17、19显示出被试在认知重评前后对不同的情绪类型反应产生显著变化。认知重评主要激活前额叶皮层的中部及右侧,单相抑郁患者表现为两侧DLPFC及右侧PFC后部的激活相对减弱,BD组的右侧PFC后部相对于对照组激活减弱,MDD组在认知重评时右侧DLPFC的激活比BD组减弱。
[Abstract]:Good emotion regulation ability is an important condition to adapt to the society, and bipolar depression and depressive disorder patients have obvious persistent depression, There are difficulties in emotional processing and regulation. Previous studies have focused on the differential diagnosis and treatment of the disease, and less on the social cognition of patients with bipolar depression. As a widely used emotion regulation strategy, cognitive reassessment has shown good emotion regulation ability and social adaptability in many studies. It is necessary to explore the use of cognitive reassessment in patients with bipolar depression. The results of subjective emotion assessment and Near-infrared imaging (NIRS) were compared using cognitive reassessment paradigm to explore whether they could help patients with effective emotional regulation. In order to provide neurophysiological basis for the differential diagnosis, 19 bipolar depression patients (25 patients with depression) and 22 controls were measured with emotion Regulation scale (ERS). The results showed that there was no significant difference in the use of expression inhibition between the patients with bipolar depression and the control group. But the use of cognitive reassessment strategies was significantly lower than that of the control group. Patients with depression were less likely to use the adaptive emotion regulation strategy of cognitive reassessment. The behavioral (subjective emotion rating) and NIRS data were analyzed by using 3 脳 3 脳 2 design. Among them, the group was inter-group variable, the emotional type and experimental operation were intra-group variables. The subjective scores of negative emotional stimulation in the three groups were significantly higher than those in natural viewing. The subjective scores of bipolar group were significantly higher after cognitive reevaluation than before, and the subjective scores of monophasic group before and after cognitive reevaluation were not significantly different, but were significantly lower than those of control group. The results of NIRS analysis showed that the brain activity of the monophasic group changed significantly during the cognitive reassessment, and the difference between the two groups was significant. The responses to different emotion types were significantly changed before and after cognitive reassessment. Cognitive reassessment mainly activated the middle and right of prefrontal cortex. In monophasic depression patients, the activation of bilateral DLPFC and the posterior part of right PFC was relatively weakened. The activation of the right posterior PFC of BD group was weaker than that of the control group. The activation of right DLPFC in the group of MDD was lower than that in the group BD during cognitive reassessment.
【学位授予单位】：深圳大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：B842.1

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