中国临床心理学杂志

药物成瘾对决策行为的损伤及戒断后的恢复

单位：1. 北京师范大学心理学院应用实验心理北京市重点实验室北京 100875
2. 认知神经科学与学习国家重点实验室（北京师范大学）北京 100875
3. 南京大学社会学院心理学系南京 210093
4. 脑与学习协同创新中心北京 100875
5. 北京市天堂河戒毒康复所北京 102609

关键词：药物成瘾戒断期决策 N2

分类号：R395.1

出版年,卷(期):页码：2014,22(6):951-956

摘要：

目的:本研究采用赌博任务考察不同戒断时长的药物戒断者(短期戒断组:平均2.7个月,中期戒断组:平均19.4个月,长期戒断组:平均49.6个月),行为决策能力的损伤与恢复情况。方法:实验中要求药物戒断者与正常控制组完成赌博任务,被试根据屏幕所示的概率判断目标出现在屏幕的左边还是右边。结果:行为结果发现,所有戒断组赌博得分均低于控制组,说明药物戒断者的行为具有高冲动性;中期组和长期组的赌博得分在实验的中期、后期均显著高于实验的前期,表明随着戒断时间延长,药物成瘾对学习能力产生的损伤逐渐恢复。脑电结果发现,面对不同类型的赌博界面,短期组和中期组均未显示出N2波的差异,而长期组能够区分Pass类型与Gamble类型,以及Pass类型与Nogo类型,但是区分的方向与控制组相反,说明药物对长期戒断者决策偏好、选择能力的损伤并未完全恢复。结论:药物成瘾者的行为决策偏好、选择能力和执行控制能力都存在损害,戒断4年后的长期组决策能力有所恢复,但仍未恢复至正常水平。

Objective: Using a gamble task, the aim of the study is to explore the impairment and recovery of decision making in patients with drug addiction. We measured, the different ERP activities in abstainers with different abstinent- terms(short-term group: mean=2.7 months, middle-term group: mean=19.36 months, long-term group: 49.6 months) and healthy control participants. Methods: Participants were required to identify the position of target on the left or the right of the screen according to the probability. Results: Behavioral data showed that all abstainers acquired lower gambling scores than control group, indicating that the behavior of all abstainers have higher impulsivity compared to control. And gambling scores acquired by short-and middle-term groups significantly increased in the middle and late stages of the experiment compared to the early stage. This suggest sthat the decline of study ability gradually recovered with the withdrawal time prolonged. Electroencephalographic(EEG) results found that the short-and middle-term groups had no difference in N2 amplitude, and that long-term group showed similar but not identical pattern of brain activation compared to control group. Conclusion: Drugs impair the ability of information-analysis and executive control. This damage seems to be recovered after four years withdrawal in long-term group, but not returned to normal levels yet.

基金项目：

作者简介：

参考文献：

1 Janes AC, Pizzagalli DA, Richardt S, et al. Neural substr-ates of attentional bias for smoking-related cues: an FMRI study. Neuropsychopharmacology, 2010, 35(12): 2339-2345
2 Edwards W. The theory of decision making. Psychological Bulletin, 1954, 51(4): 380-417
3 Ernst M, Bolla K, Mouratidis M, et al. Decision-making in a risk-taking task: a PET study. Neuropsychopharmacology, 2002, 26(5): 682-691
4 Bechara A, Damasio H, Damasio AR, et al. Different contr-ibutions of the human amygdala and ventromedial prefrontal cortex to decision-making. The Journal of Neuroscience, 1999, 19(13): 5473-5481
5 罗秋铃, 魏晓波, 陆夏平, 等. 病理性赌徒决策缺陷的内在机制研究综述. 中国临床心理学杂志, 2013, 21(5): 719-722, 718
6 Volkow ND, Fowler JS. Addiction, a disease of compulsion and drive: Involvement of the orbitofrontal cortex. Cerebral Cortex, 2000, 10(3): 318-325
7 张锋, 邓云菁, 杨宏, 等. 药物依赖者复吸研究模型的回顾与展望. 中国临床心理学杂志, 2006, 14(4): 368-370, 383
8 Bolla KI, Eldreth D, London E, et al. Orbitofrontal cortex dysfunction in abstinent cocaine abusers performing a deci-sion-making task. Neuroimage, 2003, 19(3): 1085-1094
9 佟月华, 王敏, 宋尚桂. 成瘾人群的延迟折扣. 中国临床心理学杂志, 2012, 20(5): 670-673
10 Bolla KI, Eldreth DA, Matochik JA, et al. Neural substrates of faulty decision-making in abstinent marijuana users. Ne-uroimage, 2005, 26(2): 480-492
11 Adinoff B, Devous MD, Cooper DB, et al. Resting regional cerebral blood flow and gambling task performance in coca-ine-dependent subjects and healthy comparison subjects. American Journal of Psychiatry, 2003, 160(10): 1892-1894
12 张楠, 汪凯, 梁振, 等. 执行功能与网络成瘾. 中国临床心理学杂志, 2011, 19(6): 792-794
13 Franken IH, Van Strien JW, Franzek EJ, et al. Error-proces-sing deficits in patients with cocaine dependence. Biological Psychology, 2007, 75(1): 45-51
14 Battisti RA, Roodenrys S, Johnstone SJ, et al. Chronic cann-abis users show altered neurophysiological functioning on Stroop task conflict resolution. Psychopharmacology, 2010, 212(4): 613-624
15 王金良, 吴明霞, 余林. 物质成瘾Stroop效应研究进展. 中国临床心理学杂志, 2007, 15(6): 656-658
16 Fillmore MT, Rush CR. Impaired inhibitory control of beha-vior in chronic cocaine users. Drug and Alcohol Dependen-ce, 2002, 66(3): 265-273
17 Monterosso JR, Aron AR, Cordova X, et al. Deficits in resp-onse inhibition associated with chronic methamphetamine abuse. Drug and Alcohol Dependence, 2005, 79(2): 273-277
18 Dawkins L, Powell JH, West R, et al. A double-blind place-bo-controlled experimental study of nicotine: II—Effects on response inhibition and executive functioning. Psychophar-macology, 2007, 190(4): 457-467
19 De Wit H. Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addiction biolo-gy, 2009, 14(1): 22-31
20 Jentsch JD, Taylor JR. Impulsivity resulting from frontostria-tal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology, 1999, 146(4): 373-390
21 王志纲, 张宪武, 李国文, 等. 海洛因成瘾者家庭环境、亲密度和适应性的研究. 中国临床心理学杂志, 1998, 6(1): 32-34
22 王绪轶, 李宝娟, 周旭辉, 等. 海洛因成瘾者静息状态下脑功能连接研究. 中国临床心理学杂志, 2011, 19(1): 7-9
23 Ersche KD, Roiser JP, Robbins TW, et al. Chronic cocaine but not chronic amphetamine use is associated with persev-erative responding in humans. Psychopharmacology, 2008, 197(3): 421-431
24 Mennes M, Wouters H, Van Den Bergh B, et al. ERP corre-lates of complex human decision making in a gambling para-digm: Detection and resolution of conflict. Psychophysiology, 2008, 45(5): 714-720
25 Mennes M, Bergh BVD, Lagae L, et al. Developmental brain alterations in 17 year old boys are related to antenatal mat-ernal anxiety. Clinical Neurophysiology, 2009, 120(6): 1116-1122
26 Van Veen V, Carter CS. The timing of action-monitoring pr-ocesses in the anterior cingulate cortex. Journal of Cognitive Neuroscience, 2002, 14(4): 593-602
27 Falkenstein M, Hoormann J, Hohnsbein J. ERP components in Go/Nogo tasks and their relation to inhibition. Acta Psy-chologica, 1999, 101(2): 267-291
28 Van Veen V, Cohen JD, Botvinick MM, et al. Anterior cingu-late cortex, conflict monitoring, and levels of processing. Ne-uroimage, 2001, 14(6): 1302-1308
29 Tarter RE, Kirisci L, Feske U, et al. Modeling the pathways linking childhood hyperactivity and substance use disorder in young adulthood. Psychology of Addictive Behaviors, 2007, 21(2): 266-271
30 Jentsch JD, Taylor JR. Impaired inhibition of conditioned re-sponses produced by subchronic administration of phencycl-idine to rats. Neuropsychopharmacology, 2001, 24(1): 66-74
31 刘晓滨, 张诗茗, 李东俊, 等. 海洛因依赖者人格特征. 中国临床心理学杂志, 2008, 16(4): 432-433, 445
32 杨玲, 崔诣晨. 193 例戒毒者人格类型及其与自尊, 社会支持和应对策略的关系. 心理科学, 2004, 26(6): 1034-1038
33 Trull TJ, Waudby CJ, Sher KJ. Alcohol, tobacco, and drug use disorders and personality disorder symptoms. Experime-ntal and Clinical Psychopharmacology, 2004, 12(1): 65-75
34 陈玄玄, 陈晗晖, 杜江, 等. 海洛因依赖者人格特征分析及与首次吸毒年龄的关系. 中国临床心理学杂志, 2008, 16 (6): 662-664

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