Department of Psychology, Renmin University of China, Beijing, 100872, P.R China.
Department of Psychology, Renmin University of China, Beijing, 100872, P.R China.
Psychiatry Res. 2020 Dec;294:113507. doi: 10.1016/j.psychres.2020.113507. Epub 2020 Oct 13.
Diminished neural responses to punitive stimulus related to high level of pain avoidance may be biomarkers in distinguishing patients with history of suicide attempts from those without such histories. Outpatients with Major Depression Disorder (MDD, n=44) and healthy controls (HCs, n=28) were administered the Beck Depression Inventory-I (BDI-I), the Three-Dimensional Psychological Pain Scale (TDPPS), and the Beck Scale for Suicide Ideation (BSS), and then patients were allocated to two groups: suicide attempts (MDD-SA, n=12) and suicidal ideation (MDD-SI, n=32). All participants were required to complete the measurements and performed the Monetary Incentive Delay (MID) task with recording of electroencephalography synchronously. The MDD-SA group scored higher in the BDI-I, total TDPPS, pain avoidance subscale, and BSS-W scores than the MDD-SI and healthy control groups. Pain avoidance subscale scores had the highest correlations with SA than other inventory scores. The P3 elicited by negative feedback under punitive condition was significantly larger than those of reward and neutral conditions in the MDD-SA group, whereas no significant differences were found between the MDD-SI and HC groups. The P3 elicited by punitive and reward cues was negatively correlated to the total TDPPS and pain avoidance scores, and the P3 elicited by positive feedback in reward and punitive conditions was negatively correlated to the total TDPPS and painful feeing scores. Pain avoidance is a strong behavioral index in distinguishing suicide attempters from suicide ideators. The P3 patterns elicited by punitive cue and feedback may represent psychological pain processing which contribute to suicide act.
回避疼痛程度较高与惩罚性刺激相关的神经反应减弱，可能是将有自杀尝试史的患者与无此类病史的患者区分开来的生物标志物。将 44 名患有重度抑郁症障碍（MDD）的门诊患者和 28 名健康对照者（HCs）分为两组：有自杀企图（MDD-SA，n=12）和有自杀意念（MDD-SI，n=32）。所有参与者都需要完成测量，并在记录脑电图的同时进行货币激励延迟（MID）任务。与 MDD-SI 组和健康对照组相比，MDD-SA 组的 BDI-I、总 TDPPS、疼痛回避子量表和 BSS-W 评分更高。疼痛回避子量表得分与 SA 的相关性高于其他量表得分。在惩罚条件下，MDD-SA 组负反馈引起的 P3 明显大于奖励和中性条件下的 P3，而 MDD-SI 组和 HCs 组之间没有差异。惩罚和奖励线索引起的 P3 与总 TDPPS 和疼痛回避评分呈负相关，奖励和惩罚条件下正反馈引起的 P3 与总 TDPPS 和疼痛感觉评分呈负相关。回避疼痛是区分自杀企图者和自杀意念者的一个强有力的行为指标。惩罚性线索和反馈引起的 P3 模式可能代表心理疼痛处理，有助于自杀行为。
