抑郁症情绪失调的动态特征:情绪动力学的视角

The dynamic features of emotion dysregulation in major depressive disorder:An emotion dynamics perspective

抑郁症在DSM-5中界定的核心特征是持久的情绪紊乱,如过度悲伤和急剧减少的愉悦情绪体验。近年来,情绪动力学强调:抑郁症临床人群的情绪失调不局限于较高的消极情绪平均强度和较低的积极情绪平均强度,还表现为异常的情绪动态模式。本综述系统地纳入18篇采用生态瞬时评估探究日常生活中抑郁症临床人群的情绪动态特征的文献,结果表明:1)相比于健康对照组,抑郁症患者消极情绪波动幅度更大,表现为更大的消极情绪变异性和消极情绪不稳定性。2)抑郁症患者的情绪系统僵化且缺乏灵活性,表现为更大的消极情绪惯性和更密集的情绪网络。3)抑郁症患者情绪反应性存在异常,表现为经历积极事件后的心境点亮效应,经历消极事件后更大的消极情绪反应性。4)患者情绪系统的复杂度下降,表现为更低的情绪分化水平。处于抑郁症缓解期的个体也表现出一定程度的情绪失调。本综述首次从情绪动力学的视角总结了抑郁症情绪失调的特征,这些情绪动态特征为抑郁症的个体化医疗和复发预防提供了潜在的、具有高生态效度的干预靶点。

The core feature of major depressive disorder,as defined in the DSM-5,is persistent emotional disturbances characterized by excessive sadness and drastically reduced pleasant emotional experiences.Recent research on emotion dynamics has emphasized that the emotion dysregulation in major depressive disorder goes beyond increased negative emotional intensity and decreased positive emotional intensity.It is also manifested as abnormal patterns of emotion dynamics.A total of 18 studies were included in this systematic review,which utilized ecological momentary assessment to explore everyday emotion dynamics in major depressive disorder.The key findings are as follows:(1)Patients with depression have greater negative emotion fluctuations compared with the healthy control group.These fluctuations were manifested as greater negative emotion variability and instability.(2)Depressed patients exhibit a rigid and inflexible emotional system,characterized by greater negative emotion inertia and denser emotion networks.(3)Depressed patients exhibit abnormalities in emotional reactivity.This is reflected as the mood brightening effect after positive events and greater negative emotion reactivity after negative events.(4)Patients with depression experience a decreased complexity in their emotional system.This is manifested as a lower level of emotion differentiation.Furthermore,patients with remitted depression also exhibit some degree of emotion dysregulation.This review is the first to comprehensively elucidate the primary features of emotion dysregulation in major depressive disorder from the perspective of emotion dynamics.These features provide potential intervention targets with high ecological validity for individualized treatment and relapse prevention of depression.