D型人格冠心病患者的注意偏向特征研究  

Characteristics of attention bias in patients with type D personality coronary heart disease

作　　者：吴晓倩 高学琴[1] 林平[1] 王旖旎[1] 李玲[1] 赵振娟[1] Wu Xiaoqian;Gao Xueqin;Lin Ping;Wang Yini;Li Ling;Zhao Zhenjuan(Department of Cardiology,the 2nd Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院心内科,哈尔滨150086

出　　处：《中华现代护理杂志》2022年第35期4903-4909,共7页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金委员会面上项目(31771241,31971015);2019教育部人文社会科学研究一般项目(19YJC190034)。

摘　　要：目的探讨D型人格冠心病患者的注意偏向特征,为阐明D型人格作用于冠心病的发病机制以及制订相应预防策略提供新的理论视角。方法应用目的抽样法及事件相关电位(ERP)研究经验法,选取2021年3—9月在哈尔滨医科大学附属第二医院心血管内科住院治疗的40例冠心病患者为研究对象,应用D型人格量表测评将研究对象分为D型人格组和非D型人格组,并根据年龄、性别、受教育年限进行1∶1匹配分组。应用抑郁自评量表排除抑郁者,应用负性认知加工偏向问卷测量其负性注意偏向程度,并以情绪面孔图片作为实验刺激材料,分别应用行为学的点探测范式和ERP技术对患者注意偏向进行分析。结果最终纳入15例D型人冠心病患者和15例非D型人格冠心病患者。D型人格冠心病患者负性认知加工偏向问卷总分及负性沉思偏向维度得分均高于非D型人格冠心病患者,差异均有统计学意义(P<0.05);行为学实验数据显示,在非D型人格组患者中,积极面孔图片较消极面孔图片在不一致条件刺激下的反应时更短(F=10.646,P<0.05),一致性提示类型较不一致提示类型消极面孔图片刺激下的反应时更短(F=4.744,P<0.05);ERP实验数据显示,与非D型人格组患者相比,D型人格组患者对消极面孔图片及积极面孔图片刺激均能诱发更大的N1波幅(F=8.973,P<0.05);在非D型人格组患者中,积极面孔图片刺激能诱发更大的P3波幅(F=6.750,P<0.05)。结论D型人格冠心病患者存在负性注意偏向,表现为对消极刺激更敏感,并在认知加工的早期即投入了更多的注意资源,且对消极刺激存在注意脱离困难。临床医护人员应对D型人格冠心病患者减少负性刺激并进行积极的心理干预,以降低负性刺激对患者预后的不良影响。Objective To explore the characteristics of attention bias in patients with type D personality coronary heart disease(CHD),and provide a new theoretical perspective for elucidating the effect of type D personality on the pathogenesis of CHD and formulating prevention strategies.Methods From March 2021 to September 2021,a total of 40 CHD patients who were hospitalized in the 2nd Affiliated Hospital of Harbin Medical University were enrolled using the convenient sampling method and event-related potential(ERP).Patients were divided into the type D personality group and the non-type D personality group by Type D Personality Scale-14,and matched according to age,gender and years of education.The Self-Rating Depression Scale was used to exclude patients with depression.The Negative Cognitive Processing Bias Questionnaire(NCPBQ)was used to measure negative cognitive processing bias.Dot-probe task and ERP technology were used to analyze the characteristics of attention bias,with the emotional face images as experimental stimulation materials.Results A total of 15 CHD patients with type D personality and 15 CHD patients without type D personality were enrolled.The scores of NCPBQ and negative rumination bias dimension of CHD patients with type D personality were higher than those of CHD patients without type D personality,and the differences were statistically significant(P<0.05).Behavioral experiments data showed that CHD patients without type D personality had a shorter response time to positive face images than negative face images in inconsistent conditional stimulation(F=10.646,P<0.05),CHD patients without type D personality had a shorter response time to negative face images in consistent prompt type than inconsistent prompt type(F=4.744,P<0.05).ERP experimental data showed that CHD patients with type D personality has higher N1 amplitude facing negative and positive face images stimulation(F=8.973,P<0.05),CHD patients without type D personality had higher P3 amplitude facing positive face images stimulation(F=6.75

关 键 词：冠心病 D型人格 注意偏向 事件相关电位 点探测范式 

分 类 号：R541.4[医药卫生—心血管疾病]