本文選題：情志相勝 + 情緒誘導(dǎo)��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：背景:閾閡下抑郁(SD,Subthreshold Depression)是指存在抑郁狀態(tài)表現(xiàn),但尚未達(dá)到抑郁癥臨床診斷標(biāo)準(zhǔn)的一種亞健康狀態(tài)。綜合國內(nèi)外現(xiàn)有研究,閾下抑郁的患病率約為19%,普遍存在于人群之中,并且有研究表示閾下抑郁人群發(fā)展為抑郁癥甚至重癥抑郁的風(fēng)險高于普通人,但閾下抑郁人群的認(rèn)知加工特點尚未達(dá)成統(tǒng)一認(rèn)識。中醫(yī)情志相勝理論能夠從"治未病"角度出發(fā),有效改善閾下抑郁患者的情緒狀態(tài),但其作用靶點和作用機(jī)制尚不明確。目的:探索情志相勝理論指導(dǎo)下喜情緒誘導(dǎo)對閾下抑郁人群的的作用靶點和作用機(jī)制。方法:本研究通過張貼海報招募被試,使用流調(diào)中心用抑郁自評量表和漢密爾頓抑郁量表(17項版)評估被試的情緒狀態(tài),以CES-D≥16且7≤HAMD-1717作為閾下抑郁被試辨別依據(jù),使用隨機(jī)數(shù)表法將招募來的被試分為閾下抑郁被試情緒誘導(dǎo)組、閾下抑郁被試對照組、正常被試對照組和正常被試情緒誘導(dǎo)組,分組情況對被試隱藏。以中醫(yī)情志相勝理論為基礎(chǔ)構(gòu)建由電影片段和喜情緒相關(guān)回憶共同構(gòu)成的喜情緒誘導(dǎo)方案,經(jīng)初步驗證后作為實驗材料用于后續(xù)研究。本研究實驗將行為學(xué)Oddball范式和事件相關(guān)電位技術(shù)相結(jié)合進(jìn)行研究,閾下抑郁被試情緒誘導(dǎo)組和正常被試情緒誘導(dǎo)組接受喜情緒誘導(dǎo)后參與ERP實驗,閾下抑郁被試對照組和正常對照組直接參與ERP實驗,從實驗倫理角度考慮,對照組ERP實驗結(jié)束后接受喜情緒誘導(dǎo)。本研究使用依據(jù)視覺模擬評分法設(shè)計的《情緒狀態(tài)調(diào)查問卷(2)》對情緒誘導(dǎo)的主觀感受效果進(jìn)行評價,使用正確率和反應(yīng)時作為行為學(xué)指標(biāo),使用額區(qū)N2成分和頂區(qū)P3成分的波幅和潛伏期作為ERP指標(biāo),使用SPSS 22.0對資料進(jìn)行統(tǒng)計分析。結(jié)果:①本研究納入分析的樣本量為閾下抑郁被試情緒誘導(dǎo)組14人,閾下抑郁被試對照組13人,正常被試對照組17人,正常被試誘導(dǎo)組16人,人口學(xué)信息分析顯示,本研究中閾下抑郁人群和正常人群之間的人口學(xué)資料無統(tǒng)計學(xué)差異,閾下抑郁被試情緒誘導(dǎo)組、閾下抑郁被試對照組、正常被試對照組兩兩比較人口學(xué)資料也無統(tǒng)計學(xué)差異;②情緒誘導(dǎo)主觀感受分析顯示,"喜"情緒的人群和測量時間無交互作用(F=0.016,P0.05),測量時間有主效應(yīng)(F=70.016,P0.05),人群有主效應(yīng)(F=6.229,P0.05);"悲"情緒的人群和測量時間無交互作用(F=0.28,P0.05),測量時間沒有主效應(yīng)(F=2.57,P0.05),人群有主效應(yīng)(F=9.57,P0.05);"焦慮"情緒的人群和測量時間無交互作用(F=1.480,P0.05),測量時間有主效應(yīng)(F=1.8552,P0.05),人群有主效應(yīng)(F=13.313,P0.05);③行為學(xué)數(shù)據(jù)分析顯示,SD對照組被試在面對不同類型刺激時正確率有統(tǒng)計學(xué)差異(X2=8.227,P0.05),SD誘導(dǎo)組和正常對照組面對中性刺激時反應(yīng)時有統(tǒng)計學(xué)差異(X2=-2.645,P0.05),其他組別及刺激類型分析無統(tǒng)計學(xué)差異;④ERP數(shù)據(jù):通過繪制ERP腦電地形圖發(fā)現(xiàn),刺激呈現(xiàn)后200-300ms在右側(cè)額區(qū)FZ、F2、FCZ、FC2通道附近有較強(qiáng)的負(fù)電位激活,300-430ms在左側(cè)頂區(qū)CZ、C1、CPZ、CP1通道附近有較強(qiáng)的正電位激活;額區(qū)N2成分波幅分組和刺激類型之間不存在交互作用(F=12.617,P0.05),分組(F=8.282,P0.05)、刺激類型(F=1.294,P0.05)均有主效應(yīng);額區(qū)N2成分潛伏期分組和刺激類型間無交互作用(F=0.437,P0.05),分組(F=2.039,P0.05)無主效應(yīng),刺激類型(F=11.383,P0.05)有主效應(yīng);頂區(qū)P3成分波幅分組和刺激類型間有交互作用(F=4.922,P0.05),分組(F=1.788,P0.05)無主效應(yīng),刺激類型(F=3.282,P0.05)有主效應(yīng);頂區(qū)P3成分潛伏期分組和刺激類型間有交互作用(F=7.606,P0.05),分組無主效應(yīng)(F=1.363,P0.05),刺激類型無主效應(yīng)(F=1.873,P0.05)。結(jié)論:本研究構(gòu)建的喜情緒誘導(dǎo)方案能夠有效增強(qiáng)被試喜情緒感受,減弱焦慮情緒感受,改善閾下抑郁被試和正常被試的情緒狀態(tài)。進(jìn)一步分析發(fā)現(xiàn)喜情緒誘導(dǎo)調(diào)節(jié)閡下抑郁被試的認(rèn)知機(jī)制為增強(qiáng)認(rèn)知控制能力、增強(qiáng)對正性刺激的注意加工和對中性刺激的認(rèn)知加工能力三個方面。而喜情緒誘導(dǎo)能夠使閡下抑郁被試的部分認(rèn)知加工和對正性刺激的注意加工恢復(fù)到正常水平,而認(rèn)知控制能力和對中性刺激的認(rèn)知加工能力甚至強(qiáng)于正常水平。
[Abstract]:Background: SD (Subthreshold Depression) refers to the presence of depression status, but it has not yet reached a subhealth state of clinical diagnostic criteria for depression. The prevalence of subliminal depression is about 19% in the current study at home and abroad. The prevalence of subliminal depression is common in the population, and there is a study that subliminal depression develops to depression. The risk of severe depression is higher than that of the ordinary people, but the cognitive processing characteristics of the subthreshold depression have not yet reached a unified understanding. The theory of traditional Chinese medicine can effectively improve the emotional state of subthreshold depressive patients from the perspective of "cure the disease", but the target and mechanism of its action are not yet clear. The target and mechanism of emotional induction on subthreshold depression. Methods: the subjects were recruited by poster, using the depression scale and the Hamilton Depression Scale (17 Editions) to evaluate the emotional state of the subjects, with CES-D more than 16 and 7 less HAMD-1717 as the basis for subthreshold depression, and the use of random numbers. The recruited subjects were divided into subthreshold depression subjects' emotional induction group, subthreshold depression group, normal subjects control group and normal subjects emotional induction group. The group situation was hidden in the subjects. In this study, the behavioral Oddball paradigm and event related potential technology were combined to study. The study was conducted in this study. The emotional induction group and the normal subjects in the normal subjects were induced to participate in the ERP experiment, and the subthreshold depression was directly involved in the E and the normal control group. RP experiment, from the experimental ethics point of view, the control group ERP after the end of the experiment to accept the joy of emotion induction. This study used the visual analogue scale design "emotional state questionnaire (2) > to evaluate the subjective feelings of emotional induction, use the correct rate and reaction as a behavioral index, the use of N2 components in the frontal area and the top area P3 The amplitude and incubation period were used as ERP index and SPSS 22 was used to analyze the data. Results: (1) the sample size was 14 in the subthreshold depression group, 13 in the subthreshold depression group, 17 in the normal control group and 16 in the normal trial group. The demographic information analysis showed that the threshold of this study was in this study. There was no statistical difference in the demographic data between the lower depression group and the normal population, the subthreshold depression was tested in the emotional induction group, the subthreshold depression was in the control group, and the 22 of the normal control group had no statistical difference, and the subjective feeling analysis showed that there was no interaction between the crowd of "happy" emotion and the time of measurement (F=0 .016, P0.05), the measurement time has the main effect (F=70.016, P0.05), the crowd has the main effect (F=6.229, P0.05); the people of "sad" mood and the measurement time have no interaction (F=0.28, P0.05), the measurement time has no main effect (F=2.57, P0.05), the crowd has the main effect (F=9.57, P0.05); "anxiety" mood people and measurement time have no interaction. There were main effects (F=1.8552, P0.05), and the population had main effect (F=13.313, P0.05). (3) behavioral data analysis showed that the correct rate of the SD control group was statistically different (X2=8.227, P0.05) in the face of different types of stimulation (X2=8.227, P0.05). The response of SD induction group and normal control group to neutral stimulus was statistically different (X2=-2.645, P0.05), and the other groups were different (X2=-2.645, P0.05). There was no statistical difference in the analysis of the type of stimulation; (4) ERP data: by plotting the ERP EEG map, it was found that 200-300ms was activated in the right frontal area FZ, F2, FCZ, FC2 channel, and 300-430ms was activated in the left top region CZ, C1, CPZ, and there was a strong positive potential activation near the CP1 channel. There is no interaction between types (F=12.617, P0.05), group (F=8.282, P0.05), and the type of stimulus (F=1.294, P0.05) has the main effect; there is no interaction (F=0.437, P0.05) between the subgroups of N2 components in the frontal region and the type of stimulus (F=0.437, P0.05), and the group (F=2.039, P0.05) has no main effect, and the stimulus type (F=11.383,) has the main effect. There were F=4.922 (P0.05), F=1.788 (P0.05) had no main effect, and the type of stimulus (F=3.282, P0.05) had the main effect; the subgroup of P3 components in the top region had interaction (F=7.606, P0.05), and the group had no main effect (F= 1.363, P0.05), and the type of stimulus had no main effect (F=1.873,). The emotional induction scheme can effectively enhance the emotional feeling of the subjects, weaken the anxiety emotion, improve the emotional state of the subthreshold depression subjects and the normal subjects. Further analysis shows that the cognitive mechanism of the depression under the mood induced regulation of depression is enhanced, the enhancement of the attention processing and the neutral stimulus to the positive stimulus is enhanced. There are three aspects of cognitive processing ability. Emotional induction can lead to partial cognitive processing and attention processing for positive stimuli to normal levels, while cognitive control and cognitive processing ability to neutral stimuli are even stronger than normal levels.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.7

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