肝豆?fàn)詈俗冃圆』颊哂洃洷O(jiān)測(cè)及道德判斷的神經(jīng)心理學(xué)研究
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本文選題：肝豆?fàn)詈俗冃圆?/strong> + 記憶監(jiān)測(cè)�。� 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文
【摘要】：目的記憶監(jiān)測(cè)是個(gè)體對(duì)自身記憶狀況的總體把握；道德判斷指的是人們根據(jù)自己心目中的道德準(zhǔn)則，按照所處特定文化或亞文化環(huán)境中規(guī)定的美好品德的標(biāo)準(zhǔn)，對(duì)個(gè)體行為進(jìn)行好或壞的評(píng)價(jià)。記憶監(jiān)測(cè)和道德判斷的神經(jīng)基礎(chǔ)尚不十分明了，主要涉及的部位均位于前額葉。肝豆?fàn)詈俗冃圆』颊咂�、基底�?jié)等區(qū)域廣受累及，伴有多種認(rèn)知能力受損，但尚無其記憶監(jiān)測(cè)與道德判斷的行為學(xué)研究。本文通過研究肝豆?fàn)詈俗冃圆。╤epatolenticular degeneration，HLD）患者記憶監(jiān)測(cè)及道德判斷的情況，進(jìn)一步了解HLD患者記憶監(jiān)測(cè)障礙和道德感下降的損害特征，并探討其可能的機(jī)制。 方法選取在安徽中醫(yī)藥大學(xué)神經(jīng)病學(xué)研究所附屬醫(yī)院神經(jīng)科病房住院診斷為肝豆?fàn)詈俗冃圆〉幕颊呒?0名人口學(xué)數(shù)據(jù)匹配的健康被試，進(jìn)行知道感及道德兩難情境決策的實(shí)驗(yàn)。采用SPSS17.0對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析，采用兩獨(dú)立樣本t檢驗(yàn)及Pearson相關(guān)分析進(jìn)行研究，以P＜0.05為差異有統(tǒng)計(jì)學(xué)意義。實(shí)驗(yàn)一：建立情景記憶(EM)及語義記憶(SM)的知道感(feeling-of-knowing，F(xiàn)OK)實(shí)驗(yàn)范式，對(duì)30例WD患者及30例年齡及教育程度相匹配的健康對(duì)照者（HC）進(jìn)行研究。實(shí)驗(yàn)二：漢化使用Joshua D. Greene編寫的道德兩難問卷，問卷包括50個(gè)假設(shè)，，被試讀題后作出“愿意這樣做”或“不愿意這樣做”的判斷,對(duì)實(shí)驗(yàn)一中30例WD患者及30例年齡及教育程度相匹配的健康對(duì)照者（HC）進(jìn)行研究。結(jié)果實(shí)驗(yàn)一：與HC組的FOK-EM的線索回憶率（64.17%±29.21%）以及FOK-SM的線索回憶率（84.72%±11.44%）比較，HLD患者組FOK-EM的線索回憶率（26.55%±20.92%）、FOK-SM的線索回憶率（53.93%±28.42%）顯著降低，差異有統(tǒng)計(jì)學(xué)意義（t=-5.140,p0.01;t=-5.123,p0.01）；FOK-EM的肯定判斷/正確再認(rèn)成績（50.64%±29.43%）、否定判斷/正確再認(rèn)成績（12.80%±18.32%）與HC組的肯定判斷/正確再認(rèn)成績（75.15%±31.73%）、否定判斷/正確再認(rèn)成績（1.81%±5.41%）之間差異有統(tǒng)計(jì)學(xué)意義（t=-2.693,p0.05;t=3.026,p0.01）；且stroop效應(yīng)與FOK-EM的否定判斷/正確再認(rèn)成績呈正相關(guān)（r=0.601，p0.01）。實(shí)驗(yàn)二：HLD患者與健康對(duì)照在“個(gè)人情感的”道德判斷中做出愿意（功利主義傾向）選擇的概率顯著的大于健康對(duì)照（t=3.908，p0.01），在“非個(gè)人情感的”道德判斷和“道德無關(guān)的”判斷中做出“愿意”回答的概率差異無統(tǒng)計(jì)學(xué)意義。 結(jié)論HLD患者的情景記憶監(jiān)測(cè)受損，表現(xiàn)為對(duì)自身再認(rèn)能力的低估，這種記憶監(jiān)測(cè)受損與執(zhí)行功能的損害相關(guān)，推測(cè)前額葉功能損傷可能是導(dǎo)致HLD患者情景記憶障礙的重要因素；同時(shí)患者的語義記憶監(jiān)測(cè)相對(duì)保留，提示語義記憶的知道感與情景記憶的知道感神經(jīng)機(jī)制是不同的�；颊咴凇皞€(gè)人情感的”道德判斷中高度傾向于功利主義選擇，推測(cè)與前額葉功能不足，道德決策過程中負(fù)性情緒加工障礙有關(guān)。前額葉與基底節(jié)之間直接和間接環(huán)路的損傷可能是HLD患者出現(xiàn)以上表現(xiàn)的神經(jīng)基礎(chǔ)。
[Abstract]:Objective memory monitoring is an individual's overall grasp of his or her own memory. Moral judgment refers to the standard of good character defined by people according to their own moral norms and according to their specific cultural or subcultural environment. A good or bad assessment of an individual's behavior. The neural basis of memory monitoring and moral judgment is not well understood, and the main sites involved are located in the prefrontal lobe. The cortical and basal ganglia were extensively involved in patients with hepatolenticular degeneration, accompanied by a variety of cognitive impairment, but there was no behavioral research on their memory monitoring and moral judgment. By studying the memory monitoring and moral judgment of patients with hepatolenticular degeneration-induced disease (HLD), we further understand the characteristics of impaired memory monitoring and moral decline in patients with HLD, and explore its possible mechanism. Methods 30 healthy subjects who were diagnosed as hepatolenticular degeneration in the neurology ward of the affiliated Hospital of Institute of Neurology of Anhui University of traditional Chinese Medicine and 30 healthy subjects with matched demographic data were selected to conduct the knowledge sense and moral dilemma decision making experiment. SPSS17.0 was used to analyze the data, two independent samples t test and Pearson correlation analysis were used to study the data. The difference was statistically significant (P < 0. 05). Experiment 1: to study 30 WD patients and 30 healthy controls matched with age and education by establishing the perception-of-knowing FOK paradigm of situational memory (EMM) and semantic memory (SMSM). Experiment 2: the Chinese version of the moral dilemmas questionnaire, written by Joshua D. Greene, consisted of 50 hypotheses. After reading the questions, the subjects made a judgment of "willing to do this" or "not willing to do so". In experiment 1, 30 WD patients and 30 healthy controls matched with age and education were studied. Results in experiment 1, compared with HC group (64.17% 鹵29.21%) and FOK-SM group (84.72% 鹵11.44%), the clue recall rate of FOK-EM group (26.55% 鹵20.92% 鹵28.42%) was significantly lower than that of HC group (53.93% 鹵28.42%). The difference was statistically significant between the positive judgment / correct recognition of FOK-EM (50.64% 鹵29.43%, negative judgment / correct recognition 12.80% 鹵18.32%) and the positive judgment / correct recognition of 75.15% 鹵31.737.30% in HC group and 1.81% 鹵5.41% in negative judgment / correct recognition score. There was a positive correlation between the stroop effect and the negative judgment / correct recognition of FOK-EM. Experiment 2: HLD patients and healthy controls were significantly more likely to make a willing (utilitarian) choice in "personal emotional" moral judgment than the healthy control (t = 3.908 / p 0.01), and had no relationship with "non-personal emotional" moral judgment. There was no statistically significant difference in the probability of making a willing answer in the judgment. Conclusion the impairment of situational memory monitoring in patients with HLD is characterized by an underestimation of their recognition ability. The impairment of memory monitoring is related to the impairment of executive function. It is speculated that the impairment of prefrontal function may be an important factor leading to the impairment of situational memory in patients with HLD. At the same time, the patients' semantic memory monitoring is relatively reserved, suggesting that the sense of knowledge in semantic memory is different from that in situational memory. The patients were highly inclined to utilitarianism in the moral judgment of personal emotion, which was related to the deficiency of prefrontal function and the negative emotional processing disorder in the process of moral decision. The injury of direct and indirect loop between the prefrontal lobe and basal ganglia may be the neural basis of the above findings in HLD patients.
【學(xué)位授予單位】：安徽醫(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)】：R742.4
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