金钱激励延迟任务下抑郁症自杀者的神经电生理特征及其与心理痛苦的关系  

The Event-related EEG Responses of MDD Patients with Suicide Attempts to Monetary Incentive Delay Tasks and Its Relationship with the Three-Dimensional Psychological Pain

作　　者：宋巍 李欢欢[1] 郭婷[1] 王湘[2] 王淼 SONG Wei;LI Huan-huan;GUO Ting;WANG Xiang;WANG Miao(Department of Psychology,Renmin University of China,Beijing 100872,China;Medical Psychological Center,The Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中国人民大学心理学系,北京100872 [2]中南大学湘雅二医院医学心理学研究所,长沙410011

出　　处：《中国临床心理学杂志》2018年第6期1049-1056,1090,共9页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金青年项目(81401120);教育部人文社会科学重点研究基地重大项目(16JJD190006);中国科学院心理健康重点实验室开放课题重点项目(KLMH2018K01)

摘　　要：目的:探索心理痛苦,特别是痛苦逃避预测重性抑郁症患者自杀的潜在神经电生理指标。方法:选取被试62人,包括抑郁自杀未遂组(MDD—SA,N=9)、抑郁自杀意念组(MDD—SI,N=24)和健康控制组(HC,N=29)。所有被试填写BDI-Ⅱ(贝克抑郁量表第二版)、TDPPs(三维心理痛苦量表)、BSI—W(贝克自杀意念量表-最严重时)和BSI—C量表(贝克自杀意念量表-最近一周),并采用金钱激励延迟(Monetary Incentive Delay,MID)范式对被试进行ERP检测,关注结果反馈阶段所诱发的FRN和LPP波幅。结果:MDD—SA组的BSI—W、BSI—C、TDPPS总分和痛苦逃避维度分显著高于MDD-SI和HC组。奖励条件下接受负反馈时所诱发的FRN波幅值与痛苦体验得分显著负相关,接受正反馈所诱发的凹P与BDI—Ⅱ得分显著负相关。中性条件下接受正反馈所诱发的LPP与BDI—Ⅱ、TDPPS总分、痛苦体验和痛苦逃避得分显著负相关。接受正反馈时:MDD—SA组惩罚条件所诱发的LPP波幅>中性条件;MDD-SI组奖励条件所诱发的LPP波幅>惩罚和中性条件,但惩罚和中性条件之间差异不显著;HC组奖励条件诱发的LPP波幅>中性>惩罚条件。结论:痛苦逃避得分可作为区分高自杀风险重性抑郁症患者的行为学指标。惩罚条件下的LPP的波幅可能是与痛苦加工过程密切相关的神经电生理指标。Objective:To explore the neural correlates of the three-dimensional psychological pain,especially the active pain avoidance underlying the suicidality among patients with major depressive patients.Methods:All participants were divided into three groups:patients with major depressive disorder with a history of suicide attempt(MDD-SA,N=9),patients with major depressive disorder without a history of suicide attempt (MDD-SI,N=24)and healthy controls(HC,N=29). All participants completed the Beck Scale for Suicide Ideation,Beck Depression Inventory,and Three-Dimensional Psychological Pain Scale,and performed an even-related potential based analogue of the monetary incentive delay task.Results: Scores of the BSI-W,BSI-C,the total TDPPS and pain avoidance subscale in the MDD-SA group were significantly higher than those of the MDD-SI and HC groups.As for the reward condition,FRN elicited by negative feedbacks were negatively correlated with the scores of painful feeling,whereas LPP elicited by positive feedback were negatively correlated with the BDI scores.Further,LPP induced by positive feedback under the punitive condition in the MDD-SA group were higher than those under the neutral condition.LPP induced by positive feedback under the reward condition were higher than those induced by the punitive and neutral conditions in the MDD-SI group.LPP induced by positive feedback under the punitive condition were lower than those under the neutral condition in the HC group.LPP induced by the neutral condition were negatively correlated to the BDI,total TDPPS,painful feeling and pain avoidance subscale scores.Conclusion:LPP elicited by the punitive condition may be a neuro-electrophysiological biomarker associated with psychological pain.

关 键 词：心理痛苦 自杀未遂 自杀意念 金钱激励延迟 

分 类 号：R395.1[哲学宗教—心理学]