报告题目不同戒断期甲基苯丙胺成瘾者对药物渴求的研究——基于动机状态对惊反射的调节

PSYCH OpenIR > 健康与遗传心理学研究室

	报告题目不同戒断期甲基苯丙胺成瘾者对药物渴求的研究——基于动机状态对惊反射的调节
其他题名	The Craving for Drugs of Methamphetamine Addicts in Different Withdrawal Period ——a research based on the modulation effect of motivation on startle
	王超逸
	2015-05
摘要	中脑边缘多巴胺系统在动机奖赏中扮演重要角色，参与成瘾和觅药。新型成瘾性药物甲基苯丙胺直接作用多巴胺能神经系统，长期用滥用导致多巴胺水平下降、受体下调，神经元形态改变引起动机系统敏感化，成瘾者对自然奖赏欲求减弱，易被药物相关线索激活，产生对药物的强烈渴求。渴求是复吸产生的重要原因，对于甲基苯丙胺成瘾者渴求测量常用的主观报告法可靠性低，心率、皮肤电等生理测量的方法缺乏对其动机状态（欲求/厌恶）的区分。惊反射是一种可以被动机状态调控的非条件反射，受欲求动机抑制，被回避动机增强。因此，惊反射可以用来测量评估成瘾相关线索的欲求状态。本研究以甲基苯丙胺成瘾者为对象，考察戒断期不同时间点其基本情绪刺激引发动机状态及药物相关线索引发的渴求程度。研究结果：（1）对照组的正负性情绪刺激下惊反射调节具有双向性：正性情绪刺激-惊反射减小，负性情绪刺激-惊反射增大，甲基苯丙胺成瘾者负性情绪刺激下惊反射也会增强，但正性情绪刺激的呈现却未能降低甲基苯丙胺成瘾者的惊反射，即使戒断 1年以后，正性情绪刺激仍然不能降低成瘾者的惊反射；（2）药物相关的线索对甲基苯丙胺成瘾者的惊反射具有显著的抑制作用，相比毒品和吸毒场所，吸毒器具和使用过程有关的图片更能抑制甲基苯丙胺成瘾者的惊反射；（3）对于不同戒断期的甲基苯丙胺成瘾者线索相关线索对惊反射的抑制程度不同， 4到 6个月戒断期抑制现象最为明显；（4）阈下呈现药物相关线索也能够显著抑制甲基苯丙胺成瘾者的惊反射。本研究结果表明，甲基苯丙胺成瘾者对自然奖赏欲求降低，随着戒断时间的延长，成瘾者对正性情绪刺激的反应仍不能恢复。药物相关线索能够引发甲基苯丙胺成瘾者对药物的渴求，在戒断期 4 到 6 个月对药物的欲求程度最高，甲基苯丙胺成瘾者对药物相关线索存在无意识自动化的加工。本研究首次运用惊反射作为甲基苯丙胺成瘾者对药物的渴求程度测量的客观工具，展现了戒断期甲基苯丙胺成瘾者的渴求状态的变化规律，对成瘾者的复吸的防治具有重要作用。
其他摘要	Mesolimbic dopamine system, playing a crucial role in reward motivation system, also is a participant in most drug addiction and seeking. The impact of methamphetamine (MA) on this circuitry may be more profound than other addictive drugs. Long term MA abuse leads to decreasing dopamine levels, receptor down-regulation, neuronal morphology changes and motivation system sensitization. The neural deficit likely contributes to MA addicts having less appetite for natural reward and high rate of relapse. Carving is one of major cause of relapse. However, self-report of MA addicts’ craving for MA has low reliability. Heart rate and skin conductance as physiological methods can not differentiate the status of their motivation (appetite / aversive). Startle reflex (SR) is modulated by motivation status, aversive-potentiated / appetitive-inhibited. Thus, SR can measure the craving induced by drug-related cues. MA addicts in different withdrawal periods were tested in this study, including their motivation to basic emotional stimuli and craving to drug-related cues. Research results: (1)In control group, positive and negative emotional stimuli has bidirectional regulation effect on SR: positive stimuli reduced SR and negative stimuli increased SR. MA addicts’ startle enhanced by negative stimuli, but positive stimuli failed to reduce their SR even after one year withdrawal; (2) Drug-related cues inhibited MA addicts’ SR significantly; compared to images of drug and images of drug context, MA addicts’ SR is inhibited much more by images of drug instrument and images of drug using; (3) Different withdrawal periods for MA addicts have different inhibition of SR under drug-related cues, and this phenomenon is the most apparent in 4-6-month withdrawal period MA addicts; (4) Subliminal drug-related stimuli suppress MA addicts’ SR significantly. The results of this study show that MA addicts’ appetite for natural reward decreased, and this phenomenon wouldn’t disappear over time. Secondly, drug-related cues can trigger MA addicts’ craving for MA, and MA addicts has the highest degree of craving in 4-6 months’ withdrawal Finally MA addicts have automated processing of drug-related cues. This study firstly used startle reflex as an objective tool to measure MA addicts craving degree, and demonstrated the variation of MA addicts craving in different withdrawal periods. It may prove an effective way of preventing MA addicts’ relapse.
学科领域	药物成瘾的脑机制
关键词	甲基苯丙胺中脑边缘多巴胺系统动机惊反射渴求
学位类型	硕士
语种	中文
学位专业	医学心理学
学位授予单位	中国科学院研究生院
学位授予地点	北京
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/19706
专题	健康与遗传心理学研究室
作者单位	中科院心理所
推荐引用方式 GB/T 7714	王超逸. 报告题目不同戒断期甲基苯丙胺成瘾者对药物渴求的研究——基于动机状态对惊反射的调节[D]. 北京. 中国科学院研究生院,2015.

条目包含的文件
文件名称/大小	文献类型	版本类型	开放类型	使用许可
王超逸－硕士学位论文.pdf（3398KB）	学位论文		限制开放	CC BY-NC-SA	请求全文