中国临床心理学杂志

大学生人格障碍者奖赏动机及决策缺陷研究

作者：范乐佳¹ 张蓓¹ 欧阳紫榕¹ 罗兴伟¹ 李欢欢² 张江华³ 熊燕³ 罗伏生⁴ 王湘¹ 姚树桥¹

单位：1. 中南大学湘雅二医院医学心理中心长沙 410011
2. 中国人民大学心理学系北京 100872
3. 中南大学学生工作部长沙 410083
4. 中南林业科技大学学生工作部长沙 410004

分类号：R395.1

出版年,卷(期):页码：2016,24(4):583-587

摘要：

目的：本研究采用奖赏动机和决策的行为范式，旨在探索人格障碍患者的非适应性行为和社会功能损害的潜在机制。方法：通过人格诊断问卷（Personality Diagnostic Questionnaire-4，PDQ+4）筛查和SCID—Ⅱ人格障碍定式访谈，在两所高校一年级大学生中纳入170名人格障碍被试和112名正常被试，并要求其完成贝克抑郁量表和焦虑自评量表，以及计算机版的“付出努力的奖赏任务”（the Effort Expenditure for Rewards Task，EEfRT）。结果：人格障碍组在高概率水平及中等概率水平下对困难任务的选择率均显著低于正常组（P<0.01），人格障碍各亚型在高概率水平下对困难任务的选择率也均显著低于正常组（P<0.05）。广义估计方程结果表明组别、奖赏概率、奖赏幅度、期望值的主效应均显著（P<0.01），组别和奖赏概率、组别和期望值的交互作用均显著（P<0.01），但组别和奖赏幅度的交互作用不显著。结论：人格障碍者倾向于采用较少努力获得较小回报的奖赏相关决策，表现出明显的奖赏动机缺乏和对奖赏的钝化。人格障碍者在整合概率、期望值信息的奖赏敏感性方面与正常被试存在显著差异。

Objective: By using the Effort Expenditure for Rewards Task (EEfRT),this study aimed to explore deficits of reward-related motivation and decision-making in patients with personality disorders.Methods: 170 personality disorders and 112 health controls finished EEfRT,Beck Depression Inventory,and Beck Anxiety Inventory.Results: Difficult task choice rate in high and moderate probability was significantly lower in the personality disorders group than that of health control group (P<0.01).Difficult task choice rate in high probability was significantly lower in all the subtypes of personality disorder.Generalized Estimating Equation (GEE) models revealed significant main effects of group,reward probability,reward magnitude,and expected value,and significant interactive effect between group and reward probability,as well as between group and expected value.Conclusion: Personality disorders have less willingness to make effort for reward than controls,which may contribute to the motivation deficit and reward bluntness in this disorder.Additionally,Patients with personality disorder are less able to effectively use reward information about magnitude and probability of rewards to guide their choice behavior.

基金项目：

国家自然科学基金青年基金（30700236，81401120）；教育部人文社会科学研究规划基金（13YJA190015）；新世纪优秀人才支持计划（NCET-12-0557）

作者简介：

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