Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zürich, Switzerland; Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany; Clinic for Psychiatry and Psychotherapy AR, Herisau, Switzerland.
Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zürich, Switzerland.
Psychiatry Res Neuroimaging. 2018 Jul 30;277:7-13. doi: 10.1016/j.pscychresns.2018.04.008. Epub 2018 May 9.
Depressed patients suffer from an impairment to voluntarily influence and regulate their unpleasant emotional state. Strengthening the mental ability to interfere with dysfunctional emotion processing may be beneficial in treating depression. According to models of emotion processing this may be done by successful down-regulation of enhanced amygdala activity. We investigated short periods of intentional emotion-introspection compared with cognitive self-reflection as two domains of self-awareness in terms of effects on emotion regulation. Thirty depressed patients performed twelve second periods of emotion-introspection, self-reflection and a neutral condition during functional magnetic resonance imaging. We analyzed brain activation in the patients with depression by means of whole brain, region of interest and connectivity analyses. Amygdala activity decreased during emotion-introspection relative to self-reflection and to the neutral condition, whereby left amygdala was inversely activated relative to the left insula. Insula activity itself was correlated with medial and dorsolateral prefrontal cortex (PFC) activation. In conclusion, depressed patients are able to down-regulate amygdala activity by emotion-introspection. This may be interpreted as well-working emotion regulation supposedly induced by PFC connections mediated via insula. The finding supports the application of emotion-introspection, a mindfulness-related process, in a clinical setting as an element of psychotherapy to train and improve emotion regulation.
抑郁患者在自愿影响和调节自身不良情绪状态方面存在障碍。增强干扰功能失调情绪处理的心理能力可能有益于治疗抑郁症。根据情绪处理模型，这可以通过成功下调增强的杏仁核活动来实现。我们研究了短时间的有意情绪内省与认知自我反思作为自我意识的两个领域，以探讨它们对情绪调节的影响。30 名抑郁患者在功能磁共振成像期间进行了 12 秒的情绪内省、自我反思和中性状态。我们通过全脑、感兴趣区域和连接分析来分析抑郁患者的大脑激活。与自我反思和中性状态相比，情绪内省期间杏仁核活动减少，而左杏仁核相对于左脑岛呈反向激活。脑岛活动本身与内侧和背外侧前额叶皮层（PFC）的激活相关。总之，抑郁患者能够通过情绪内省来下调杏仁核活动。这可以解释为 PFC 通过脑岛介导的连接所诱导的、据称良好的情绪调节作用。这一发现支持将情绪内省作为一种正念相关的过程应用于临床环境中，作为心理治疗的一个元素，以训练和改善情绪调节。
