Major Depression Is Not Associated with Blunting of Aversive Responses; Evidence for Enhanced Anxious Anticipation
Major Depression Is Not Associated with Blunting of Aversive Responses; Evidence for Enhanced Anxious Anticipation
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DOI：
10.1371/journal.pone.0070969
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发表时间：
2013-08-08
期刊：
影响因子：
3.7
通讯作者：
Zarate, Carlos A.
中科院分区：
文献类型：
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作者：
Grillon, Christian;Franco-Chaves, Jose A.;Zarate, Carlos A.
根据情绪情境不敏感（ECI）假说，重度抑郁症（MDD）与对积极刺激的情绪反应能力下降以及对威胁的防御反应迟钝有关。 MDD 中的防御反应减弱似乎与 MDD 的概念化和诊断疾病学不一致。本研究使用休克威胁范式测试了 MDD 中的 ECI 假设。将 28 名 MDD 患者（35.5+/-10.4 岁）与 28 名对照者（35.1+/-7.4 岁）进行比较。参与者面临三种情况：无冲击、可预测的冲击和不可预测的冲击。惊吓幅度用于评估防御反应。与 ECI 假设不一致的是，MDD 组中对可预测和不可预测休克的惊吓增强并未减少。相反，MDD 患者在整个测试过程中表现出更高的惊吓程度，并且在放置电击电极期间和在可预测的条件下表现出更高的情境焦虑。回归分析表明，病程和贝克抑郁量表评分解释了 37% (p
According to the emotion-context insensitivity (ECI) hypothesis, major depressive disorder (MDD) is associated with a diminished ability to react emotionally to positive stimuli and with blunting of defensive responses to threat. That defensive responses are blunted in MDD seems inconsistent with the conceptualization and diagnostic nosology of MDD. The present study tested the ECI hypothesis in MDD using a threat of shock paradigm. Twenty-eight patients with MDD (35.5+/-10.4 years) were compared with 28 controls (35.1+/-7.4 years). Participants were exposed to three conditions: no shock, predictable shock, and unpredictable shock. Startle magnitude was used to assess defensive responses. Inconsistent with the ECI hypothesis, startle potentiation to predictable and unpredictable shock was not reduced in the MDD group. Rather, MDD patients showed elevated startle throughout testing as well as increased contextual anxiety during the placement of the shock electrodes and in the predictable condition. A regression analysis indicated that illness duration and Beck depression inventory scores explained 37% (p