强戒期毒品成瘾人员工作记忆的可塑性  及远迁移效应

PSYCH OpenIR > 健康与遗传心理学研究室

	强戒期毒品成瘾人员工作记忆的可塑性及远迁移效应
其他题名	Plasticity of Working Memory and Associated Far-Transfer Effects in Drug Addicts
	詹奕
	2016-05
摘要	预防毒品成瘾复发一直是世界性难题。近年来，认知训练（Cognitive training）作为毒品成瘾治疗领域的新方法，越来越受到研究者的重视。然而，目前该领域的实证研究还比较缺乏，关于为何选用某种目标能力进行训练的阐述尚不够清晰。双过程模型将毒品成瘾行为解释为冲动系统（Impulsive System）和反思系统（Reflective System）两个互相独立的系统之间相互作用失衡的结果（Strack & Deutsch, 2004），冲动系统主要依赖于杏仁核-纹状体系统，反思系统主要依赖于前额叶功能。近期的神经影像学研究表明，前额叶在毒品成瘾机制占据重要地位，前额叶损伤与无法抑制冲动行为有关（Goldstein & Volkow, 2011; Noël, Brevers, & Bechara, 2013）。工作记忆能力与冲动抑制能力关系密切，高工作记忆广度的个体具有更强的冲动抑制能力（Redick, Calvo, Gay, & Engle, 2011）。本研究的主要目的是，在考察强戒期毒品成瘾人员认知损伤特点的基础上，采用工作记忆训练的方法，针对双过程模型中的反思系统进行干预，考察毒品成瘾人员工作记忆能力的可塑性，以及训练对他们的冲动性、注意能力以及一般认知能力的影响。本研究主要包括两个方面的内容：1）选取66名强戒期毒品成瘾人员和与之教育、年龄相匹配的66名未接触过毒品的健康人群个体，比较他们在各项认知能力任务上的表现，考察强戒期毒品成瘾人员是否存在认知损伤，以及他们的认知损伤特点如何。2）选取33名强戒期毒品成瘾人员，采用随机入组的方法分配到工作记忆训练组（16人）和控制组（17人），分别进行为期六周的工作记忆训练和积极教育。研究的主要结果如下：与健康人群对照组相比，强制隔离戒毒人员在冲动决策任务上的表现预防毒品成瘾复发一直是世界性难题。近年来，认知训练（Cognitive training）作为毒品成瘾治疗领域的新方法，越来越受到研究者的重视。然而，目前该领域的实证研究还比较缺乏，关于为何选用某种目标能力进行训练的阐述尚不够清晰。双过程模型将毒品成瘾行为解释为冲动系统（Impulsive System）和反思系统（Reflective System）两个互相独立的系统之间相互作用失衡的结果（Strack & Deutsch, 2004），冲动系统主要依赖于杏仁核-纹状体系统，反思系统主要依赖于前额叶功能。近期的神经影像学研究表明，前额叶在毒品成瘾机制占据重要地位，前额叶损伤与无法抑制冲动行为有关（Goldstein & Volkow, 2011; Noël, Brevers, & Bechara, 2013）。工作记忆能力与冲动抑制能力关系密切，高工作记忆广度的个体具有更强的冲动抑制能力（Redick, Calvo, Gay, & Engle, 2011）。本研究的主要目的是，在考察强戒期毒品成瘾人员认知损伤特点的基础上，采用工作记忆训练的方法，针对双过程模型中的反思系统进行干预，考察毒品成瘾人员工作记忆能力的可塑性，以及训练对他们的冲动性、注意能力以及一般认知能力的影响。本研究主要包括两个方面的内容：1）选取66名强戒期毒品成瘾人员和与之教育、年龄相匹配的66名未接触过毒品的健康人群个体，比较他们在各项认知能力任务上的表现，考察强戒期毒品成瘾人员是否存在认知损伤，以及他们的认知损伤特点如何。2）选取33名强戒期毒品成瘾人员，采用随机入组的方法分配到工作记忆训练组（16人）和控制组（17人），分别进行为期六周的工作记忆训练和积极教育。研究的主要结果如下：第一，与健康人群对照组相比，强制隔离戒毒人员在冲动决策任务上的表现更差，体现了毒品成瘾人员更冲动的认知特点。在某些任务中，毒品成瘾人员在毒品刺激条件下的反应时更短，表明他们对毒品刺激更加敏感。然而，两组被试在其它认知能力任务上的成绩无显著差异。第二，在工作记忆的可塑性方面，强制隔离戒毒人员在12次训练过程中，标准任务成绩和训练任务难度都呈整体上升趋势，超过半数的被试晋级到难度5及以上水平（最高难度为6）。在近迁移任务中，与控制组相比，训练组被试经过六周训练后在操作广度任务上的成绩显著提高，表明戒毒人员的工作记忆能力通过训练得到了显著提高。第三，在远迁移效应上，训练组被试在爱荷华赌博任务中选择坏牌次数在训练后整体上呈减少趋势，表明他们风险决策能力的增强；而在注意能力任务和一般认知能力任务上无显著的迁移效应。第四，进一步使用ERP研究发现，在工作记忆任务——延迟匹配上，考察条件2和条件3的CDA（contralateral delay activity）波幅差异，发现训练效应在450~600ms和850~900ms时段达到了显著性水平，表明训练组的工作记忆能力得到了显著改善，而在行为抑制任务——Go/Nogo上，远迁移效应不显著。第五，工作记忆能力上的训练效应在三个月后得到了一定的保持。综合上述研究结果，本研究的结论如下：1）毒品成瘾人员在冲动性上存在明显损伤，而在其它认知能力上损伤不明显，我们推测在较长戒断期（平均13个月）后，他们的认知能力损伤可得到较大程度的恢复。2）通过训练，毒品成瘾人员的工作记忆能力得到了显著提高，抑制冲动的能力也得到了改善，但需要更长时间和更大强度的训练才能达到更明显的效果。
其他摘要	Preventing relapse of drug addiction has been a worldwide problem. As a novel attempt in the field of addiction treatment, cognitive training has been considered as a promising method to treat addiction, while there is still a lack of empirical studies on the effects of cognitive training on addicts, and the relationship between a certain ability to be trained and addiction has not been described clearly in these limited studies. Dual-Process Models interpreted addictive behavior as the imbalance of impulsive system and reflective system( Strack & Deutsch, 2004), the impulse system is mainly dependent on the amygdala-striatum system, and the reflective system is mainly dependent on the prefrontal function. Recent neuroimaging studies have indicated that prefrontal cortex plays an important role in drug addiction (Goldstein & Volkow, 2011; Noel, Brevers, & Bechara, 2013). Previous studies have indicated that there was a close relationship between working memory ability and impulse inhibition ability, and individuals with high working memory span have stronger impulse inhibition ability (Redick, Calvo, Gay, & Engle, 2011). The main purpose of this study was to investigate the plasticity of working memory of drug addicts, and the effects of training on their impulsivity, attention and general cognitive ability by using working memory training to enhance the reflective system of Dual-Process Models based on the examination of their cognitive impairments. This study was divided into two parts: 1) chose 66 drug addicts under compulsory isolation detoxification and 66 individuals who never use drugs, examines their difference of performance on various cognitive tasks to explore the cognitive impairments of drug addicts. 2) 33 drug addicts from the 66 subjects in part one were selected and randomly assigned to the training group(16 persons) and active control group(17 persons) to accept working memory training and active education for 6 weeks . The main results of the study are as follows: First, compared with the control group, the drug addicts had a worse performance on decision making tasks, suggesting that they were more impulsive than those who never use drugs. On some tasks, the drug addicts had a shorter reaction time under the condition of drug stimulus, indicating that they were more sensitive to the drug stimulus. However, there was no significant difference on other cognitive tasks between drug addicts and the control group. Second, on the plasticity of working memory, the average recall number of the standard task and difficulty levels of the training tasks were both showed continuous growth among the 12 sessions, over half of the 16 participants reached level 5(the highest difficulty was 6) and above (62.5%), which showed that the working memory capacity of drug addicts was significantly improved by training. Third, on far transfer effects, compared with the control group, the training group had some positive changes in the cognitive tasks. After 6 weeks of training, their performance on operation span task improved significantly, showing that working memory capacity increased. On Iowa Gambling task, the number of selecting bad cards decreased in training group, suggesting that training enhanced their decision making ability. However, there were no significant effects on attention tasks and general cognitive tasks. Fourth, further ERP (Event Related Potential) study indicated that the training effect on 450~600ms and 850~900ms periods reached significant level by examine the difference between the condition 2 and 3 of the CDA in the visual working memory task, which showed that their inhibitory function had been improved significantly. However, far transfer effect was not significant on behavioral inhibition task(Go/Nogo). At last, The training effects of working memory was partially maintained after three months. Based on the above research results, the conclusions of this study are as follows: 1) There was impairment in impulsivity of the drug addicts, while their cognitive deficits were not obvious in other cognitive abilities. We concluded that there was a recovery of their cognitive abilities after a long withdrawal period (average 13 months); 2) Working memory training enhanced the drug addicts' working memory ability, and also improved the ability to suppress the impulse, but it would need more time and greater intensity of training to achieve better effects.
学科领域	发展与教育心理学
关键词	毒品成瘾认知训练双过程模型工作记忆训练强制隔离戒毒
学位类型	硕士
语种	中文
学位专业	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/311026/19864
专题	健康与遗传心理学研究室
作者单位	中国科学院心理研究所
推荐引用方式 GB/T 7714	詹奕. 强戒期毒品成瘾人员工作记忆的可塑性及远迁移效应[D]. 北京. 中国科学院研究生院,2016.

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