本文關(guān)鍵詞： 廣泛性焦慮障礙 表情 前注意加工 事件相關(guān)電位 失匹配負(fù)波　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：廣泛性焦慮障礙，以莫名的擔(dān)憂和多慮為主要表現(xiàn)，伴自主神經(jīng)癥狀或運(yùn)動(dòng)性不安等。該病患病率高，已成為嚴(yán)重危害人類健康的疾病之一。盡管GAD患者的發(fā)病機(jī)制尚不明確，，但大多數(shù)的臨床觀察和實(shí)驗(yàn)證據(jù)提出，GAD患者對(duì)情緒信息的異常加工可能與其發(fā)病相關(guān)。面孔表情可傳遞重要的社會(huì)信息，快速識(shí)別威脅性和非威脅性面孔表情對(duì)人類生存具有重大意義。結(jié)合廣泛性焦慮障礙的臨床發(fā)病特點(diǎn)，推測(cè)其異常信息加工很可能起始于自動(dòng)加工階段。目前對(duì)GAD面孔表情自動(dòng)加工階段的研究，特別是前注意階段的研究為數(shù)不多。前注意（pre-attention）是注意的前過程，反映了人腦對(duì)變化信息的一種自動(dòng)檢測(cè)能力。人們通常意識(shí)不到前注意加工，而且行為學(xué)方法由于其自身局限性往往難以對(duì)其進(jìn)一步深入研究。事件相關(guān)電位是種特殊的腦誘發(fā)電位。高時(shí)間分辨率和實(shí)時(shí)性等優(yōu)點(diǎn)，使其在認(rèn)知研究領(lǐng)域中占據(jù)得天獨(dú)厚的地位。失匹配負(fù)波（MMN）是研究人腦前注意自動(dòng)加工的經(jīng)典事件相關(guān)電位成分。由面孔表情誘發(fā)的視覺MMN被稱為表情MMN（Expression Mismatch Negativity，EMMN）。EMMN反映了大腦對(duì)面孔表情信息變化的前注意探測(cè)能力，可以用來(lái)探討GAD患者對(duì)面孔表情前注意自動(dòng)加工的生理機(jī)制。 方法：研究對(duì)象為20例GAD患者和20例年齡、性別、教育程度與其相匹配的健康人。所有被試的焦慮和抑郁癥狀嚴(yán)重程度均用漢密爾頓焦慮量表（HAMA）和漢密爾頓抑郁量表（HRSD-17）進(jìn)行評(píng)估。利用真人情緒面孔作為刺激材料。選取具有威脅含義的恐懼面孔和非威脅含義的悲傷面孔作為刺激。刺激程序采用reverse oddball范式，實(shí)驗(yàn)過程中要求受試者對(duì)“十”字形靶刺激變化次數(shù)進(jìn)行默計(jì)，并忽略視野周邊的（非靶刺激）表情面孔。64導(dǎo)電極帽記錄連續(xù)性腦電，并完成離線分析，分析非靶刺激在枕區(qū)（O1/O2）、頂區(qū)（P7/P8）誘發(fā)的表情MMN的平均波幅。兩組被試的MMN波幅進(jìn)行重復(fù)測(cè)量方差分析。 結(jié)果： 1.廣泛性焦慮障礙患者對(duì)（威脅性表情）恐懼表情的MMN波幅與正常對(duì)照比較無(wú)明顯差異（p0.05）。 2.廣泛性焦慮障礙患者對(duì)悲傷表情（非威脅性表情）的MMN波幅較正常對(duì)照組減低，具有顯著性差異（p0.05）。 3.表情MMN波幅與患者焦慮和抑郁癥狀嚴(yán)重程度評(píng)分之間無(wú)顯著相關(guān)性（p0.05）。 結(jié)論： 1.廣泛性焦慮障礙患者在前注意自動(dòng)加工階段對(duì)威脅性情緒面孔加工無(wú)明顯差異，而對(duì)非威脅性情緒面孔加工減弱。 2.廣泛性焦慮障礙患者情緒信息加工異常與焦慮和抑郁癥狀嚴(yán)重程度之間無(wú)明顯相關(guān)性。
[Abstract]:Objective: generalized anxiety disorder, mainly characterized by inexplicable anxiety and anxiety, accompanied by autonomic nervous symptoms or motor anxiety. Has become one of the serious diseases that endanger human health. Although the pathogenesis of GAD patients is not clear, However, most clinical observations and experimental evidence suggest that abnormal processing of emotional information in patients with GAD may be related to their pathogenesis. Facial expressions can transmit important social information. Rapid recognition of threatening and non-threatening facial expressions is of great significance for human survival. It is speculated that the abnormal information processing probably started at the automatic processing stage. At present, there are few studies on the GAD facial expression automatic processing stage, especially in the pre-attention stage. The pre-attention stage is the pre-attention process. It reflects the ability of the human brain to detect change information automatically. People usually don't realize how to process it before they are aware of it. Because of its limitations, behavioral methods are often difficult to further study. Event-related potentials are special brain evoked potentials, high temporal resolution, real-time, and so on. Mismatched negative wave (MMN) is a classical event-related potential component in the study of automatic processing of human brain attention. The visual MMN induced by facial expression is called MMN(Expression Mismatch Negativityn. EMMN. Reflecting the brain's ability to detect changes in facial expression information, It can be used to explore the physiological mechanism of automatic processing of facial expression in patients with GAD. Methods: twenty patients with GAD and 20 patients with age and sex were studied. All subjects were evaluated with Hamilton anxiety scale (Hama) and Hamilton Depression scale (HRSD-17). Select the face of fear with threatening meaning and the face of sadness with non-threatening meaning as stimulus. The stimulus program adopts reverse oddball paradigm, In the course of the experiment, the subjects were asked to measure the number of stimuli of "ten" glyph targets, and to ignore the (non-target stimuli) facial expression around the field of vision, and record the continuous EEG in the face (non-target stimuli), and complete the off-line analysis. The mean amplitude of expression MMN induced by non-target stimulation in occipital region (O1 / O2) and parietal region (P7 / P8) was analyzed. The MMN amplitudes of the two groups were measured repeatedly by variance analysis. Results:. 1. There was no significant difference in the MMN amplitude of fear expression between patients with generalized anxiety disorder and normal controls (P 0.05). 2. The amplitude of MMN in the patients with generalized anxiety disorder was significantly lower than that in the control group (P 0.05). 3. There was no significant correlation between expression MMN amplitude and anxiety and depression severity score (P 0.05). Conclusion:. 1. There was no significant difference in the processing of threatening emotional faces in the patients with generalized anxiety disorder at the stage of pre-attention automatic processing, but the processing of non-threatening emotional faces was weakened. 2. There was no significant correlation between the abnormal processing of emotional information and the severity of anxiety and depression in patients with generalized anxiety disorder.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R749.72

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本文編號(hào)：1519617