定向遗忘范式下不同情绪调节策略对抑郁患者的干预研究

发布时间：2018-06-16 06:49

本文选题：抑郁 + 定向遗忘　；参考：《河北大学》2017年硕士论文

【摘要】：抑郁障碍(Major Depressive Disorder,MDD)是一种情感性精神障碍,以显著而持久的心境低落为主要临床表现。负性认知偏向和情绪调节功能受损是导致抑郁产生和持续的重要因素(Campbell-Sills,Barlow,2006;Gross,1995;Kovacs,Joormann,Gotlib,2008;Kring,Werner,2004)。抑郁(障碍)患者最强的负性认知偏向是对负性信息的记忆偏向(Blaney,P.H,1986;Vrijsen J N,2014)。而负性记忆偏向和情绪调节策略功能受损主要与其抑制功能障碍有关(Disner et al.,2011;Joormann,2010,Johnstone,2005)。然而目前已有的多是记忆抑制与认知偏向、认知偏向与情绪调节的研究,对抑郁患者记忆抑制与情绪调节相互关系认知机制尚无一致性的解释。本研究首次采用定向遗忘的范式对不同情绪调节策略(自发调节、表达抑制、认知重评)对抑郁患者负性情绪的调节效果及对情绪性记忆抑制的作用效果进行研究。从定向遗忘的角度探讨抑郁患者负性认知偏向与情绪调节的关系,不仅对定向遗忘的理论内涵有所拓展,还对抑郁障碍的认知机制有了进一步地了解。同时,将定向遗忘范式与情绪调节策略结合形成认知策略,不仅对抑制患者的心理治疗提供了可操作性的模式,还为正常人群的心理保健工作提供新的思路。本研究以单字法定向遗忘为实验范式,以情绪图片作为实验材料,筛选出43名抑郁症患者和48名正常人作为研究对象,随机分到三个实验(自发调节、表达抑制、认知重评)中,每个实验都采用2(指令类型:记/忘)×2(被试类型:正常/抑郁)×2(图片类型:中性/负性)的实验设计,因变量为再认成绩和前后情绪效价的差值。实验结果显示:在自发调节下,抑郁患者也能够定向遗忘情绪性信息,但有意遗忘能力比正常个体差。相对于中性图片,抑郁患者对负性信息更难定向遗忘,但与正常个体无显著差异。表达抑制对正常个体和抑郁患者的定向遗忘都没有影响,但使图片的情绪性对定向遗忘的影响消失。认知重评对正常个体的定向遗忘没有影响,但使图片的情绪性对定向遗忘的影响消失,且使抑郁个体定向遗忘效应消失。认知重评的情绪调节效果优于表达抑制。抑郁患者对负性情绪刺激反应不敏感,调节负性情绪时使用表达抑制更多。定向遗忘指令与认知重评结合比与表达抑制结合对情绪调节的效果更好,且忘记指令与认知重评结合对情绪改善的效果更显著。表达抑制策略与记忆指令结合的训练可提高抑郁患者的情绪调节能力。本研究结果显示定向遗忘范式与情绪策略调节结合的认知策略训练模式有效。
[Abstract]:Major depressive disorder (MDD) is an affective disorder characterized by significant and persistent depression. Negative cognitive bias and impaired emotional regulation are important factors leading to the development and persistence of depression. The strongest negative cognitive bias in patients with depression (disorder) is the memory bias of negative information, Blaneyn P.Heng 1986 / Vrijsen J / N / 2014 / 4. The negative memory bias and the impairment of emotional regulation strategy function were mainly related to the inhibitory dysfunction. However, there are many researches on memory inhibition and cognitive bias, cognitive bias and emotion regulation, and there is no consistent explanation for the cognitive mechanism of the relationship between memory inhibition and emotion regulation in depressive patients. In this study, the effects of different emotion regulation strategies (spontaneous regulation, expression inhibition, cognitive reassessment) on negative emotion and emotional memory inhibition in depression patients were studied for the first time using the pattern of directed amnesia. To explore the relationship between negative cognitive bias and emotion regulation in depressive patients from the perspective of directional amnesia not only extends the theoretical connotation of directional amnesia but also has a further understanding of the cognitive mechanism of depression disorder. At the same time, the combination of directed amnesia paradigm and emotion regulation strategies to form cognitive strategies not only provides an operational model for the suppression of patients' psychotherapy, but also provides a new way of thinking for the mental health care of the normal population. In this study, 43 patients with depression and 48 normal subjects were randomly divided into three experiments (spontaneous regulation, expression inhibition). In cognitive reassessment, each experiment was designed with 2 (instruction type: remember / forget) 脳 2 (subject type: normal / depressed) 脳 2 (picture type: neutral / negative). The results showed that depression patients could also be directed to forget emotional information under spontaneous regulation, but the ability of intentional forgetfulness was lower than that of normal individuals. Compared with neutral images, negative information is more difficult for depression patients to forget, but there is no significant difference between depression patients and normal individuals. Expression inhibition had no effect on the directed amnesia of both normal individuals and depressive patients, but the emotional effect of the picture on the directed amnesia disappeared. Cognitive reassessment had no effect on the directed amnesia of normal individuals, but the emotional effect of pictures disappeared and the directed forgetting effect of depressed individuals disappeared. The effect of cognitive reappraisal on emotion regulation was better than that on expression inhibition. Depression patients are insensitive to negative emotional stimuli and use more expression inhibition when regulating negative emotions. The combination of directed forgetting instruction and cognitive reappraisal was better than that of expression inhibition, and the combination of forgetting instruction and cognitive reassessment had more significant effect on emotional improvement. The combination of expression inhibition strategy and memory command can improve the ability of emotion regulation in depressive patients. The results show that the cognitive strategy training model combined with directed forgetting paradigm and emotional strategy regulation is effective.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：B842.6

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