本文選題：閾下抑郁　切入點(diǎn)：趨近—回避行為　出處：《成都醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：人們每天都會(huì)無意識(shí)地做出趨近與回避的行為選擇。趨近行為指試圖接近獎(jiǎng)賞等正性刺激的行為,反之,回避行為指試圖阻止、逃離或減少與主觀上厭惡的負(fù)性刺激接觸的行為。趨近與回避行為是人類最基本的行為模式,也是與生物體的生存、繁衍、避免傷害和死亡等重大主題息息相關(guān)的行為。與普通人群相比,抑郁癥被試表現(xiàn)出不同的趨近-回避特點(diǎn),即對(duì)正性刺激的趨近行為較少。也有的研究發(fā)現(xiàn),除對(duì)正性刺激的趨近行為較少外,還對(duì)負(fù)性刺激的回避行為較多。但是閾下抑郁被試的趨近—回避行為具有什么特點(diǎn),是否和抑郁癥被試相似?目前研究較少。目的采用對(duì)照實(shí)驗(yàn)比較閾下抑郁被試、健康對(duì)照組被試的趨近—回避行為特點(diǎn)。通過外顯反饋—操縱桿實(shí)驗(yàn)探討閾下抑郁被試的外顯趨近—回避行為特征,通過內(nèi)隱反饋—操縱桿實(shí)驗(yàn)探討閾下抑郁被試的內(nèi)隱趨近—回避行為特征與內(nèi)隱趨近—回避行為的神經(jīng)機(jī)制特征。通過比較閾下抑郁被試、健康對(duì)照組被試的趨近—回避行為與腦電的特點(diǎn)并綜合前人有關(guān)抑郁癥被試趨近—回避行為的報(bào)告,回答閾下抑郁是一種獨(dú)立的異常情緒狀況還是抑郁癥的過渡階段這一問題。材料與方法實(shí)驗(yàn)一的目的是考察閾下抑郁被試的外顯趨近—回避行為特點(diǎn)。通過發(fā)放量表的方式篩選出合適的被試參加實(shí)驗(yàn)。實(shí)驗(yàn)組納入標(biāo)準(zhǔn)(1)流調(diào)用抑郁量表得分≥16,貝克抑郁量表第二版得分≥16;(2)結(jié)構(gòu)化臨床訪談量表(Structured Clinical Interview for DSM-IV,SCID)符合1種以上4種以下癥狀,且包括心情低落或興趣減少其中1項(xiàng)核心癥狀,癥狀持續(xù)≥2周;(3)右利手。實(shí)驗(yàn)組排除標(biāo)準(zhǔn):(1)有重大身體疾病、神經(jīng)系統(tǒng)疾病或最近一個(gè)月內(nèi)服用精神類藥物;(2)重性抑郁障礙。健康對(duì)照組納入標(biāo)準(zhǔn)為:(1)CES-D16分,BDI-II16分;(2)右利手。排除標(biāo)準(zhǔn)與實(shí)驗(yàn)組相同。兩組被試在年齡、性別上進(jìn)行匹配。兩組被試完成外顯反饋—操縱桿實(shí)驗(yàn),記錄兩組被試的反應(yīng)時(shí)數(shù)據(jù)。數(shù)據(jù)分析采用2(組別:實(shí)驗(yàn)組/對(duì)照組)×3(表情圖片類型:悲傷/高興/厭惡)×2(動(dòng)作:趨近/回避)的重復(fù)測(cè)量方差分析,組別為組間因素,表情圖片類型與動(dòng)作為組內(nèi)因素。實(shí)驗(yàn)二的目的是考察閾下抑郁被試的內(nèi)隱趨近—回避行為特點(diǎn)。兩組被試的篩選過程與標(biāo)準(zhǔn)同實(shí)驗(yàn)一。兩組被試完成內(nèi)隱反饋—操縱桿實(shí)驗(yàn),記錄兩組被試的反應(yīng)時(shí)數(shù)據(jù)。數(shù)據(jù)分析采用2(組別:實(shí)驗(yàn)組/對(duì)照組)×4(表情圖片類型:憤怒/高興/悲傷/厭惡)×2(動(dòng)作:趨近/回避)的重復(fù)測(cè)量方差分析,組別為組間因素,表情圖片類型與動(dòng)作為組內(nèi)因素。實(shí)驗(yàn)三的目的是探索閾下抑郁被試完成趨近—回避行為的神經(jīng)機(jī)制。采用事件相關(guān)電位技術(shù)記錄被試的EEG。選取F3,FZ,F4,C3,CZ,C4,P3,PZ,P4中P2、P3平均波幅最大的電位點(diǎn)進(jìn)行2(組別:實(shí)驗(yàn)組/對(duì)照組)×4(表情圖片類型:憤怒/高興/悲傷/厭惡)×2(動(dòng)作:趨近/回避)的重復(fù)測(cè)量方差分析。組別為組間因素,表情圖片類型與動(dòng)作為組內(nèi)因素。結(jié)果1、在實(shí)驗(yàn)一外顯反饋—操縱桿實(shí)驗(yàn)中,閾下抑郁被試趨近愉快表情圖片的反應(yīng)時(shí)(1208.18±338.92ms)長于對(duì)照組(1058.40±204.22ms)。在呈現(xiàn)負(fù)性表情圖片(悲傷、厭惡)時(shí)實(shí)驗(yàn)組與對(duì)照組相比沒有差異。2、在實(shí)驗(yàn)二內(nèi)隱反饋—操縱桿實(shí)驗(yàn)中,閾下抑郁被試無論在趨近還是回避動(dòng)作下的反應(yīng)時(shí)都長于對(duì)照組(F3,165=5.267,p=0.002),出現(xiàn)反應(yīng)時(shí)的整體延長效果。兩組被試對(duì)四種表情圖片沒有表現(xiàn)出主導(dǎo)性的動(dòng)作趨勢(shì)。3、在實(shí)驗(yàn)三趨近—回避行為事件相關(guān)電位研究中,閾下抑郁組Fz點(diǎn)的P2波波幅值大于對(duì)照組被試,出現(xiàn)兩組之間的組間效應(yīng)(F1,39=6=4.364,p=0.043),也出現(xiàn)動(dòng)作方向×表情×組別的交互作用(F3,117=7.163,p0.001)。結(jié)論閾下抑郁青少年的趨近—回避行為與對(duì)照組被試不同。閾下抑郁可能是無抑郁與抑郁癥之間的過渡狀態(tài),而不是一種單一的疾病形式。
[Abstract]:Every day people will unconsciously make approach and avoidance behavior. To reward approach behavior refers to the behavior of positive stimuli, on the other hand, avoidance behavior refers to trying to stop, escape or reduce irritation in contact with the negative subjective aversive behavior. And approach avoidance behavior is the most basic human behavior patterns, but also with the survival of the organism, reproduction, to avoid serious injury and death is closely related to the theme. Compared with the general population, depression subjects showed different approach avoidance characteristics of positive stimuli reaching behavior less. Research has found that, in addition to less positive stimuli reaching behavior outside of negative stimulus avoidance behavior. But more subthreshold depression subjects reaching avoidance behavior has what characteristics are similar and depression subjects? The present study less. The control experiment of subliminal suppression Depressed subjects, healthy control subjects reaching avoidance behavior. Through explicit feedback lever experiments to investigate subthreshold depression subjects' explicit approach avoidance behavior, through implicit feedback lever experiment to explore the implicit subthreshold depression subjects approach avoidance behavior characteristics of neural mechanism with the implicit approach avoidance behavior. By comparing the subjects of subthreshold depression, healthy control subjects approach - avoidance behavior and EEG characteristics and previous related depression subjects reaching avoidance behavior report, answer subthreshold depression is a transitional phase of an independent state or abnormal emotional depression this problem. Materials and methods experiments aimed to investigate subthreshold depression subjects' explicit approach avoidance behavior. Through the issuance scale screened out the appropriate subjects participated in the experiment. The experimental group included (1 )嫻佽皟鐢ㄦ姂閮侀噺琛ㄥ緱鍒嗏墺16,璐濆厠鎶戦儊閲忚〃絎簩鐗堝緱鍒嗏墺16;(2)緇撴瀯鍖栦復(fù)搴婅璋堥噺琛，

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