【作者】 樊洁； 刘婉婷； 夏结； 李思慧； 朱江； 高峰； 韩燕； 周欢； 谭长连； 朱熊兆；

【Author】 Jie Fan;Wanting Liu;Jie Xia;Sihui Li;Jiang Zhu;Gao Feng;Han Yan;Zhou Huan;Changlian Tan;Xiongzhao Zhu;Medical Psychological Center,the Second Xiangya Hospital,Central South University;Medical Psychological Institute of Central South University;Department of Radiology,the Second Xiangya Hospital,Central South University;

【机构】 中南大学湘雅二医院医学心理中心； 中南大学湘雅二医院医学心理学研究所； 中南大学湘雅二医院放射科；

【摘要】 目的:早年创伤是抑郁发生的高危因素,但早年创伤致抑郁发生发展的机制尚不十分清楚。快感缺失是抑郁的核心症状之一,快感缺失根据不同的分类标准可以区分为不同的类型或成分。早年创伤影响抑郁快感缺失,但是其与具体类型或成分的快感缺失的关系还有待进一步探讨。本研究拟系统性地探讨早年创伤和不同类型或成分的快感缺失的关系以明确早年创伤是否损害某些特定类型的快感体验,探讨早年创伤是否通过影响快感缺失影响抑郁的发生发展。方法:86名有早年创伤经历抑郁患者、35名无早年创伤经历抑郁患者、37名有早年创伤经历健康个体、以及41名无早年创伤经历健康个体参与研究,评估所有被试各类型或成分,包括状态、躯体、社会、期待性、以及消费性快感缺失水平。采用方差分析以及相关分析探讨早年创伤整体、早年创伤类型以及类型数量与各类型或成分快感缺失的关系。结果:(1)有早年创伤经历的个体,不论抑郁患者还是健康人群,均表现出更高的期待性、躯体和社会快感缺失水平。有早年创伤经历的抑郁患者比无早年创伤经历的抑郁患者表现出更高的状态快感缺失水平;(2)在健康人群中,早年创伤的数量与状态快感缺失水平呈显著正相关,未发现早年创伤数量与其他类型快感缺失的关系;(3)在抑郁患者和健康人群中,均发现早年创伤总分与状态快感缺失以及社会快感缺失水平显著相关。结论:(1)早年创伤与个体的快感体验水平下降有关,且与某些特定类型的快感体验水平下降有关:从引起快感体验的刺激来看,早年创伤既影响躯体快感体验也影响社会快感体验;从快感体验发生的阶段看,早年创伤主要影响期待性而非消费性快感体验;(2)早年创伤影响特质性快感缺失既出现在抑郁患者中,也出现在健康人群中,其可能是疾病易感的重要机制。更多还原

【Abstract】 Objective: Childhood trauma(CT) is a well-established risk factor for depression. However, the underlying mechanism linking CT and depression remains not fully understood. Anhedonia, a core symptom of depression, can be parsed into different components according to different criteria. CT may mainly have effects on anhedonia in depression when taking the symptom dimension into consideration; however, the relationships between CT and specific aspects of anhedonia remain inadequately understood. The present study was designed to examine the relationship between CT and different kinds of anhedonia to clarify whether CT affects the development of MDD via its effects on specific types of anhedonia. Methods: One hundred and twenty-one patients diagnosed with major depressive disorder(MDD) including 86 with and 35 without CT, and 78 healthy controls(HCs) wherein 37 with and 41 without CT were included in the behavioral study. All subjects finished a series of questionnaires in assessment of different kinds of anhedonia including state, physical, social, anticipatory as well as consummatory aspects. The ANOCOVA and correlation analysis were used for the statistical analysis. Results:(1) Individuals with CT, irrespective of MDD diagnosis, had elevated anticipatory, physical and social anhedonia compared to those without CT. MDD patients with CT had more severe state anhedonia than MDD patients without CT;(2) Among HCs, there was significant correlations between the number of CT types and the level of state anhedonia;(3) the total score of CT was significantly correlated with state and social anhedonia in both MDD and HC groups. Conclusions: These findings highlight anhedonia as targets of CT. CT is associated with specific types of anhedonia. Individuals with CT have elevated physical, social and anticipatory anhedonia. CT has no effects on consummatory pleasure. Trait blunted hedonic responses may be a marker for vulnerability towards psychiatric conditions in healthy adults with CT.更多还原