健康与遗传心理学研究室知识库

背景：心理时间之旅(mental time travel)是指我们在心理上将自我投射到过去重新经历过去的事情，以及把自我投射到未来，预先经历未来事情的能力。这种能力在人们的日常生活中起着重要的作用。精神分裂症患者心理时间之旅存在缺损，但以往大多数研究集中在对过去事件的回忆上，关于想象未来的研究较少，而且对精神分裂症患者这一缺损的干预研究更少。
目的：本研究通过对精神分裂症患者进行生命回顾训练(Life Review Therapy)干预，考察能否提高精神分裂症患者回忆过去和想象未来的能力，以及能否改善患者的情绪状态和生活满意度等。
方法：本研究招募精神分裂症患者50名，将其随机分配到训练组和控制组，每组25人。控制组只接受常规药物治疗，训练组在常规药物治疗的基础上，进行生命回顾训练。生命回顾训练由对生命中特定时间阶段的自传性事件的提取练习组成。分成四周，每周两次，每次训练一个小时。在训练前后评估两组患者的心理时间之旅(回忆过去和想象未来事件的具体性、在事件中参与者的比率以及事件的类别等)、自评情绪状态和生活满意度以及基本认知功能等。同时招募健康对照组25人，进行相同的测试作为健康标准，用于考察精神分裂症患者与健康对照组的差异。
结果：精神分裂症训练组及控制组前测时回忆过去及想象未来事件的具体性比率显著低于健康对照组，而且回忆事件具体性比率显著高于想象；在产生的事件中参与者的比率显著低于健康对照组；回忆想象关系事件、娱乐事件比率显著低于健康对照组；与医院相关事件、无法归类事件、回忆想象不出来情况的比率显著高于健康对照组。视觉记忆、数字广度、词汇流畅性显著低于健康组。经过生命回顾训练后，精神分裂症训练组回忆想象具体事件性的比率显著高于控制组，而且与健康对照组差异不显著；精神分裂症训练组参与者比率显著高于控制组，与健康对照组差异不显著。探索、娱乐事件的回忆想象比率显著高于控制组，与健康对照组差异不显著；无法归类事件、想象不出来情况的比率显著低于控制组，与健康对照组差异不显著。精神分裂症训练组情感表达意愿增加。言语记忆、词汇流畅性有改善。抑郁焦虑情绪、生活满意度改善效果不显著。
结论：精神分裂症患者心理时间之旅存在缺损，而生命回顾训练可以提高患者的心理时间之旅能力，表现为回忆想象的具体性的提高，内容上更有适应性。对言语记忆、词汇流畅性及情绪表达能力有改善作用。

Background:Mental Time Travel (MTT) is the ability that individuals project themselves to the past and re-experiencing their past experiences, or project themselves to the future to pre-experience the future. This ability is important in daily lives. Studies have shown that schizophrenia patients were impaired in MTT. To date, most studies of MTT were on remembering the past, only a few studies explored imaging the future, and even less studies examined how to improve MTT in patients with schizophrenia.
Objective: Our study aimed to examine whether MTT in patients with schizophrenia can be improved through the Life Review Therapy, andemotion state and life satisfaction, etc. can be improved as well.
Methods:This study recruited 50 patients with schizophrenia, they were randomly assigned to the training group (SZ-training) and control group (SZ-control), each group consisted 25 patients. The SZ-control group only accepted conventional anti-psychotic medication treatment. On the other hand, the SZ-training group received the Life Review Therapy in addition to conventional anti-psychotic medication treatment. Life Review Therapy consisted of practices of retrieving autobiographical events from specific time period in one's life. The therapy was divided into four weeks, twice a week, and each training session lasted for about an hour. MTT, self-reported emotional status, life satisfaction and basic cognitive functions were assess before and after training for both groups. The event specificity, field perspective, and category of events that participants remembered or imagined were the main index of MTT. At the same time, we also recruited 25 healthy controls who completed all the assessments at baseline to compare the difference between schizophrenia patients and healthy controls.
Results:Resultofpre-trainingassessmentshowedthatboth SZ groups showed impairments in remembering the pastand imagining the future compared to healthy controls.SZ patients adopted less field perspective than healthy controls in MTT. Of the content of events generated in MTT, SZ patients showed a lower proportion in categories of relationship and entertainment, and higher proportion in categories of hospital-related, non-classifiable, and no response compared to healthy controls.
Results of post-training assessment showed that the specificity of events generated in MTT in SZ-training group was higher than that of SZ-control group, and no significant difference was found between SZ-training group and healthy control group. The field perspective adopted in SZ-training group was higher than that of the SZ-control group, and no significant difference was found between SZ-training group and healthy control group. The proportion of exploring/entertainment events in SZ-training group was higher than SZ-control group, and no significant difference was found between SZ-training group and healthy control group. The proportion of unclassifiable and no response in the SZ-training group was lower than SZ-control group, and no significant difference was found between SZ-training group and healthy control group.
For self-reported assessments, SZ-training group showed significant improvement in emotional expression. There was no significant improvement in depression or anxiety nor increase in life-satisfaction. Significant improvement was found in semantic memory, and verbal fluency in SZ-training group.
Conclusions:Schizophrenia patients showed impairment in remembering the past and imagining the future, and Life Review Therapy is effective in improving the specificity of MTT and made the content more adaptive. It can also improve patients' emotion expression and basic cognitive functions.