強(qiáng)迫癥與強(qiáng)迫型人格障礙執(zhí)行功能的比較研究
發(fā)布時(shí)間：2018-07-22 19:41
【摘要】：目的:強(qiáng)迫癥(obsessive-compulsive disorder,OCD)是一種以強(qiáng)迫思維或強(qiáng)迫行為為主要特征的精神障礙,強(qiáng)迫型人格障礙(obsessive-compulsive personality disorder,OCPD)是一種專注于追求細(xì)節(jié)、完美,以及精神和人際關(guān)系的控制,不惜犧牲靈活性、開(kāi)放性和效率的精神障礙。雖然強(qiáng)迫癥與強(qiáng)迫型人格障礙在美國(guó)精神障礙診斷與統(tǒng)計(jì)手冊(cè)第5版上是獨(dú)立的精神疾病,但它們的核心癥狀常有重疊,使得在臨床上鑒別兩種疾病比較困難。當(dāng)前執(zhí)行功能是認(rèn)知神經(jīng)心理學(xué)的研究重點(diǎn)和熱點(diǎn)。關(guān)于執(zhí)行功能的研究有很多,大部分的精神障礙都存在不同程度的執(zhí)行功能損傷,其中包括強(qiáng)迫癥和強(qiáng)迫型人格障礙。因此本研究利用認(rèn)知神經(jīng)心理學(xué)測(cè)試,結(jié)合事件相關(guān)電位技術(shù),探討強(qiáng)迫癥與強(qiáng)迫型人格障礙之間執(zhí)行功能的差異,為二者之間的關(guān)系提供一些行為學(xué)及電生理方面的證據(jù)。方法:研究一:利用威斯康星卡片分類任務(wù)(WCST)、愛(ài)荷華博弈測(cè)試(IGT)、骰子測(cè)試(GDT)對(duì)31例強(qiáng)迫癥患者,33例強(qiáng)迫型人格障礙患者,33例正常對(duì)照的認(rèn)知靈活性和決策功能進(jìn)行測(cè)試。三組被試年齡,性別,教育年限相匹配。同時(shí)利用耶魯布朗強(qiáng)迫量表來(lái)評(píng)估強(qiáng)迫癥疾病嚴(yán)重程度。研究二:利用停止信號(hào)任務(wù)對(duì)21例強(qiáng)迫癥患者,20例強(qiáng)迫型人格障礙患者,20例正常對(duì)照的反應(yīng)抑制能力進(jìn)行測(cè)試,并利用Neuroscan ERP記錄與分析系統(tǒng)來(lái)記錄分析被試的行為學(xué)與腦電數(shù)據(jù)。三組被試年齡,性別,教育年限相匹配。結(jié)果:研究一:WCST中OCD組的總錯(cuò)誤數(shù)、持續(xù)性反應(yīng)數(shù)和持續(xù)性錯(cuò)誤數(shù)均大于OCPD組與HC組,且達(dá)到統(tǒng)計(jì)學(xué)差異水平(P0.05)。IGT中,OCD組和OCPD組的block3,block4,總凈得分均低于HC組,且達(dá)到統(tǒng)計(jì)學(xué)差異水平(P0.01)。分別對(duì)三組被試的決策進(jìn)程進(jìn)行單因素方差分析發(fā)現(xiàn),OCPD組(P0.05)和HC組(P0.01)不同block的凈得分差異有統(tǒng)計(jì)學(xué)意義。OCPD組的block3至block5的凈得分均大于block1(P0.05),HC組的block2至block5的凈得分均大于block1(P0.01)。OCD組不同block的凈得分差異無(wú)統(tǒng)計(jì)學(xué)意義。GDT中,三組各項(xiàng)指標(biāo)均無(wú)統(tǒng)計(jì)學(xué)差異。研究二:(1)行為學(xué)結(jié)果:OCD組比OCPD組和HC組的Go信號(hào)反應(yīng)時(shí)間要長(zhǎng),有統(tǒng)計(jì)學(xué)意義(P0.01)。OCD組的Stop信號(hào)反應(yīng)時(shí)間比OCPD組長(zhǎng),有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)腦電結(jié)果:N2平均波,組間主效應(yīng)不顯著;N2潛伏期,OCD組比HC組短(P0.05)。OCD組的Go-P3波幅在F3,F4,FZ,C3,C4,CZ點(diǎn)上顯著大于OCPD組與HC組(P0.05);OCD組的Stop-P3平均波幅在F4,FZ,C3,CZ,P3點(diǎn)上顯著大于OCPD組與HC組(P0.05)。P3潛伏期組間主效應(yīng)不顯著。結(jié)論:研究一:強(qiáng)迫癥患者的認(rèn)知靈活性差于強(qiáng)迫型人格障礙患者與正常人。強(qiáng)迫癥患者和強(qiáng)迫型人格障礙患者在風(fēng)險(xiǎn)不明確情境下的決策功能均存有缺陷,但同時(shí)二者的決策模式不同。在風(fēng)險(xiǎn)明確的情境下,二者的決策功能均完整。研究二:強(qiáng)迫癥患者抑制能力比強(qiáng)迫型人格障礙患者差,強(qiáng)迫癥和強(qiáng)迫型人格障礙患者、正常人的Go-P3和Stop-P3成分存在差異。
[Abstract]:Objective: obsessive-compulsive disorder (obsessive-compulsive) is a mental disorder characterized by obsessive-compulsive thinking or obsessive-compulsive behavior, and obsessive-compulsive personality disorder is a focus on detail, perfection, and control of mental and interpersonal relationships at the expense of flexibility. Mental disorder of openness and efficiency. Although obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCD) are independent mental disorders in the fifth edition of the American Handbook for the diagnosis and Statistics of Mental Disorders, their core symptoms often overlap, making it difficult to differentiate the two diseases clinically. Executive function is the focus and focus of cognitive neuropsychology. There are many researches on executive function, most of mental disorders have different degree of executive dysfunction, including obsessive-compulsive disorder and obsessive-compulsive personality disorder. Therefore, using cognitive neuropsychological test and event-related potential technique, this study explored the difference of executive function between obsessive-compulsive disorder and obsessive-compulsive personality disorder, and provided some evidence of behavior and electrophysiology for the relationship between them. Methods: first, the cognitive flexibility and decision-making function of 33 patients with obsessive-compulsive personality disorder (OCD) were tested by Wisconsin Card sorting Task (WCST), Iowa Game Test (IGT) and Dice Test (GDT) in 33 patients with obsessive-compulsive personality disorder (OCD). The three groups matched age, sex, and educational years. The Yale Brown obsessive-compulsive scale was also used to assess the severity of obsessive-compulsive disorder. Study 2: the response inhibition ability of 21 patients with obsessive-compulsive disorder (OCD) and 20 patients with obsessive-compulsive personality disorder (OCD) was measured by stop signal task. Neuroscan ERP recording and analysis system was used to record and analyze behavioral and EEG data. The three groups matched age, sex, and educational years. Results: the total number of errors, the number of persistent reactions and the number of persistent errors in OCD group were higher than those in OCPD group and HC group, and reached the level of statistical difference (P0.05) .The total net score of OCD group and OCPD group in IGT was lower than that in HC group. And reached the level of statistical difference (P0.01). Univariate ANOVA analysis of the decision-making process of the three groups showed that there were significant differences in the net scores of block3 to block5 between OCPD group (P0.05) and HC group (P0.01). The net score of block3 to block5 in OCPD group was higher than that in block1 group (P0.05). In the block1 (P0.01) .OCD group, there was no significant difference in the net score of different block. There was no statistical difference among the three groups. Study 2: (1) Behavioral results showed that the reaction time of go signal in the OCPD group was longer than that in the OCPD group and HC group, and the response time of stop signal in the OCD group was significantly longer than that in the OCPD group (P0.05). (2). The amplitude of Go-P3 in the OCD group was significantly shorter than that in the HC group (P0.05). The amplitude of Go-P3 in the F3F4F4FZC _ 3C _ 4C _ 4C _ 4 CZ was significantly higher than that in the OCPD group and the HC group (P0.05). The mean amplitude of Stop-P3 in the F4FZZC3CZP3 group was significantly higher than that in the OCPD group and the HC group (P0.05) .P3 latency was not significantly different between the OCPD group and the HC group (P0.05). Conclusion: 1. The cognitive flexibility of obsessive-compulsive disorder patients is worse than that of obsessive-compulsive personality disorder patients and normal people. Both the patients with obsessive-compulsive disorder and the patients with obsessive-compulsive personality disorder have defects in their decision-making function in uncertain risk situations, but their decision-making patterns are different at the same time. Under the situation of clear risk, both of them have complete decision-making function. Study 2: the inhibition ability of obsessive-compulsive disorder patients was worse than that of obsessive-compulsive personality disorder patients. There were differences in Go-P3 and Stop-P3 components in patients with obsessive-compulsive disorder and obsessive-compulsive personality disorder.
【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】：2017
【分類號(hào)】：B848
本文編號(hào)：2138364
[Abstract]:Objective: obsessive-compulsive disorder (obsessive-compulsive) is a mental disorder characterized by obsessive-compulsive thinking or obsessive-compulsive behavior, and obsessive-compulsive personality disorder is a focus on detail, perfection, and control of mental and interpersonal relationships at the expense of flexibility. Mental disorder of openness and efficiency. Although obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCD) are independent mental disorders in the fifth edition of the American Handbook for the diagnosis and Statistics of Mental Disorders, their core symptoms often overlap, making it difficult to differentiate the two diseases clinically. Executive function is the focus and focus of cognitive neuropsychology. There are many researches on executive function, most of mental disorders have different degree of executive dysfunction, including obsessive-compulsive disorder and obsessive-compulsive personality disorder. Therefore, using cognitive neuropsychological test and event-related potential technique, this study explored the difference of executive function between obsessive-compulsive disorder and obsessive-compulsive personality disorder, and provided some evidence of behavior and electrophysiology for the relationship between them. Methods: first, the cognitive flexibility and decision-making function of 33 patients with obsessive-compulsive personality disorder (OCD) were tested by Wisconsin Card sorting Task (WCST), Iowa Game Test (IGT) and Dice Test (GDT) in 33 patients with obsessive-compulsive personality disorder (OCD). The three groups matched age, sex, and educational years. The Yale Brown obsessive-compulsive scale was also used to assess the severity of obsessive-compulsive disorder. Study 2: the response inhibition ability of 21 patients with obsessive-compulsive disorder (OCD) and 20 patients with obsessive-compulsive personality disorder (OCD) was measured by stop signal task. Neuroscan ERP recording and analysis system was used to record and analyze behavioral and EEG data. The three groups matched age, sex, and educational years. Results: the total number of errors, the number of persistent reactions and the number of persistent errors in OCD group were higher than those in OCPD group and HC group, and reached the level of statistical difference (P0.05) .The total net score of OCD group and OCPD group in IGT was lower than that in HC group. And reached the level of statistical difference (P0.01). Univariate ANOVA analysis of the decision-making process of the three groups showed that there were significant differences in the net scores of block3 to block5 between OCPD group (P0.05) and HC group (P0.01). The net score of block3 to block5 in OCPD group was higher than that in block1 group (P0.05). In the block1 (P0.01) .OCD group, there was no significant difference in the net score of different block. There was no statistical difference among the three groups. Study 2: (1) Behavioral results showed that the reaction time of go signal in the OCPD group was longer than that in the OCPD group and HC group, and the response time of stop signal in the OCD group was significantly longer than that in the OCPD group (P0.05). (2). The amplitude of Go-P3 in the OCD group was significantly shorter than that in the HC group (P0.05). The amplitude of Go-P3 in the F3F4F4FZC _ 3C _ 4C _ 4C _ 4 CZ was significantly higher than that in the OCPD group and the HC group (P0.05). The mean amplitude of Stop-P3 in the F4FZZC3CZP3 group was significantly higher than that in the OCPD group and the HC group (P0.05) .P3 latency was not significantly different between the OCPD group and the HC group (P0.05). Conclusion: 1. The cognitive flexibility of obsessive-compulsive disorder patients is worse than that of obsessive-compulsive personality disorder patients and normal people. Both the patients with obsessive-compulsive disorder and the patients with obsessive-compulsive personality disorder have defects in their decision-making function in uncertain risk situations, but their decision-making patterns are different at the same time. Under the situation of clear risk, both of them have complete decision-making function. Study 2: the inhibition ability of obsessive-compulsive disorder patients was worse than that of obsessive-compulsive personality disorder patients. There were differences in Go-P3 and Stop-P3 components in patients with obsessive-compulsive disorder and obsessive-compulsive personality disorder.
【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】：2017
【分類號(hào)】：B848
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 Negin PAAST;Zohreh KHOSRAVI;Amir Hossein MEMARI;Monir SHAYESTEHFAR;Mohammad ARBABI;;強(qiáng)迫癥患者、強(qiáng)迫型人格障礙患者和健康對(duì)照者之間的認(rèn)知靈活性和計(jì)劃能力比較（英文）[J];上海精神醫(yī)學(xué);2016年01期
2 閆俊;李凌江;季建林;司天梅;魏鏡;鄭毅;張亞林;何燕玲;趙旭東;張偉;孫學(xué)禮;于欣;;強(qiáng)迫障礙診療概要[J];中國(guó)心理衛(wèi)生雜志;2014年04期
3 孫彥;張小玲;張?zhí)觳?;強(qiáng)迫癥患者的執(zhí)行功能研究進(jìn)展[J];海南醫(yī)學(xué);2013年10期
4 王東;周曙;;強(qiáng)迫癥患者反應(yīng)控制能力研究[J];重慶醫(yī)科大學(xué)學(xué)報(bào);2012年11期
5 張龍;季益富;董毅;朱春燕;汪凱;;強(qiáng)迫癥患者及其一級(jí)親屬神經(jīng)認(rèn)知功能研究[J];中華精神科雜志;2012年05期
6 蔡厚德;張權(quán);蔡琦;陳慶榮;;愛(ài)荷華博弈任務(wù)(IGT)與決策的認(rèn)知神經(jīng)機(jī)制[J];心理科學(xué)進(jìn)展;2012年09期
7 陸茜;肖澤萍;張?zhí)旌?;強(qiáng)迫型人格障礙與強(qiáng)迫障礙的譜性關(guān)系[J];中國(guó)臨床心理學(xué)雜志;2012年04期
8 曹文勝;于宏華;焦志安;;強(qiáng)迫障礙患者的共病人格障礙[J];中國(guó)心理衛(wèi)生雜志;2011年02期
9 岳計(jì)輝;溫盛霖;程敏鋒;韓自力;周紹輝;;首次發(fā)病的強(qiáng)迫癥患者的認(rèn)知功能[J];中國(guó)神經(jīng)精神疾病雜志;2010年09期
10 張微;徐精敏;宋紅艷;;兒童注意缺陷多動(dòng)障礙(ADHD)的“冷”“熱”執(zhí)行功能[J];心理科學(xué)進(jìn)展;2010年01期
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