强迫症道德厌恶与生理厌恶的ERP研究

发布时间：2018-10-15 18:11

【摘要】：目的强迫症(obsessive-compulsive disorder,OCD)是一种慢性精神疾病,以控制不住的反复出现的强迫思维或强迫行为为基本特征,具有复发性和难治性的特点。研究发现,强迫症患者厌恶加工能力受损,厌恶情绪在强迫症的发病过程中扮演着重要角色。厌恶情绪可由非洁净物(如细菌、排泄物等)及违反社会道德规范的行为引起。强迫症的道德感普遍过强,他们对自我和他人不道德行为更为厌恶。本研究将厌恶情绪分为道德厌恶与生理厌恶,采用神经电生理技术对强迫症患者厌恶情绪进行研究,探讨强迫症患者道德厌恶与生理厌恶认知加工的特点及其与强迫症状之间的关系,以及它们之间相互作用的行为学证据和电生理机制。方法纳入28例符合《国际疾病与相关健康问题统计分类》(International Statist ical Classification of Diseases and Related Health Problems,ICD-10)诊断标准的强迫症患者,及30名年龄、性别构成及受教育年限相匹配的对照组进行词汇判断任务,采用Neuroscan ERP记录与分析系统记录被试的行为学数据与脑电数据。所有被试均完成蒙特利尔认知评估(Montreal Cognitive Assessment,Mo CA)、数字广度测试(Digital Span Task,DS)和言语流畅性测试(Verbal Fluency Test,VFT)、Stroop色词任务(Stroop Colour Word Test,SCWT),帕多瓦量表-华盛顿州立大学修订版(Padua Inventory-Washington State University Revision,PIWSUR)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表17项(Hamilton depression scale-17,HAMD-17)的测试,同时对强迫症患者进行耶鲁布朗强迫量表(Yale-Brown Obsessive Compulsive Scale,Y-BOCS)评定。结果(1)行为学结果:强迫症组相比较于对照组,对道德厌恶词[(7.08±1.23)vs.(5.77±1.44)]和生理厌恶词[(6.38±1.78)vs.(5.03±1.64)]的厌恶程度更高,对生理厌恶词[(762.69±128.25)ms vs.(648.69±162.66)ms]以及道德厌恶词[(798.73±115.26)ms vs.(727.00±106.06)ms]的反应时也更长,且差异均有统计学意义(P0.05);强迫症组两类厌恶词的厌恶程度与Y-BOCS总分及Y-BOCS强迫思维分、Y-BOCS强迫行为分、PI-WSUR总分及污染/清洗强迫因子分、穿衣/打扮强迫因子分、检查强迫因子分、伤害他人/自己的强迫想法分、伤害他人/自己的强迫冲动分正相关(P0.05)。(2)脑电结果:LPC成分的刺激类型主效应显著(P0.05),刺激类型与组别交互作用临界显著(P=0.05),简单效应分析强迫症组生理厌恶与道德厌恶所诱发的LPC波幅[(5.35±0.68)μV vs.(5.30±0.84)μV]差异无统计学意义(P0.05),对照组生理厌恶与道德厌恶诱发的LPC波幅[(5.69±0.64)μV vs.(4.35±0.65)μV]差异有统计学意义(P0.05);强迫症组Y-BOCS量表评分、帕多瓦量表总分及其污染/清洗强迫因子、伤害他人及自己强迫想法因子等与道德厌恶LPC波幅呈正相关(P0.05)。结论本研究发现,相较于对照组,强迫症组的道德厌恶感和生理厌恶感更强烈,且道德厌恶感与生理厌恶感的强烈程度与强迫症患者临床症状的严重程度正相关。
[Abstract]:Objective obsessive-compulsive disorder (obsessive-compulsive disorder,OCD) is a chronic mental disorder characterized by recurrent compulsive thinking or obsessive-compulsive behavior. The study found that obsessive-compulsive disorder (OCD) has impaired ability of aversion and processing, and aversion plays an important role in the pathogenesis of obsessive-compulsive disorder (OCD). Aversion can be caused by unclean substances (such as bacteria, excreta, etc.) and against social ethics. The morality of obsessive compulsive disorder is generally too strong, they are more abhorrent to immoral behavior of self and others. In this study, aversion was divided into moral aversion and physiological aversion. Neuroelectrophysiological techniques were used to study the aversion of obsessive-compulsive disorder (OCD) patients. To explore the characteristics of cognitive processing of moral aversion and physiological aversion in patients with obsessive-compulsive disorder (OCD) and their relationship with obsessive-compulsive symptoms (OCD), as well as the behavioral evidence and electrophysiological mechanism of their interaction. Methods Twenty-eight patients with obsessive-compulsive disorder (OCD) who met the diagnostic criteria of International Classification of Diseases and related Health problems (International Statist ical Classification of Diseases and Related Health Problems,ICD-10) and 30 controls matched with age, sex composition and length of education were included to perform lexical judgment tasks. Behavioral data and EEG data were recorded by Neuroscan ERP recording and analysis system. All participants completed the Montreal Cognitive Assessment (Montreal Cognitive Assessment,Mo CA), digit Span Test (Digital Span Task,DS) and the speech fluency Test (Verbal Fluency Test,VFT), Stroop Color word Task (Stroop Colour Word Test,SCWT), Padua scale-Washington State University revision (Padua Inventory-Washington State University Revision,PIWSUR), Hanmi (Hamilton anxiety scale,HAMA, Hamilton Depression scale, 17 items of (Hamilton depression scale-17,HAMD-17, The obsessive-compulsive disorder patients were assessed with Yale Brown obsessive-compulsive scale (Yale-Brown Obsessive Compulsive Scale,Y-BOCS). Results (1) Behavioral outcome: compared with the control group, the obsessive-compulsive group had a higher degree of disgust to the words of moral disgust [(7.08 卤1.23) vs. (5.77 卤1.44)] and physiological words [(6.38 卤1.78) vs. (5.03 卤1.64)], and the reaction time to the words of physical disgust [(762.69 卤128.25) ms vs. (648.69 卤162.66) ms] and the word of moral disgust [(798.73 卤115.26) ms vs. (727.00 卤106.06) ms] was also longer. The scores of Y-BOCS, PI-WSUR, pollution / cleaning, dressing / dressing, and obsessive-compulsive factors were significantly different between the two groups of obsessive-compulsive disorder (OCD) (P0.05), and the scores of obsessive-compulsive behavior (OCD) and obsessive-compulsive behavior (OCD) were measured. Forced thoughts that hurt others / themselves, The scores of compulsive impulses that hurt others / oneself were positively correlated (P0.05). (2). The results of EEG showed that the main effect of stimulation type of LPC component was significant (P0.05), and the threshold of interaction between stimulus type and group was significant (P0. 05). The simple effect analysis of obsessive-compulsive disorder group was physical and moral aversion (P0. 05). The amplitude of LPC [(5.35 卤0.68) 渭 V vs. (5.30 卤0.84 渭 V] had no significant difference (P0.05), but the amplitude of LPC induced by physical aversion and moral aversion in the control group [(5.69 卤0.64) 渭 V vs. (4.35 卤0.65 渭 V] was significantly different (P0.05); The total score of Padua scale and its pollution / cleaning compulsive factors, the factors of hurting others and their own compulsive thoughts were positively correlated with the amplitude of LPC wave of moral aversion (P0.05). Conclusion compared with the control group, the OCD group has stronger sense of moral aversion and physiological aversion, and the intensity of moral aversion and physiological aversion is positively related to the severity of clinical symptoms of OCD patients.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.7

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