内感受影响述情障碍的心理和神经机制: 基于精神分裂症的临床研究
文献类型：学位论文
| 作者 | 沈浩冉 |
| 答辩日期 | 2023-06 |
| 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 | 魏高峡 |
| 关键词 | 述情障碍 内感受 精神分裂症 情绪识别 岛叶皮层 |
| 学位名称 | 理学硕士 |
| 学位专业 | 健康心理学 |
| 其他题名 | Mental mechanisms and neural mechanisms of underlying the relationshibs between interoception and alexithvmia: Evidence from schizophrenia |
| 中文摘要 | Alexithymia, also known as "inability to express emotions disorder", is a type of affective cognitive disorder in which patients have difficulty recognizing and describing feelings, distinguishing feelings between emotional arousal and body. Alexithymia has been regarded as one of the risk factors for physical and mental problems. The incidence of alexithymia is much higher in schizophrenia than in healthy individuals, which affects their clinical symptoms and quality of life. Interoception refers to the process by which the nervous system perceives, interprets and integrates signals within the body which is a real-time mapping of the internal state of the body at the conscious and unconscious levels. According to the three-dimensional model of interoception, interoception can be divided into interoceptive accuracy, interoceptive sensibility and interoceptive awareness. Studies have indicated that there exists unique relationship between interoception and alexithymia in schizophrenia, but no studies have systematically examined the effect of interoceptive on alexithymia in this population and the differences in the role of different dimensions of interoceptive. In addition, the psychological mechanism of interoception influence on alexithymia has not been explored. Based on the current research status, this study aims to explore the influence of interoceptive perception on alexithymia in schizophrenia, a group with a high incidence of alexithymia, and the underlying psychological and neural mechanisms from the behavioral and brain mechanisms. The study consists of three sub-studies. Study 1 aimed to explore the relationships between interoception and alexithymia. In this study, 201 schizophrenia patients were recruited, scores of alexithymia, three dimensions of interoception and clinical were measured by questionnaires and heartbeat task. Study 2 aimed to test the mediation role of emotion recognition between interoception and alexithymia, which used emotion recognition task based on heartbeat cycle in 21 schizophrenia patients. In Study 3, a total of 28 patients with schizophrenia were selected to investigate the brain activation differences between low alexithymia patients and high alexithymia patients during interoception task. Results of Study 1 showed that the prevalence of alexithymia in schizophrenia was 34.17%. Compared with low alexithymia patients, high alexithymia patients showed significant decreases in interoceptive sensibility, interoceptive accuracy and interoceptive awareness. The three domains negatively predicted the occurrence of alexithymia. Results of Study 2 showed that, compared with low alexithymia patients, high alexithymia patients had lower sensibility to emotional faces, needed more intensity to recognize specific emotions, and the accuracy was decreased. At high morph level, systolic emotion recognition was better than diastolic emotion recognition, systolic emotion sensibility was stronger, and the accuracy was higher. Furthermore, there were interactions between alexithymia and heartbeat cycles in high morph levels. Systolic emotion recognition was superior to diastolic emotion recognition in patients with low alexithymia patients, while there were no differences in high alexithymia patients. Due to the impaired interoception, the promoting effect of emotion recognition during systole is reduced, resulting in the defect of emotion recognition ability, the impaired emotion recognition ability further leaded to the occurrence of alexithymia. Results of Study 3 showed that the main brain regions activated in schizophrenia patients during the interoceptive task were bilateral middle temporal gyros, bilateral superior temporal gyros, bilateral insula and right middle frontal gyros. The activation in bilateral insula higher in low alexithymia patients than high alexithymia patients. Further, correlation analysis showed that activations in bilateral insula was negatively correlated with the total score of the alexithymia scale and subscale. These results suggested that: (1) The prevalence of alexithymia in patients with schizophrenia was 34.17%. Interoceptive sensibility, interoceptive accuracy and interoceptive awareness negatively predicted the occurrence of interoception; (2) Interoceptive deficits decreased the promoting effect of cardiac systolic on emotion recognition in high alexithymia patients, which further leads to the occurrence of alexithymia. (3) The decreased activity of bilateral insular cortex in interoceptive task is the neural mechanism of alexithymia in patients with schizophrenia. This study explores the mental and neural mechanism underlying the relationships between interoception and alexithymia in schizophrenia. On the one hand, it is helpful to better understand the pathogenesis of alexithymia, and clarify the relationship between emotion recognition and the corresponding feelings and interoceptive feelings. On the other hand, it can also provide objective scientific enlightenment for clinical intervention in schizophrenia with alexithymia. |
| 英文摘要 | 述情障碍，又称“情感表达不能障碍”，是一类情感认知障碍，表现为个体难以识别和描述感觉或者难以区分情绪唤醒引起的感觉和生理感觉，是多种身心问题风险因素。已有研究表明，内感受可能是影响述情障碍发生的重要因素之一，但内感受影响述情障碍心理和神经机制尚未得到揭示。在精神分裂症患者中，述情障碍的发生率远高于健康人，这种共病现象往往被临床忽视，影响治疗效果。由于精神分裂症中内感受与述情障碍间有独特的关系模式，从精神分裂症这一典型群体为窗口，探索内感受对述情障碍的影响及内感受不同维度的作用差异，有重要的理论意义和临床意义。 本研究包含三个子研究。研究一共选取201名精神分裂症患者，采用问卷测量、数心跳任务以及视觉评估量表，分别测量患者述情障碍和内感受三个维度，探讨述情障碍在精神分裂症中的发生率，以及内感受三个维度对述情障碍发生的影响。研究二共选取40名具有高、低述情障碍分数精神分裂症患者，采用基于心跳周期的情绪识别任务，探讨情绪识别是否为内感受影响述情障碍核心心理机制。研究三共选取28名具有高、低述情障碍分数的精神分裂症患者，采用任务态磁共振研究，探讨低述情障碍患者和高述情障碍患者完成内感受任务时的神经表征差异。 研究一发现，精神分裂症患者述情障碍发生率为34.17%。回归分析发现，内感受敏感性、内感受准确性和内感受觉知均负向预测述情障碍发生，内感受能力越低的患者，越容易发生述情障碍。相比于低述情障碍患者，高述情障碍患者内感受敏感性、内感受准确性和内感受觉知均存在显著降低。研究二显示，相比于低述情障碍患者，高述情障碍患者对情绪面孔的敏感性降低，识别的正确率降低。在低述情障碍患者中，心跳收缩期对情绪面孔识别的敏感性和正确率优于舒张期; 在高述情障碍患者中，心跳收缩期和舒张期在识别情绪面孔无显著差异。研究三发现，精神分裂症患者在进行内感受任务时，主要激活的脑区为双侧颗中回、双侧颗上回、双侧岛叶和右侧额中回。方差分析显示，在进行内感受条件下，低述情障碍患者双侧岛叶和右侧颗中回的激活高于高述情障碍组。相关分析发现，内感受条件下双侧岛叶激活程度与述情障碍量表总分及情感辨别不能子维度之间存在负相关。 基于上述研究结果，得出以下结论:C1)精神分裂症患者中述情障碍发生率较高，内感受敏感性、内感受准确性、内感受觉知皆负向预测述情障碍发生;（2)情绪识别在内感受影响述情障碍之间起到中介作用，内感受能力受损导致患者情绪识别能力出现缺陷，进一步导致述情障碍发生;(3)内感受状态下双侧岛叶皮层活动降低是精神分裂症患者述情障碍发生的神经机制。本研究在精神分裂症这一述情障碍高发群体中探讨内感受影响述情障碍的心理和神经机制，一方面有助于更好地理解述情障碍的发病机理，明确内感受与情绪识别的关系，另一方面也能为精神分裂症以及述情障碍的临床干预提供客观的科学启示。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/46095]  |
| 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 | 沈浩冉. 内感受影响述情障碍的心理和神经机制: 基于精神分裂症的临床研究[D]. 中国科学院心理研究所. 中国科学院大学. 2023. |
入库方式： OAI收割
来源：心理研究所
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