抑郁障碍的愧疚情绪与道德行为：来自神经科学的证据

Exploring the “social brain” of the psychiatric patients has attracted increasing attention in the current field of social neuroscience. Previous studies showed that social cognition dysfunction has a critical impact on the occurrence, development and prognosis of the depressive disorder. Patients suffering from depressive disorder have abnormalities in the processing of moral information which is a high-order and peculiar social cognition to mankind. However, the cognitive and neural mechanisms underlying these abnormalities are still unclear. Based on morality and the depressive disorder that we have studied before, this project attempts to use functional magnetic resonance imaging to investigate the cognitive neural mechanisms of the abnormal moral mind of depressed pateints, and subsequently utilize pattern recognition analysis to build the neural diagnostic markers for diagnosing these abnormalities. Our research mainly includes: (1) exploring the cognitive neural mechanism of the survivor guilt that is peculiar to depressed patients; (2) investigating the influence of survivor guilt on the prosocial and moral violation behaviors of depressed patients, and revealing the cognitive neural mechanisms underlying these relationships; (3) finding the neural diagnostic markers which could help to diagnose the depression-related abnormal guilt, prosocial behavior bias and moral violation behavior bias with higher accurateness. This project would provide important empirical data for constructing the social cognitive model of depression and scientific evidence for screening the susceptibility, diagnosing and evaluating prognosis of depression.

探索精神疾患的“社会脑”是当前社会神经科学的研究热点，对抑郁障碍而言，社会认知功能异常对疾病的发生、发展和预后都具有关键性的影响。研究表明抑郁患者在道德心理这一社会认知功能上存在异常，突出表现为具有过度的幸存性愧疚，并导致道德行为偏差，但这些过程的认知神经机制尚不明确。本项目将结合功能磁共振成像技术和模式识别分析技术，探明抑郁障碍的异常愧疚情绪和道德行为偏差的认知神经机制，并建立相应的神经诊断指标。研究内容包括：(1)揭示抑郁障碍的幸存性愧疚的认知神经机制；(2)探讨在幸存性愧疚的影响下，患者的亲社会行为和违规行为表现及认知神经机制；(3)建立抑郁障碍的异常愧疚、亲社会行为偏差和违规行为偏差的神经诊断指标。本项目将为构建抑郁障碍的社会认知模型提供数据支持，也为抑郁障碍的易感人群筛查、诊断和预后评价提供科学依据，具有重要的理论和实践意义。申请人已发表相关SCI论文多篇，为项目实施奠定了基础。

本项目围绕抑郁障碍的道德心理异常问题，采用磁共振成像和认知行为实验，考察抑郁患者愧疚情绪和道德行为的异常模式及神经机制。主要成果包括：（1）采集了62例单相抑郁（MDD）、55例双相抑郁（BD）和60例正常对照的临床、认知和多模态磁共振成像数据；（2）初步揭示了抑郁患者异常愧疚的认知神经机制，发现抑郁患者表现出过度的愧疚情绪，其中，MDD的过度愧疚与其奖赏系统灰质体积的升高有关，而BD的过度愧疚与其情绪和奖赏系统之间功能连接的变异性增强有关；初步揭示了抑郁患者道德行为异常及神经机制，发现抑郁患者具有过度的顺从行为倾向，其中，MDD和BD的过度顺从分别与其奖赏和认知控制系统的结构变异有关；此外，采用模式识别方法，探寻抑郁患者异常道德心理的神经表征，发现情感与心理理论脑区之间的静息态功能连接能够有效预测个体的道德行为，而患者在这些连接上的异常改变可能是其道德行为发生变异的重要原因；（3）进一步探测了抑郁障碍及与其具有病理同源性的情感障碍和人格特质的神经机制，发现自我、心理理论、奖赏等与道德心理密切相关的社会认知脑区域和脑网络的异常十分突出；（4）拓展研究了与道德心理密切关联的自我加工、负性偏好等认知过程在抑郁患者中的异常模式及神经机制，为构建抑郁障碍的社会认知模型积累更全面的线索。以上研究成果在社会认知、脑影像领域国际期刊Social Cognitive and Affective Neuroscience，NeuroImage，Human Brain Mapping等发表和录用SCI论文9篇，其中影响因子大于5的2篇；培养硕士研究生2名；项目组成员通过积极参与相关领域主流国际会议、开展合作研究等方式与国内外同行进行了深入的学术交流和合作。