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甲基苯丙胺成瘾者戒断早期冲动行为变化特征的追踪研究
Alternative TitleLongitudinal study on the profiles of impulsive behaviors in male individuals with methamphetamine use disorders during their early abstinence periods
冀东杰
Subtype硕士
Thesis Advisor李勇辉
2017-05
Degree Grantor中国科学院大学
Place of Conferral中国科学院心理研究所
Degree Name理学硕士
Degree Discipline医学心理学
Keyword甲基苯丙胺 戒断期 冲动行为 行为决策
Abstract

目前我国以甲基苯丙胺为首的合成毒品滥用情况日趋严重,目前尚没有确切疗效的干预和治疗方法,复吸率较高,故对甲基苯丙胺滥用者的心理行为特征进行深入研究具有重要意义。反应抑制减弱和冲动性增强是成瘾行为的核心特征。冲动性在药物成瘾行为发生发展的各阶段均起关键作用,特别是戒断期停止使用药物后,冲动行为的变化特征和复吸之间关系是目前成瘾领域的重点研究方向,以期为成瘾行为复吸风险性的预警以及干预治疗提供依据。由于冲动的多维特性,哪一个维度的冲动行为的变化在复吸过程中起关键作用尚未明确。目前大多研究关注冲动性作为成瘾易感性的指标在成瘾行为早期识别和干预中的作用,相对而言,关于完全戒断时期内冲动行为的变化特征及其临床意义的研究不多。我们实验室的前期研究考察了女性甲基苯丙胺吸食者在强制隔离戒断期的后期(戒断9个月之后)认知冲动行为的变化特征,发现戒断9个月之后冲动行为变化不明显。其中的原因之一可能是戒断时间比较长(9个月),冲动行为已经恢复。本研究进一步考察男性甲基苯丙胺成瘾者强制隔离戒断期间的早期(戒断后3到6个月)冲动行为的动态变化特征,并且比较在没有情绪激发状态下的冲动性和有情绪激发状态下的冲动行为的发展变化特征。以期为强制隔离戒毒的戒毒管理、干预治疗和复吸风险预警提供依据。

本研究筛选强制隔离戒断期间男性甲基苯丙胺吸食者33人参与实验,平均年龄32岁,教育程度平均9年,平均吸食月数为19个月,累积吸食量最大500克,最少为1克,平均72克。在最后一次吸食冰毒戒断3个月(( 3m)与6个月左右((6m)两个时间点,采用问卷和行为任务对不同维度的冲动行为进行纵向跟踪研究。研究任务包括:1) UPPS-P冲动行为量表,Zukerman感觉寻求量表测量被试特质性冲动;2)延迟折扣任务(DDT),概率折扣任务(PDT)测量被试的冲动决策;3)停止信号任务(Stop signal )测量被试的冲动行为抑制水平;4)情绪Stroop任务测量被试在情绪干扰下的认知冲动控制能力,5)爱荷华赌博任务测量情绪激发状态下的冲动决策行为。

结果发现:(1)与戒断3个月的时间点相比,戒断6个月后成瘾者的stop-sigal任务中的停止信号反应时间(S}1ZT )显著缩短,Pl.T测试任务中曲线下面积显著减少,提示随着戒断时间的延长成瘾者的冲动行为抑制功能和冒险性冲动决策有一定程度的恢复;(2) UpPS-P冲动行为量表与SSS感觉寻求量表两个冲动特质测量的总量表和各分量表分数在间隔3个月的两次测试得分无显著差异;测量冲动决策的延迟折扣任务的得分前后两次测试的成绩无显著差异;情绪激发状态下的IGT测试,和情绪干扰效应的Stroop任务测量前后两次测试无显著差异。进一步根据吸食量将成瘾者分为高成瘾组和低成瘾组考察成瘾严重程度对不同维度冲动行为恢复的影响,结果表明,(3)和低吸食组比较,高吸食组冒险性决策下降更显著,其他冲动测试中,吸食量对戒断期冲动行为的恢复没有显著作用。

以上结果表明:在强制隔离戒毒期早期,随着戒断时间的延长男性甲基苯丙胺成瘾者不同维度的冲动行为的发展变化趋势存在一定的差异,冲动行为抑制能力和冒险性决策行为戒断6个月之后有一定程度的恢复;而其他类型的冲动行为没有显著的变化;成瘾严重程度对成瘾者冲动行为的发展变化趋势有一定的影响,高吸食者的冒险性决策行为恢复更明显。以上研究关于冲动性在戒断期的发展变化趋势特征,为戒毒所内针对性的心理康复具有一定的指导意义。

Other Abstract

Synthetic drug abuse, especially methamphetamine abuse is becoming more and more serious public health problem in China. So far the effective therapeutic or treatment methods are not available to methamphetamine use disorders. High impulsive behaviors are one of the most important hallmark of addiction including methamphetamine use disorders. Studies indicated that impulsivity plays a key role in all phases of the development of drug addiction. Due to the multidimensional characteristics of impulsivity, it is not clear that which dimension of the impulsivity plays key role in relapse. The previous studies paid much attention to the role of impulsivity in the initiation and formation of addiction, and the impulsivity is identified as the core targets for early detection and intervention. However, few studies examined the changing trajectories of different dimension of impulsivity at the different time points during abstinence periods. To characterize the impulsivity feature and changing traj ectory9 will help a lot to management for drug treatment and relapse prevention for those whom are being compulsorily isolated for detoxification in the drug rehabilitation center.

Longitudinal study was launched in the present studies with 33 female 11}A addicts with different duration of abstinence periods, to study the changing trajectories of impulsivity at the time point 3 months and 6 months during the abstinence periods.

All the tests on impulsivity are as follows: I)UPPS少and SSS questionnaire fort the trait impulsivity; 2)Delay Discounting Tasks(DDT) and Probability of Discounting Tasks(PDT) for the impulsive choice test; 3)Stop Signal was used to test impulsive behavior; 4) drug-related words Emotional Stroop Task and Iowa gambling test (IGT) were used to test impulsive behaviors with emotional arousal status. The subjects are 32 years old by average and average education time is about 9 years, and the average accumulation doses of abuse is about 72 grams ranging from 1-500 grams. The findings are as following:(1) There is not significant change on the impulsive behaviors by all the task after 3 months abstinence duration.(2)The linear regression analysis showed that the accumulation doses of abuse can predict the impulsivity score in DDT_1000 test, PDT_ 50000, PDT一 000,Stop Signal and UPPS_Perseverance; duration of abuse can predict the impulsivity score of test in Stop Signal; duration of abstinence can predict the impulsivity score in DDT-1000 and PDT 50000; the severity scores tested by DSIVI-5 can predict the impulsivity score in UPPS Negative Urgency; (3)Longitu dinal study(difference score by pre and post test by the method of linear regression):

the accumulation doses of abuse can predict the score in DDT-50000, PDT50000, PDT-1000;.the scores assessed by DSM-5 can predict the score in DDT-50000;③duration of abstinence can predict the change of test in PDt-50000. The finding in the present study showed that:(1)Cross sectional study: as the increasing of accumulation doses of abuse, duration of abuse and duration of abstinence,MA addicts' impulsive behaviors(including impulsive decision and impulsive behavior) enhance in varying degrees, and impulsive decision was influenced by the duration of abstinence most. (2)Longitudinal tracked study:by the increasing of duration of abstinence,the change of impulsivity is barely on the decision dimension in MA addicts', and there is no significance data to show the changes in impulsive behavior dimension. This study used in combination with transverse and longitudinal research to show the impulsive changing in withdrawal period by MA addicts' and the results prove the evidences to classification of treatment and organization of the MA addiction withdrawal, and suggested that the prolongation of withdrawal time can be an effective way of preventing MA addicts' impulsivity.

Pages48
Language中文
Document Type学位论文
Identifierhttp://ir.psych.ac.cn/handle/311026/28474
Collection健康与遗传心理学研究室
Recommended Citation
GB/T 7714
冀东杰. 甲基苯丙胺成瘾者戒断早期冲动行为变化特征的追踪研究[D]. 中国科学院心理研究所. 中国科学院大学,2017.
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