Kaviani H, Gray J A, Checkley S A, Raven P W, Wilson G D, Kumari V
Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
J Affect Disord. 2004 Nov 15;83(1):21-31. doi: 10.1016/j.jad.2004.04.007.
The amplitude of the startle reflex response is known to be influenced by the concomitant presentation of affect-toned material--if it is positive affect-toned, the reflex is inhibited, and if it is negative affect-toned, the reflex is augmented. Abundant evidence demonstrates the utility of the affect-startle paradigm as a significant tool for measuring both positive and negative emotions. We applied this paradigm to study emotional reactivity in depression, particularly in relation to symptoms of depression, anhedonia, and anxiety.
Depressed patients (22) and controls (22) were shown a series of film clips, consisting of two clips with positive valence, two with negative valence, and two with relatively neutral valence. The startle response was measured in reaction to the acoustic startle-eliciting stimuli presented three times binaurally during each clip.
Highly depressed and anhedonic patients, relative to controls, showed a reduced mood (self-ratings) and a lack of startle modulation in response to affective film clips whereas patients relatively low on depression/anhedonia displayed a reduced mood only with pleasant clips and a normal pattern of affective startle modulation. Anhedonia and depression were highly positively correlated but neither correlated with anxiety. Anxious patients displayed larger reflexes across all clips and showed a reduced mood modulation with pleasant, but not unpleasant, clips.
The large majority of patients was medicated with antidepressants which may have influenced the results. CONCLUSIONS. Reactivity to pleasant stimuli is diminished in patients suffering from low levels of depression and/or anhedonia, but reactivity even to unpleasant stimuli seems compromised at high levels of depression and/or anhedonia. Anxiety is associated with hyperstartle responding.
已知惊吓反射反应的幅度会受到伴有情感基调材料呈现的影响——如果是积极情感基调，反射会受到抑制，如果是消极情感基调，反射会增强。大量证据表明情感-惊吓范式作为测量积极和消极情绪的重要工具的效用。我们应用此范式研究抑郁症患者的情绪反应性，特别是与抑郁症状、快感缺失和焦虑的关系。
向22名抑郁症患者和22名对照者展示一系列电影片段，包括两个正性效价片段、两个负性效价片段和两个相对中性效价片段。在每个片段中，对双耳呈现三次的听觉惊吓诱发刺激做出反应时测量惊吓反应。
与对照组相比，高度抑郁和快感缺失的患者情绪（自评）降低，并且对情感电影片段的惊吓调节缺失，而抑郁/快感缺失程度相对较低的患者仅在观看愉快片段时情绪降低，且情感惊吓调节模式正常。快感缺失与抑郁高度正相关，但两者均与焦虑无关。焦虑患者在所有片段中表现出更大的反射，并且在观看愉快但非不愉快的片段时情绪调节降低。
绝大多数患者正在服用抗抑郁药，这可能影响了结果。结论：患有轻度抑郁和/或快感缺失的患者对愉快刺激的反应性降低，但在重度抑郁和/或快感缺失时，甚至对不愉快刺激的反应性似乎也受到损害。焦虑与惊吓反应增强有关。
