【作者】 陈建军；

【导师】 汪凯；

【作者基本信息】 安徽医科大学 ， 神经病学， 2012， 硕士

【摘要】 目的了解精神分裂症患者注意障碍的认知神经心理学特征。通过线段等分试验证实精神分裂症患者是否存在单侧空间注意障碍，而通过情绪面孔嵌合试验进一步探讨精神分裂症患者在不同情绪面孔识别干扰下是否存在空间注意障碍。通过以上两种试验方法探讨精神分裂症患者在注意偏向上是否存在相关性，并为临床注意偏向的筛查提供一种新方法。方法试验对象为32例门诊及住院精神分裂症患者和32名年龄、性别、文化程度及简易精神状态量表（Mini-mental state examination，MMSE）评分等相匹配的健康人。线段等分试验：两组被试要求标出20cm长度线段的主观中点，观察线段的偏移值和偏移率。情绪面孔嵌合试验：两组被试要求观察由中性面孔、正性情绪面孔（喜）和负性情绪面孔（怒、恐）构成的嵌合图形组，并按键选择这些嵌合图形中情绪程度较深的一张，据此计算出偏移率。同时比较上述两种试验结果是否存在相关性。结果在线段等分试验中，线段长度为20CM，两组的偏移值及偏移率均为负值，但精神分裂症组的偏移率较正常对照组高，差异有统计学差异（Z=-3.56，P<0.01）。在情绪面孔嵌合试验中，两组在本顿面孔识别试验中的差异无统计学意义（P>0.05）。在情绪为喜的面孔嵌合试验中，精神分裂症组的偏移率均比对照组高，差异有统计学意义（Z=-2.04，P <0.01）；精神分裂症组与对照组的情绪（喜）面孔嵌合和线段等分之间偏移率正相关（r=0.68，P <0.01）；而在情绪为怒和恐的嵌合面孔试验中，患者组的偏移率与对照组比较，差异无统计学意义（P>0.05）。结论精神分裂症患者在正性情绪（喜）面孔嵌合试验和线段等分试验中均表现为注意明显左偏，提示患者右侧空间注意受损，可能与左侧脑半球功能障碍有关，并且上述两种试验正相关。两组被试在负性情绪（怒，恐）的嵌合面孔试验中的差异无统计学意义，提示患者可能对于负性情绪面孔识别上存在一定障碍；更多还原

【Abstract】 Objective Understanding the cognitive neuropsychological characteristics of patientswith schizophrenia attention disorder. Through the physical line bisection test confirmedthat schizophrenic patients whether there is unilateral spatial attention disorder, then tofurther explore patients with schizophrenia in different emotional face recognitioninterference whether there is spacial attention disorder by the emotional chimeric facestest. Through above two test in patients with schizophrenia to explore of associatedprocessing between line bisection test and emotional face recognition by attentionalbias, and provide a new method for the screening of clinical attention bias.Methods32cases of schizophrenes and32normal persons(control group), whoseage,educational degree, the grade of Mini-mental Status Examination were matchable,were comparatively measured by emotional chimeric facial test and line bisection test.The line bisection test: two groups marked the subjective midpoint of the segmentlength20cm, and observe the segment offset and drift rate. Emotional chimeric facestest: two groups were to require the first after Benton face recognition test assessment toproperly identify the range of those that can correctly identify the human facial features,choose the neutral faces of the people in the gallery of the standard face positiveemotion faces (happy) and negative emotional faces (anger, fear) graphics, the graphicsare along the midline incision, and graphics of neutral faces with different emotionalfaces graphic symmetrical splicing, synthesis are mirror images the two faces of theupper and lower place constitute a chimeric picture, and based on different emotionsconstitute a set of emotions (happy, anger, fear) chimeric group of pictures, each group have their own32pictures. Use of computer-generated random presents a variety ofemotional pictures group, to observe and calculate the offset value and offset raterespectively. Compare the test results are correlated.Results The line bisection test, the segment length20CM, the offset and drift rate ofthe two groups were negative, but the offset rate of the patient group compared withnormal control group, the difference was statistically different (Z=-3.56, P <0.01).Emotional Chimeric Faces Test, There was no statistic difference in the two groups inBenton Facial Recognition Test(BFRT)（P>0.05）. Compared with the normal controlgroup, schizophrenes in the happy emotional chimeric facial test and line bisection testrevealed apparent left attentional bias, with statistic difference(P <0.01); and the angryand fearful emotions chimeric faces test, the patient group offset rate, compared withthe control group, no statistically significant difference (P>0.05). Furthermore, the biasrates between happy emotional chimeric face and line bisection in schizophrenes existedthe relativity(r=0.68，P <0.01).ConclusionSchizophrenes apparent left attentional bias in happy emotional chimeric face, thischaracteristics and the line bisection test results the same line, and two kinds of tests arepositively correlated, which reminds patients of spacial attention damage that may berelated to functional disorder of left cerebral hemisphere.No significant differencebetween the two groups were in negative emotions (anger, fear) in the emotion chimericfaces test.Suggesting that patients may have negative emotional face recognition, thereare certain obstacles.更多还原