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精神分裂症患者目标相关未来情景想象的缺损与干预研究
其他题名Deficits in Goal-related Episodic Future Thinking and Intervention Study in Patients with Schizophrenia
刘佳丽
导师王亚
2024-06
摘要

在日常生活中,我们经常会想象未来可能发生的事情,这一过程即是未来情景想象。未来情景想象是指想象或模拟未来可能发生的事件的能力,具有许多重要的功能,并与个人目标密切相关。研究发现,精神分裂症患者在未来情景想象中存在缺损,想象的具体未来事件和细节数量比健康对照组更少。未来情景想象依赖于多个心理过程和多处脑区的活动,其中默认网络在未来情景想象中起着重要作用。但较少研究探讨精神分裂症患者个人目标相关的未来情景想象缺损及相关的神经基础。另外,目前有多种改善未来情景想象能力的干预方法,但较少考虑个人目标的作用。最好可能自我是个人目标的一种表现形式,结合最好可能自我的未来情景想象干预涉及未来情景想象的多个心理过程,可更好地改善未来情景想象能力。因此,本论文探究精神分裂症患者个人目标相关未来情景想象能力,并试图通过基于最好可能自我的未来情景想象训练改善患者未来情景想象能力,增加积极情绪并缓解其临床症状。同时采用功能磁共振技术探明精神分裂症患者未来情景想象能力缺损以及干预后未来情景想象能力提高的神经基础。共包括两个研究。

研究一采用不同目标类型的未来情景想象和未来目标流畅性等任务进行测试,探究精神分裂症患者目标相关的未来想象功能,并通过静息态功能磁共振成像方法探究神经基础。研究共计纳入 64 名精神分裂症患者以及 40 名健康对照。结果发现,精神分裂症患者的未来情景想象客观的具体性更低,但生动性、场景 细节、经历感和情绪效价等主观评分异常升高;此外,患者想象未来目标的流畅性更低。在神经基础方面,患者默认网络的关键节点的功能连接既有异常增强,也有异常减弱;而且前内侧前额叶和左侧小脑 CrusI 区功能连接的异常增强与未来情景想象更低的具体性总分相关。上述结果说明,精神分裂症患者未来情景想象能力受损,其背后的神经基础可能是前内侧前额叶异常的功能连接。

研究二使用基于最好可能自我的未来想象干预对精神分裂症患者进行为期四周的干预,通过干预前后测量不同目标类型的未来情景想象和目标流畅性任务考察干预的效果,并采用干预前后进行静息态功能磁共振成像探究其神经基础。研究共计纳入 29 名干预组和 31 名对照组精神分裂症患者。结果发现,预显著 提升了患者未来情景想象的具体性以及想象未来目标的流畅性;而且颞顶联合区和左侧额极功能连接的增强与未来情景想象具体性总分的提升相关。上述结果说明,干预能够提升精神分裂症患者的未来情景想象能力,其背后的神经基础可能是与细节表征密切相关的颞顶联合区的功能连接增强。

综上所述,本研究对精神分裂症患者未来情景想象能力的行为表现、神经基础和干预进行了系统地探究,初步揭示了精神分裂症未来情景想象能力缺损的神经基础,并说明了干预提升其未来情景想象能力的可行性和有效性,为今后患者中的临床应用提供了理论和实证基础。

其他摘要

In daily life, people often engage in the process of imagining possible future events, which is referred to as episodic future thinking (EFT). EFT involves the ability to imagine or simulate events that may occur in the future, serving many important functions and being closely related to personal goals. Previous studies have found that patients with schizophrenia show deficits in EFT, with fewer specific and detailed future events compared to healthy controls. EFT relies on multiple psychological processes and activity of various brain regions, with the default mode network playing a crucial role in EFT. However, there is limited research on deficits in EFT related to personal goals in individuals with schizophrenia and their neural basis. Additionally, while there are various interventions to improve EFT abilities, few studies consider the role of personal goals. The best possible self (BPS) may be a representation of personal goals, and EFT intervention based on BPS which consists multiple psychological processes of EFT could better improve EFT abilities. Therefore, we conducted two studies to investigate EFT abilities related to personal goals in patients with schizophrenia and to improve EFT abilities, increase positive emotions, and alleviate clinical symptoms of patients with schizophrenia through EFT intervention based on BPS. Additionally, resting-state magnetic resonance imaging was employed to explore the neural basis of EFT deficits in patients with schizophrenia and the improvement of EFT performance by intervention.

Study 1 examined EFT tasks with different goal types and future goal fluency to investigate goal-related EFT functions in patients with schizophrenia. The neural basis was examined with resting-state functional connectivity. A total of 64 patients with schizophrenia and 40 healthy controls were recruited in the study. The results showed that patients with schizophrenia exhibited lower EFT specificity, but higher subjective ratings in vividness, episodic details, sense of pre-experience, and positive emotional valence. Additionally, the future goal fluency was lower in patients. Regarding the neural basis, key nodes in the default mode network was found to show both hypo-connectivity and hypo-connectivity in patients with schizophrenia. Moreover, enhancement in functional connectivity between the anterior medial prefrontal cortex and the left cerebellar Crus I was correlated with lower EFT specificity. These findings indicated that EFT abilities were impaired in patients with schizophrenia, and the underlying neural basis may involve hyper-connectivity in the anterior medial prefrontal cortex.

Study 2 involved a four-week EFT intervention based on BPS to enhance EFT performance in patients with schizophrenia. The effects of the intervention were assessed by measuring EFT tasks with different goal types and future goal fluency before and after the treatment. Additionally, resting-state magnetic resonance imaging was conducted before and after the treatment to explore its neural basis. The study included 29 patients with schizophrenia in the intervention group and 31 patients in the control group. The results showed that the EFT intervention significantly improved the EFT specificity, and future goal fluency in patients with schizophrenia. Furthermore, significant functional connectivity increase was found between the temporal parietal junction and the frontal pole, and this functional connectivity increase was associated with the EFT specificity improvement in the intervention group. These findings indicated that the EFT intervention based on BPS could enhance EFT abilities in patients with schizophrenia, and the underlying neural basis might involve increased functional connectivity in the temporal parietal junction, which was closely related to detail representation.

In summary, these studies systematically investigated the behavioral performance, neural basis, and EFT intervention in patients with schizophrenia. The study preliminarily revealed the neural basis of deficits in EFT in patients with schizophrenia and demonstrated the feasibility and effectiveness of EFT intervention based on BPS in improving their EFT abilities. These findings provide a theoretical and empirical basis for clinical applications of EFT intervention for patients with schizophrenia.

关键词精神分裂症 未来情景想象 个人目标 神经基础 默认网络
学位类型硕士
语种中文
学位名称应用心理硕士
学位专业应用心理
学位授予单位中国科学院大学
学位授予地点中国科学院心理研究所
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/48140
专题认知与发展心理学研究室
推荐引用方式
GB/T 7714
刘佳丽. 精神分裂症患者目标相关未来情景想象的缺损与干预研究[D]. 中国科学院心理研究所. 中国科学院大学,2024.
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刘佳丽-专业硕士论文.pdf(3777KB)学位论文 限制开放CC BY-NC-SA请求全文
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