軀體形式障礙的注意偏向及其與疼痛癥狀的關(guān)聯(lián)
發(fā)布時(shí)間：2018-11-28 18:34
【摘要】：目的:為了研究軀體形式障礙伴有疼痛癥狀患者是否存在對(duì)負(fù)性信息注意偏向以及該注意偏向障礙與疼痛的關(guān)聯(lián),探究軀體形式障礙的疼痛癥狀的關(guān)聯(lián)因素,為軀體形式障礙疼痛等軀體不適的研究提供新的參考依據(jù),為其癥狀治療提供新的途徑。方法:選擇軀體形式障礙伴疼痛癥狀患者30例作為實(shí)驗(yàn)組;選取30例與實(shí)驗(yàn)組性別、年齡相匹配的正常健康人,同時(shí)排除軀體形式障礙及其他精神疾病和軀體嚴(yán)重疾病作為對(duì)照組。采用點(diǎn)探測(cè)范式和線索-靶范式對(duì)30例軀體形式障礙患者(實(shí)驗(yàn)組)與30例正常被試(對(duì)照組)的注意偏向反應(yīng)時(shí)進(jìn)行測(cè)量。采用整體疼痛評(píng)估量表中文版(GPS)對(duì)實(shí)驗(yàn)組進(jìn)行疼痛測(cè)量評(píng)估。采用90項(xiàng)癥狀自評(píng)量表(SCL-90)對(duì)兩組進(jìn)行心理健康狀況的測(cè)量。結(jié)果:30例實(shí)驗(yàn)組和30例對(duì)照組都完成了實(shí)驗(yàn)前期預(yù)先設(shè)計(jì)的一般資料問卷的搜集,且兩組都完成了點(diǎn)探測(cè)范式和線索靶范式。兩組的性別、年齡、受教育程度無顯著差異(P=0.796,0.588,0.796)。在點(diǎn)探測(cè)范式中,對(duì)照組對(duì)兩種圖片性質(zhì)(正性,負(fù)性)的反應(yīng)時(shí)差異不顯著(F=0.119,P=0.703);實(shí)驗(yàn)組對(duì)兩種圖片性質(zhì)(正性,負(fù)性)的反應(yīng)時(shí)存在顯著差異,且負(fù)性圖片反應(yīng)時(shí)顯著長(zhǎng)于正性圖片(F=21.004,P=0.000);實(shí)驗(yàn)組的負(fù)性圖片反應(yīng)時(shí)長(zhǎng)于對(duì)照組的負(fù)性圖片反應(yīng)時(shí)(F=42.007,P=0.000)。在線索-靶范式中,實(shí)驗(yàn)組在有效線索和無效線索下對(duì)負(fù)性圖片反應(yīng)時(shí)差異有顯著性(F=17.33,P=0.00;F=16.51,P=0.00);進(jìn)一步簡(jiǎn)單效應(yīng)分析,A1B2在C水平效應(yīng)中,實(shí)驗(yàn)組在無效線索條件下,對(duì)負(fù)性圖片刺激的平均反應(yīng)時(shí)長(zhǎng)于對(duì)正性圖片刺激的平均反應(yīng)時(shí)(F=16.51,P=0.00)。實(shí)驗(yàn)組整體疼痛評(píng)估量表總分為(63.12±19.60),其中疼痛項(xiàng)目分為(17.74±6.43),情緒項(xiàng)目分為(16.38±6.50),臨床表現(xiàn)項(xiàng)目分為(16.00±6.35),日常行為項(xiàng)目分為(13.00±6.17)。實(shí)驗(yàn)組負(fù)性圖片反應(yīng)時(shí)與GPS總分以及GPS量表的情緒、疼痛癥狀項(xiàng)目分呈顯著正相關(guān)(r=0.429,0.416,0.534);負(fù)性圖片反應(yīng)時(shí)與GPS量表的臨床表現(xiàn)項(xiàng)目分及日常行為項(xiàng)目分不相關(guān)(r=0.064,0.299)。實(shí)驗(yàn)組負(fù)性圖片反應(yīng)時(shí)與SCL-90的軀體化、強(qiáng)迫、恐怖、精神病性因子分呈顯著正相關(guān);正性圖片反應(yīng)時(shí)與軀體化、精神病性因子分呈負(fù)相關(guān)。結(jié)論:軀體形式障礙疼痛癥狀的患者具有對(duì)負(fù)性信息的注意偏向。軀體形式障礙疼痛患者產(chǎn)生負(fù)性情緒的注意偏向的病理心理特點(diǎn)是對(duì)負(fù)性信息注意解除的困難。軀體形式障礙疼痛患者的負(fù)性信息注意偏向與疼痛兩者存在相互加強(qiáng)的精神交互作用,這可能是本病疼痛癥狀發(fā)生發(fā)展的機(jī)制之一,也是心理治療需要針對(duì)的靶點(diǎn)。軀體形式障礙的軀體化、強(qiáng)迫、恐懼、精神病性癥狀與疼痛存在交互加強(qiáng)機(jī)制,也可能是抗抑郁劑治療本病疼痛的有效機(jī)制之一。
[Abstract]:Objective: to investigate whether there is a negative information attention bias and its association with pain in patients with somatoform disorder accompanied by pain symptoms, and to explore the related factors of pain symptoms in patients with somatoform disorder. It provides a new reference for the study of somatic discomfort such as somatoform disorder pain and provides a new way for the treatment of symptoms. Methods: 30 patients with somatoform disorder with pain symptoms were selected as experimental group. Thirty healthy subjects matched with sex and age in the experimental group were selected, and the control group were excluded from somatoform disorder and other mental disorders and severe somatic diseases at the same time. The attention bias responses of 30 patients with somatoform disorder (experimental group) and 30 normal subjects (control group) were measured by point-detection paradigm and cue-target paradigm. The Chinese version of the global pain assessment scale (GPS) was used to measure and evaluate the pain in the experimental group. 90 symptom Checklist (SCL-90) were used to measure the mental health of the two groups. Results: 30 cases of experimental group and 30 cases of control group completed the pre-designed general information questionnaire, and both groups completed point detection paradigm and clue target paradigm. There was no significant difference in sex, age and education level between the two groups (P < 0. 796 / 0. 588 / 0. 796). In the point detection paradigm, there was no significant difference in the response time of the control group to the two types of image properties (positive and negative) (F0. 1. 19% P + 0. 703). There was significant difference in the reaction time of the two types of images (positive and negative) in the experimental group, and the reaction time of the negative picture was significantly longer than that of the positive image (FF21.004 / P0. 000). The negative picture reaction time of the experimental group was longer than that of the control group. In the cue-target paradigm, there was a significant difference in the response time of the experimental group to negative images under effective cues and ineffective cues (F17. 33, P0. 00F0. 00FN 16. 51 P0. 00). In the C level effect of A1B2, the average response time of the experimental group to the negative picture stimulation was longer than that to the positive picture stimulus under the condition of invalid cues (F 16. 51% P0. 00). The total score of the overall pain assessment scale in the experimental group was (63.12 鹵19.60), in which the pain items were (17.74 鹵6.43), the emotional items were (16.38 鹵6.50), and the clinical manifestations were (16.00 鹵6.35). The daily behavior items were (13.00 鹵6.17). In the experimental group, the time of negative picture reaction was positively correlated with the total score of GPS, the emotion of GPS scale and the item score of pain symptom (r = 0.429 ~ 0.416 鹵0.534). Negative picture reaction time was not correlated with the scores of clinical manifestations and daily behavior items of GPS scale (r = 0.064 鹵0.299). The scores of somatization, compulsion, phobia and psychosis of SCL-90 were positively correlated with the time of negative picture reaction in the experimental group, and negatively correlated with the scores of somatization and psychosis in the positive picture reaction. Conclusion: the patients with somatoform disorder have negative information. The pathophysiological characteristic of attention bias in patients with somatoform disorder pain is the difficulty of paying attention to negative information. The negative information attention bias of patients with somatoform disorder and the psychological interaction between them are mutually reinforcing, which may be one of the mechanisms for the occurrence and development of the pain symptoms of the disease, and is also the target of psychotherapy. The interaction between somatization, compulsion, fear, psychotic symptoms and pain in somatoform disorders may also be one of the effective mechanisms of antidepressants in the treatment of pain.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：B842.3
本文編號(hào)：2363890
[Abstract]:Objective: to investigate whether there is a negative information attention bias and its association with pain in patients with somatoform disorder accompanied by pain symptoms, and to explore the related factors of pain symptoms in patients with somatoform disorder. It provides a new reference for the study of somatic discomfort such as somatoform disorder pain and provides a new way for the treatment of symptoms. Methods: 30 patients with somatoform disorder with pain symptoms were selected as experimental group. Thirty healthy subjects matched with sex and age in the experimental group were selected, and the control group were excluded from somatoform disorder and other mental disorders and severe somatic diseases at the same time. The attention bias responses of 30 patients with somatoform disorder (experimental group) and 30 normal subjects (control group) were measured by point-detection paradigm and cue-target paradigm. The Chinese version of the global pain assessment scale (GPS) was used to measure and evaluate the pain in the experimental group. 90 symptom Checklist (SCL-90) were used to measure the mental health of the two groups. Results: 30 cases of experimental group and 30 cases of control group completed the pre-designed general information questionnaire, and both groups completed point detection paradigm and clue target paradigm. There was no significant difference in sex, age and education level between the two groups (P < 0. 796 / 0. 588 / 0. 796). In the point detection paradigm, there was no significant difference in the response time of the control group to the two types of image properties (positive and negative) (F0. 1. 19% P + 0. 703). There was significant difference in the reaction time of the two types of images (positive and negative) in the experimental group, and the reaction time of the negative picture was significantly longer than that of the positive image (FF21.004 / P0. 000). The negative picture reaction time of the experimental group was longer than that of the control group. In the cue-target paradigm, there was a significant difference in the response time of the experimental group to negative images under effective cues and ineffective cues (F17. 33, P0. 00F0. 00FN 16. 51 P0. 00). In the C level effect of A1B2, the average response time of the experimental group to the negative picture stimulation was longer than that to the positive picture stimulus under the condition of invalid cues (F 16. 51% P0. 00). The total score of the overall pain assessment scale in the experimental group was (63.12 鹵19.60), in which the pain items were (17.74 鹵6.43), the emotional items were (16.38 鹵6.50), and the clinical manifestations were (16.00 鹵6.35). The daily behavior items were (13.00 鹵6.17). In the experimental group, the time of negative picture reaction was positively correlated with the total score of GPS, the emotion of GPS scale and the item score of pain symptom (r = 0.429 ~ 0.416 鹵0.534). Negative picture reaction time was not correlated with the scores of clinical manifestations and daily behavior items of GPS scale (r = 0.064 鹵0.299). The scores of somatization, compulsion, phobia and psychosis of SCL-90 were positively correlated with the time of negative picture reaction in the experimental group, and negatively correlated with the scores of somatization and psychosis in the positive picture reaction. Conclusion: the patients with somatoform disorder have negative information. The pathophysiological characteristic of attention bias in patients with somatoform disorder pain is the difficulty of paying attention to negative information. The negative information attention bias of patients with somatoform disorder and the psychological interaction between them are mutually reinforcing, which may be one of the mechanisms for the occurrence and development of the pain symptoms of the disease, and is also the target of psychotherapy. The interaction between somatization, compulsion, fear, psychotic symptoms and pain in somatoform disorders may also be one of the effective mechanisms of antidepressants in the treatment of pain.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：B842.3
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