伴或不伴污染洗涤症状强迫障碍患者厌恶的ERP研究

发布时间：2018-01-06 10:26

本文关键词：伴或不伴污染洗涤症状强迫障碍患者厌恶的ERP研究　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:强迫障碍是一种异质性疾病,不同强迫症状的发病机制?神经电生理表现及治疗应答率均有差异?大量研究表明厌恶在污染/洗涤症状强迫障碍的发生及发展中占有重要作用。厌恶既可由排泄物?腐烂的食物引起,也可由不道德言行诱发,前者称为生理厌恶,后者称为道德厌恶。但厌恶与其他症状的强迫障碍之间的关系研究较少,尚无统一结论?本研究采用事件相关电位(event-related potential,ERP)技术探索伴或不伴污染洗涤症状的强迫障碍患者厌恶加工的特点,从厌恶角度进一步理解强迫障碍的异质性?方法:共纳入符合《疾病及有关健康问题的国际分类》(International Statistical Classification of Diseases and Related Health Problems,Tenth Revision,ICD-10)中强迫性障碍诊断标准的门诊及住院患者57例。病程中且目前仍伴有污染/洗涤症状的强迫障碍患者纳入清洗组,病程中且目前无污染/洗涤症状的强迫障碍患者纳入非清洗组?其中清洗组27人,非清洗组30人?并招募性别?年龄?受教育程度与强迫障碍患者相匹配的健康人作为正常对照组,共50人?所有被试均完成帕多瓦强迫量表?耶鲁布朗强迫严重程度量表?汉密顿焦虑量表?汉密顿抑郁量表,在完成词汇判断任务的同时记录ERP数据?结果:(1)词汇判断任务行为学结果:在生理厌恶词及道德厌恶词中,非清洗组正确率小于清洗组及正常对照组(均P0.05)?中性词正确率三组无统计学差异(P0.05)?清洗组及非清洗组生理厌恶词?道德厌恶词反应时均长于正常对照组,两类词的厌恶程度评级均高于正常对照组(均P0.05),清洗组与非清洗组间无统计学差异?三组被试中性词厌恶程度评级无统计学差异(均P0.05)?(2)ERP数据结果:在P2成分上,生理厌恶词刺激及道德厌恶词刺激下,三组诱发的波幅无统计学差异?中性词刺激下,清洗组诱发的波幅高于正常对照组(均P0.05)?在N2成分上:生理厌恶词刺激下,清洗组诱发的波幅高于非清洗组和正常对照组(均P0.05);在道德厌恶词及中性词刺激下,清洗组诱发的波幅均高于非清洗组及正常对照组(均P0.05),非清洗组与正常对照组间无统计学差异;正常对照组中生理厌恶词和道德厌恶词诱发的N2成分波幅均高于中性词(均P0.05),清洗组及非清洗组两组中三类刺激类型诱发的波幅无统计学差异(均P0.05)?在LPC成分上:清洗组诱发的波幅高于非清洗组?不同刺激类型诱发的波幅中:生理厌恶词道德厌恶词中性词?Pearson相关分析显示,污染/洗涤因子分与厌恶词诱发的P2成分波幅大小均呈正相关(均P0.05)?其他强迫症状因子分与各脑电成分均无明显相关关系?结论:伴或不伴污染洗涤/症状的强迫障碍患者自我评估中厌恶感均升高;污染/洗涤症状患者厌恶加工中污染信念、注意偏向、诱发情绪强度等过程均有异常,而其他强迫症状患者厌恶加工无明显异常;伴或不伴污染洗涤症状的强迫障碍患者之间厌恶加工存在差异,厌恶刺激下脑电活动指标可作为潜在的症状分型标准之一。本研究从厌恶角度为强迫障碍的异质性增加神经电生理证据,为强迫障碍个体化治疗提供理论依据?
[Abstract]:Objective: obsessive-compulsive disorder is a heterogeneous disease, the pathogenesis of different obsessive-compulsive symptoms? The electrophysiological features and treatment response rates were different? A large number of studies show that disgust plays an important role in occurrence and development of contamination / washing symptoms of obsessive compulsive disorder. Disgusted either by faeces? Rotten food can also cause. The former is called moral behavior induced by physiological disgust, the latter is called moral disgust. But hate relationship between obsessive compulsive disorder and other symptoms are less, there is no unified conclusion? This study used event-related potential (event-related potential, ERP) in patients with obsessive-compulsive disorder characteristics of disgust processing technology to explore with or without pollution washing symptoms the further understanding of the heterogeneity of obsessive-compulsive disorder from aversion perspective? Methods: International Classification in accordance with < > of diseases and related health problems were included in the International (Statistical Classificati On of Diseases and Related Health Problems, Tenth Revision, ICD-10) strong compulsive disorder diagnostic criteria of outpatient and inpatient patients in 57 cases. In the course of the disease and is still associated with pollution / obsessive-compulsive disorder symptoms in patients with washing cleaning group, and there is no pollution in the course of patients with obsessive-compulsive disorder symptoms in non washing cleaning group? The cleaning group of 27 people, 30 people of non cleaning group and recruited? Sex? Age? Health education in patients with obsessive-compulsive disorder and the degree of matching as a normal control group, a total of 50 people? All the subjects completed Padova YBOCS? Lord Rubrand forced the severity scale? Hamilton Anxiety Scale, Hamilton depression? Scale, record ERP data in the complete lexical decision task at the same time? Results: (1) lexical decision task behavior results in physical disgust words and moral disgust in the word, the correct rate of non cleaning group is less than the normal control group and cleaning Group (P0.05)? Neutral word correct rate of no significant difference between three groups (P0.05) group and non group cleaning cleaning? Physical disgust words? Moral disgust words reaction were longer than the normal control group, the two word aversion ratings were higher than the normal control group (P0.05), no significant difference between the group and non cleaning cleaning group? The three groups of subjects were neutral words. There were no significant differences in rating aversion (P0.05)? (2) results: ERP data on the P2 composition, physical disgust words stimulation and moral disgust words stimulation, no significant differences between the three groups induced by amplitude? Neutral words stimulation, cleaning group induced amplitude higher than the normal control group (P0.05)? N2 component: physical disgust words under the stimulation evoked amplitude is higher than that of group cleaning cleaning group and normal control group (P0.05); in moral disgust words and neutral words under the stimulation of cleaning group induced wave amplitude was higher than that of non cleaning group and normal control group (P 0.05), non cleaning group and the control group had no significant difference; amplitude of N2 component of normal control group in physical disgust words and moral disgust words were higher than that induced by neutral words (P0.05), cleaning group and non cleaning group three kinds of stimulus type induced by two in the group was no significant difference in Statistics (P0.05)? On the LPC composition: cleaning group induced amplitude is higher than that of non cleaning group? Different stimulus types evoked amplitude: physical disgust words moral disgust words neutral words? Pearson correlation analysis showed that the contamination / washing factor scores and disgust words evoked P2 component amplitudes were positively correlated (P0.05) other obsessive-compulsive factors? There was no obvious correlation with the EEG components? Conclusion: with or without pollution washing / patients with obsessive-compulsive disorder symptoms self assessment in disgust were increased; the contamination / pollution washing symptoms in patients with disgust processing in belief, attention bias, emotional Strength of process abnormality, and other compulsive symptoms in patients with no obvious abnormal processing aversion; disgust processing differences between patients with obsessive-compulsive disorder with or without pollution washing symptoms, brain electrical activity under aversive stimuli can be used as indicators of potential symptoms of type standard one. This research increased electrophysiological evidence for the heterogeneity of obsessive-compulsive disorder from the perspective of disgust, obsessive-compulsive disorder for individualized treatment and provide a theoretical basis?

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.7

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