高自杀意念与低自杀意念重性抑郁障碍患者情绪冲突及认知融合差异

Differences in emotional conflict and cognitive fusion among patients with major depressive disorder with high and low suicidal ideation

目的:探讨高自杀意念抑郁症患者与低自杀意念抑郁症患者的情绪冲突效应及认知融合差异。方法:采用贝克自杀意念量表中文版(Beck scale for suicide ideation-Chinese version,BSI-CV)、17项汉密尔顿抑郁量表(Hamilton depression scale-17,HAMD-17)、贝克抑郁自评量表(Beck depression inventory,BDI)、认知融合问卷(cognitive fusion questionnaire,CFQ)进行测评,应用2×2×2词-面孔Stroop任务混合试验设计,使用两因素重复测量方差分析比较高自杀意念抑郁症患者( n=22)和低自杀意念抑郁症患者( n=22)完成情绪面孔判断任务的反应时和正确率。以两组被试( n=44)的BSI-CV得分为因变量,高兴面孔的反应时、愤怒面孔的反应时、面孔词一致的反应时、面孔词不一致的反应时、BDI得分和CFQ得分为自变量,进行多元线性逐步回归分析。 结果:高自杀意念和低自杀意念抑郁症患者在词-面孔Stroop任务下都会产生情绪冲突效应,即相对于面孔词不一致条件,抑郁症患者在面孔词一致条件下的反应时更短[(707.19±128.79) ms, (793.55±148.33)ms, F(1,41)=11.38, P<0.01, ηp2=0.217]、正确率更高[(95.85±4.50)%,(84.77±11.54)%, F(1,41)=6.06, P<0.05, ηp2=0.129]。面孔词一致条件下,高自杀意念抑郁症患者反应时长于低自杀意念抑郁症患者[(803.69±91.35) ms, (610.69±78.13)ms, P<0.01]。面孔的表情类型主效应不显著,即高自杀意念与低自杀意念抑郁症患者未对高兴面孔或愤怒面孔表现出注意偏向[ F(1,41)=0.68, P=0.413, ηp2=0.016]。回归分析结果显示,抑郁得分、认知融合得分、面孔词不一致的反应时正向预测BSI-CV得分( β=0.40、0.29、0.29,均 P<0.05)。 结论:高自杀意念抑郁症患者较低自杀意念抑郁症患者的认知融合程度有差异,情绪识别无差异;面孔词不一致的反应时、认知融合得分和抑郁得分对自杀意念得分有正向预测作用。

Objective To compare the differences of emotional conflict and cognitive fusion between depression patients with high and low suicidal ideation.Methods Beck scale for suicide ideation-Chinese version(BSI-CV),Hamilton depression scale-17(HAMD-17),Beck depression inventory(BDI)and cognitive fusion questionnaire(CFQ)were used for evaluation.The 2×2×2 word-face Stroop task hybrid experimental design was used to compare the response time and accuracy of emotional face judgment in patients with depression with high suicidal ideation(n=22)and patients with depression with low suicidal ideation(n=22)using two-factor repeated measure ANOVA.BSI-CV scores of the two groups(n=44)were used as the dependent variable,and the reaction time of happy face,angry face,consistent face,inconsistent face,BDI score and CFQ score were used as independent variables to perform multiple linear stepwise regression analysis.Results Both high and low suicidal ideation depression patients had emotional conflict effect in the word-face Stroop task,that was,compared with the face word inconsistent condition,the participants in the face word consistent condition had shorter response time((707.19±128.79)ms vs(793.55±148.33)ms,F(1,41)=11.38,P<0.01,ηp2=0.217)and higher accuracy(95.85±4.50)%,(84.77±11.54)%,(F(1,41)=6.06,P<0.05,ηp2=0.129).Under the condition of consistent face words,the response time of depression patients with high suicidal ideation was longer than that of depression patients with low suicidal ideation((803.69±91.35)ms,(610.69±78.13)ms,P<0.01).The main effect of facial expression type was not statistically significant between the two groups,that was,depression patients with high and low suicidal ideation did not show attentional bias to happy faces or angry faces(F(1,41)=0.68,P=0.413,ηp2=0.016).Regression analysis results showed depression score,cognitive fusion score,and reaction time of inconsistent face had positively predictive effects on BSI-CV score(β=0.40,0.29,0.29,all P<0.05).Conclusion The cognitive fusion degree of the depression patients with high suicidal ideation is different from that of the depression patients with low suicidal ideation,but there is no difference in the emotion recognition.Reaction time of inconsistent face,cognitive fusion score and depression score have positively predictive effects on suicidal ideation.