抑郁癥患者異常歸因方式的腦神經(jīng)機(jī)制
發(fā)布時間：2019-06-08 17:17
【摘要】：歸因是在日常生活中個體對其行為或發(fā)生的事件進(jìn)行解釋并總結(jié)原因的一種過程,這對于個體情緒表達(dá)及認(rèn)知圖式的建構(gòu)是非常重要的。抑郁癥患者發(fā)病原因一方面源于自身的認(rèn)知易感性以及負(fù)性生活事件的刺激,另一方面也與他們常用的歸因方式有密切的聯(lián)系。國內(nèi)關(guān)于抑郁癥患者歸因方式的行為研究很多,但在神經(jīng)影像學(xué)方面的研究卻很少,抑郁癥患者歸因方式產(chǎn)生異常是由于大腦結(jié)構(gòu)局部發(fā)生變化、腦功能出現(xiàn)紊亂還是兩種情況同時存在,原因還不是很清楚。我們希望能夠從神經(jīng)影像學(xué)角度發(fā)現(xiàn)抑郁癥異常歸因方式的大腦特征,以彌補(bǔ)這一領(lǐng)域的不足。所以本文通過探討抑郁癥患者異常歸因方式相關(guān)的腦結(jié)構(gòu)基礎(chǔ)以及大腦活動的特征,來尋找其歸因方式異常的大腦證據(jù)。 本研究包括兩個實驗,實驗一主要探討抑郁癥患者異常歸因方式的大腦結(jié)構(gòu)基礎(chǔ),通過大腦結(jié)構(gòu)灰質(zhì)體積這個指標(biāo)觀察結(jié)構(gòu)的變化。首先,通過應(yīng)用基于體素水平的VBM分析方法得到抑郁組與正常組的大腦灰質(zhì)體積,并使用雙樣本-T檢驗方法,比較兩組大腦灰質(zhì)體積的差異；其次,我們使用多重回歸方法,將兩組人口學(xué)變量作為協(xié)變量回歸,重點關(guān)注歸因方式問卷得分與抑郁癥患者以及正常組大腦結(jié)構(gòu)灰質(zhì)體積的相關(guān)性。實驗的行為結(jié)果顯示,兩組的歸因方式問卷得分均表明兩組呈現(xiàn)自利性的歸因偏向,但抑郁組的自利偏向不如正常組自利偏向趨勢大,而且抑郁癥患者消極事件得分高于正常組,說明抑郁組具有偏向非自利歸因的趨勢。MRI結(jié)構(gòu)分析結(jié)果顯示：與正常組相比,抑郁組的右側(cè)額上回灰質(zhì)體積減��；同時,回歸分析報告,抑郁組歸因方式消極事件得分越高,越消極,右側(cè)額上回體積越��；正常組歸因方式積極事件得分越高,越積極,右側(cè)杏仁核體積越小。結(jié)構(gòu)結(jié)果表明,抑郁癥患者大腦右側(cè)額上回灰質(zhì)體積減小,可能在結(jié)構(gòu)上出現(xiàn)了萎縮,而且歸因方式的異�？赡芘c右側(cè)額上回結(jié)構(gòu)的萎縮有關(guān)系：抑郁組與正常組大腦杏仁核的灰質(zhì)體積與兩組各自的自利偏向程度可能呈現(xiàn)一致的相關(guān)關(guān)系,抑郁癥患者的杏仁核體積增大可能與其異常的歸因方式有關(guān)系。 實驗二利用fMRI技術(shù)探討抑郁癥患者完成歸因方式判斷任務(wù)時的大腦活動。實驗采用經(jīng)過改進(jìn)的經(jīng)典歸因方式實驗范式,將描述積極、消極生活事件的句子作為實驗刺激圖片。首先,比較兩組在自利以及非自利歸因時大腦激活情況；其次,我們把兩組在負(fù)性事件條件下非自利歸因的大腦激活情況進(jìn)行重點分析。行為結(jié)果報告,正常組的歸因方式問卷得分顯示正常人呈現(xiàn)一個自利的歸因偏向,而抑郁組歸因方式問卷得分顯示其在自利與非自利歸因趨勢上保持平衡,說明抑郁癥患者已經(jīng)出現(xiàn)了偏離正常人的非自利歸因偏向；方差分析結(jié)果顯示,2(抑郁組,正常組)×2(積極得分,消極得分)交互作用顯著。fMRI任務(wù)態(tài)分析結(jié)果顯示：與正常組比較,抑郁癥患者在自利、非自利歸因時,額下回以及顳中回分別表現(xiàn)出強(qiáng)烈的激活,說明抑郁癥患者歸因方式異�？赡芘c大腦額—顳網(wǎng)絡(luò)的異常激活有關(guān)；在對負(fù)性事件進(jìn)行非自利歸因時,抑郁癥患者大腦頂下小葉激活更強(qiáng),而且其激活程度與抑郁癥患者病程呈顯著的正相關(guān)。這提示我們,抑郁癥患者大腦頂下小葉激活強(qiáng)度的變化可能與其異常的歸因方式有關(guān),也可能是抑郁癥患者抑郁癥狀持續(xù)的一個大腦生理標(biāo)記。 然而,本研究還存在一定的不足：如抑郁癥患者服藥與否沒有得到嚴(yán)格的控制,服藥后疾病有所緩解的情況對實驗結(jié)果可能會有一定的影響；患者年齡跨度較大,沒有把青年抑郁與老年抑郁癥進(jìn)行區(qū)分；實驗材料涉及生活事件的范圍可能不夠廣泛等。 結(jié)合實驗一與實驗二的結(jié)果,我們認(rèn)為：抑郁癥患者的歸因方式特征,在行為方面表現(xiàn)出非自利的異常歸因偏向,在神經(jīng)影像方面也表現(xiàn)出與正常組不同的腦網(wǎng)絡(luò)激活模式,尤其是額—顳網(wǎng)絡(luò)可能出現(xiàn)了異常的激活模式；另外,我們推斷,抑郁癥患者大腦頂下小葉的活動強(qiáng)度可能與其異常的歸因方式有關(guān),也與抑郁癥患者抑郁癥狀的持續(xù)有關(guān)。因此,抑郁癥患者歸因方式的異常,不僅與大腦結(jié)構(gòu)的異常變化有關(guān),而且與局部腦區(qū)的異�；顒佑嘘P(guān)；結(jié)構(gòu)與功能的異常共同影響了抑郁癥的發(fā)展以及抑郁癥狀的持續(xù)。更重要的是,在現(xiàn)實意義上,本研究為抑郁癥患者的治療、康復(fù)以及人類對精神疾病的預(yù)防提供了建設(shè)性的意見,提示抑郁癥的治療方向是促進(jìn)抑郁癥患者以更積極的方式解釋自身行為,形成積極自利的歸因方式。
[Abstract]:Attribution is a process of explaining and summarizing the individual's behavior or events in daily life, which is very important to the individual's emotional expression and the construction of the cognitive schema. The causes of depression in patients with depression are based on their own cognitive susceptibility and the stimulation of negative life events, and on the other hand, they have a close relationship with their common attribution patterns. There are many studies on the behavior of the attribution style of the patients with depression, but the study on the neuroimaging is very low, and the cause of the attribution of the patients with depression is due to the local change of the structure of the brain, the disorder of the brain function and the existence of the two cases, The reason is not clear. We hope to be able to find out the brain features of the abnormal attribution of depression from the neuroimaging perspective in order to make up for the deficiency in this field. So this paper is to find out the brain structure and the characteristics of the brain activity in the study of the abnormal attribution of the patients with depression, to find the evidence of the brain's abnormal attribution. The study included two experiments, one of which mainly discussed the brain structure of the abnormal attribution of the patients with depression, and the change of the structure was observed by the volume of the gray matter in the brain. Firstly, the volume of gray matter in the brain of the depression group and the normal group was obtained by applying the VBM analysis method based on the level of the voxel, and the difference of the volume of the gray matter in the two groups was compared by using the double-sample-T test method. Methods: The two groups of demographic variables were returned as covariates, and the focus was on the correlation between the score of attribution and depression and the volume of gray matter in the normal group. The results of the experiment show that the two groups of attribution style questionnaire scores show that the two groups are self-serving, but the self-interest of the depression group is not as large as that of the normal group, and the negative event score of the depression patients is higher than that of the normal group. The tendency of the group to explain the tendency of the depression group to the non-self-interest attribution Potential. The results of MRI structure analysis showed that the volume of gray matter on the right side of the depression group was reduced as compared with the normal group; meanwhile, the regression analysis reported that the higher the negative event score, the more negative the negative event score was, the smaller the volume of the upper back volume on the right side, and the higher the positive event score in the normal group attribution High, the more positive, the larger the right amygdala volume The results show that the volume of the gray matter on the right of the brain of the patients with depression is reduced, and atrophy may occur in the structure, and the abnormality of the attribution pattern may be related to the atrophy of the back structure on the right. The relationship between the gray matter volume of the amygdala in the depression group and the normal group and the degree of self-interest of the two groups may be consistent, and the increase of the amygdala volume in the patients with depression may be related to the attribution of the abnormality. System. The experiment 2 uses fMRI to study the large-scale factor in the determination of the attribution of the patients with depression. The experiment uses the improved classical attribution style experimental paradigm, which will describe the positive and negative life events as the experimental stinging. First, we compare two groups of brain activation with self-interest and non-self-interest; secondly, we re-focus the two groups of the non-self-interest attribution of the brain in the negative event. Point analysis. The behavior result reported that the normal group's attribution style questionnaire score showed that the normal person presented a self-interest self-interest, and the depression group attribution style questionnaire score showed that the self-interest and non-self-interest attribution trend The results of analysis of variance showed that 2 (depression group, normal group) and 2 (positive score and negative score) interacted with each other. Compared with the normal group, the results of the analysis of the results showed that the patients with depression showed a strong activation in the self-interest, self-interest attribution, the amount of return and the return of the brain, indicating that the abnormal behavior of the patients with depression could be related to the abnormal excitation of the brain amount and the abnormal network. In the event of non-self-interest attribution to negative events, the lower lobe of the middle of the brain of the patients with depression was more active and the degree of activation was significant than that of the patients with depression. There is a positive correlation. This suggests that the change in the intensity of the activation of the lobule in the top of the brain of a patient with depression may be related to the manner of attribution of the abnormality, or may be a persistent brain in the depression of a patient with depression. However, there is a certain deficiency in this study: if the patients with depression are not subject to strict control, the results may have a certain effect on the results of the experiment after taking the medicine. The patient's age span is large, and the depression of the young people and the depression of the old people are not considered. the case may be distinguished; the range of the experimental material involved in the living event may In combination with the results of experiment 1 and experiment 2, we consider that the attribution style of the patients with depression is characterized by non-self-interest in behavior, and in the aspect of neuroimaging, it is different from that of the normal group. In addition, we conclude that the activity intensity of the lower lobule of the lower brain of the depression is related to the attribution of the abnormality, and is also associated with the depression of the patients with depression. It is related to the persistence of symptoms. Therefore, the abnormal behavior of the patients with depression is related not only to the abnormal changes of the structure of the brain, but also to the abnormal activities of the local brain regions. The abnormality of the structure and function affects the development of the depression. Depression-like persistence. More importantly, in the practical sense, this study provides a constructive view of the treatment, rehabilitation, and prevention of mental illness in patients with depression, suggesting that the direction of treatment for depression is a more active way to promote depression to explain its own behavior and form a positive one
【學(xué)位授予單位】：西南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：B845
本文編號：2495452
[Abstract]:Attribution is a process of explaining and summarizing the individual's behavior or events in daily life, which is very important to the individual's emotional expression and the construction of the cognitive schema. The causes of depression in patients with depression are based on their own cognitive susceptibility and the stimulation of negative life events, and on the other hand, they have a close relationship with their common attribution patterns. There are many studies on the behavior of the attribution style of the patients with depression, but the study on the neuroimaging is very low, and the cause of the attribution of the patients with depression is due to the local change of the structure of the brain, the disorder of the brain function and the existence of the two cases, The reason is not clear. We hope to be able to find out the brain features of the abnormal attribution of depression from the neuroimaging perspective in order to make up for the deficiency in this field. So this paper is to find out the brain structure and the characteristics of the brain activity in the study of the abnormal attribution of the patients with depression, to find the evidence of the brain's abnormal attribution. The study included two experiments, one of which mainly discussed the brain structure of the abnormal attribution of the patients with depression, and the change of the structure was observed by the volume of the gray matter in the brain. Firstly, the volume of gray matter in the brain of the depression group and the normal group was obtained by applying the VBM analysis method based on the level of the voxel, and the difference of the volume of the gray matter in the two groups was compared by using the double-sample-T test method. Methods: The two groups of demographic variables were returned as covariates, and the focus was on the correlation between the score of attribution and depression and the volume of gray matter in the normal group. The results of the experiment show that the two groups of attribution style questionnaire scores show that the two groups are self-serving, but the self-interest of the depression group is not as large as that of the normal group, and the negative event score of the depression patients is higher than that of the normal group. The tendency of the group to explain the tendency of the depression group to the non-self-interest attribution Potential. The results of MRI structure analysis showed that the volume of gray matter on the right side of the depression group was reduced as compared with the normal group; meanwhile, the regression analysis reported that the higher the negative event score, the more negative the negative event score was, the smaller the volume of the upper back volume on the right side, and the higher the positive event score in the normal group attribution High, the more positive, the larger the right amygdala volume The results show that the volume of the gray matter on the right of the brain of the patients with depression is reduced, and atrophy may occur in the structure, and the abnormality of the attribution pattern may be related to the atrophy of the back structure on the right. The relationship between the gray matter volume of the amygdala in the depression group and the normal group and the degree of self-interest of the two groups may be consistent, and the increase of the amygdala volume in the patients with depression may be related to the attribution of the abnormality. System. The experiment 2 uses fMRI to study the large-scale factor in the determination of the attribution of the patients with depression. The experiment uses the improved classical attribution style experimental paradigm, which will describe the positive and negative life events as the experimental stinging. First, we compare two groups of brain activation with self-interest and non-self-interest; secondly, we re-focus the two groups of the non-self-interest attribution of the brain in the negative event. Point analysis. The behavior result reported that the normal group's attribution style questionnaire score showed that the normal person presented a self-interest self-interest, and the depression group attribution style questionnaire score showed that the self-interest and non-self-interest attribution trend The results of analysis of variance showed that 2 (depression group, normal group) and 2 (positive score and negative score) interacted with each other. Compared with the normal group, the results of the analysis of the results showed that the patients with depression showed a strong activation in the self-interest, self-interest attribution, the amount of return and the return of the brain, indicating that the abnormal behavior of the patients with depression could be related to the abnormal excitation of the brain amount and the abnormal network. In the event of non-self-interest attribution to negative events, the lower lobe of the middle of the brain of the patients with depression was more active and the degree of activation was significant than that of the patients with depression. There is a positive correlation. This suggests that the change in the intensity of the activation of the lobule in the top of the brain of a patient with depression may be related to the manner of attribution of the abnormality, or may be a persistent brain in the depression of a patient with depression. However, there is a certain deficiency in this study: if the patients with depression are not subject to strict control, the results may have a certain effect on the results of the experiment after taking the medicine. The patient's age span is large, and the depression of the young people and the depression of the old people are not considered. the case may be distinguished; the range of the experimental material involved in the living event may In combination with the results of experiment 1 and experiment 2, we consider that the attribution style of the patients with depression is characterized by non-self-interest in behavior, and in the aspect of neuroimaging, it is different from that of the normal group. In addition, we conclude that the activity intensity of the lower lobule of the lower brain of the depression is related to the attribution of the abnormality, and is also associated with the depression of the patients with depression. It is related to the persistence of symptoms. Therefore, the abnormal behavior of the patients with depression is related not only to the abnormal changes of the structure of the brain, but also to the abnormal activities of the local brain regions. The abnormality of the structure and function affects the development of the depression. Depression-like persistence. More importantly, in the practical sense, this study provides a constructive view of the treatment, rehabilitation, and prevention of mental illness in patients with depression, suggesting that the direction of treatment for depression is a more active way to promote depression to explain its own behavior and form a positive one
【學(xué)位授予單位】：西南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：B845
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