抑郁症患者对情绪面孔的定向遗忘效应

Directed forgetting of emotional faces in patients with depression

目的:对比分析抑郁症患者与正常人对情绪面孔的定向遗忘效应,探究抑郁症患者存在认知偏差的原因是否与定向遗忘的能力有关。方法:选取符合疾病和有关健康问题的国际统计分类第十次修订本(ICD-10)抑郁症诊断标准、汉密顿抑郁量表(HAMD)评估抑郁症状轻至中度的患者35例,选取年龄、受教育程度与之相匹配的健康对照33例。采用项目法定向遗忘范式,以情绪面孔(愉悦、平静、悲伤)作为刺激材料,比较两组在面孔再认成绩上的差异。要求记住项目(TBR)的再认成绩高于要求忘记项目(TBF)的再认成绩即出现了定向遗忘效应。结果:项目类型和组别的主效应有统计学意义(均P<0.05),项目类型×情绪的交互效应有统计学意义(P<0.001),两组对愉悦面孔的TBR和TBF再认数差异有统计学意义(P<0.001)。项目类型×组别的简单效应分析显示:两组被试的定向遗忘效应不同,对照组对TBR的再认数高于TBF再认数[(10.1±2.3)vs.(8.7±2.2),P<0.01],而抑郁组的TBR与TBF的再认成绩间差异无统计学意义[(8.0±2.7)vs.(7.7±2.9),P>0.05]。抑郁组对悲伤面孔的TBR再认反而低于TBF[(2.1±1.3)vs.(3.1±1.6),P<0.05]。结论:抑郁症患者总体上并未出现明显的定向遗忘效应,对悲伤面孔的再认出现了压抑后的反弹效应。不能及时有效的遗忘负性材料可能是抑郁症患者存在负性认知的原因之一。

Objective： To explore the directed forgetting（DF） effect on emotional faces in depressive patients, then to invoke more about the relation between the ability of forgetting and their cognitive prejudice. Methods： The diagnoses were made according to International Statistical Classification of Diseases and Related Health Problem, Tenth Revision（ICD-10） criteria. Totally 35 hospitalized depression patients with mild to moderate depression and 33 normal controls were enrolled in the study. The Hamilton depression Scale （HAMD） was used to assess the severity of depression. The DF paradigm was used and emotional （happy, neutral, and sad） faces as stimulus material to compare the difference of the DF effect between the two groups. If recognition of TBF was worse than TBR, then DF effect was appeared. Results： There was a significantly differences in item type and group （Ps 〈 0. 05）, the interaction effect of item type ×emotion were statistically significant （P 〈 0. 001）, the TBR and TBF＇s recognitionof happy faces was statistically significant in the two groups（P 〈 0. 001）. Separate analyses of item type × group showed that, the DF effect in the two groups was different, the control group recognized more TBR than TBF [（10. 1 ±2. 3） vs. （8. 7 ±2. 2）, P 〈0. 01], but there was no significant difference in the depression group [ （8.0 ±2.7）vs. （7.7 ± 2. 9）, P 〉 0. 05 ]. However, depressive patients recognition scores of TBF were lower than TBR on the sad faces[ （2. 1 ± 1.3） vs. （3.1 ± 1.6）, P 〈 0.05]. Conclusion： It suggests that there be no directed forgetting effect in depressive patients, but may be post-suppression rebound effects on the sad faces. Negative information could not be timely and effectively forgotten may be one of the reasons to explain the bias of cognition in depressive people.