Emotional Cognitive Impairment Regulated by Happy Emotional Induction in People with Subthreshold Depression：an Event-related Potential Study

doi:10.12114/j.issn.1007-9572.2019.00.567

Abstract

Abstract: Background　Subthreshold depression is a sub-health state between health and depression.Because it does not meet the clinical standard，non-drug treatments are more used in practice.The happy emotional induction program developed earlier by our research group can effectively regulate individual emotions，whose mechanism of action may be clarified from the cognitive perspective.Objective　The purpose of this study was to explore whether the people with subthreshold depression have emotional cognitive impairment（ECI） and the regulation results of happy emotional induction program for ECI.Methods　44 undergraduate students of Beijing University of Chinese Medicine were recruited from December 2016 to March 2017 in accordance with the criteria of event-related potential（ERP） for testing different cognitive functions，including 17 healthy individuals（control group） and 27 with subthreshold depression 〔subthreshold depression group，was further randomized into induction subgroup（n=14） and non-intervention subgroup（n=13）〕 by the results assessed by Center for Epidemiological Survey，Depression Scale（CES-D） and 17-item Hamilton Depression Rating Scale（HAMD-17）．All participants performed ERP experiments without pre-test interventions，except those in the induction group received emotional induction according to the happy emotional induction program.A two-factor repeated measure ANOVA was utilized to examine the latencies and amplitudes of N2 and P3 components，with the group（non-intervention subgroup，induction subgroup and healthy controls） as the between-subject factor，and the emotion（positive，negative，and neutral） as the within-subject factor.The Greenhouse-Geisser correction was used to correct repeated measure ANOVA that violated the sphericity assumption，and the Bonferroni correction was applied to all post-hoc pairwise comparisons.Results　Compared with the healthy group，the amplitude of P3 decreased after positive stimulation while the latency of P3 prolonged after neutral stimulation in the non-intervention subgroup（P<0.05）．Compared with the non-intervention subgroup，in the induction subgroup，the positive stimulation increased the amplitude of P3，and prolonged the latency of P3，neutral stimulation decreased the amplitude of N2 and shortened the latency of P3（P<0.05）．Conclusion　There was emotional cognitive impairment in individuals with subthreshold depression.The happy emotional induction program can effectively regulate and improve the cognitive impairment.

Key words: Depressive disorder, Subthreshold depression, Emotional cognitive processing, Emotional induction, Event-related potentials

摘要： 背景　阈下抑郁是指介于健康与抑郁症之间的亚健康状态，因其未满足临床诊断标准，目前多采用非药物治疗。本课题组前期构建喜情绪诱导方案能有效改善个体情绪。从认知层面探索该方案对阈下抑郁个体情绪认知损伤的调节作用，可阐明情绪诱导这类干预方法的作用机制。目的　借助事件相关电位技术（ERP）探索阈下抑郁人群的情绪认知功能损伤以及喜情绪诱导方案对其的调节作用。方法　2016年12月—2017年3月，依据ERP试验差异性检验要求招募北京中医药大学本科学生44人。依据流调中心用抑郁量表（CES-D）以及汉密尔顿抑郁量表（HAMD-17）评分分为健康组17人，阈下抑郁组27人；阈下抑郁组采用随机数字表法进一步分为未干预组13人、干预组14人。对所有被试进行ERP试验。干预组在试验前按中医情绪诱导方案进行喜情绪诱导。ERP成分（N2、P3）比较采用两因素重复测量方差分析，以刺激类型（正、中、负）为组内因素，组别（健康组、未干预组、干预组）为组间因素，采用Greenhouse-Geisser修正违反球形假设的重复测量方差分析，Bonferroni校正应用于方差分析后的两两比较。结果　与健康组比较，未干预组正性刺激时P3波幅降低，中性刺激时P3潜伏期延长（P<0.05）；经过喜情绪诱导后，与未干预组比较，干预组正性刺激时P3波幅升高、P3潜伏期延长，中性刺激时N2波幅降低、P3潜伏期缩短（P<0.05）。结论　阈下抑郁个体存在情绪认知功能损伤，喜情绪诱导方案可对其进行有效调节。

关键词: 抑郁症, 阈下抑郁, 情绪认知加工, 情绪诱导, 事件相关电位

ZHANG Jinpeng,LI Xue,TAN Xi, et al. Emotional Cognitive Impairment Regulated by Happy Emotional Induction in People with Subthreshold Depression：an Event-related Potential Study　[J]. Chinese General Practice, 2019, 22(35): 4312-4317. DOI: 10.12114/j.issn.1007-9572.2019.00.567.
张金鹏,李雪,谭曦等. 喜情绪诱导调节阈下抑郁人群情绪认知损伤的事件相关电位技术研究[J]. 中国全科医学, 2019, 22(35): 4312-4317. DOI: 10.12114/j.issn.1007-9572.2019.00.567.

References

［1］谭曦，杨秋莉，杜渐，等．阈下抑郁人群团体中医心理干预方案构建［J］．中医杂志，2012，53（24）：2087-2089．DOI：10.13288/j.11-2166/r.2012.24.007.http：//www.cnki.com.cn/Article/CJFDTotal-ZZYZ201224011.htm.
［2］BECK A T，LERNER R M，PHILLIPSON A，et al．Cognitive Therapy and the Emotional Disorders（Meridian）［Paperback］［M］．New York：New American Library，1976.
［3］DISNER S G，BEEVERS C G，HAIGH E A，et al．Neural mechanisms of the cognitive model of depression［J］．Nat Rev Neurosci，2011，12（8）：467-477．DOI：10.1038/nrn3027.
［4］EVERAERT J，KOSTER E H，DERAKSHAN N.The combined cognitive bias hypothesis in depression［J］．Clin Psychol Rev，2012，32（5）：413-424．DOI：10.1016/j.cpr.2012.04.003.
［5］SHESTYUK A Y，DELDIN P J，BRAND J E，et al．Reduced sustained brain activity during processing of positive emotional stimuli in major depression［J］．Biol Psychiatry，2005，57（10）：1089-1096．DOI：10.1016/j.biopsych.2005.02.013.
［6］DELDIN P J，KELLER J，GERGEN J A，et al．Right-posterior face processing anomaly in depression［J］．J Abnorm Psychol，2000，109（1）：116-121.
［7］KAYSER J，BRUDER G E，TENKE C E，et al．Event-related potentials（ERPs） to hemifield presentations of emotional stimuli：differences between depressed patients and healthy adults in P3 amplitude and asymmetry［J］．Int J Psychophysiol，2000，36（3）：211-236.
［8］R?SCHKE J，WAGNER P.A confirmatory study on the mechanisms behind reduced P300 waves in depression［J］．Neuropsychopharmacology，2003，28（Suppl 1）：S9-12．DOI：10.1038/sj.npp.1300139.
［9］YANG W H，ZHU X Z，WANG X，et al．Time course of affective processing bias in major depression：An ERP study［J］．Neurosci Lett，2011，487（3）：372-377．DOI：10.1016/j.neulet.2010.10.059.
［10］袁远，毛春燕，王艳香，等．抑郁状态患者事件相关电位P300的特点研究［J］．中国全科医学，2015，18（11）：1337-1339．DOI：10.3969/j.issn.1007-9572.2015.11.027.
YUAN Y，MAO C Y，WANG Y X，et al．Characteristics of event reiated potential P300 in patients with depression［J］．Chinese General Practice，2015，18（11）：1337-1339．DOI：10.3969/j.issn.1007-9572.2015.11.027.
［11］宋旭升，李雪，谭曦，等．中医情绪诱导方案治疗大学生阈下抑郁31例临床观察［J］．中医杂志，2018，59（7）：591-593．DOI：10.13288/j.11-2166/r.2018.07.013.
SONG X S，LI X，TAN X，et al．Clinical observation on 31 cases of subliminal depression in college students treated with Chinese medicine emotional induction program［J］．Journal of Traditional Chinese Medicine，2018，59（7）：591-593．DOI：10.13288/j.11-2166/r.2018.07.013.
［12］RADLOFF L S.The CES-D Scale：a self-report depression scale for research in the general population［J］．Appl Psychol Meas，1977，1（3）：385-401．DOI：10.1177/014662167700100306.
［13］HAMILTON M.Development of a rating scale for primary depressive illness［J］．Br J Soc Clin Psychol，1967，6（4）：278-296．DOI：10.1111/j.2044-8260.1967.tb00530.x.
［14］白露，马慧，黄宇霞，等．中国情绪图片系统的编制——在46名中国大学生中的试用［J］．中国心理卫生杂志，2005，19（11）：719-722．DOI：10.3321/j.issn：1000-6729.2005.11.001.
BAI L，MA H，HUANG Y X，et al．The development of native Chinese affective picture system——a pretest in 46 college students［J］．Chinese Mental Health Journal，2005，19（11）：719-722．DOI：10.3321/j.issn：1000-6729.2005.11.001.
［15］OGURA C，NAGEISHI Y，OMURA F，et al．N200 component of event-related potentials in depression［J］．Biol Psychiatry，1993，33（10）：720-726.
［16］陈骁，冯正直，蒋娟.阈下抑郁个体增强或减弱情绪加工对认知控制影响的ERP研究［J］．第三军医大学学报，2016，38（17）：1991-1996．DOI：10.16016/j.1000-5404.201601043.
CHEN X，FENG Z Z，JIANG J.Effect of strengthened or weakened emotional processing on cognitive control in individuals with subthreshold depression：an event-related potential study［J］．Journal of Third Military Medical University，2016，38（17）：1991-1996．DOI：10.16016/j.1000-5404.201601043.
［17］DELDIN P J，KELLER J，GERGEN J A，et al．Right-posterior face processing anomaly in depression［J］．J Abnorm Psychol，2000，109（1）：116-121.
［18］YANG W H，ZHU X Z，WANG X，et al．Time course of affective processing bias in major depression：an ERP study［J］．Neurosci Lett，2011，487（3）：372-377．DOI：10.1016/j.neulet.2010.10.059.
［19］JOHNSON J D，ALLANA T N，MEDLIN M D，et al．Meta-analytic review of P3 components in posttraumatic stress disorder and their clinical utility［J］．Clin EEG Neurosci，2013，44（2）：112-134．DOI：10.1177/1550059412469742.
［20］CAVANAGH J，GEISLER M W.Mood effects on the ERP processing of emotional intensity in faces：a P3 investigation with depressed students［J］．Int J Psychophysiol，2006，60（1）：27-33．DOI：10.1016/j.ijpsycho.2005.04.005.
［21］DAI Q，FENG Z Z.More excited for negative facial expressions in depression：evidence from an event-related potential study［J］．Clin Neurophysiol，2012，123（11）：2172-2179．DOI：10.1016/j.clinph.2012.04.018.

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