偏执型精神分裂症面部情绪识别与述情障碍的执行功能与人格基础

发布时间：2018-03-31 10:43

本文选题：述情障碍　切入点：执行功能　出处：《浙江大学》2012年博士论文

【摘要】：背景：精神分裂症是一个严重的精神障碍,终生患病率0.7%,我国现有患者780万,其病因不明,机制不清,预后不良,社会影响巨大；进一步了解其病因、病理、改善其预后等具有重大的科研价值和社会意义。情感症状是精神分裂症核心症状之一,与患者的社会功能及预后密切相关,因此情绪处理研究是本领域的重要课题。情绪处理过程包括情绪体验、表达与识别。面部情绪识别是情绪识别的核心,述情障碍则属于情绪体验与情绪表达的异常,对面部情绪识别和述情障碍的深入研究是精神分裂症情绪处理课题的重要组成部分。执行功能作为高级认知参与面部情绪识别的处理环节,而人格障碍功能类型可能是分裂症既往述情障碍研究结果不一致的重要解释。因此,探求执行功能和人格障碍功能类型分别作为面部情绪识别和述情障碍基础存在的相关表现,对精神分裂症此类研究而言可能是有意义的视角。目的： 1.研究精神分裂症面部情绪识别与执行功能的关系； 2.研究精神分裂症述情障碍与人格障碍功能类型的关系； 3.探索精神分裂症面部情绪识别与述情障碍的关系。方法：选取88名偏执型精神分裂症患者及75名健康被试,以the Japanese and Caucasian Facial Expressions of Emotion测试面部情绪识别,以the Wisconsin Card Sorting Test (WCST)测试执行功能。且分别以the Toronto Alexithymia Scale (TAS)中文版及the Parker Personality measure (PERM)评测述情障碍与人格障碍功能类型。同时用the Positive and Negative Symptom Scale (PANSS), the Hamilton Depression Scale与the Hamilton Anxiety Scale评估临床症状。结果： 1.患者大多数面部情绪识别的准确性和WCST成绩均低于健康对照。患者对厌恶、轻蔑识别准确性与PANSS阴性症状负相关,对恐惧识别准确性与PANSS阳性症状正相关,而对惊讶识别准确性与PNASS一般精神病理学症状负相关。WCST完成分类数可预测患者对轻蔑、厌恶、悲伤识别准确性。 2.患者TAS情感辨别困难与情感描述困难因子及大多数PERM分量表得分均高于健康被试。患者PERM反社会型人格障碍功能类型可预测TAS情感辨别困难,回避型人格障碍功能类型可预测情感描述困难；反之,情感辨别困难与情感描述困难因子可预测PERM人格障碍功能类型。 3.患者愤怒识别准确性与情感辨别困难及情感描述困难呈负相关,惊讶的识别准确性与情感辨别困难负相关。结论： 1.精神分裂症患者执行功能影响面部情绪识别,支持精神分裂症面部情绪识别存在特异性损害的认知环节。 2.精神分裂症患者述情障碍存在人格障碍功能类型基础。 3.精神分裂症患者述情障碍与面部情绪识别相互影响。
[Abstract]:Background:. Schizophrenia is a serious mental disorder, lifetime prevalence is 0. 7%, there are 7.8 million patients in our country, its etiology is unknown, the mechanism is unclear, the prognosis is poor, and the social influence is enormous. It is of great scientific value and social significance to improve its prognosis. Emotional symptoms are one of the core symptoms of schizophrenia, which are closely related to the social function and prognosis of the patients. Therefore, the research of emotion processing is an important subject in this field. The process of emotion processing includes emotional experience, expression and recognition. Facial emotion recognition is the core of emotion recognition, and alexithymia is the abnormality of emotion experience and emotion expression. The in-depth study of facial emotion recognition and alexithymia is an important part of the subject of emotion processing in schizophrenia. The functional type of personality disorder may be an important explanation for the inconsistent results of the previous alexithymia study in patients with schizophrenia. Therefore, to explore the related manifestations of executive function and personality disorder as the basis of facial emotion recognition and alexithymia, respectively. This may be a meaningful perspective for such studies on schizophrenia. Objective:. 1. To study the relationship between facial emotion recognition and executive function in schizophrenia; 2. To study the relationship between alexithymia and personality disorder. 3. To explore the relationship between facial emotion recognition and alexithymia in schizophrenia. Methods:. 88 paranoid schizophrenic patients and 75 healthy subjects were tested for facial emotion recognition with the Japanese and Caucasian Facial Expressions of Emotion. The functional types of alexithymia and personality disorder were evaluated by the Toronto Alexithymia Scale and the Parker Personality measure PERM.The clinical symptoms were evaluated by the Positive Negative Negative Symptom Scale PANSS, the Hamilton Depression Scale and Scale Hamilton Scale respectively. The clinical symptoms were evaluated by using the Positive Negative Symptom Symptom Scale PANSS, the Hamilton Depression Scale and Scale Hamilton Anxiety Scale respectively. Results:. 1. The accuracy of facial emotion recognition and WCST scores of most patients were lower than that of healthy controls. The accuracy of disdain recognition was negatively correlated with the negative symptoms of PANSS, and the accuracy of recognition of fear was positively correlated with the positive symptoms of PANSS. The accuracy of surprise recognition was negatively correlated with the general psychopathological symptoms of PNASS. 2. The scores of TAS emotional discrimination difficulty, affective description difficulty factor and most of PERM subscale were higher than those of healthy subjects. PERM antisocial personality disorder function type could predict TAS affective discrimination difficulty. The function types of avoidance personality disorders can predict the difficulty of affective description, whereas the factors of emotional discrimination difficulties and affective description difficulties can predict the functional types of PERM personality disorders. 3.There was a negative correlation between the accuracy of anger recognition and the difficulty of emotion identification and the difficulty of emotion description, and the accuracy of surprised recognition was negatively correlated with the difficulty of emotion identification. Conclusion:. 1. The executive function of schizophrenia affects facial emotional recognition and supports the cognitive link of specific impairment of facial emotional recognition in schizophrenia. 2. Alexithymia in schizophrenic patients is based on the functional type of personality disorder. 3. The interaction between alexithymia and facial emotion recognition in schizophrenic patients.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2012
【分类号】：R749.3

【引证文献】