ISSN 1671-3710
CN 11-4766/R
主办：中国科学院心理研究所
出版：科学出版社

心理科学进展 ›› 2015, Vol. 23 ›› Issue (7): 1187-1195.doi: 10.3724/SP.J.1042.2015.01187

• 研究前沿 • 上一篇    下一篇

基于“心理痛苦”理论的眶额皮质介导抑郁症自杀机制

李欢欢;谢蔚臻;李永娜   

  1. (中国人民大学心理学系, 北京 100872)
  • 收稿日期:2014-10-30 出版日期:2015-07-15 发布日期:2015-07-15
  • 通讯作者: 李欢欢, E-mail: psylihh@ruc.edu.cn; 李永娜, E-mail: cogpsyli@ruc.edu.cn
  • 基金资助:

    国家自然科学基金(81401120)、中国科学院心理研究所心理健康重点实验室开放课题和中国人民大学团队预研项目基金(14XNLQ05)资助。

Neural Circuits of Orbitofrontal Cortex Involved in Suicidal Attempts Among Major Depression Patients

LI Huanhuan; Xie Weizhen; LI Yongna   

  1. (Department of Psychology, Renmin University of China, Beijing 100872, China)
  • Received:2014-10-30 Online:2015-07-15 Published:2015-07-15
  • Contact: LI Huanhuan, E-mail: psylihh@ruc.edu.cn; LI Yongna, E-mail: cogpsyli@ruc.edu.cn

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摘要：

近年来, 自杀的心理痛苦三因素模型(包括痛苦唤醒、痛苦体验和痛苦逃避)在临床抑郁症患者群体得到验证。痛苦逃避是该模型的核心成分。行为学研究证据显示, 痛苦逃避维度得分对抑郁症患者自杀意念和自杀行为的预测力远高于Beck抑郁问卷得分和痛苦体验得分。由于眶额皮质是介导情绪反应和控制复杂行为的关键界面, 主要参与负性情绪引发回避惩罚(痛苦)的动机控制, 与动机、决策和行为监控密切相关。眶额皮质及其与前额叶、皮层下结构(扣带前回、杏仁核和下丘脑等)的异常激活模式可能是痛苦体验引发高逃避动机、进而产生自杀行为(风险决策)的重要神经基础。本文在综述以往研究的基础上, 提出通过改编和发展情感激励延迟和金钱激励延迟的认知任务, 对痛苦体验和痛苦逃避动机阶段进行时间上的分离, 建立眶额皮质介导抑郁症自杀的脑功能病理模型的研究思路。

关键词: 心理痛苦, 痛苦逃避, 抑郁, 自杀, 眶额皮质

Abstract:

For a suicidal person, suicide seems to be the only means of escaping the torment of psychological pain. Pain avoidance, representing the wish to escape psychological pain, may be a primary predictor of subsequent suicide. Given that the Orbitofrontal cortex dysfunction may trigger overreaction to a social signal of disapproval (painful feelings) and induced high level motivation for escaping from punishment (pain avoidance), event-related functional MRI was used to measure orbitofrontal cortex and its neural circuit activity in response to stimuli representing negative/positive emotional incentives among patients with a history of suicidal attempts (vs.no suicidal history) in furture work. Our work will extend interactive modes of motivation and cognitive control circuits underying higher levels of psychological pain and ultimately may provide a empiral evidence for the neural correlates of pain avoidance which trigger suicidal behavior.

Key words: suicidal attempt, depression, psychological pain, pain avoidance, orbitofrontal cortex