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題名 海洛因成癮者的決策判斷與抑制控制缺損探討
The impairment of decision making and inhibitory control in heroin addicts作者 鍾昀蓁
Chung, Yun Chen貢獻者 許文耀
Hsu, Wen Yau
鍾昀蓁
Chung, Yun Chen關鍵詞 海洛因成癮
決策判斷
抑制控制
heroin addict
decision making
inhibition control日期 2011 上傳時間 30-Oct-2012 15:21:38 (UTC+8) 摘要 本研究目的主要在探討海洛因成癮者是否具有決策判斷的問題與抑制控制能力缺損,利用數理認知模型的參數值檢驗受試者在新式Go/No-Go作業的表現,該作業結合IGT與原先Go/No-Go作業的特性,並將作業刺激改為中性與海洛因相關的圖片,探討海洛因成癮者在此作業的決策歷程與抑制反應功能,並與控制組作比較。另者,根據誘發─敏感化理論 ( Robinson & Berridge, 1993 ) 與誘發─習慣化模式 ( Di Chiara, 2000 ) 的預測,前者認為成癮越嚴重者的抑制缺損情形會越嚴重,對藥物相關刺激的注意力偏誤也越明顯;後者則認為藥物依賴階段的初期會發生較嚴重的注意力偏誤情形,但隨著依賴程度增加而對藥物相關刺激已習慣化,尋求藥物行為也已變成自動化反應,故注意力偏誤的情形反而會減少。因此,本研究試圖在加入藥物相關刺激的Go/No-Go作業中驗證這兩種理論的預測。 本研究以48位一般控制組、88位海洛因受戒治人為樣本,利用Go/No-Go作業與線索依賴學習模式 ( CD model ) 分析受試者對酬賞或處罰的注意力 ( w參數 )、學習率 ( 參數 )、反應一致性 ( c參數 )、以及海洛因圖片價值的影響 ( I_Heroin參數 ),結果發現,比起控制組,海洛因成癮者對酬賞的注意力較低、受到藥物相關刺激影響較明顯。另外,將戒治組分為物質高依賴組與低依賴組時,比起控制組,高依賴組對酬賞的注意力較低;而低依賴組受到海洛因圖片價值影響較明顯。結果證實當面對同時具有中性與藥物相關刺激時的情況下,海洛因成癮者與過去古柯鹼成癮者在決策作業上的表現不同,不僅受到酬賞或處罰的影響,藥物相關刺激本身亦帶有某種價值,影響成癮者的決策與抑制能力;另外,結果部分支持誘發─習慣化的預測。
The purpose of present study was to investigate the decision making and inhibitory problem in heroin addicts, and to use the mathematics cognitive model parameters to examine performance in a new Go/No-Go Task of subjects. The task combined the characteristics of IGT and original Go/No-Go Task. We changed the task’s stimuli to neural and heroin related pictures, to explore the decision making and inhibitory reactive function in the task, and compared with control group. On the other hands, according to Incentive-sensitization theory (Robinson & Berridge, 1993) and ‘Incentive ─ habit’ model (Di Chiara, 2000), the incentive-sensitization thoery thought that people with increasing severity of addiction get more inhibitory problems and attentional bias toward drug related cues, but the incentive-habit model suggests that attentional bias for drug cues will be more severe in the early stage of drug dependence., but with the increase in dependence and habit to drug cues, drug-seeking behavior has become automatic reaction, so attentional bias will be attenuated when abusers get more dependence. Therefore, this study attempted to verify the prediction of two theories in the Go / No-Go Task with drug-related stimuli. This research was based on the data collected from the 48 normals and 88 heroin addicts, using Go/No-Go Task and Cue-dependence learning model ( CD model ) analysis their attention to reward or punishment ( parameter w ), learning rate ( ), reactive consistence ( c ), and valence of heroin pictures ( I_Heroin). The result revealed that compare to controls, heroin addicts had fewer attention to rewards, and more obvious influenced by drug related stimuli. Otherwise, to divided addicts group into high dependence group and low dependence group, compared to control group, the high dependence addicts had lower attention to reward, and the lower dependence addicts was higher influenced by drug related stimuli. It confirm that when heroin abusers faced to neural and drug related stimili, their performance in decision making task was different from cocaine abusers, it’s not only influenced from reward or punishment, but also from the valence of drug related cues. 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國立政治大學
心理學研究所
97752019
100資料來源 http://thesis.lib.nccu.edu.tw/record/#G0097752019 資料類型 thesis dc.contributor.advisor 許文耀 zh_TW dc.contributor.advisor Hsu, Wen Yau en_US dc.contributor.author (Authors) 鍾昀蓁 zh_TW dc.contributor.author (Authors) Chung, Yun Chen en_US dc.creator (作者) 鍾昀蓁 zh_TW dc.creator (作者) Chung, Yun Chen en_US dc.date (日期) 2011 en_US dc.date.accessioned 30-Oct-2012 15:21:38 (UTC+8) - dc.date.available 30-Oct-2012 15:21:38 (UTC+8) - dc.date.issued (上傳時間) 30-Oct-2012 15:21:38 (UTC+8) - dc.identifier (Other Identifiers) G0097752019 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/55031 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學研究所 zh_TW dc.description (描述) 97752019 zh_TW dc.description (描述) 100 zh_TW dc.description.abstract (摘要) 本研究目的主要在探討海洛因成癮者是否具有決策判斷的問題與抑制控制能力缺損,利用數理認知模型的參數值檢驗受試者在新式Go/No-Go作業的表現,該作業結合IGT與原先Go/No-Go作業的特性,並將作業刺激改為中性與海洛因相關的圖片,探討海洛因成癮者在此作業的決策歷程與抑制反應功能,並與控制組作比較。另者,根據誘發─敏感化理論 ( Robinson & Berridge, 1993 ) 與誘發─習慣化模式 ( Di Chiara, 2000 ) 的預測,前者認為成癮越嚴重者的抑制缺損情形會越嚴重,對藥物相關刺激的注意力偏誤也越明顯;後者則認為藥物依賴階段的初期會發生較嚴重的注意力偏誤情形,但隨著依賴程度增加而對藥物相關刺激已習慣化,尋求藥物行為也已變成自動化反應,故注意力偏誤的情形反而會減少。因此,本研究試圖在加入藥物相關刺激的Go/No-Go作業中驗證這兩種理論的預測。 本研究以48位一般控制組、88位海洛因受戒治人為樣本,利用Go/No-Go作業與線索依賴學習模式 ( CD model ) 分析受試者對酬賞或處罰的注意力 ( w參數 )、學習率 ( 參數 )、反應一致性 ( c參數 )、以及海洛因圖片價值的影響 ( I_Heroin參數 ),結果發現,比起控制組,海洛因成癮者對酬賞的注意力較低、受到藥物相關刺激影響較明顯。另外,將戒治組分為物質高依賴組與低依賴組時,比起控制組,高依賴組對酬賞的注意力較低;而低依賴組受到海洛因圖片價值影響較明顯。結果證實當面對同時具有中性與藥物相關刺激時的情況下,海洛因成癮者與過去古柯鹼成癮者在決策作業上的表現不同,不僅受到酬賞或處罰的影響,藥物相關刺激本身亦帶有某種價值,影響成癮者的決策與抑制能力;另外,結果部分支持誘發─習慣化的預測。 zh_TW dc.description.abstract (摘要) The purpose of present study was to investigate the decision making and inhibitory problem in heroin addicts, and to use the mathematics cognitive model parameters to examine performance in a new Go/No-Go Task of subjects. The task combined the characteristics of IGT and original Go/No-Go Task. We changed the task’s stimuli to neural and heroin related pictures, to explore the decision making and inhibitory reactive function in the task, and compared with control group. On the other hands, according to Incentive-sensitization theory (Robinson & Berridge, 1993) and ‘Incentive ─ habit’ model (Di Chiara, 2000), the incentive-sensitization thoery thought that people with increasing severity of addiction get more inhibitory problems and attentional bias toward drug related cues, but the incentive-habit model suggests that attentional bias for drug cues will be more severe in the early stage of drug dependence., but with the increase in dependence and habit to drug cues, drug-seeking behavior has become automatic reaction, so attentional bias will be attenuated when abusers get more dependence. Therefore, this study attempted to verify the prediction of two theories in the Go / No-Go Task with drug-related stimuli. This research was based on the data collected from the 48 normals and 88 heroin addicts, using Go/No-Go Task and Cue-dependence learning model ( CD model ) analysis their attention to reward or punishment ( parameter w ), learning rate ( ), reactive consistence ( c ), and valence of heroin pictures ( I_Heroin). The result revealed that compare to controls, heroin addicts had fewer attention to rewards, and more obvious influenced by drug related stimuli. Otherwise, to divided addicts group into high dependence group and low dependence group, compared to control group, the high dependence addicts had lower attention to reward, and the lower dependence addicts was higher influenced by drug related stimuli. It confirm that when heroin abusers faced to neural and drug related stimili, their performance in decision making task was different from cocaine abusers, it’s not only influenced from reward or punishment, but also from the valence of drug related cues. In addition, the result partially support the prediction of the incentive-habit model. en_US dc.description.tableofcontents 第一章 緒論……………………………………………………… 1第一節 研究背景與動機………………………………………… 1第二節 物質濫用者的低自我控制……………………………… 4第三節 藥癮者的決策與抑制控制缺損………………………… 6第四節 海洛因成癮者的認知缺損……………………………… 10第五節 藥癮者的認知缺損理論………………………………… 12第二章 研究架構………………………………………………… 19第一節 研究目的………………………………………………… 19第二節 研究架構………………………………………………… 21第三節 研究問題與假設………………………………………… 26第三章 研究方法………………………………………………… 31第一節 研究對象………………………………………………… 31第二節 研究程序………………………………………………… 32第三節 研究工具………………………………………………… 33第四節 資料分析與處理………………………………………… 39第四章 研究結果…………………………………………………. 41第一節 受試者的基本資料描述…………………………………. 41第二節 實驗結果分析……………………………………………. 49第五章 綜合討論…………………………………………………. 59第一節 研究結果討論……………………………………………. 59第二節 研究限制與建議…………………………………………. 62 參考文獻…………………………………………………. 67附錄一 自我評量人型圖.....................……………… 82附錄二 受試者參與研究同意書...……………………………….. 85附錄三 物質使用情況.…………………………………..……….. 86附錄四 貝克焦慮量表..…………………………………..………. 88附錄五 貝克憂鬱量表………………………………..………....... 90附錄六 依賴嚴重度量表..…………………………………..……. 95附錄二 物質渴想量表................................. 96表目次表3-1: 中性圖片─海洛因圖片的相關分析……………………………… 34表4-1: 各組受試者年齡分佈情形………………………………………… 42表4-2: 各組受試者婚姻狀態分佈情形…………………………………… 42表4-3: 各組受試者教育程度分佈情形…………………………………… 43表4-4: 各組受試者職業類型分佈情形…………………………………… 44表4-5: 海洛因組受試者首次施用年齡分佈情形……………………………45表4-6: 海洛因組受試者施用海洛因之方式與頻率…………………………46表4-7: 海洛因組渴想分數與成癮嚴重度分數情形…………………………47表4-8: 各組情緒分數與瑞文氏分數情形……………………………………48表4-9: 各組Go/Nogo Task的反應錯誤情形………………………………50表4-10: 兩種模型BIC值的摘要表……………………………………………50表4-11: 四種控制變項的相關情形……………………………………………51表4-12: 控制組與戒治組─模型二參數平均數/標準差摘要表…………… 52表4-13: 同時控制教育程度、焦慮、憂鬱及智力分數下,有無施用海洛因(組 間)對認知參數的共變數分析摘要表 ─依變項w參數…………… 52表4-14: 同時控制教育程度、焦慮、憂鬱及智力分數下,有無施用海洛因(組 間)對認知參數的共變數分析摘要表─依變項 參數……………53表4-15: 同時控制教育程度、焦慮、憂鬱及智力分數下,有無施用海洛因(組 間)對認知參數的共變數分析摘要表 ─依變項c參數……………53表4-16: 同時控制教育程度、焦慮、憂鬱及智力分數下,有無施用海洛因(組 間)對認知參數的共變數分析摘要表 ─依變項I_Heroin參數……54表4-17: 同時控制教育程度、焦慮、憂鬱及智力分數下,海洛因成癮嚴重度 (分組變項)對認知參數的共變數分析摘要表─依變項w參數…55表4-18: 同時控制教育程度、焦慮、憂鬱及智力分數下,海洛因成癮嚴重度 (分組變項)對認知參數的共變數分析摘要表─依變項 參數…55表4-19: 同時控制教育程度、焦慮、憂鬱及智力分數下,海洛因成癮嚴重度 (分組變項)對認知參數的共變數分析摘要表─依變項c參數…56表4-20: 同時控制教育程度、焦慮、憂鬱及智力分數下,海洛因成癮嚴重 度(分組變項)對認知參數的共變數分析摘要表─依變項I_Heroin參 數…………………………………………………………………… 56表4-21 所有受試者認知參數和Omission error、 Commission error的 相關58表4-22 兩組受試者認知參數和error的相關(相關係數)……………58圖次圖一: Go/No-Go Discrimination 作業的嘗試次中,螢幕中央呈現按鍵 會獲得酬賞/接受懲罰的 Good/Bad 圖片時,受試者按鍵與未按鍵 的程序………………………………………………………………37 zh_TW dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0097752019 en_US dc.subject (關鍵詞) 海洛因成癮 zh_TW dc.subject (關鍵詞) 決策判斷 zh_TW dc.subject (關鍵詞) 抑制控制 zh_TW dc.subject (關鍵詞) heroin addict en_US dc.subject (關鍵詞) decision making en_US dc.subject (關鍵詞) inhibition control en_US dc.title (題名) 海洛因成癮者的決策判斷與抑制控制缺損探討 zh_TW dc.title (題名) The impairment of decision making and inhibitory control in heroin addicts en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 參考文獻中文文獻中央警察大學犯罪防治學系(民97年8月)。毒品施用者替代療法之研究。執行 單位:中央警察大學犯罪防治學系。委託單位:財團法人林心正教育基金 會。孔繁鐘(編譯)(2009)。DSM-IV-TR精神疾病診斷準則手冊。台北市:合紀圖 書出版社。行政院衛生署管制藥品管理局.(2008)。強化藥物濫用防治體系(四年計畫)。 台北市,行政院衛生署。行政院衛生署管制藥品管理局 (2008)。藥物濫用 案件暨檢驗統計資料【一 ○○年十一月】。台北市,行政院衛生署。行政院衛生署管制藥品管理局 (民92年6月)。物質濫用。台北市,行政院衛 生署。林一真 (民89)。貝克焦慮量表中文版指導手冊。台北市:中國行為科學研究 社。(BAI原著出版年:1993年)。俞筱鈞 (1994)。瑞文氏標準圖形推理測驗指導手冊。台北市:中國行為科學 研究社。(原版出版年:1960年)。胡海國、林信男譯,ICD-10精神與行為障礙之分類:臨床描述與指引。中華 民國精神醫學會,1996年初版。陳心怡 譯 (民89)。貝克憂鬱量表 ( BDI-II )中文版第二版指導手冊。台 北市:中國行為科學研究社。(原著出版年:1994年)。許文耀(2009)。海洛因藥癮者的抑制控制探討。台北市,政治大學。(國科會 計畫)。黃華妮(2000)。 利用神經心理作業初探台灣地區海洛因戒治者之認知功能研 究。碩士, 國立政治大學, 台北市。傅雅懌(2009)。海洛因藥癮者的抑制歷程初探。碩士,國立中正大學,嘉義 縣。英文文獻Baker, T., Piper, M., McCarthy, D., Majeskie, M., & Fiore, M. 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