躯体形式障碍的注意偏向及其与疼痛症状的关联
发布时间：2018-11-28 18:34
【摘要】：目的:为了研究躯体形式障碍伴有疼痛症状患者是否存在对负性信息注意偏向以及该注意偏向障碍与疼痛的关联,探究躯体形式障碍的疼痛症状的关联因素,为躯体形式障碍疼痛等躯体不适的研究提供新的参考依据,为其症状治疗提供新的途径。方法:选择躯体形式障碍伴疼痛症状患者30例作为实验组;选取30例与实验组性别、年龄相匹配的正常健康人,同时排除躯体形式障碍及其他精神疾病和躯体严重疾病作为对照组。采用点探测范式和线索-靶范式对30例躯体形式障碍患者(实验组)与30例正常被试(对照组)的注意偏向反应时进行测量。采用整体疼痛评估量表中文版(GPS)对实验组进行疼痛测量评估。采用90项症状自评量表(SCL-90)对两组进行心理健康状况的测量。结果:30例实验组和30例对照组都完成了实验前期预先设计的一般资料问卷的搜集,且两组都完成了点探测范式和线索靶范式。两组的性别、年龄、受教育程度无显著差异(P=0.796,0.588,0.796)。在点探测范式中,对照组对两种图片性质(正性,负性)的反应时差异不显著(F=0.119,P=0.703);实验组对两种图片性质(正性,负性)的反应时存在显著差异,且负性图片反应时显著长于正性图片(F=21.004,P=0.000);实验组的负性图片反应时长于对照组的负性图片反应时(F=42.007,P=0.000)。在线索-靶范式中,实验组在有效线索和无效线索下对负性图片反应时差异有显著性(F=17.33,P=0.00;F=16.51,P=0.00);进一步简单效应分析,A1B2在C水平效应中,实验组在无效线索条件下,对负性图片刺激的平均反应时长于对正性图片刺激的平均反应时(F=16.51,P=0.00)。实验组整体疼痛评估量表总分为(63.12±19.60),其中疼痛项目分为(17.74±6.43),情绪项目分为(16.38±6.50),临床表现项目分为(16.00±6.35),日常行为项目分为(13.00±6.17)。实验组负性图片反应时与GPS总分以及GPS量表的情绪、疼痛症状项目分呈显著正相关(r=0.429,0.416,0.534);负性图片反应时与GPS量表的临床表现项目分及日常行为项目分不相关(r=0.064,0.299)。实验组负性图片反应时与SCL-90的躯体化、强迫、恐怖、精神病性因子分呈显著正相关;正性图片反应时与躯体化、精神病性因子分呈负相关。结论:躯体形式障碍疼痛症状的患者具有对负性信息的注意偏向。躯体形式障碍疼痛患者产生负性情绪的注意偏向的病理心理特点是对负性信息注意解除的困难。躯体形式障碍疼痛患者的负性信息注意偏向与疼痛两者存在相互加强的精神交互作用,这可能是本病疼痛症状发生发展的机制之一,也是心理治疗需要针对的靶点。躯体形式障碍的躯体化、强迫、恐惧、精神病性症状与疼痛存在交互加强机制,也可能是抗抑郁剂治疗本病疼痛的有效机制之一。
[Abstract]:Objective: to investigate whether there is a negative information attention bias and its association with pain in patients with somatoform disorder accompanied by pain symptoms, and to explore the related factors of pain symptoms in patients with somatoform disorder. It provides a new reference for the study of somatic discomfort such as somatoform disorder pain and provides a new way for the treatment of symptoms. Methods: 30 patients with somatoform disorder with pain symptoms were selected as experimental group. Thirty healthy subjects matched with sex and age in the experimental group were selected, and the control group were excluded from somatoform disorder and other mental disorders and severe somatic diseases at the same time. The attention bias responses of 30 patients with somatoform disorder (experimental group) and 30 normal subjects (control group) were measured by point-detection paradigm and cue-target paradigm. The Chinese version of the global pain assessment scale (GPS) was used to measure and evaluate the pain in the experimental group. 90 symptom Checklist (SCL-90) were used to measure the mental health of the two groups. Results: 30 cases of experimental group and 30 cases of control group completed the pre-designed general information questionnaire, and both groups completed point detection paradigm and clue target paradigm. There was no significant difference in sex, age and education level between the two groups (P < 0. 796 / 0. 588 / 0. 796). In the point detection paradigm, there was no significant difference in the response time of the control group to the two types of image properties (positive and negative) (F0. 1. 19% P + 0. 703). There was significant difference in the reaction time of the two types of images (positive and negative) in the experimental group, and the reaction time of the negative picture was significantly longer than that of the positive image (FF21.004 / P0. 000). The negative picture reaction time of the experimental group was longer than that of the control group. In the cue-target paradigm, there was a significant difference in the response time of the experimental group to negative images under effective cues and ineffective cues (F17. 33, P0. 00F0. 00FN 16. 51 P0. 00). In the C level effect of A1B2, the average response time of the experimental group to the negative picture stimulation was longer than that to the positive picture stimulus under the condition of invalid cues (F 16. 51% P0. 00). The total score of the overall pain assessment scale in the experimental group was (63.12 卤19.60), in which the pain items were (17.74 卤6.43), the emotional items were (16.38 卤6.50), and the clinical manifestations were (16.00 卤6.35). The daily behavior items were (13.00 卤6.17). In the experimental group, the time of negative picture reaction was positively correlated with the total score of GPS, the emotion of GPS scale and the item score of pain symptom (r = 0.429 ~ 0.416 卤0.534). Negative picture reaction time was not correlated with the scores of clinical manifestations and daily behavior items of GPS scale (r = 0.064 卤0.299). The scores of somatization, compulsion, phobia and psychosis of SCL-90 were positively correlated with the time of negative picture reaction in the experimental group, and negatively correlated with the scores of somatization and psychosis in the positive picture reaction. Conclusion: the patients with somatoform disorder have negative information. The pathophysiological characteristic of attention bias in patients with somatoform disorder pain is the difficulty of paying attention to negative information. The negative information attention bias of patients with somatoform disorder and the psychological interaction between them are mutually reinforcing, which may be one of the mechanisms for the occurrence and development of the pain symptoms of the disease, and is also the target of psychotherapy. The interaction between somatization, compulsion, fear, psychotic symptoms and pain in somatoform disorders may also be one of the effective mechanisms of antidepressants in the treatment of pain.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：B842.3
本文编号：2363889
[Abstract]:Objective: to investigate whether there is a negative information attention bias and its association with pain in patients with somatoform disorder accompanied by pain symptoms, and to explore the related factors of pain symptoms in patients with somatoform disorder. It provides a new reference for the study of somatic discomfort such as somatoform disorder pain and provides a new way for the treatment of symptoms. Methods: 30 patients with somatoform disorder with pain symptoms were selected as experimental group. Thirty healthy subjects matched with sex and age in the experimental group were selected, and the control group were excluded from somatoform disorder and other mental disorders and severe somatic diseases at the same time. The attention bias responses of 30 patients with somatoform disorder (experimental group) and 30 normal subjects (control group) were measured by point-detection paradigm and cue-target paradigm. The Chinese version of the global pain assessment scale (GPS) was used to measure and evaluate the pain in the experimental group. 90 symptom Checklist (SCL-90) were used to measure the mental health of the two groups. Results: 30 cases of experimental group and 30 cases of control group completed the pre-designed general information questionnaire, and both groups completed point detection paradigm and clue target paradigm. There was no significant difference in sex, age and education level between the two groups (P < 0. 796 / 0. 588 / 0. 796). In the point detection paradigm, there was no significant difference in the response time of the control group to the two types of image properties (positive and negative) (F0. 1. 19% P + 0. 703). There was significant difference in the reaction time of the two types of images (positive and negative) in the experimental group, and the reaction time of the negative picture was significantly longer than that of the positive image (FF21.004 / P0. 000). The negative picture reaction time of the experimental group was longer than that of the control group. In the cue-target paradigm, there was a significant difference in the response time of the experimental group to negative images under effective cues and ineffective cues (F17. 33, P0. 00F0. 00FN 16. 51 P0. 00). In the C level effect of A1B2, the average response time of the experimental group to the negative picture stimulation was longer than that to the positive picture stimulus under the condition of invalid cues (F 16. 51% P0. 00). The total score of the overall pain assessment scale in the experimental group was (63.12 卤19.60), in which the pain items were (17.74 卤6.43), the emotional items were (16.38 卤6.50), and the clinical manifestations were (16.00 卤6.35). The daily behavior items were (13.00 卤6.17). In the experimental group, the time of negative picture reaction was positively correlated with the total score of GPS, the emotion of GPS scale and the item score of pain symptom (r = 0.429 ~ 0.416 卤0.534). Negative picture reaction time was not correlated with the scores of clinical manifestations and daily behavior items of GPS scale (r = 0.064 卤0.299). The scores of somatization, compulsion, phobia and psychosis of SCL-90 were positively correlated with the time of negative picture reaction in the experimental group, and negatively correlated with the scores of somatization and psychosis in the positive picture reaction. Conclusion: the patients with somatoform disorder have negative information. The pathophysiological characteristic of attention bias in patients with somatoform disorder pain is the difficulty of paying attention to negative information. The negative information attention bias of patients with somatoform disorder and the psychological interaction between them are mutually reinforcing, which may be one of the mechanisms for the occurrence and development of the pain symptoms of the disease, and is also the target of psychotherapy. The interaction between somatization, compulsion, fear, psychotic symptoms and pain in somatoform disorders may also be one of the effective mechanisms of antidepressants in the treatment of pain.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：B842.3
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