本文關鍵詞：精神分裂癥共情缺陷及其rTMS干預研究　出處：《安徽醫(yī)科大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 精神分裂癥 一級親屬 rTMS 共情能力 疼痛共情

【摘要】：目的目前研究證明精神分裂癥存在廣泛的社會認知缺陷,此障礙是導致社會功能衰退的重要原因。共情是社會認知的重要成分,研究精神分裂癥及其一級親屬的共情能力有助于理解精神分裂癥社會功能障礙的神經(jīng)心理機制,同時為進一步探究共情缺陷是否能成為精神分裂癥認知障礙內(nèi)表型提供依據(jù)。共情能力可以通過物理、認知行為訓練等干預技術得到改善,經(jīng)顱磁刺激(transcranial magnetic stimulation,TMS)技術作為一種新型無創(chuàng)的物理治療方法成為越來越重要的治療手段,本研究探討低頻r TMS干預對精神分裂患者共情能力的影響。方法研究一:對35個精神分裂癥患者,教育年限、年齡相匹配的33個一級親屬以及34個正常對照組施以認知測試、人際反應指針量表(The Interpersonal Reactivity Index,IRI)、疼痛共情范式,并統(tǒng)計各項任務的指標,分析比較三組的差異。研究二:對22個精神分裂癥患者采用c TBS刺激模式精準定位左側顳頂聯(lián)合區(qū)連續(xù)進行15天的低頻r TMS干預,在干預前后施以認知測試、IRI-C量表、疼痛共情范式,并將干預前后的各項任務指標與性別、年齡、教育年限相匹配的22個對照組進行分析比較,觀察干預前后患者共情能力與對照組的差異,同時比較患者自身干預前后的差異。結果研究一:患者組IRI-C總分(p=0.006)、觀點采擇(perspective taking,PT)(p=0.037)、想象(fantasy,FS)(p=0.001)、共情性關心(empathy concern,EC)(p=0.015)得分顯著低于對照組;患者組的EC(p=0.029)得分顯著低于親屬組;親屬組的FS(p=0.013)得分顯著低于對照組;患者組疼痛圖片的正確率顯著低于對照組(p=0.005);患者組對中性圖片(p=0.001)及疼痛圖片的反應時(p=0.006)均顯著長于對照組;患者組臨床陰性癥狀得分與對疼痛圖片判斷的正確率(p=0.020)和評級得分(p=0.049)呈負相關。研究二:患者干預前后IRI-C量表總分(p=0.004)、PT(p=0.000)、EC(p=0.015)、對疼痛圖片判斷的正確率(p=0.000)、臨床評估(positive and negative syndrome scale,PANSS)總分(p=0.000)、陽性癥狀得分(p=0.000)、陰性癥狀得分(p=0.001)存在顯著差異。結論精神分裂癥患者共情能力及疼痛共情能力顯著差于對照組,一級親屬的FS能力低于對照組;對精神分裂癥患者進行r TMS干預能夠改善其共情能力。
[Abstract]:Objective to prove that schizophrenia has a wide range of social cognitive defects, which is an important factor leading to the decline of social function. Empathy is an important component of social cognition. To study the empathy ability of schizophrenia and its first-degree relatives is helpful to understand the neuropsychological mechanism of social dysfunction of schizophrenia. At the same time, it provides a basis for further exploring whether empathy defects can become the phenotype of schizophrenia cognitive impairment. Empathy ability can be improved through physical, cognitive behavior training and other intervention techniques. Transcranial magnetic stimulation. As a new non-invasive physiotherapy technique, TMS320T has become more and more important. The purpose of this study was to investigate the effect of low frequency r TMS intervention on the empathy ability of schizophrenic patients. Methods study 1: 35 schizophrenic patients, education years. Cognitive tests were performed on 33 first-degree relatives matched with age and 34 normal controls. The Interpersonal Reactivity Index, the pain empathy paradigm, and the indicators of each task were evaluated by the interpersonal response pointer scale. Analysis and comparison of the differences among the three groups. Study 2: 22 patients with schizophrenia using c TBS stimulation mode to accurately locate the left temporoparietal joint area for 15 days of low-frequency r TMS intervention. Before and after intervention, IRI-C scale and pain empathy paradigm were used to analyze and compare 22 control groups whose task indexes matched with gender, age and education years before and after intervention. Observe the difference between the patients before and after intervention and the control group, and compare the differences before and after intervention. Results 1: the total score of IRI-C in the patients group was 0.006). Take a perspective on your point of view (P0.037). Imagine a fantasy (P0. 001). The score of empathy was significantly lower than that of the control group. The score of ECP 0.029 in the patients group was significantly lower than that in the relatives group. The scores of the relative group were significantly lower than that of the control group. The correct rate of pain pictures in the patients group was significantly lower than that in the control group (P 0.005). The response time of the patient group to both the neutral image and the pain picture was significantly longer than that of the control group. Scores of clinical negative symptoms and correct judgment of pain pictures in the patients group (p0.020) and rating scores (p0.049). There was a negative correlation. Study 2: the total score of IRI-C scale before and after intervention was 0.004). The correct rate of judging pain picture was 0.000 ~ (0.000)% (P = 0.000). The total score of positive and negative syndrome scaleSSS was 0.000). There was significant difference between positive symptom score and negative symptom score (P < 0. 001). Conclusion the empathy ability and pain empathy ability of schizophrenia patients are significantly lower than those of the control group. The FS ability of first-degree relatives was lower than that of control group. R TMS intervention in schizophrenic patients can improve their empathy ability.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R749.3;B842.6

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