阈下抑郁青少年趋近—回避行为特点及神经机制研究

发布时间：2018-03-03 15:48

  本文选题：阈下抑郁　切入点：趋近—回避行为　出处：《成都医学院》2017年硕士论文　论文类型：学位论文

【摘要】：人们每天都会无意识地做出趋近与回避的行为选择。趋近行为指试图接近奖赏等正性刺激的行为,反之,回避行为指试图阻止、逃离或减少与主观上厌恶的负性刺激接触的行为。趋近与回避行为是人类最基本的行为模式,也是与生物体的生存、繁衍、避免伤害和死亡等重大主题息息相关的行为。与普通人群相比,抑郁症被试表现出不同的趋近-回避特点,即对正性刺激的趋近行为较少。也有的研究发现,除对正性刺激的趋近行为较少外,还对负性刺激的回避行为较多。但是阈下抑郁被试的趋近—回避行为具有什么特点,是否和抑郁症被试相似?目前研究较少。目的采用对照实验比较阈下抑郁被试、健康对照组被试的趋近—回避行为特点。通过外显反馈—操纵杆实验探讨阈下抑郁被试的外显趋近—回避行为特征,通过内隐反馈—操纵杆实验探讨阈下抑郁被试的内隐趋近—回避行为特征与内隐趋近—回避行为的神经机制特征。通过比较阈下抑郁被试、健康对照组被试的趋近—回避行为与脑电的特点并综合前人有关抑郁症被试趋近—回避行为的报告,回答阈下抑郁是一种独立的异常情绪状况还是抑郁症的过渡阶段这一问题。材料与方法实验一的目的是考察阈下抑郁被试的外显趋近—回避行为特点。通过发放量表的方式筛选出合适的被试参加实验。实验组纳入标准(1)流调用抑郁量表得分≥16,贝克抑郁量表第二版得分≥16;(2)结构化临床访谈量表(Structured Clinical Interview for DSM-IV,SCID)符合1种以上4种以下症状,且包括心情低落或兴趣减少其中1项核心症状,症状持续≥2周;(3)右利手。实验组排除标准:(1)有重大身体疾病、神经系统疾病或最近一个月内服用精神类药物;(2)重性抑郁障碍。健康对照组纳入标准为:(1)CES-D16分,BDI-II16分;(2)右利手。排除标准与实验组相同。两组被试在年龄、性别上进行匹配。两组被试完成外显反馈—操纵杆实验,记录两组被试的反应时数据。数据分析采用2(组别:实验组/对照组)×3(表情图片类型:悲伤/高兴/厌恶)×2(动作:趋近/回避)的重复测量方差分析,组别为组间因素,表情图片类型与动作为组内因素。实验二的目的是考察阈下抑郁被试的内隐趋近—回避行为特点。两组被试的筛选过程与标准同实验一。两组被试完成内隐反馈—操纵杆实验,记录两组被试的反应时数据。数据分析采用2(组别:实验组/对照组)×4(表情图片类型:愤怒/高兴/悲伤/厌恶)×2(动作:趋近/回避)的重复测量方差分析,组别为组间因素,表情图片类型与动作为组内因素。实验三的目的是探索阈下抑郁被试完成趋近—回避行为的神经机制。采用事件相关电位技术记录被试的EEG。选取F3,FZ,F4,C3,CZ,C4,P3,PZ,P4中P2、P3平均波幅最大的电位点进行2(组别:实验组/对照组)×4(表情图片类型:愤怒/高兴/悲伤/厌恶)×2(动作:趋近/回避)的重复测量方差分析。组别为组间因素,表情图片类型与动作为组内因素。结果1、在实验一外显反馈—操纵杆实验中,阈下抑郁被试趋近愉快表情图片的反应时(1208.18±338.92ms)长于对照组(1058.40±204.22ms)。在呈现负性表情图片(悲伤、厌恶)时实验组与对照组相比没有差异。2、在实验二内隐反馈—操纵杆实验中,阈下抑郁被试无论在趋近还是回避动作下的反应时都长于对照组(F3,165=5.267,p=0.002),出现反应时的整体延长效果。两组被试对四种表情图片没有表现出主导性的动作趋势。3、在实验三趋近—回避行为事件相关电位研究中,阈下抑郁组Fz点的P2波波幅值大于对照组被试,出现两组之间的组间效应(F1,39=6=4.364,p=0.043),也出现动作方向×表情×组别的交互作用(F3,117=7.163,p0.001)。结论阈下抑郁青少年的趋近—回避行为与对照组被试不同。阈下抑郁可能是无抑郁与抑郁症之间的过渡状态,而不是一种单一的疾病形式。
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