抑郁症自杀未遂者的痛苦逃避与背外侧前额叶−脑岛有效连接特征  

Pain avoidance and effective connectivity between dlPFC and insula in suicide attempters with major depressive disorder

作　　者：郝子雨 李欢欢[1] 林亦轩 HAO Ziyu;LI Huanhuan;LIN Yixuan(Department of Psychology,Renmin University of China,Beijing 100872,China)

机构地区：[1]中国人民大学心理学系,北京100872

出　　处：《心理学报》2023年第12期1966-1978,共13页Acta Psychologica Sinica

基　　金：中国人民大学科学研究基金项目重大项目(21XNL016)资助;中国人民大学2021年度拔尖创新人才培育资助计划成果。

摘　　要：以往研究发现心理痛苦三因素模型中的核心成分痛苦逃避对自杀未遂的区分和预测效能显著优于抑郁。然而,对于脑内的“痛苦网络”如何界定,以及“痛苦网络”的异常加工模式是否涉及自杀的脑机制仍未阐明。本研究以原创性心理痛苦三因素模型为理论基础,依据网络识别原则提出“痛苦网络”的关键脑区,创新性采用Granger因果分析,考察抑郁症自杀未遂者脑内“痛苦网络”的序列激活模式,及其与痛苦逃避、自杀未遂的关系。结果表明,痛苦逃避和自上而下的dlPFC到脑岛有效连接的钝化是抑郁症自杀未遂者的关键行为和神经特征。研究为进一步揭示抑郁症自杀未遂者的痛苦网络加工模式提供了神经影像学的证据。Previous research has established pain avoidance as a critical and stable variable for identifying suicide attempts across samples.However,the neural mechanisms underlying pain avoidance and its relationship to suicide attempts remain unclear.Additionally,most previous research on the brain mechanisms of suicide has focused on single brain regions or circuits,neglecting the principle that the brain is organized into networks.Psychological pain is a complex,negative emotional experience that involves cognitive appraisal,psychosomatic responses,and motivational tendencies.Therefore,the brain mechanisms underlying psychological pain mainly involve impairments in pain processing,motivation,and decision-making circuits.Therefore,a more comprehensive approach is necessary to explore the neural mechanisms underlying psychological pain and its relationship with suicide attempts.The“pain matrix”is a functional brain network that plays an important role in pain processing.The medial pathway of the pain matrix is responsible for processing affective pain information and is considered the neural basis of psychological pain.The three-dimensional psychological pain model divides psychological pain into cognitive,affective,and motivational components.The medial pathway of the pain matrix is responsible for processing the affective components of psychological pain.Pain arousal,as a cognitive component,represents an individual's cognitive appraisal of painful past situations based on the recollection of past negative events and is closely related to the function of the hippocampus.Pain avoidance,as a motivational component,is closely related to the functions of brain regions involved in cognitive control,with the dlPFC being the core node for top-down cognitive control.Therefore,a combination of the medial pathway,dlPFC,and the hippocampus,defined as a“pain processing network”,can be used to explore the neural mechanisms of psychological pain and its relation to suicide attempts.Previous studies have linked neural mechani

关 键 词：自杀未遂 心理痛苦三因素模型 抑郁症 痛苦网络 有效连接 

分 类 号：B845[哲学宗教—心理学]