精神分裂症谱系的冷、热认知功能缺损研究

PSYCH OpenIR > 健康与遗传心理学研究室

	精神分裂症谱系的冷、热认知功能缺损研究
其他题名	Cool and hot cognitive function impairments across theschizophrenia spectrum disorders
	肖亚辉
	2016-05
摘要	精神分裂症是一种表现为心理功能异常和行为扰乱的大脑疾病，而药物治疗只能够缓解精神分裂症患者的症状，对患者已经受损的认知功能的恢复作用很微弱，导致精神分裂症患者的预后效果不理想。因此有研究者提出精神分裂症谱系的概念，从发展的角度看待精神分裂症，试图通过对精神分裂症进行早期识别和干预，减少疾病带来的认知损伤，从而延缓甚至阻止疾病的进程。精神分裂谱系中包括高危时期的个体（社会快感缺失个体），超高危时期的个体，首发精神分裂症患者和慢性精神分裂症患者。认知功能缺损是精神分裂症的核心特点，而认知功能又可以分为冷认知功能和热认知功能。冷认知功能是指与情绪独立的认知功能，比如记忆和注意；热认知功能指与情绪相关的功能，比如奖惩，情绪加工和决策。因此，从精神分裂症谱系的角度同时探讨不同阶段，特别是疾病的早期的个体在冷、热认知功能上的缺损情况，一方面补充精神分裂症谱系上各个阶段冷、热认知缺损的理论知识，另外一方面它可以为制定有针对性的早期干预和治疗提供重要的参考依据，具有重要的临床意义。本研究主要是想探讨精神分裂症谱系中慢性精神分裂症患者（研究一）、首发精神分裂症患者（研究二）和社会快感缺失个体（研究三）在冷认知(逻辑记忆和视觉记忆、工作记忆、持续性注意和执行功能)和热认知(情绪体验、情绪知觉和情绪表达)上的表现。研究一招募了34名慢性精神分裂症患者和33名健康对照组，结果表明在冷认知上，慢性精神分裂症患者在逻辑记忆和视觉记忆，工作记忆和持续性注意上均表现出显著的缺损，但是在自我报告的执行功能上没有缺损；在热认知上，慢性精神分裂症患者在愉快情绪体验上存在缺损，但是在情绪知觉和情绪表达上没有表现出缺损。研究二招募了首发精神分裂症患者和健康对照组各40名，结果表明在冷认知上，首发精神分裂症患者在逻辑记忆和视觉记忆，工作记忆，持续性注意和执行功能上均有损伤；在热认知上，首发精神分裂症患者在与愉快情绪体验上有缺损，但是在情绪知觉和情绪表达上没有缺损。研究三招募了37名社会快感缺失个体和38名健康对照组，结果表明在冷认知上，社会快感缺失个体在逻辑记忆和视觉记忆，工作记忆和持续性注意上并没有变现出明显的缺损，但是却在自我报告的执行功能上表现出严重的缺损；在热认知上，社会快感缺失在愉快情绪体验和情绪表达上均有缺损，但是在情绪知觉上没有缺损。总体来说,慢性精神分裂症患者和首发精神分裂症患者存在显著缺损,社会快感缺失个体只在自我报告的执行功能上表现出缺损;慢性精神分裂症患者,首发精神分裂症患者和社会快感缺失个体在在愉快情绪体验上均存在缺损,但是只有社会快感缺失个体在情绪表达上自我报告出缺损,三组在情绪知觉上均没有表现出缺损。从谱系的角度来看，冷认知的缺损在慢性和首发精神病人中的缺损比较严重，但是在社会快感缺失个体中的缺损不是很明显，而热认知中的愉快情绪体验却稳定地存在于三组被试中，表明冷认知和热认知在精神分裂症谱系中的缺损是分离的，而热认知的缺损在高危时期就已经表现出来，提示相比于传统的冷认知功能，热认知特别是愉快情绪体验可能是精神分裂症谱系中早期识别更加敏感的指标。
其他摘要	Schizophrenia is a brain disease characterized by a wide range impairments in cognitive, emotional and psychosocial functions. Recent findings suggest that pharmacological intervention could only alleviate positive symptoms of patients withschizophrenia,but have a very weak impact on recovery of impaired cognitive and emotional functions, leading to an unsatisfied recovery of the illness. Therefore, the concept of schizophrenia spectrum is proposed, which considers schizophrenia disease as a neurodevelopmental mental disorder, hoping to delay, or even prevent the aggravating of the disease by early-stage diagnosis and intervention. Impairments in cognitive function arecore featuresof patients with schizophrenia. Cognitive function, on the other hand,canbe divided in to cool cognitive function and hot cognitive function. The cool cognitive function refers to cognitive functions that are mechanistic and independent of emotion, such as memory and intention, whereasthe hot cognitive function refers to cognitive functionsthat are related to emotion, such as reward and punishment, emotion processing, and decision-making. Therefore, investigating the cool and hot cognitive function impairments across the schizophrenia spectrum disorders, especially the earlystage of the illnessis important to the understanding ofcognitive function impairments and its relationship to schizophrenia spectrum disorders. The present study aimed to examinethe performancesof cool cognitive functions(including logical memory, visual memory, working memory, sustained attention, and executive function) and hot cognitive functions(including hedonic experience, emotion perception, and emotion expressivity) in patients with chronic schizophrenia (study 1), patients withfirst-episode schizophrenia (study 2) and individuals with social anhedonia (study 3). Study 1recruited 34 patients with chronic schizophrenia and matched 33 healthy controls. The findings showed that, for cool cognitive functions, patients with chronic schizophreniahad significant impairments in logical memory, visual memory, working memory and sustained attention, but did not show any impairments in self-reported executive function; for hot cognitive function, they showed significant impairments in hedonic experience, but not in emotion perception and emotion expressivity. Study 2recruited 40 patients with first-episode schizophrenia and 40 healthy controls. The findings showed that patients with first-episode schizophrenia demonstrated obvious deficits across allthe selected domains of cool cognitive function, but only showed deficit in hedonic experience in hot cognitive function. Study 3recruited 37 individuals with social anhedonia and 38 healthy controls. The findings showed that no significant impairments were found in logical memory, visual memory, working memory and sustained attention in social anhedonia individuals, however, they reported significant impairment in executive function in cool cognitive function, for hot cognitive function, only impaired hedonic experience and emotion expressivity were identified in individuals with social anhedonia. Taken together, the present findingsdemonstrated that patients with chronic and first-episode schizophrenia showed significant impairments in cool cognitive functions, especially in logical memory, visual memory, working memory and sustained attention. However, individuals with social anhedonia only reported impairments in executive functions. However, the impairmentsin hot cognitive function were demonstrated in differentstages of the illness. The results indicate thatthere wasadissociation between cool and hot cognitive functionsacross the spectrum of schizophrenia. Compared to cool cognitive function impairments, hot cognitive function impairmentswere already presencein individuals withsocial anhedonia, a stage much earlier to the onset of schizophrenia. Therefore, the hot cognitive function, especially hedonic experience,maybe an importantmarker for the early-stage diagnosis of schizophrenia.
学科领域	专业神经生物学
关键词	精神分裂症谱系障碍疾病进程冷认知功能热认知功能社会快感缺失
学位类型	硕士
语种	中文
学位专业	心理学
学位授予单位	中国科学院研究生院
学位授予地点	北京
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/19874
专题	健康与遗传心理学研究室
作者单位	中国科学院心理研究所
推荐引用方式 GB/T 7714	肖亚辉. 精神分裂症谱系的冷、热认知功能缺损研究[D]. 北京. 中国科学院研究生院,2016.

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