中国科学院心理健康重点实验室知识库

摘要:目的：阴性症状的评估对于精神分裂症的研究非常重要。最新研究显示，阴性症状可以汇聚成动机与愉悦及表达两个维度。阴性症状临床评估访谈（CAINS）是在这种评估要求下发展的新型临床评估工具，且在国内外研究中验证了其具有良好的信效度。但是否能基于CAINS评分对精神分裂症患者进行分类需要进行探讨。本研究旨在检验是否可以根据CAINS两因子上的评分把精神分裂症患者聚类为不同阴性症状表现的亚型。方法：招募了精神分裂症患者112人和健康对照组80人，结合CAINS等临床访谈、自评问卷及期待性和即时性愉快体验任务进行评估。结果：精神分裂症患者可以聚类成以动机/愉悦缺损为主的患者组（n=38）和非阴性症状患者组（n=74），以动机/愉悦缺损为主的患者在PANSS的阴性症状及SANS的情感迟钝、言语减少、动机缺乏及快感缺失上缺损更严重，两组患者在PANSS的阳性症状、一般病理及SANS的注意障碍评分上没有显著差异；在自我报告上，通过这两组患者和健康对照组（n=80）的对比发现，两组患者在情绪表达上出现类似程度的缺损，非阴性症状组患者愉悦体验正常，但以动机/愉悦缺损为主的患者在愉悦体验上存在缺损。在行为任务上，以动机/愉悦缺损为主的患者（n=15）、非阴性症状组患者（n=25）及健康对照组（n=23）在愉悦度及唤醒度的评分上均没有组间差异；在动机强度上，相对于健康对照组，精神分裂症患者按键速度较慢，但两组患者间没有差异；在情绪与行为一致性上，动机/愉悦缺损为主的患者出现缺损，其他患者和健康对照组间没有显著差异。结论：根据CAINS评分，可以把以动机/愉悦为主的精神分裂症患者和非阴性症状的精神分裂症患者区分开。

Abstract: Impaired empathy is one of the major dysfunctions commonly found in patients with schizophrenia, with alexithymia being its possible underlying cause. To test this speculation, we administered the Interpersonal Reactivity Index (IRI) to measure cognitive and affective empathy, the Toronto Alexithymia Scale (TAS) to measure alexithymia, and the Chapman scales (Chapman Scale for Social Anhedonia, CRSAS; Chapman Scale for Physical Anhedonia Scale, CPAS) to evaluate an individual’s schizotypy score. Atotal of 811 college students were queried on the IRI, TAS, and the Chapman scales. Networkanalysis method was used to explore the relationships of the above factors. In particular,regularized partial correlation (LASSO) networks of male and female participants were estimated. In the visualization of the model, items are displayed as nodes, edges represent regularized partial correlations between the nodes. Centrality denotes a node's connectedness with other nodes in the network. Negative edges were found among nodes belonging to the IRI and Chapman scale as well as among nodes belonging to TAS and IRI. Node representing the subscale TAS-F1 (“difficulty identifying feelings”) showed the highest strength centrality score. The network accuracy and stability were tested, edges and node centrality order were accurately estimated. Results show that 1) the IRI-F1(“personal distress”) is associated with TAS-F1(“difficulty identifying feelings”), while perspective taking negatively was correlated with physical anhedonia and TAS-F3 (“externally oriented thinking”); 2) the IRI-F4 (“empathic concern”) is significantly negatively correlated to social anhedonia; 3) the IRI-F1(“personal distress”) lies in the center of these relationships. These results suggest an important role of alexithymia in schizotypy individuals’ empathic deficits, especially for empathy’s sub-component “personal distress”. Overall, network analysis has highlightedthe connections between sub-components of empathy and alexithymia, implying that alexithymia may serve as a potential intervention target for the empathy deficits in schizophrenia spectrum disorders.