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精神分裂症谱系的自我缺损研究
其他题名Self impairments in schizophrenia spectrum disorders
王玉娜
学位类型博士
导师陈楚侨
2012-05
学位授予单位中国科学院研究生院
学位授予地点北京
学位专业心理学
关键词自我 自我参照过程 自我面孔识别 精神分裂症谱系 功能磁共振成像
摘要自从有了自我异常这一概念,它就被认为是精神分裂症最基本和最核心的临床表现。现象精神病学同样强调了非精神疾病的主观体验异常是精神分裂症的核心特征。本研究从自我参照过程、自我面孔识别这两个代表了不同的自我层次的过程出发,全面的考察自我与精神分裂症的关系。考虑到谱系研究能够帮助更好的理解精神分裂症的病理学,并且为这一疾病的早起识别和干预提供依据,本研究关注的是自我参照过程和自我面孔识别过程在精神分裂症谱系中的行为表现和神经机制。 本研究共包括四个部分,分别是自我参照过程的在精神分裂症谱系中的行为和神经机制研究、自我面孔识别在精神分裂症谱系中的行为和神经机制研究。 在第一个研究中,我们主要采用典型的自我参照效应任务,来探讨精神分裂症谱系中自我参照过程行为表现的缺损情况,以及自知力与自我参照过程是否有关。结果发现精神分裂症患者与健康对照相比表现出了一定程度的自我参照过程损伤。自知力似乎影响了患者自我概念的范围,在自知力保留组中,母亲与自我具有同一层次的记忆水平,显著好于孙中山参照,而在自知力缺损组中,母亲与孙中山具有相同水平的记忆成绩,都差于自我参照刺激,出现了母亲这一概念与自我的分离。 在第二个研究中,探讨了精神分裂症谱系中自我参照过程神经活动的变化。结果发现,精神分裂症患者在自我与他人条件进行比较时,表现出了神经活动的减弱,而分裂型人格倾向组则是表现出了神经活动的增强。 在第三个研究中,采用一系列自我和他人之间不同程度变形的图片作为刺激材料,让被试进行自我和他人的判断来探讨精神分裂症谱系中自我面孔识别过程行为表现的缺损情况。结果发现精神分裂症患者及一级家属均表现出了对自我面孔和他人面孔更差的辨别能力,而在分裂型人格倾向组中,仍然没有发现与对照组的显著差异。另外,也没有发现能够证明自知力与患者的自我面孔识别过程缺损有关的证据。 第四个研究中,探讨了精神分裂症谱系中自我面孔识别过程神经活动的变化。发现精神分裂症患者在自我与他人条件进行比较时,表现出了神经活动的减弱,而分裂型人格倾向组则是表现出了神经活动的增强。 总之,通过我们的研究发现,精神分裂症患者在行为和神经活动方面均表现出了自我参照过程和自我面孔识别过程的缺损。一级家属组在自我面孔参照过程中没有表现出行为缺损,在自我面孔识别过程中表现出了行为损伤。而分裂型人格倾向的个体在两个行为任务中均没有表现出损伤,但是展现了神经活动的异常。
其他摘要Schizophrenia is associated with changes of self and related disorders. However, the underlying mechanism of self impairment in schizophrenia is still not fully known. In this research, we reviewed the concept of self from the perspectives of psychology, psychiatry and cognitive neuroscience. In particular, we examined self-referential processing and self-face recognition and reviewed how these constructs may relate to schizophrenia. Given that the concept of spectrum can help better understand of pathology of schizophrenia, and provide relevant information for the early detection and prevention of schizophrenia, this research would focus on both the behavioral and neural performances self-related concepts in schizophrenia spectrum. In the first study, we used the typical self-reference effect task to examine self-referential process defects in schizophrenia patients and individuals with schizotypal personality features (SPD). We also explored the relationship between insight and self-reference process in schizophrenia. Results showed that schizophrenia patients group and healthy control group both showed the self-reference effect. However, the magnitude of self-reference effect in schizophrenia patients was significantly less than the healthy control group. These findings suggested that schizophrenia exhibited a certain degree of impairment in self-referential processing. Insight seemed to be related with the scope of self-concept in schizophrenia, in insight-reserved group, mother and self-related stimuli have the same level of memory performance, both significantly better than Sun Zhongshan related stimuli, while in the insight defected group, mother and Sun Zhongshan have the comparable level of memory performance, both worse than that of the self-referential stimuli. In the second study, we used a fMRI paradigm to explore the neural responses of self-referential processing in schizophrenia patients and SPD. Schizophrenia patients showed abnormal hyperactivity across the conditions of self-referential process task, but in comparingthe neural activity by subtracting other condition from self condition, patients with schizophrenia showed abnormal hypoactivity compared with healthy control. The SPD group showed enhanced neural activity when comparing self with Sun Zhongshan. In the third study, we examined the self-face recognition by taking a series of morphed pictures between self and a stranger as stimuli and asking subjects to make self and/or other judgment. The results suggested that schizophrenia patients and first-degree relatives exhibited poorer ability in self- and other- face discrimination as indexed by the βvalue ( the slope of inflection point of self-face recognition curve). The SPD group still kept comparable self-face recognition ability with the control group. In the fourth study, we examined the neural basis of self-face recognition process in schizophrenia patients and individuals with SPD. We found that schizophrenia patients showed enhanced neural activity across all of the conditions of the self-face recognition task. However, when the neural activity of the self-face judgment was compared with other-face judgment, schizophrenia patients showed weakened neural activity in the medial frontal gyrus, inferior frontal gyrus, superior temporal gyrus, middle temporal gyrus and middle frontal gyrus. The SPD group showed enhanced neural activity , when compared with healthy control group, in the insula, thalamus, precuneus, cingulate gyrus medial frontal gyrus and inferior parietal lobe. Taken together, the findings showed that schizophrenia patients exhibited impaired behavioral performance and abnormal neural activity in both self-referential processing and self-face recognition. The first-degree relative group showed behavioral performance deficits in self-face recognition process rather than in self-referential process. The behavioral performance of the SPD group in both was consistent with the healthy control group, while the neural activity in both self-related tasks was enhanced when compared with healthy controls.
学科领域认知神经科学
语种中文
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/20409
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
王玉娜. 精神分裂症谱系的自我缺损研究[D]. 北京. 中国科学院研究生院,2012.
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