污名化经历对抑郁症患者疼痛感知的影响
文献类型：学位论文
| 作者 | 章玉琪 |
| 答辩日期 | 2022-06 |
| 文献子类 | 硕士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 孔亚卓 |
| 关键词 | 抑郁症 污名 自我报告疼痛 诱发性热痛 |
| 学位名称 | 理学硕士 |
| 学位专业 | 应用心理 |
| 其他题名 | Effects of stigmatization experience on pain perception in patients with depression |
| 中文摘要 | As a kind of social pain, stigma refers to the negative characteristics of individuals or groups that are not accepted by mainstream culture. Mental illness is one of the most typical labels and results in discrimination and internalized stigma that will cause serious interference to personal life. Meanwhile, depression, as the most common mental illness, is inevitably discriminated against by the public. Clinical studies have shown that depression is closely related to physical pain, which is one of the main clinical manifestations of patients with depression. Research on social pain reveals that there are similar neural mechanisms and complex interactions between social pain and individual physical pain. These works suggest that stigma may affect patients' physical pain perception to some extent. Previous studies on pain perception of depressive patients mostly focused on the clinical symptoms, with less attention paid to the possible effects of the social environment, such as mental illness stigma. Therefore, this study combines three experiments to explore the pain perception of patients with depression from the perspective of stigmatization. Experiment1investigatedtheeffectofstigmatizationexperienceonself-reported pain perception in patients with depression. The results showed that depressedpatientswithstigmaexperiencehadstrongerawarenessofpaincatastrophizing than those without stigma experience. Meanwhile, the level ofdepression and the severity of anxiety mediated the effects of patients’ stigma experience on self-reported pain perception. Experiment 2 investigated the effects of stigmatization experience of depressive patients on their perception of induced thermal pain. It revealed that stigma can aggravate the patient's perception of thermal pain stimulation, and the depressive patients with stigma experience not only have stronger pain-related awareness than the healthy controls but also show significantly higher pain concerns than the depressive patients without stigma experience; In addition, the difference in pain perception between patients and the controls is mainly reflected in the self-reported pain severity. Experiment 3 explored the effect of depression stigma cues on the perception of induced thermal pain in patients with depression and its neural mechanism by combining behavioral tasks and EEG recording. The results showed that theinternalized stigma of patients was positively correlated with their self-reported pain perception; the level of depression and the severity of anxiety mediated the effects of patients’ stigma experience on self-reported pain perception; stigma cues significantly exacerbated patients' perception of induced thermal pain. This study systematically investigated the impact of stigmatization experience onpain perception of patients with depression in the clinical, behavioral, andelectrophysiological levels. The study’s main conclusions are that stigmatization experience could exacerbate patients' self-reported and evoked pain perception, andrelevant clinical characteristics mediated the process. These results are not only conducive to an in-depth understanding of the essence of pain in patients withdepression, more importantly, they can provide new ideas for effective analgesic treatment for patients. |
| 英文摘要 | 污名是指个体或群体所具有的不被主流文化接受的、特殊的、有缺陷的、耻辱的消极特征，它导致被污名化的对象价值受损，社会身份贬抑。精神疾病污名是典型的污名标签，由此产生的歧视和内化的耻辱感会严重地干扰个人生活。抑郁症作为最常见的精神疾病，不可避免地受到大众群体的偏见和歧视。临床研究表明抑郁与疼痛密切相关，疼痛是抑郁症患者的主要临床表现之一。另一方面，有关社会疼痛的研究揭示社会疼痛与个体的躯体疼痛存在类似的神经机制和复杂的相互作用，而以社会歧视为核心的污名本质上是一种社会疼痛。这些证据说明抑郁症污名可能在一定程度上影响患者的躯体疼痛感知。之前有关抑郁患者疼痛感知的研究主要关注患者本身的临床症，而还尚未有研究探讨社会环境因素（如精神疾病污名）对抑郁症患者本身疼痛感知的影响。因此本研究结合三个实验，从污名化的角度研究抑郁症患者的躯体疼痛感知。 实验一考察污名化经历对抑郁症患者自我报告疼痛感知的影响。95 名被试完成了临床症状的评估以及疼痛相关多维度问卷的填写。结果发现有污名体验的抑郁症患者比没有污名体验的患者有更强的疼痛灾难化意识，且患者的抑郁水平和焦虑水平介导了污名化体验和自我报告疼痛感知之间的关系。 实验二考察抑郁症患者因抑郁症被污名的经历是否对其诱发性热痛的感知产生影响。共 15 名有污名经历的抑郁症患者，28 名无污名经历的抑郁症患者以及 28 名健康对照完成了临床信息采集及行为实验的测量。通过给参与者施加诱发性热痛刺激，实验发现抑郁污名体验会加剧患者对阈上热痛刺激的感知，并且有污名经历的抑郁症患者比另外两组被试有更强的主观疼痛意识；此外抑郁症患者和对照组在疼痛感知上的差别主要体现在主观报告的疼痛严重程度。 实验三考察抑郁症污名线索对抑郁症患者诱发性热痛感知的影响及其神经机制。共 31 名抑郁症患者完成了量表信息的采集以及行为脑电实验。该实验采用线索启动范式，以污名线索诱发患者的污名化体验，并通过诱发性热痛评估患者的疼痛感知，结果发现污名线索显著提高了患者对诱发性热痛的感知，抑郁症患者自我污名体验与其自我报告的疼痛感知显著正相关；患者的抑郁水平、焦虑水平介导了自我污名体验和自我报告疼痛感知之间的关系。然而目前的分析尚未发现抑郁症污名线索显著性地调节了疼痛相关的脑响应。 本研究从临床、行为和电生理三个层面出发，系统地考察了污名化经历对抑郁症患者疼痛感知的影响。研究主要结论为污名化经历提升了患者对自我报告和诱发性疼痛的感知，并且该过程受相关临床特征（如抑郁水平和焦虑水平）的中介。这些发现不仅有利于深入理解抑郁症患者疼痛的本质，更重要的是能够为患者有效的镇痛治疗提供新的思路，在一定程度上为易被污名化的精神疾病患者的早期预警、诊断和干预评估提供科学依据。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/43211]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 章玉琪. 污名化经历对抑郁症患者疼痛感知的影响[D]. 中国科学院心理研究所. 中国科学院大学. 2022. |
入库方式： OAI收割
来源：心理研究所
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