双相情感障碍中的心理意象研究：探索“心灵之眼”。
An investigation of mental imagery in bipolar disorder: Exploring "the mind's eye".
作者信息
Di Simplicio Martina, Renner Fritz, Blackwell Simon E, Mitchell Heather, Stratford Hannah J, Watson Peter, Myers Nick, Nobre Anna C, Lau-Zhu Alex, Holmes Emily A
机构信息
Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany.
出版信息
Bipolar Disord. 2016 Dec;18(8):669-683. doi: 10.1111/bdi.12453. Epub 2016 Dec 20.
OBJECTIVES
Mental imagery abnormalities occur across psychopathologies and are hypothesized to drive emotional difficulties in bipolar disorder (BD). A comprehensive assessment of mental imagery in BD is lacking. We aimed to test whether (i) mental imagery abnormalities (abnormalities in cognitive stages and subjective domains) occur in BD relative to non-clinical controls; and (ii) to determine the specificity of any abnormalities in BD relative to depression and anxiety disorders.
METHODS
Participants included 54 subjects in the BD group (depressed/euthymic; n=27 in each subgroup), subjects with unipolar depression (n=26), subjects with anxiety disorders (n=25), and non-clinical controls (n=27) matched for age, gender, ethnicity, education, and premorbid IQ. Experimental tasks assessed cognitive (non-emotional) measures of mental imagery (cognitive stages). Questionnaires, experimental tasks, and a phenomenological interview assessed subjective domains including spontaneous imagery use, interpretation bias, and emotional mental imagery.
RESULTS
(i) Compared to non-clinical controls, the BD combined group reported a greater impact of intrusive prospective imagery in daily life, more vivid and "real" negative images (prospective imagery task), and higher self-involvement (picture-word task). The BD combined group showed no clear abnormalities in cognitive stages of mental imagery. (ii) When depressed individuals with BD were compared to the depressed or anxious clinical control groups, no significant differences remained-across all groups, imagery differences were associated with affective lability and anxiety.
CONCLUSIONS
Compared to non-clinical controls, BD is characterized by abnormalities in aspects of emotional mental imagery within the context of otherwise normal cognitive aspects. When matched for depression and anxiety, these abnormalities are not specific to BD-rather, imagery may reflect a transdiagnostic marker of emotional psychopathology.
目的
心理意象异常在多种精神疾病中均有出现，并且据推测其会导致双相情感障碍（BD）患者出现情绪问题。目前尚缺乏对BD患者心理意象的全面评估。我们旨在测试：（i）与非临床对照相比，BD患者是否存在心理意象异常（认知阶段和主观领域的异常）；（ii）确定BD患者相对于抑郁症和焦虑症的任何异常的特异性。
方法
参与者包括BD组的54名受试者（抑郁/心境正常；每个亚组n = 27）、单相抑郁症患者（n = 26）、焦虑症患者（n = 25）以及在年龄、性别、种族、教育程度和病前智商方面匹配的非临床对照（n = 27）。实验任务评估心理意象的认知（非情感）指标（认知阶段）。问卷、实验任务和现象学访谈评估主观领域，包括自发意象使用、解释偏差和情感心理意象。
结果
（i）与非临床对照相比，BD合并组报告侵入性前瞻性意象在日常生活中的影响更大、负面意象更生动且“真实”（前瞻性意象任务）以及自我卷入程度更高（图片-单词任务）。BD合并组在心理意象的认知阶段未表现出明显异常。（ii）将BD抑郁个体与抑郁或焦虑临床对照组进行比较时，所有组之间均无显著差异——在所有组中，意象差异均与情感不稳定和焦虑相关。
结论
与非临床对照相比，BD的特征在于在认知方面正常的情况下，情感心理意象方面存在异常。当在抑郁和焦虑方面进行匹配时，这些异常并非BD所特有——相反，意象可能反映了情绪精神病理学的跨诊断标志物。
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