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定向遺忘范式下不同情緒調節(jié)策略對抑郁患者的干預研究

發(fā)布時間:2018-06-16 06:49

  本文選題:抑郁 + 定向遺忘 ; 參考:《河北大學》2017年碩士論文


【摘要】:抑郁障礙(Major Depressive Disorder,MDD)是一種情感性精神障礙,以顯著而持久的心境低落為主要臨床表現(xiàn)。負性認知偏向和情緒調節(jié)功能受損是導致抑郁產生和持續(xù)的重要因素(Campbell-Sills,Barlow,2006;Gross,1995;Kovacs,Joormann,Gotlib,2008;Kring,Werner,2004)。抑郁(障礙)患者最強的負性認知偏向是對負性信息的記憶偏向(Blaney,P.H,1986;Vrijsen J N,2014)。而負性記憶偏向和情緒調節(jié)策略功能受損主要與其抑制功能障礙有關(Disner et al.,2011;Joormann,2010,Johnstone,2005)。然而目前已有的多是記憶抑制與認知偏向、認知偏向與情緒調節(jié)的研究,對抑郁患者記憶抑制與情緒調節(jié)相互關系認知機制尚無一致性的解釋。本研究首次采用定向遺忘的范式對不同情緒調節(jié)策略(自發(fā)調節(jié)、表達抑制、認知重評)對抑郁患者負性情緒的調節(jié)效果及對情緒性記憶抑制的作用效果進行研究。從定向遺忘的角度探討抑郁患者負性認知偏向與情緒調節(jié)的關系,不僅對定向遺忘的理論內涵有所拓展,還對抑郁障礙的認知機制有了進一步地了解。同時,將定向遺忘范式與情緒調節(jié)策略結合形成認知策略,不僅對抑制患者的心理治療提供了可操作性的模式,還為正常人群的心理保健工作提供新的思路。本研究以單字法定向遺忘為實驗范式,以情緒圖片作為實驗材料,篩選出43名抑郁癥患者和48名正常人作為研究對象,隨機分到三個實驗(自發(fā)調節(jié)、表達抑制、認知重評)中,每個實驗都采用2(指令類型:記/忘)×2(被試類型:正常/抑郁)×2(圖片類型:中性/負性)的實驗設計,因變量為再認成績和前后情緒效價的差值。實驗結果顯示:在自發(fā)調節(jié)下,抑郁患者也能夠定向遺忘情緒性信息,但有意遺忘能力比正常個體差。相對于中性圖片,抑郁患者對負性信息更難定向遺忘,但與正常個體無顯著差異。表達抑制對正常個體和抑郁患者的定向遺忘都沒有影響,但使圖片的情緒性對定向遺忘的影響消失。認知重評對正常個體的定向遺忘沒有影響,但使圖片的情緒性對定向遺忘的影響消失,且使抑郁個體定向遺忘效應消失。認知重評的情緒調節(jié)效果優(yōu)于表達抑制。抑郁患者對負性情緒刺激反應不敏感,調節(jié)負性情緒時使用表達抑制更多。定向遺忘指令與認知重評結合比與表達抑制結合對情緒調節(jié)的效果更好,且忘記指令與認知重評結合對情緒改善的效果更顯著。表達抑制策略與記憶指令結合的訓練可提高抑郁患者的情緒調節(jié)能力。本研究結果顯示定向遺忘范式與情緒策略調節(jié)結合的認知策略訓練模式有效。
[Abstract]:Major depressive disorder (MDD) is an affective disorder characterized by significant and persistent depression. Negative cognitive bias and impaired emotional regulation are important factors leading to the development and persistence of depression. The strongest negative cognitive bias in patients with depression (disorder) is the memory bias of negative information, Blaneyn P.Heng 1986 / Vrijsen J / N / 2014 / 4. The negative memory bias and the impairment of emotional regulation strategy function were mainly related to the inhibitory dysfunction. However, there are many researches on memory inhibition and cognitive bias, cognitive bias and emotion regulation, and there is no consistent explanation for the cognitive mechanism of the relationship between memory inhibition and emotion regulation in depressive patients. In this study, the effects of different emotion regulation strategies (spontaneous regulation, expression inhibition, cognitive reassessment) on negative emotion and emotional memory inhibition in depression patients were studied for the first time using the pattern of directed amnesia. To explore the relationship between negative cognitive bias and emotion regulation in depressive patients from the perspective of directional amnesia not only extends the theoretical connotation of directional amnesia but also has a further understanding of the cognitive mechanism of depression disorder. At the same time, the combination of directed amnesia paradigm and emotion regulation strategies to form cognitive strategies not only provides an operational model for the suppression of patients' psychotherapy, but also provides a new way of thinking for the mental health care of the normal population. In this study, 43 patients with depression and 48 normal subjects were randomly divided into three experiments (spontaneous regulation, expression inhibition). In cognitive reassessment, each experiment was designed with 2 (instruction type: remember / forget) 脳 2 (subject type: normal / depressed) 脳 2 (picture type: neutral / negative). The results showed that depression patients could also be directed to forget emotional information under spontaneous regulation, but the ability of intentional forgetfulness was lower than that of normal individuals. Compared with neutral images, negative information is more difficult for depression patients to forget, but there is no significant difference between depression patients and normal individuals. Expression inhibition had no effect on the directed amnesia of both normal individuals and depressive patients, but the emotional effect of the picture on the directed amnesia disappeared. Cognitive reassessment had no effect on the directed amnesia of normal individuals, but the emotional effect of pictures disappeared and the directed forgetting effect of depressed individuals disappeared. The effect of cognitive reappraisal on emotion regulation was better than that on expression inhibition. Depression patients are insensitive to negative emotional stimuli and use more expression inhibition when regulating negative emotions. The combination of directed forgetting instruction and cognitive reappraisal was better than that of expression inhibition, and the combination of forgetting instruction and cognitive reassessment had more significant effect on emotional improvement. The combination of expression inhibition strategy and memory command can improve the ability of emotion regulation in depressive patients. The results show that the cognitive strategy training model combined with directed forgetting paradigm and emotional strategy regulation is effective.
【學位授予單位】:河北大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:B842.6

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