【摘要】：在四十年的失眠認(rèn)知研究中，已經(jīng)形成較有影響力的理論模型包括：Harvey的“失眠維持認(rèn)知模型”與Espie的“注意—意向—努力路徑模型”。Harvey的模型強(qiáng)調(diào)的是監(jiān)控與選擇性注意在失眠維持中的作用，，而Espie的模型則重點(diǎn)說明了注意—意向—努力在失眠形成過程中的作用，盡管表述各異，但明顯表達(dá)出選擇性注意（注意偏向）是慢性失眠者重要的心理進(jìn)程。多數(shù)研究結(jié)論也表明，失眠者存在睡眠相關(guān)刺激的注意偏向，并且部分研究進(jìn)一步發(fā)現(xiàn)，注意偏向是引發(fā)、維持失眠的原因。 盡管失眠認(rèn)知模型一再強(qiáng)調(diào)：失眠患者注意或監(jiān)控來自白天與夜間的威脅，因而引起焦慮，擔(dān)心以及睡眠努力，但是目前沒有研究針對(duì)威脅刺激的來源，同時(shí)選擇夜間癥狀和日間損傷的刺激材料進(jìn)行實(shí)驗(yàn)；另外，僅有一篇文獻(xiàn)進(jìn)一步探索了失眠者注意偏向主要成分，因此研究者有必要繼續(xù)探索失眠者注意偏向成分。 由于注意偏向不僅是失眠的伴隨癥狀，更是引發(fā)、維持失眠的原因，那么可以通過訓(xùn)練注意偏向以達(dá)到改善失眠癥狀的目的；在低自尊、物質(zhì)成癮、焦慮等領(lǐng)域廣泛使用的注意偏向訓(xùn)練（ABT）被證明有良好的臨床效果；那么ABT可以為失眠治療提供了一個(gè)新的視角。 所以，本研究試圖通過使用嚴(yán)格控制威脅刺激類型（夜間癥狀，日間損傷）的兩種圖片材料，試圖驗(yàn)證前人研究結(jié)論即原發(fā)性失眠者存在睡眠相關(guān)威脅刺激注意偏向，并進(jìn)一步探究到底是注意偏向的哪種成分在起作用；進(jìn)一步將注意偏向訓(xùn)練（ABT）首次引入到失眠認(rèn)知行為治療中。 本研究得到的結(jié)論如下： （1）原發(fā)性失眠者對(duì)睡眠相關(guān)威脅刺激存在注意偏向，而睡眠正常者不存在注意偏向。（2）刺激類型（日間損傷、夜間癥狀）對(duì)原發(fā)性失眠者的注意偏向的影響沒有差異。（3）原發(fā)性失眠者的注意偏向主要成分為注意脫離困難。（4）注意偏向訓(xùn)練（ABT）不僅改善了原發(fā)性失眠者的注意偏向，而且使其失眠癥狀得到好轉(zhuǎn)。
[Abstract]:In forty years of cognitive research on insomnia, More influential theoretical models have been developed, including Harvey's "Insomnia maintenance Cognitive Model" and Espie's "notice-intention-effort path model". The Harvey model emphasizes the role of monitoring and selective attention in insomnia maintenance. The model of Espie focuses on the role of attention-intention-effort in the process of insomnia formation. Although the expression is different, it clearly shows that selective attention (attention bias) is an important psychological process in patients with chronic insomnia. Most of the results also showed that insomnia patients had attention bias related to sleep stimulation, and some studies further found that attention bias was the cause of causing and maintaining insomnia. Although insomnia cognitive models have repeatedly stressed that insomnia patients pay attention to or monitor threats from day and night, causing anxiety, worry, and sleep effort, no research has been conducted on the sources of threat stimulation. At the same time, the stimulating materials of nocturnal symptoms and daytime injury were selected for experiment. In addition, only one article further explored the main components of attention bias in insomnia, so it is necessary for researchers to continue to explore the attention bias components of insomnia. Because attention bias is not only the accompanying symptom of insomnia, but also the cause of maintaining insomnia, we can improve the insomnia symptoms by training attention bias; (ABT), which is widely used in the fields of low self-esteem, substance addiction, anxiety and so on, has been proved to have a good clinical effect, so ABT can provide a new perspective for the treatment of insomnia. Therefore, by using two kinds of image materials that strictly control the types of threat stimuli (nocturnal symptoms, daytime injuries), this study attempts to verify the previous findings that Sleep related threat stimuli tend to exist in patients with primary insomnia. And further explore which component of attention bias is working; Furthermore, attention bias training (ABT) was introduced into cognitive behavior therapy for insomnia for the first time. The conclusions of this study are as follows: (1) attention bias was found in patients with primary insomnia on sleep-related threat stimuli, but not in those with normal sleep. (2) stimulation type (daytime injury), (3) the main component of attention bias in patients with primary insomnia was difficulty of attention separation. (4) attention bias training (ABT) not only improved the primary cause of insomnia. Attention bias in patients with sexual insomnia, And make its insomnia symptoms get better.
【學(xué)位授予單位】：寧波大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：B842.3

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