原发性失眠者注意偏向及干预研究

发布时间：2018-12-12 07:36

【摘要】：在四十年的失眠认知研究中，已经形成较有影响力的理论模型包括：Harvey的“失眠维持认知模型”与Espie的“注意—意向—努力路径模型”。Harvey的模型强调的是监控与选择性注意在失眠维持中的作用，，而Espie的模型则重点说明了注意—意向—努力在失眠形成过程中的作用，尽管表述各异，但明显表达出选择性注意（注意偏向）是慢性失眠者重要的心理进程。多数研究结论也表明，失眠者存在睡眠相关刺激的注意偏向，并且部分研究进一步发现，注意偏向是引发、维持失眠的原因。尽管失眠认知模型一再强调：失眠患者注意或监控来自白天与夜间的威胁，因而引起焦虑，担心以及睡眠努力，但是目前没有研究针对威胁刺激的来源，同时选择夜间症状和日间损伤的刺激材料进行实验；另外，仅有一篇文献进一步探索了失眠者注意偏向主要成分，因此研究者有必要继续探索失眠者注意偏向成分。由于注意偏向不仅是失眠的伴随症状，更是引发、维持失眠的原因，那么可以通过训练注意偏向以达到改善失眠症状的目的；在低自尊、物质成瘾、焦虑等领域广泛使用的注意偏向训练（ABT）被证明有良好的临床效果；那么ABT可以为失眠治疗提供了一个新的视角。所以，本研究试图通过使用严格控制威胁刺激类型（夜间症状，日间损伤）的两种图片材料，试图验证前人研究结论即原发性失眠者存在睡眠相关威胁刺激注意偏向，并进一步探究到底是注意偏向的哪种成分在起作用；进一步将注意偏向训练（ABT）首次引入到失眠认知行为治疗中。本研究得到的结论如下：（1）原发性失眠者对睡眠相关威胁刺激存在注意偏向，而睡眠正常者不存在注意偏向。（2）刺激类型（日间损伤、夜间症状）对原发性失眠者的注意偏向的影响没有差异。（3）原发性失眠者的注意偏向主要成分为注意脱离困难。（4）注意偏向训练（ABT）不仅改善了原发性失眠者的注意偏向，而且使其失眠症状得到好转。
[Abstract]:In forty years of cognitive research on insomnia, More influential theoretical models have been developed, including Harvey's "Insomnia maintenance Cognitive Model" and Espie's "notice-intention-effort path model". The Harvey model emphasizes the role of monitoring and selective attention in insomnia maintenance. The model of Espie focuses on the role of attention-intention-effort in the process of insomnia formation. Although the expression is different, it clearly shows that selective attention (attention bias) is an important psychological process in patients with chronic insomnia. Most of the results also showed that insomnia patients had attention bias related to sleep stimulation, and some studies further found that attention bias was the cause of causing and maintaining insomnia. Although insomnia cognitive models have repeatedly stressed that insomnia patients pay attention to or monitor threats from day and night, causing anxiety, worry, and sleep effort, no research has been conducted on the sources of threat stimulation. At the same time, the stimulating materials of nocturnal symptoms and daytime injury were selected for experiment. In addition, only one article further explored the main components of attention bias in insomnia, so it is necessary for researchers to continue to explore the attention bias components of insomnia. Because attention bias is not only the accompanying symptom of insomnia, but also the cause of maintaining insomnia, we can improve the insomnia symptoms by training attention bias; (ABT), which is widely used in the fields of low self-esteem, substance addiction, anxiety and so on, has been proved to have a good clinical effect, so ABT can provide a new perspective for the treatment of insomnia. Therefore, by using two kinds of image materials that strictly control the types of threat stimuli (nocturnal symptoms, daytime injuries), this study attempts to verify the previous findings that Sleep related threat stimuli tend to exist in patients with primary insomnia. And further explore which component of attention bias is working; Furthermore, attention bias training (ABT) was introduced into cognitive behavior therapy for insomnia for the first time. The conclusions of this study are as follows: (1) attention bias was found in patients with primary insomnia on sleep-related threat stimuli, but not in those with normal sleep. (2) stimulation type (daytime injury), (3) the main component of attention bias in patients with primary insomnia was difficulty of attention separation. (4) attention bias training (ABT) not only improved the primary cause of insomnia. Attention bias in patients with sexual insomnia, And make its insomnia symptoms get better.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：B842.3

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