【作者】 王艳郁； 邹颖敏； 倪珂； 田雪； 孙宏伟； 吕世裕； 张复炽； 陈楚侨； 王毅；

【Author】 Yan-yu Wang;Yi Wang;Ying-min Zou;Ke Ni;Xue Tian;Hong-wei Sun;Simon S.Y.Lui;Eric F.C.Cheung;Raymond C.K.Chan;Neuropsychology and Applied Cognitive Neuroscience Laboratory; CAS Key Laboratory of Mental Health, Institute of Psychology;Department of Psychology, Weifang Medical University;Department of Psychology, University of Chinese Academy of Sciences;Mental Health Center of Qiqihar city;Castle Peak Hospital, Hong Kong Special Administrative Region;

【机构】 中国科学院心理研究所； 潍坊医学院心理学系； 中国科学院大学心理学系； 齐齐哈尔市精神卫生中心； 香港青山医院；

【摘要】 心理理论是指推测他人的目的、意图、想法及情绪状态的能力。作为社会认知的重要组成部分,心理理论的缺损通常带来社会适应困难。已有的研究结果显示,精神分裂症、抑郁症以及双相障碍患者均存在不同程度的心理理论缺损。然而,对于三类疾病患者心理理论缺损的相似性及独特性的阐述尚不清晰。本研究采用计算机"Yoni"任务对年龄、性别以及智商均匹配的35名精神分裂症患者、35名抑郁症患者、35名双相障碍患者以及35名健康对照志愿者的心理理论能力进行了测量。重复测量的方差分析结果显示,组别(精神分裂症组、抑郁症组、双相障碍组、正常对照组)(F=5.83, p=0.001,?~2=0.114)、水平(一阶心理理论、二阶心理理论)(F=76.56, p <0.001,?~2=0.360)、条件(认知成分、情感成分、物理条件)(F=5.31, p <0.05,?~2=0.038)的主效应以及组别x水平(F=2.68, p <0.05,?~2=0.056)、水平x条件(F=6.20, p <0.05,?~2=0.044)交互作用均显著。事后检验发现,三组患者在"Yoni"任务上的成绩均显著低于健康对照组,精神分裂症患者相对于双相障碍来说成绩更差(p=0.042)。以物理条件作为协变量,四组在一阶认知(F=2.33, p=0.077,?~2=0.049)以及一阶情感心理理论(F=2.08, p> 0.1,?~2=0.044)上的对比均未见显著差异。在二阶心理理论上,认知(F=11.83, p <0.001,?~2=0.207)以及情感心理理论(F=9.51, p <0.001,?~2=0.173)条件下的组别主效应均显著。事后对比发现,三组患者二阶认知心理理论均显著差于健康对照组,但三组患者间的差异不显著。在二阶情感心理理论上,精神分裂症及抑郁症组的成绩均显著差于健康对照组,而双相障碍组与健康对照组的差异临近显著(p=0.057),三组患者间的差异不显著。本研究揭示了精神分裂症、抑郁症及双相障碍患者心理理论的缺损,尤其体现在二阶心理理论能力上。未来有关精神疾病患者心理理论的研究应该更多朝向于大样本、跨诊断的研究,从而有利于心理理论缺损机制的阐释以及有效干预措施的制定。更多还原

【Abstract】 Theory of mind(ToM), refers to the ability to infer others’ aims, beliefs, intentions and emotional states. As one of the key aspects of social cognition, the deficits of ToM always lead to the difficulties in social adaption. Although ToM impairment has been reported in patients with schizophrenia(SCZ), major depressive disorder(MDD) and bipolar disorder(BD), the similarity and uniqueness of these deficits across diagnostic groups remains unclear. The present study recruited four groups of participants including 35 patients with SCZ, 35 with BD, 35 with MDD, and 35 healthy controls. All participants were matched in age, gender proportion and IQ estimates. The Yoni task capturing both the cognitive and affective components of ToM at the first-and second-order level was administered to all participants. Repeated-measure ANOVA revealed significant main effects for Group(F = 5.83, p = 0.001, ?~2 = 0.114), Order(F = 76.56, p < 0.001, ?~2 = 0.360) and Condition(F = 5.31, p < 0.05, ?~2 = 0.038) of the Yoni Task. The Order x Condition(F = 6.20, p < 0.05, ?~2 = 0.044) and Order x Group(F = 2.68, p < 0.05, ?~2 = 0.056) interactions were also significant. Post-hoc tests showed that all the patient groups showed significant impairment in their overall performance on the Yoni Task, with SCZ patients performing worse than patients with BD(p = 0.042). For the first-order conditions, the results showed non-significant differences between the four groups in ToM performance in both the cognitive(F = 2.33, p = 0.077, ?~2 = 0.049) and the affective(F = 2.08, p > 0.1, ?~2 = 0.044) conditions, even after controlling for ToM performance in the physical condition. For the second-order conditions, a significant Group effect were found in the cognitive(F = 11.83, p < 0.001, ?~2 = 0.207) and the affective condition(F = 9.51, p < 0.001, ?~2 = 0.173). Post-hoc pairwise comparisons showed that ToM performance of all three patient groups were significantly worse than healthy controls in the cognitive condition, while the difference between the three patient groups was not significant. For the second-order affective condition, both the SCZ group and the MDD group had poorer ToM performance than healthy controls, while the difference between the BD group and healthy controls only showed a trend towards statistical significance(p = 0.057). There were no significant differences between the three patient groups in ToM performance. Taken together, we found significant ToM impairments in patients with SCZ, BD and MDD, especially in the higher-order ToM conditions. Future study about ToM in patients with mental disorders should consider bigger sample size and cross-diagnostic method, thus in favour of the explanation of mechanism and the intervention of ToM deficits.更多还原