抑郁症的脑功能整合异常-来自有效连接的证据

摘 要：抑郁症是一种常见的精神障碍。从疾病负担看,目前抑郁症已经成为世界第四大疾病,患病人数呈逐年上升的态势,给家庭和社会带来了沉重的负担。以往大多数对抑郁症的研究关注的是单个脑区结构或功能的损伤,而抑郁症通常伴随多脑区、多系统的异常,而不是单一脑区的损伤。近年来研究者开始关注抑郁症多个脑区之间的功能整合。利用功能整合的方法,动态监测抑郁症多个脑区间的相互作用,能进一步揭示抑郁症的脑网络机制。功能整合的研究方法主要包括功能连接和有效连接。有效连接刻画的是两个（或多个）脑区之间相互作用的因果关系,主要包括结构方程模型、动态因果模型、Granger 因果分析、生理心理交互作用等方法。通过对新近研究的梳理,总体而言,抑郁症的认知控制系统(如背外侧前额叶)和边缘系统（如杏仁核）的之间的有效连接减弱,即背外侧前额叶对杏仁核的抑制作用减弱,使得杏仁核对负性刺激的反应增强,出现了情绪加工偏差和认知偏差。认知控制系统和边缘系统之间有效连接的减弱能够解释抑郁症执行认知控制任务和情绪任务中的异常表现。     

抑郁症患者的自传体记忆特征及其应用自传体记忆测验的元分析

研究目的在于探讨抑郁症患者自传体记忆的特征以及自传体记忆测验(the autobiographical memory test, AMT)在该领域的应用情况。通过文献检索, 搜集了18篇应用AMT作为测评工具的抑郁症自传体记忆研究, 抑郁症患者566人, 正常对照组457人。元分析研究发现, 和正常对照组比较, 抑郁症组的具体性记忆减少, 概括化记忆增多, 反应迟缓。目前对这种现象的解释主要有功能性回避模型、认知执行受损模型和沉思模型; 年龄、抑郁情绪以及AMT测试程序对测试结果有明显影响; 发表偏倚和敏感性分析显示存在发表偏倚, 但稳定性较好。AMT在抑郁症研究存在灵敏度不足等局限, 作者从AMT程序、研究设计等方面提出了改善建议。     

攻击行为社会信息加工模型与道德领域理论的整合

儿童攻击行为研究中Dodge等人提出的社会信息加工模型,强调社会交互作用情境下个体的信息加工过程与后来的社会行为之间的联系,对于信息加工所依据的数据库则缺乏系统的阐述。领域理论源于对道德认知的思考,将个体的社会知识分为道德、常规和个人三个领域,强调个体在领域认同标准和领域混合事件推理上的差异。Arsenio和Lemerise在情绪与社会信息加工模型整合的基础上,提出借鉴领域理论来说明数据库的内部结构以及其中的社会知识对于信息加工的影响。这些整合体现了认知和情绪在社会行为加工和决策过程中的交互作用,有利于说明存储在长时记忆中的社会知识之间的联系及作用,引发了对各种形式的内部心理成分的理论思考和多个实证研究方向,也为心理研究其他方面的整合工作提供了值得借鉴的研究思路     

记忆抑制在正常人群与抑郁人群中的研究进展

抑郁症认知障碍的突出表现之一为患者的负性记忆偏向。已有研究常关注患者对负性信息自下而上的选择性注意,往往忽略了自上而下执行控制障碍对记忆的影响。近年研究提示,抑郁症患者和抑郁状态个体的记忆抑制缺陷在其负性记忆偏向的形成和维持中起到了重要作用,无法有效地主动抑制负性记忆可能是患者持续性负性反刍的主要原因。从抑郁症自上而下的执行控制缺陷入手,研究患者的记忆抑制障碍与其主要症状－负性反刍间的相关性,不仅能从理论上丰富Beck的抑郁症认知模型,还能指导临床建立更准确的预后评估指标,同时制定更有效的治疗方案。本文分别介绍了健康成人及抑郁症患者和抑郁状态个体的记忆抑制研究现状,并就当前在抑郁人群研究领域亟待解决的三个问题进行了探讨。     

记忆活动中情绪调节的效果和认知神经机制

情绪对记忆的促进作用, 已得到了大量研究的证实。但是, 情绪对记忆的损害作用还没有得到一致的研究结果。情绪诱导的记忆损害的条件和机制还没有得到很好的确认和解释。并且, 在证实了情绪对记忆的影响之后, 一个更具有现实意义的问题是, 人类能够在多大程度上调控情绪对记忆的影响呢？虽然已有的情绪调节研究对一些重要的情绪调节策略如认知重评和抑制进行了较多的探讨, 考察了情绪调节对情绪事件记忆的影响。但是, 关于情绪调节是否可以有效地调整情绪唤醒对中性项目记忆的影响, 目前只有少量的研究。对情绪调节影响记忆的认知神经机制还所知甚少。因此, 本项目拟综合使用行为测量和认知神经科学技术, 在考察情绪唤醒对记忆的损害效应的条件和机制的基础上, 进一步探讨认知重评、抑制和忽视等情绪调节策略调控记忆中的情绪效应的有效性和认知神经机制。研究结果将会有助于对情绪、情绪调节和记忆的关系的理解, 并对促进学生的学习记忆活动有现实意义。     

空间知识记忆和提取的理论模型

对物理空间知识记忆和提取规律的探讨一直是空间认知领域研究中的一个重点和热点。对其进行深入研究,不仅有助于了解人类的空间行为,而且为相关的诸如界面设计、虚拟环境等空间认知应用领域（研究）提供支持。该文从空间记忆的内在参照系理论、坐标系统模型、空间情境模型和位置记忆的空间类属模型4个方面对当前有关物理环境中空间知识记忆和提取的理论或模型进行了回顾并作了初步评价。     

激活右腹外侧前额叶提高抑郁症患者对社会疼痛的情绪调节能力：一项TMS研究

负性人际交往经历和负性社会事件是抑郁症的重要诱导因素, 而社会功能受损是抑郁症患者的重要特征之一, 患者通常表现出对社会疼痛的情绪失调。为了提高抑郁症患者在负性社交情境中或面对负性社会事件时的情绪调节能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在腹外侧前额叶(the ventrolateral prefrontal cortex, VLPFC)被激活后其情绪调节能力的改变。结果表明, 当右侧VLPFC被TMS激活且患者采用认知重评策略调节情绪时, 实验组患者(n = 64)比对照组患者(n = 63)在社会排斥情境下报告了更弱的负性情绪体验, 这说明激活右侧VLPFC可以有效提高患者对社会疼痛的外显性情绪调节能力。本研究是采用TMS提高抑郁症患者情绪调节能力的首次尝试, 实验发现不但支持了VLPFC与认知重评策略的因果关系, 还为临床改善抑郁症等社会功能障碍患者的情绪调节能力提供了明确的神经治疗靶点。后续研究还需探讨多疗程TMS刺激方案、改变社会疼痛的诱发方式、对比左右侧VLPFC的治疗效果、尝试使用其他的情绪调节策略, 进一步验证本研究的结论, 优化TMS治疗方案。     

知情交互作用的实证研究现状与展望

知情交互作用(the interaction of cognition-emotion)是指认知与情绪之间相互作用,相互影响,二者密不可分.当前,知情交互作用的研究主要涉及两个方面:一是认知对情绪的影响,即认知对情绪的产生和情绪调节的影响;二是情绪对认知的影响,即情绪对感知觉、记忆和思维的影响.本文从实证角度,综合相关文献选取各自领域具有代表性的最新研究成果进行了概要述评,并进一步指出未来的研究应该在无意识情绪的脑机制、情绪-想象的交互作用、情绪-语言的交互作用,以及知-情-行的整合等方面进一步探讨.     

群体面孔情绪的整体编码及其影响因素

当面孔以群体形式出现,认知神经系统会自动整合情绪信息提取平均情绪,此过程被称为群体面孔情绪的整体编码。探讨其与低水平整体表征的分离,与个体表征的关系及神经活动特点是揭示其加工机制的关键,但目前尚未形成系统性模型。未来应综合利用眼动、神经电生理和脑成像技术,结合注意、记忆及社会线索进一步拓展对其认知神经机制和影响因素的研究,同时关注具有认知情感障碍的特殊人群,并从毕生发展的角度探索其发展轨迹。     

一种认知分析心理治疗模式对抑郁症患者的干预

为了探索基于"自我"与感受、需要、能力和角色交互相整合的认知分析心理治疗模式及其在抑郁症患者治疗中的效果,对7例门诊和8例住院抑郁症患者进行心理治疗,采用HAMD和CGI-GI评估治疗的效果,并追踪治疗1年后患者的社会功能及健康状况。所有患者治疗前后HAMD分值差异显著,配对t=8.08(P0.01),门诊与住院治疗患者HAMD分值和CGI-GI分值均无明显差异(P0.05),但产生治疗有效的平均时间差异显著,住院者(11.6±3.6)天,门诊者(60.6±25.0)天(P0.01)。该心理治疗模型能够整合到抑郁症患者的药物治疗中,产生整体治疗效果。     

Neuroimaging as a New Tool in the Toolbox of Psychological Science

ABSTRACT— During the past quarter century, advances in imaging technology have helped transform scientific fields. As important as the data made available by these new technologies have been, equally important have been the guides provided by existing theories and the converging evidence provided by other methodologies. The field of psychological science is no exception. Neuroimaging is an important new tool in the toolbox of psychological science, but it is most productive when its use is guided by psychological theories and complemented by converging methodologies including (but not limited to) lesion, electrophysiological, computational, and behavioral studies. Based on this approach, the articles in this special issue specify neural mechanisms involved in perception, attention, categorization, memory, recognition, attitudes, social cognition, language, motor coordination, emotional regulation, executive function, decision making, and depression. Understanding the contributions of individual and functionally connected brain regions to these processes benefits psychological theory by suggesting functional representations and processes, constraining these processes, producing means of falsifying hypotheses, and generating new hypotheses. From this work, a view is emerging in which psychological processes represent emergent properties of a widely distributed set of component processes.     

A single bout of resistance exercise can enhance episodic memory performance

Acute aerobic exercise can be beneficial to episodic memory. This benefit may occur because exercise produces a similar physiological response as physical stressors. When administered during consolidation, acute stress, both physical and psychological, consistently enhances episodic memory, particularly memory for emotional materials. Here we investigated whether a single bout of resistance exercise performed during consolidation can produce episodic memory benefits 48 h later. We used a one-leg knee extension/flexion task for the resistance exercise. To assess the physiological response to the exercise, we measured salivary alpha amylase (a biomarker of central norepinephrine), heart rate, and blood pressure. To test emotional episodic memory, we used a remember-know recognition memory paradigm with equal numbers of positive, negative, and neutral IAPS images as stimuli. The group that performed the exercise, the active group, had higher overall recognition accuracy than the group that did not exercise, the passive group. We found a robust effect of valence across groups, with better performance on emotional items as compared to neutral items and no difference between positive and negative items. This effect changed based on the physiological response to the exercise. Within the active group, participants with a high physiological response to the exercise were impaired for neutral items as compared to participants with a low physiological response to the exercise. Our results demonstrate that a single bout of resistance exercise performed during consolidation can enhance episodic memory and that the effect of valence on memory depends on the physiological response to the exercise.     

Memory bias for emotional facial expressions in major depression

Sixteen clinically depressed patients and sixteen healthy controls were presented with a set of emotional facial expressions and were asked to identify the emotion portrayed by each face. They, were subsequently given a recognition memory test for these faces. There was no difference between the groups in terms of their ability to identify emotion between from faces. All participants identified emotional expressions more accurately than neutral expressions, with happy expressions being identified most accurately. During the recognition memory phase the depressed patients demonstrated superior memory for sad expressions, and inferior memory for happy expressions, relative to neutral expressions. Conversely, the controls demonstrated superior memory for happy expressions, and inferior memory for sad expressions, relative to neutral expressions. These results are discussed in terms of the cognitive model of depression proposed by Williams, Watts, MacLeod, and Mathews (1997).     

Recalling positive self-defining memories in depression: The impact of processing mode

Recalling positive memories is a powerful and effective way to improve mood. However, unlike never-depressed individuals, those with current or past depression do not benefit emotionally from positive memory recall. To examine whether rumination is involved in this difficulty, 80 participants (26 currently depressed, 29 recovered depressed, and 25 never depressed) were instructed to recall a positive self-defining memory while in a sad mood. They were then instructed to think about their memory, adopting either an abstract or concrete processing mode. Never-depressed and recovered depressed participants experienced improved mood after memory recall, regardless of processing mode. However, for depressed individuals neither an abstract nor a concrete processing mode produced emotional benefit. These findings suggest that a complex relationship exists among processing mode, memory type, and depressive status, and indicate that the way in which individuals process positive emotional material may have important consequences for treatment.     

The influence of stress hormones on emotional memory: relevance for psychopathology

Substantial progress within recent years has led to a better understanding of the impact of stress on emotional memory. These effects are of relevance for understanding and treating psychopathology. The present selective review describes how emotional memory is modulated through stress hormones. Acute as well as chronic effects are discussed and information from rodent models is compared to human experimental studies and clinical observations. Finally, the relevance of these findings for emotional memory disturbances in psychiatric disorders is exemplified by discussions on neuroendocrine alterations in depression, post traumatic stress disorder and phobias.     

Cognitive avoidance of intrusive memories: recall vantage perspective and associations with depression

Although recent research demonstrates that intrusive memories represent an overlapping cognitive feature of depression and post-traumatic stress disorder (PTSD), there is still a general paucity of research investigating the prevalence and maintenance of intrusive memories in depression. The current study investigated the association between a range of cognitive avoidant mechanisms that characterize PTSD samples (i.e., suppression, rumination, emotional detachment, and an observer vantage perspective) and intrusive memories of negative autobiographical events in relation to dysphoria. Hypotheses were based on the proposition that employment of these cognitive mechanisms would hinder the emotional processing of the negative event, thus contributing to the maintenance of intrusions. Results supported an association between negative intrusive memories, dysphoria, and avoidant mechanisms. Significant differences were also found between field and observer memories and measures of emotional detachment and rumination. Implications relating to intrusive memory maintenance and treatment approaches are discussed.     

A test of the CaR-FA-X mechanisms and depression in adolescents

ABSTRACT

People who have depression have difficulty recalling specific autobiographical information (Sumner, (2011) The mechanisms underlying overgeneral autobiographical memory: An evaluative review of evidence for the Ca R-FA-X model. Clinical Psychology Review, 3231(1), 34–48). This is called overgeneral autobiographical memory (OGM) and is associated with the development and persistence of depression. Williams, Barnhofer, Crane, Hermans, Raes, Watkins, & Dalgleish (2007 Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133(1), 122–148) proposed that OGM is maintained by three mechanisms: capture and rumination (CaR), functional avoidance (FA), and impaired executive control (X), and integrated these into the CaR-FA-X model. The aim of this study was to assess OGM and test the CaR-FA-X model in adolescents with low mood. We recruited 29 young people aged 12–17 with elevated symptoms of depression and 29 with minimal symptoms of depression, matched for gender and age. After controlling for IQ, adolescents with elevated depression retrieved fewer specific memories, ruminated more, and had poorer working memory and verbal fluency than adolescents with minimal depression. The groups did not differ on measures of inhibition or functional avoidance. The CaR-FA-X model was therefore partially supported. These results confirm that there is a relationship between low mood and OGM in young people and that OGM may arise as consequence of impaired working memory and verbal fluency and cognitive interference due to rumination.     

The Neuropsychology of Depression: A Literature Review and Preliminary Model

Neuropsychological research provides a useful framework to study emotional problems, such as depression, and their correlates. This paper reviews several prominent neuropsychological theories. Functional neuroanatomical systems of emotion and depression are reviewed, including those that describe cerebral asymmetries in emotional processing. Following the review, a model that is composed of three neuroanatomical divisions (left frontal, right frontal, and right posterior) and corresponding neuropsychological emotional sequelae within each quadrant is presented. It is proposed that dysfunction in any of these quadrants could lead to symptomatology consistent with a diagnosis of depression. The proposed model combines theories of arousal, lateralization, and functional cerebral space and lends itself to scientific methods of investigation. Accordingly, research, prevention, and treatment programs in accordance with the proposed model may promote an improved understanding of the neuropsychological mechanisms involved in depression.     

Cognitive and Emotional Abnormalities in Systemic Lupus Erythematosus: Evidence for Amygdala Dysfunction

Systemic lupus erythematosus (SLE) is a multi-system autoimmune disorder characterized by the production of autoantibodies. Approximately 30-50?% of patients produce autoantibodies directed against N-Methyl-D-aspartic acid receptors (NMDARs). Once they have gained access to brain tissue, these autoantibodies bind to the NR2A subunit of the NMDARs and synergize with glutamate to cause excitatory, non-inflammatory cell death or alter neuron function. Both humans with SLE and animal models of SLE have shown structural and functional damage to the amygdala. The amygdala is a brain region important for processing the emotional relevance of stimuli in the environment. It also serves to modulate perception, attention, and memory to facilitate the processing and learning of relevant stimuli. Research has linked amygdala damage to deficits in emotional memory and emotional behavior. Individuals with SLE often exhibit emotional dysregulation, such as lability and depression; however, the behavioral impact of possible amygdala dysfunction has yet to be studied in this population. The purpose of this review is to 1) examine possible associations between SLE, anti-NMDAR antibodies, amygdala damage, and emotional processing deficits and 2) to identify the clinical, social, and treatment implications for individuals with SLE who suffer from deficits in emotional processing.