研究目的 本研究的目的是要藉由線索暴露的實驗典範,探索長期使用安眠藥物
之患者對於安眠藥物相關刺激的注意力偏誤現象,並根據 Baker 及其同事們 (2004)與其他學者所提出的「藥物動機理論的情感模型」,強調負向情感在長 期使用安眠藥物的失眠患者所扮演的角色,本研究另欲探討長期使用失眠藥物的 患者是否在負向的情緒下能引發其對安眠藥物有更多的注意力及反應偏誤,並以 oddball 實驗典範來引發測量大腦皮質 ERP 波的注意力偏誤現象,並試圖以主觀 渴求問卷來測量個案是否在負向情感下有較強烈的主觀渴求反應。
方法 研究之有效樣本為 13 人。其中男性 5 人,女性 8 人,年齡介於 23-54 歲 (34.15 ± 11.07),參與研究之受試者會進行兩晚之實驗及多頻道睡眠生理檢查, 實驗情境分成基礎情境及挫折情境,在挫折情境中,受試者在進行較困難之認知 作業的同時,研究者會給予負向之指導語以進行情緒之操弄;而在基礎情境則給 予中性之指導語。在認知作業進行之後,開始進行線索暴露之 ERP 測量,受試 者須判斷圖片是否含有動物(目標刺激),另包含中性圖片刺激(96 張)、睡眠 相關刺激(32 張)及藥物相關刺激(32 張)。另外在認知測驗及線索暴露的前後 也會測量受試者之情緒狀態及主觀渴求狀態。研究分析以多變量變異數分析進行 檢驗。
結果 長期使用安眠藥物的患者相較於中性刺激,其對於藥物圖片刺激及睡眠相 關刺激皆有較大之 P300 及 SPW 腦波振幅。未在研究中驗證 Baker 等人提出之負 增強處理模式之因果關係,但發現,在基礎情境中,當受試者的正向情緒減少愈 多,受試者在單一題項渴求程度減少愈少;而負向情緒與其他的渴求指標較具有 相關性,研究發現當負向情緒增加愈多,單一題項渴求程度增加愈多,對藥物效 果的期待也愈高,對藥物的欲求與所帶來欣快感也會愈高,顯示情緒的改變於主 觀渴求狀態的相關性。此外本研究結果顯示客觀的腦波指標與部分主觀感受顯著 相關,其中 P300 與其對藥物的渴求程度呈正相關。
結論 無論是在基礎情境或挫折情境,長期使用安眠藥物之患者對安眠藥刺激及 睡眠相關刺激皆有注意力偏誤之現象,且此注意力偏誤現象與其對藥物的渴求程 度具有一定程度之相關性。在挫折情境中,受試者對藥物之主觀渴求有較大的傾向。 / Introduction The major goal of this study is to examine the phenomenon of craving
in hypnotic use. The Affective Processing Model of Negative Reinforcement (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004) suggests that negative affect would influence drug use through the change of cognitive process to a “hot information processing” and therefore increase the craving for drug use. The study explores the effects of negative affect on attentional bias and subjective craving associated with hypnotic use to test this model.
Method Thirteen long-term hypnotic users were included in this study. They came to the sleep laboratory for two nights for an experimental night in which negative affect was induced by giving negative comments on their performance on a cognitive task and a control night with exactly the same procedure except that the negative comments was replaced by neutral comments. For both nights, craving was assessed with subjective ratings and measure of attentional bias with recording of event-related potentials (ERPs) induced by pictures related to hypnotic use, sleep and neutral pictures.
Result The amplitude of P300 and SPW for sleep related pictures and hypnotic related pictures are significant larger than the amplitude for neutral pictures in both conditions. Also, results show that the picture of P300 are positively correlated with subjective craving for hypnotic drugs. Moreover, the data shows the tendency of condition difference in subjective craving.
Conclusion The hypnotic long-term users do show attentional bias for sleep related and hypnotic related pictures. However, the result does not show more attentional bias
for hypnotic related pictures in stressful situation. On the other hand, the data shows a tendency that the subjective craving is stronger in stressful situation than in baseline situation. The findings show only partial support for the Affective Processing Model of Negative Reinforcement.
| Identifer | oai:union.ndltd.org:CHENGCHI/G1017520051 |
| Creators | 林郁秀, Lin, Yu Siou |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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