舞动治疗：一种自下而上的精神分裂症干预探索

皮层-基底节-丘脑网络与脑岛网络属于感觉运动相关网络, 这两个网络的改变可能是导致精神分裂症的重要原因。目前主流研究与临床干预聚焦于患者的高级脑区异常, 对感觉运动系统的关注不足。对健康个体的研究发现舞蹈训练对感觉运动相关脑网络具有显著提升作用, 并自下而上地促进高级功能。以上研究提示舞蹈训练可能是干预精神分裂症、改善患者认知功能的新途径。本研究拟借助多模态磁共振成像技术, 以精神分裂症感觉运动相关网络为着力点, 通过分析精神分裂症患者在舞蹈训练前后的脑影像、临床症状及认知行为的改变, 揭示舞蹈训练临床干预的神经机制。     

疼痛恐惧的形成及其对疼痛知觉的影响

脑岛、杏仁核是疼痛恐惧形成的重要神经网络中心。疼痛恐惧增强了慢性疼痛患者的疼痛知觉体验, 进而加剧抑郁、焦虑情绪和功能损伤程度。脑岛、杏仁核、前额皮层和前扣带回是疼痛恐惧影响疼痛知觉的重要神经基础。通过认知方法干预疼痛恐惧可以改善患者的抑郁、焦虑情绪, 减少功能损伤。未来研究应拓展疼痛恐惧的测量工具, 采用功能磁共振成像技术进一步揭示疼痛恐惧影响慢性疼痛患者疼痛知觉的神经机制。     

赌博游戏中的near-miss效应

near-miss效应是指在赌博中, 与一般的输钱和赢钱相比, “几乎赢(near-miss)”的输钱会诱发个体更高的生理唤醒和更强的赌博动机, 从而导致个体持续赌博的一种现象, 是导致赌博成瘾的主要诱因之一。针对这种现象的研究范式大致有三种：老虎机/类老虎机任务、轮盘任务和刮刮乐彩票任务。这种现象的理论解释目前主要有认知曲解假说、控制幻觉理论和受挫假说。near-miss效应的脑机制和病理研究才刚刚起步, 所涉及到的脑功能区域主要包括脑岛、腹侧纹状体等。未来的研究应在near-miss效应发生机制的理论模型建构、研究范式多样化、研究技术多模态化、病理机制和临床干预等方面进一步展开。     

抑郁症的脑结构与功能异常:来自静息态下多模态脑影像的研究证据

传统单一模态、单一分析方法在揭示抑郁症脑机制上存在较多局限;而新近多种模态、多种分析方法的结合可在一定程度上较好地促进对抑郁症脑功能和结构的全面探索、挖掘,可以更加有效地运用和实施于早期辅助诊断、干预治疗当中。因此,本文首先简要介绍了多种模态下的脑影像指标及其分析技术,而后分别从结构及功能神经影像数据融合等方面,概述了抑郁症脑结构和功能的研究现状,发现抑郁症患者存在诸多脑区及相关环路结构及功能的异常。同时,通过对抑郁症多模态研究现状的梳理和总结,结合我们已有的相关前期研究工作,对未来抑郁症等情感障碍的进一步研究工作提出了一些思考和展望。     

网络成瘾病理心理机制及综合心理干预研究

针对中国青少年网络成瘾问题,综合运用心理测评、深度访谈、脑事件相关电位、心率变异性等多层面的心理学研究方法,系统、深入研究网络问题的成因、病理心理机制、评估方法及心理干预方法等多项课题。依据得到的人群调查数据、网络成瘾者的心理测量结果、脑电与心电的生理心理学数据,同时结合临床干预疗效评估,提出研究结论：（1）使用谱系概念对中国青少年网络使用问题进行分型,并制定分型标准与评估方法;（2）从青少年心理发展角度分析了网络成瘾的形成原因,提出“失补偿”假说揭示网络成瘾形成过程;（3）提出“注意功能易化机制”从脑功能水平揭示网络“成瘾”病理心理机制;（4）制定“系统补偿综合心理干预”方案,包括团体、家庭、个体及家长干预等多项心理治疗方案,在临床研究中取得了良好实效     

聋人早期手语经验对脑功能及结构的塑造作用

语言经验对脑功能和结构发展有重要的塑造作用。然而, 目前的相关证据主要来自对脑损伤导致的失语症病人的语言康复、第二语言学习以及针对成人读者进行的语言训练等方面的研究。幼儿时期的早期语言经验对脑结构与功能发展的影响更加重要, 但直接的研究证据却相当缺乏。本文提出一个研究设想, 拟综合使用多种脑成像技术, 系统探讨有早期手语经验和无早期手语经验的聋人个体在脑皮层语言功能的组织及脑结构发育的差异, 包括语言任务中大脑语言区的激活模式, 静息状态下脑功能联结的默认网络特征, 脑皮层灰质密度, 以及神经纤维束发育状况等, 揭示早期语言经验对大脑功能和结构发育的塑造作用。     

内疚的认知和情绪活动及其脑区调控

内疚是个体做出危害他人的行为或违反道德准则之后产生的良心上的反省, 对行为负有责任的一种负性体验。内疚在道德规范和人际社会中具有重要的作用。研究者主要采取自我报告范式、情境模拟范式、过失范式和经济博弈范式考察内疚的发生发展及其功能。近年来, 研究者尝试揭示内疚脑机制, 研究发现内疚主要激活前额叶皮层和脑岛等脑区, 前额叶可能与内疚的认知成分相关, 而脑岛主要与内疚的情绪成分相关。未来的研究需要采用多种技术手段进一步考察内疚的认知神经机制。     

发展性障碍儿童的脑发育特点及干预

随着发展认知神经科学的兴起, 研究者借助脑成像等技术探讨了发展性障碍儿童的脑结构发育特点, 发展缺陷与脑功能损伤的关系以及障碍干预和脑功能改善的机制等, 这为揭示发展性障碍儿童异常神经机制的共性和特异性, 进而为早期诊断和干预提供了重要的生物学标记。针对儿童期常见的发展性障碍, 从脑结构损伤、脑激活异常、脑网络连接和脑功能康复等方面对相关研究进行了总结, 指出未来研究应拓展角度, 注重揭示各发展性障碍之间异常脑发育特点的共性和特异性的具体表现、病理机制及基因基础等; 临床工作者应注重将脑发育的异常和功能改善用于辅助各类障碍的早期识别和干预效果评估。     

青少年大五人格对网络成瘾的影响:家庭功能的中介作用

目的:探究家庭功能在人格特征与网络成瘾之间的中介作用。方法:973名中学生被试完成基本人口学问卷、网络成瘾量表、人格五因素问卷、家庭功能评定量表。结果:(1)人格特征可以显著预测网络成瘾。其中,情绪性人格可以显著正向预测网络成瘾,责任心、宜人性显著负向预测网络成瘾。(2)家庭功能在情绪性、责任心对网络成瘾的影响具有部分中介作用、在宜人性对网络成瘾的影响具有完全中介作用。结论:在治疗中,可针对网络成瘾者的家庭功能进行积极干预,从而减轻其成瘾症状。     

药物成瘾诱导相关大脑核团功能和行为改变的DNA甲基化机制

药物成瘾会导致相关神经环路的结构和功能长期改变.大量新的研究证据表明,在DNA序列不变的情况下,药物成瘾可通过影响不同亚型DNA甲基转移酶(DNMTs)的表达,使脑内多个相关核团发生DNA甲基化以及基因表达的改变,进而导致神经元功能的可塑性变化.因此,DNA甲基化被视作导致成瘾行为长期存在的可能机制之一.结合近几年来的重要发现,本文将重点讨论相关脑区的DNA甲基化在成瘾行为发生发展过程中的作用,以及成瘾药物影响DNA甲基化水平的可能机制,并试图提出可深入的研究展望.     

Recognition and Treatment of Late-Life Addictions in Medical Settings

Addictive disorders among the elderly have emerged as a growing public health concern. As the proportion of the elderly population increases, more and more older adults will either develop addictions as a dysfunctional means of coping with the psychosocial consequences of aging, or will carry their long-standing addictive behaviors with them into later life. Among the most common of these addictions are smoking, excess consumption of alcohol, and gambling. This article briefly reviews these three addictive disorders and examines assessment and treatment options. The current cohort of older adults tends not to seek help for addiction problems in specialty mental health or substance abuse treatment. To improve rates of cessation and abstinence, assessment and intervention should be delivered in general medical settings such as primary care. With the addition of a behavioral health specialist, primary care has the potential to offer improved interventions in a cost-effective and time-efficient manner.     

Exploring adolescent social media and internet gaming addiction: The role of emotion regulation

Behavioral addictions such as social media addiction and internet gaming disorder are prevalent among adolescent populations. Although studies have investigated predictors of these addictive behaviors with international samples of adolescents, less is known about American adolescents. In this study, we investigated the predictive nature of emotion regulation after controlling for age, gender, and race with regard to social media addiction and internet gaming disorder severity. Results indicate that gender and emotion regulation significantly predicted both forms of behavioral addictions with small to moderate effects. Specifically, female gender and lower emotion regulation significantly predicted social media addiction and male gender and lower emotion regulation significantly predicted internet gaming disorder severity. Implications for mental health professionals are discussed.     

Controlling the uncontrollable. Self-regulation and the dynamics of addiction

The multidisciplinary research on addictions generally promotes the assumption that addictive behavior is caused and maintained by the external psychoactive substance, which accordingly is considered to be ‘addictive in itself’. The present article challenges this widespread assumption by engaging in a detailed examination of the psychodynamic structures of addiction. Tracing addictive behavior back to problems in affect regulation, the article discusses the object, motivation, dynamics, and developmental origins of addiction. Linking the problem with the topic of transitional object relations, the article eventually argues that addictive behavior amounts to a desperate pursuit for self-control. The tragedy of the addict is that he or she only manages to replace one sense of uncontrollability with another.     

Toward quantifying the abuse liability of ultraviolet tanning: A behavioral economic approach to tanning addiction

Many adults engage in ultraviolet indoor tanning despite evidence of its association with skin cancer. The constellation of behaviors associated with ultraviolet indoor tanning is analogous to that in other behavioral addictions. Despite a growing literature on ultraviolet indoor tanning as an addiction, there remains no consensus on how to identify ultraviolet indoor tanning addictive tendencies. The purpose of the present study was to translate a behavioral economic task more commonly used in substance abuse to quantify the "abuse liability" of ultraviolet indoor tanning, establish construct validity, and determine convergent validity with the most commonly used diagnostic tools for ultraviolet indoor tanning addiction (i.e., mCAGE and mDSM‐IV‐TR). We conducted a between‐groups study using a novel hypothetical Tanning Purchase Task to quantify intensity and elasticity of ultraviolet indoor tanning demand and permit statistical comparisons with the mCAGE and mDSM‐IV‐TR. Results suggest that behavioral economic demand is related to ultraviolet indoor tanning addiction status and adequately discriminates between potential addicted individuals from nonaddicted individuals. Moreover, we provide evidence that the Tanning Purchase Task renders behavioral economic indicators that are relevant to public health research. The present findings are limited to two ultraviolet indoor tanning addiction tools and a relatively small sample of high‐risk ultraviolet indoor tanning users; however, these pilot data demonstrate the potential for behavioral economic assessment tools as diagnostic and research aids in ultraviolet indoor tanning addiction studies.     

The neurobiology of substance and behavioral addictions

Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.     

成瘾人群跨期选择的神经机制及干预方法

成瘾可分为物质成瘾和行为成瘾, 两类成瘾人群在跨期选择上都表现出高时间折扣率的缺陷, 但也有各自的特异性特征。成瘾人群跨期选择缺陷的神经基础主要集中在评估网络(腹内侧前额叶、纹状体、后扣带皮层等)、认知控制网络(前额叶皮层、前扣带皮层等)和预期想象网络(海马、杏仁核等); 可利用心理训练来改善成瘾人群跨期选择缺陷, 其干预方法包括工作记忆训练、预期想象训练、金钱管理指导等。未来研究应该从成瘾者跨期选择缺陷的认知机制、3个神经网络系统的交互作用机理、行为遗传学以及开发有效的干预方法等方面展开大量研究。     

Voluntary decision-making in addiction: A comprehensive review of existing measurement tools

The notion of voluntariness, notably the inability to refrain from using an addictive substance, is central to addiction. This review examines different constructs measuring voluntariness in the context of drug addiction. We found 117 articles featuring 123 distinct scales for 11 of the 16 constructs initially searched. Self-efficacy was by far the construct with most scales. Most scales were not specifically developed with samples of people with addictions. From a methodological standpoint, current literature jeopardizes the validity of generalizations about how voluntariness functions and is measured in people with and without a drug addiction. From the standpoint of social psychology, the study of voluntariness remains anchored in an individualistic orientation to the study of cognition and behavior, thus calling for greater crosstalk between psychology subspecialties.     

Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies

Gambling, video gaming, and Internet use are typically included as everyday activities that could potentially become behavioral addictions. There is growing evidence that views non‐substance related addictions as coping mechanisms, and considers that attachment styles are likely to play a pivotal role on the development of such addictions, especially on young people. Therefore, the present study aimed to: (1) explore the association between attachment, coping, and behavioral addictions (i.e., gambling disorder, video game addiction, and problematic Internet use); and (2) to analyze the mediating/moderating effect that coping has in the relationship of attachment and these behavioral addictions. A sample consisting of 472 students from secondary education (Mean age = 15.6; SD = 1.33; 51.6% females) was recruited. The findings showed a negative association between attachment and behavioral addictions. Most coping strategies were found to be associated with attachment styles, except for self‐critique and emotional avoidance. In particular, problem avoidance was significantly correlated to all behavioral addictions. In addition, self‐blame and problem solving were significantly correlated to video game addiction and problematic Internet use. Finally, coping was found to act as a mediator and moderator between attachment and video game addiction and problematic Internet use.     

非药物成瘾的遗传学和神经生物学机制研究述评

非药物成瘾又称“非物质相关性成瘾”或“行为成瘾”。特征性表现包括对成瘾对象的渴望、受损的冲动控制、对成瘾对象的耐受、撤退反应和高复发率等。目前发现的非药物成瘾类型包括病理性赌博、网络成瘾、购物成瘾、游戏成瘾、性瘾以及贪食等。非药物成瘾与药物成瘾在症状学上表现出很高的相似性且具有较高的共病率, 提示二者之间可能存在着共同的发病机制。从遗传学和神经生物学的角度探讨非药物成瘾的机制具有重要的理论价值和临床应用价值。家庭研究和双生子研究发现, 男性的病理性赌博和贪食障碍具有中度以上的遗传度。分子遗传学研究发现, 单胺能神经递质相关基因, 如5-羟色胺转运体基因、多巴胺受体基因和单胺氧化酶A基因等, 与非药物成瘾有关。神经影像学研究发现, 非药物成瘾者脑内负责奖赏,线索加工和冲动控制的神经通路活动性异于正常对照。未来研究需要进一步从多个角度入手, 探讨非药物成瘾与药物成瘾的共性和特性。     

物质成瘾及其戒除:基于反转学习的视角

物质成瘾与反转学习损伤密切相关,成瘾者往往不能灵活地适应变化的刺激—结果的联结,这可能进一步加剧成瘾者的物质使用。近年来研究发现,物质成瘾者的反转学习相关的腹外侧前额和背外侧前额等脑区激活异常,这些异常与成瘾者的冲动性和强迫性有关。此外,个体的反转学习能力对其成瘾行为具有一定预测性。今后应增加对不同类型物质成瘾者的反转学习脑机制及物质相关线索对成瘾者反转学习影响的研究,并且进一步探讨成瘾者的冲动性和强迫性对其反转学习的调节及个体反转学习能力对其成瘾行为的预测。