海洛因成瘾者决策障碍及其行为机制的研究----短视行为及冲动、强迫和药物在决策中的作用

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	海洛因成瘾者决策障碍及其行为机制的研究----短视行为及冲动、强迫和药物在决策中的作用
其他题名	Decision making in heroin addicts: myopia and the role of impulsivity, compulsivity and history of abusing drug
	程九清
	2009-05-27
摘要	成瘾行为可以从决策的角度考察。成瘾患者在面对药物线索或具有对药物的渴求时，往往做出错误的决策，导致持续反复的用药。本研究采用了时间折扣（temporal discounting）的实验范式，来考察海洛因成瘾者的决策行为。在重复出前人已经发现的成瘾者折扣程度比正常人更大（成瘾者更偏好选择小而立即得到的奖赏，宁可舍弃将来的更大的奖赏，是一种短视的表现）的基础上，本研究提出三个问题，并设计实验解答。首先，在相比于时间折扣更为复杂的任务中，成瘾者是否会表现出短视的决策行为？我们设计了一个牌类游戏，游戏中考察被试是否会为了抢占某一轮的先手而不是全局的输赢，从而打出王牌。结果发现成瘾者打出王牌的时机显著早于正常被试，提示他们更在乎某一轮的胜负，而不是整个游戏的输赢。我们还发现牌类游戏中的成绩与折扣测验显著相关，提示成瘾者不仅在比较简单的折扣测验中表现出短视行为，在更为复杂的，日常生活化的任务中也会表现出短视。其次，本研究扩展了运用于成瘾被试的折扣测验的任务类型。在以往的成瘾实验中，研究中通常只采用延迟折扣获得任务，而在本研究中，我们还采用了延迟折扣损失任务，同时在获得与损失任务中，都包含了大小两种金额。研究发现，在各种决策条件下，海洛因成瘾者的决策成绩都要显著差于正常被试。但是，在大金额的条件下，两个组的成绩差距有所缩小，提示在大金额的决策条件下成瘾者的短视行为相对更弱，决策成绩有所提升。同时，研究还发现正常被试在损失上的折扣率比获得任务中更小，提示他们对损失具有明显的厌恶感（loss aversion），而海洛因成瘾者的折扣率在损失与获得中无明显差异，说明在实验过程中成瘾者更偏好选择延迟的损失，虽然损失的额度会比立即的损失更大。我们通过延迟折扣决策任务考察出了成瘾者对负性反馈、负性结果的不敏感这个成瘾的显著特征。再次，本研究考察了造成成瘾者决策短视的心理与药物机制。我们用Go/NoGo的方法发现成瘾者比正常被试具有更高的冲动性。此外，本研究首次设计了一个可以用于测量人类成瘾患者在有药物相关线索时所表现出的强迫性行为的测验。我们发现被试在面对药物相关线索时会表现出刻板的按键行为。对于这两种异常心理机制与决策的关系，我们发现冲动越高的被试，决策成绩相应越差；而强迫只与小金额的决策有负性相关的关系，并且相关效应偏弱。另外，为了解答先天易感性和后天用药对决策的影响，我们采用吸毒年限作为指标，发现吸毒年限长的被试在小金额的决策上成绩比吸毒年限段的被试更差，吸毒早的被试在小金额的决策上成绩要比吸毒晚的被试差，表明慢性用药的历史在特定条件下对决策具有作用。本研究的结果发现，海洛因成瘾者在决策时过于注重眼前的利益，他们更偏好选择立即的奖赏或延迟的损失；海洛因成瘾者对负性损失不敏感；海洛因成瘾者在抑制不该出现的行为存在障碍，特别是面对药物相关线索时。以上这些结果可以从决策的角度解释海洛因成瘾者反复发作的觅药与用药行为。
其他摘要	Addiction can be investigated from the perspective of decision making. Addicts usually make incorrect decisions when facing drug-related cues or they are driven to drugs, resulting in repeated drug seeking and taking. The present study adopted temporal discounting as behavioral task and on the basis of the fact that heroin addicts discounted more steeply than health participants (addicts preferred to choose immediate but smaller reward, regarded as myopia) which was consistent with previous research, three questions was raised and being concentrated on in this study. The first question was whether the character of myopia would be revealed in a somewhat complicated task? We designed a card game in which the participants were tested whether they would play the trump card in order to win a trick but not the whole game. Addicts played the trump card significantly earlier than controls did, indicating they focused on immediate single trick but not the game. Moreover, the performance in the card game and temporal discounting correlated significantly, suggesting addicts would display myopic decision not only in simply task like temporal discounting but also in task more complicated and similar to daily-life decision. Secondly, the present study adopted various kinds of temporal discounting tasks. In previous research, temporal discounting gain task was usually adopted. In the present study, we also adopted temporal discounting loss task. In either gain or loss task, there are two delayed amounts. Results showed in each decision condition addicts made poorer performance compared with control but in larger amount condition, addicts actually improved their decision performance. Meanwhile, addicts did not show loss aversion due to their close discount rates in gain and loss task while for controls, the discount rates were much lower in loss task than those in gain task. Thus we demonstrated that addicts were insensitive to negative outcomes by the method of temporal discounting. Finally, we investigated three mechanisms which exerted impacts on decision making. We adopted Go/NoGo task to test impulsivity and found addicts commits more errors (higher impulsivity) than controls did. We also designed a behavioral task which could be used to test drug-related compulsive behavior on human participants. Results showed addicts produced stereotyped key-pressing behavior when presented with drug-related cues. Furthermore, it was found participants with higher impulsivity displayed poorer performance in decision making but addicts with higher compulsivity only made poorer performance in smaller amount decision and the correlation between compulsivity and decision making was relative weak. In order to investigate the role of susceptibility and effect of drugs, we adopted years of abusing heroin as the indictor and discovered addicts with longer history of heroin abusing made poorer performance in smaller amount condition than addicts with shorter history. Also, the earlier the addicts began to use drug, the worse they would do in the smaller amount decision. The results here indicated drug itself could exert impact on decision making in certain condition. The present study revealed three characters of heroin addicts from the aspect of decision making: (1) focusing upon current benefit due to they preferred to choose immediate gain and delayed loss; (2) showed no loss aversion compared with healthy participants (3) inability to inhibit inappropriate response particularly when facing drug-related cue. These characters contribute to the facts that addicts seek and take drugs repeatedly while ignoring the negative consequences caused by abusing drugs.
关键词	时间折扣海洛因成瘾者短视冲动强迫吸毒年限损失厌恶
学位类型	硕士
语种	中文
学位授予单位	中国科学院心理研究所
学位授予地点	心理研究所
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/4776
专题	中国科学院心理研究所回溯数据库(1956-2010)
推荐引用方式 GB/T 7714	程九清. 海洛因成瘾者决策障碍及其行为机制的研究----短视行为及冲动、强迫和药物在决策中的作用[D]. 心理研究所. 中国科学院心理研究所,2009.

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