心理預(yù)期與認(rèn)知方式對(duì)負(fù)面情緒的交互調(diào)節(jié)*

楊潔敏 張 蜀 袁加錦 劉光遠(yuǎn)

(1認(rèn)知與人格教育部重點(diǎn)實(shí)驗(yàn)室(西南大學(xué));西南大學(xué)心理學(xué)部;2西南大學(xué)數(shù)學(xué)博士后流動(dòng)站;3西南大學(xué)電子信息工程學(xué)院,重慶 400715)

1 研究背景和意義

“凡事預(yù)則立,不預(yù)則廢”(《禮記·中庸》)。這一經(jīng)典名句告訴我們：做任何事情有預(yù)先的準(zhǔn)備則可以獲得成功,沒有準(zhǔn)備則導(dǎo)致失敗。人們對(duì)負(fù)性事件情緒影響的調(diào)控也不例外。研究表明,人們不但對(duì)突發(fā)創(chuàng)傷性事件(如地震災(zāi)害導(dǎo)致親人逝世)難以通過事后的認(rèn)知調(diào)節(jié)降低其情緒影響(Badour &Feldner,2013;Goldsmith,Chesney,Heath,&Barlow,2013;Punamaki,Muhammed,&Abdulrahman,2004;Schore,2002;Weiss et al.,2012);甚至對(duì)普通應(yīng)激事件帶來的情緒壓力進(jìn)行事后調(diào)節(jié)也是困難的(Herts,McLaughlin,&Hatzenbuehler,2012;Raio,Orederu,Palazzolo,Shurick,&Phelps,2013)。即便是在實(shí)驗(yàn)室情景中,許多研究也指出人們對(duì)負(fù)性刺激事后情緒調(diào)控往往是困難的(Hofmann,Sawyer,Fang,&Asnaani,2012;Joormann&D'Avanzato,2010),事后的情緒調(diào)控需要以消耗大量的認(rèn)知與抑制控制資源為代價(jià),并且有時(shí)非但不能達(dá)到調(diào)控的目的反而會(huì)產(chǎn)生更為負(fù)面的情緒后果(Denny,Ochsner,Weber,&Wager,2014;Opitz,Lee,Gross,&Urry,2014;Sheppes &Meiran,2008)。

既然事后情緒調(diào)節(jié)具有上述局限,那有無可能在情緒事件發(fā)生之前“未雨綢繆”,以達(dá)到情緒調(diào)節(jié)的效果呢？答案是肯定的,這就是對(duì)情緒事件進(jìn)行事前的心理準(zhǔn)備——預(yù)期(Anticipation)(Herwig,Abler,Walter,&Erk,2007;Nitschke,Sarinopoulos,Mackiewicz,Schaefer,&Davidson,2006;Onoda et al.,2008;Yang,Yuan,&Li,2012)。情緒預(yù)期功能是人類適應(yīng)環(huán)境的基本功能,這一能力使得我們對(duì)潛在的威脅性事件未雨綢繆,并減弱負(fù)性事件對(duì)有機(jī)體產(chǎn)生的負(fù)面影響(Golub,Gilbert,&Wilson,2009;Hauck,Fenwick,Downie,&Butt,2007)。近年來,心理預(yù)期及其情緒調(diào)控逐漸成為了心理學(xué)與認(rèn)知神經(jīng)科學(xué),特別是情緒與社會(huì)神經(jīng)科學(xué)領(lǐng)域新的研究熱點(diǎn),引起了越來越多研究者的關(guān)注(Galli,Wolpe,&Otten,2011;Golub et al.,2009;Salimpoor,Benovoy,Larcher,Dagher,&Zatorre,2011;Sarinopoulos et al.,2010 )。研究證明：對(duì)負(fù)性事件發(fā)生之前預(yù)先的心理準(zhǔn)備,即心理預(yù)期,能在無需付出認(rèn)知代價(jià)的情況下,有效降低負(fù)性事件所產(chǎn)生的情緒影響(Alvarez,Chen,Bodurka,Kaplan,&Grillon,2011;Buodo et al.,2012;Herwig,Abler,et al.,2007;Yang,Yuan,&Li,2010,2012)。情緒預(yù)期能力的不足往往與精神疾病的發(fā)生具有密切聯(lián)系(Bassett&Husted,1997;Scherpiet et al.,2014;Wynn,Horan,Kring,Simons,&Green,2010),并使得同樣的情緒事件產(chǎn)生更為嚴(yán)重的情緒后果,如神經(jīng)性暈厥(Buodo et al.,2012)。

然而,盡管心理預(yù)期作為事前策略能有效降低負(fù)性事件產(chǎn)生的情緒影響,對(duì)負(fù)性事件的預(yù)期過程本身卻能顯著激活情緒相關(guān)的神經(jīng)環(huán)路并導(dǎo)致主觀焦慮體驗(yàn)(Acheson et al.,2012;Carlson,Greenberg,Rubin,&Mujica-Parodi,2011;Drabant et al.,2011;Onoda et al.,2008;Straube,Mentzel,&Miltner,2007;Nitschke et al.,2006)。因此,如何克服預(yù)期過程本身的負(fù)面情緒效應(yīng),以充分發(fā)揮心理預(yù)期這一事前策略的情緒調(diào)控優(yōu)勢(shì),成為了情緒調(diào)節(jié)領(lǐng)域亟待解決的重要問題。研究表明,對(duì)情緒壓力源采用適應(yīng)性的認(rèn)知方式,如理性思考、積極重評(píng)與接受等有利于心理健康的保持(Amin,Constable,&Canli,2004;Connor-Smith &Flachsbart,2007;Hu et al.,2014;Shiota &Levenson,2009)。并且,有證據(jù)顯示,將認(rèn)知重評(píng)策略應(yīng)用于情緒預(yù)期階段,能促進(jìn)該策略的成功使用(Denny et al.,2014)。因此,將上述適應(yīng)性的認(rèn)知方式應(yīng)用于情緒預(yù)期與情緒刺激過程,有望降低情緒預(yù)期的負(fù)面代價(jià)從而充分發(fā)揮其情緒調(diào)控的優(yōu)勢(shì)。

另一方面,盡管事前的心理預(yù)期能提高個(gè)體對(duì)負(fù)性事件的應(yīng)對(duì)能力,但是過度負(fù)性預(yù)期——對(duì)潛在負(fù)性事件不僅作負(fù)面心理預(yù)期同時(shí)以情緒化的、擔(dān)憂的方式應(yīng)對(duì)該事件(Behar,DiMarco,Hekler,Mohlman,&Staples,2009;Boelen &Reijntjes,2009),卻是各類焦慮障礙的核心特征(Acheson et al.,2012;Carlson et al.,2011;Chansky&Kendall,1997;Grillon et al.,2008)。因此,對(duì)各類焦慮人群進(jìn)行適應(yīng)性認(rèn)知方式的訓(xùn)練,以減弱他們對(duì)未知事件的負(fù)面預(yù)期,可能是干預(yù)各類焦慮障礙的重要途徑。

因此,有必要綜合采用行為學(xué)、多導(dǎo)外周生理記錄與神經(jīng)成像手段以揭示認(rèn)知方式與心理預(yù)期對(duì)負(fù)面情緒的交互調(diào)節(jié)效應(yīng)。其意義不僅在于尋找發(fā)揮心理預(yù)期情緒調(diào)節(jié)優(yōu)勢(shì),減弱其情緒代價(jià)的方法,更在于從心理預(yù)期與認(rèn)知方式相互作用的角度為各類焦慮癥的臨床治療提供新的思路。

2 國(guó)內(nèi)外研究現(xiàn)狀分析

2.1 心理預(yù)期及其情緒影響

對(duì)潛在負(fù)性事件預(yù)先的心理準(zhǔn)備,能有效提高人們對(duì)該類事件的應(yīng)對(duì)能力,從而更好的適應(yīng)環(huán)境的變化(Grupe &Nitschke,2013;Herwig,Abler,et al.,2007;Sarinopoulos et al.,2010)。這一提前的心理準(zhǔn)備過程被研究者稱為“心理預(yù)期”(Anticipation)(Herwig,Abler,et al.,2007;Nitschke et al.,2006;Onoda et al.,2008)。在實(shí)驗(yàn)室條件下,為考察心理預(yù)期對(duì)情緒加工的影響,研究者常常采用線索-目標(biāo)范式來進(jìn)行研究,線索刺激可用抽象的圖形符號(hào)、字母、或情緒圖片等來表示,個(gè)體根據(jù)線索提示對(duì)隨后呈現(xiàn)的目標(biāo)刺激的情緒內(nèi)容(情緒圖片或是疼痛刺激等)形成預(yù)期(Carlson et al.,2011;Carlson &Mujica-Parodi,2010;Galli et al.,2011;Herwig,Abler,et al.,2007;Nitschke et al.,2006;Simmons,Strigo,Matthews,Paulus,&Stein,2006;Yang,Yuan,&Li,2010;Yang,Yuan,&Li,2012),對(duì)線索有無及線索有效性的操控可以設(shè)置不同的預(yù)期條件。個(gè)體對(duì)負(fù)性刺激的心理預(yù)期加工可以分為兩個(gè)階段：第一階段是心理準(zhǔn)備階段。該階段情緒刺激尚未呈現(xiàn),個(gè)體根據(jù)已有線索對(duì)隨后將呈現(xiàn)的情緒刺激形成心理準(zhǔn)備。第二階段是目標(biāo)呈現(xiàn)階段。此階段呈現(xiàn)目標(biāo)情緒刺激,個(gè)體對(duì)情緒刺激進(jìn)行在線加工(Galli et al.,2011)。以往眾多研究集中考察了在線索有效提示目標(biāo)情緒內(nèi)容的條件下,情緒預(yù)期過程本身的生理心理效應(yīng)及事前預(yù)期對(duì)目標(biāo)刺激情緒喚起水平的調(diào)節(jié)作用(Drabant et al.,2011;Herwig,Abler,et al.,2007;Nitschke et al.,2006;Yang,Yuan,&Li,2010;Yang,Yuan,&Li,2012)。

現(xiàn)有研究一致發(fā)現(xiàn)：在心理準(zhǔn)備階段,盡管負(fù)性情緒事件尚未出現(xiàn),這一預(yù)期過程將導(dǎo)致大腦的注意警覺效應(yīng)(對(duì)隨后情緒目標(biāo)的警覺)和情緒相關(guān)神經(jīng)環(huán)路的激活(Bocker,Baas,Kenemans,&Verbaten,2001;Grupe &Nitschke,2013;Herwig,Abler,et al.,2007;Nitschke et al.,2006;Onoda et al.,2008)。早期研究指出,人類腦電中的刺激前電位(預(yù)期過程中與警覺直接相關(guān)的腦電成分)在厭惡刺激出現(xiàn)之前活動(dòng)顯著增大,標(biāo)志著個(gè)體對(duì)負(fù)性情緒事件的預(yù)期很可能誘發(fā)相應(yīng)的負(fù)面情緒(Bocker et al.,2001)。Nitschke 等人的神經(jīng)成像研究(2006)表明預(yù)期負(fù)性刺激與觀看負(fù)性刺激誘發(fā)出相似的情緒神經(jīng)環(huán)路的激活(Nitschke et al.,2006)。這一結(jié)論得到了Herwig等人研究(2007)的進(jìn)一步支持：預(yù)期厭惡刺激相比預(yù)期中性刺激顯著激活了雙側(cè)前島葉(anterior insula)、左側(cè)紋狀體(striatum)、丘腦(thalamus)、下丘腦(hypothalamus)與杏仁核(amygdala)等情緒神經(jīng)環(huán)路(Herwig,Abler,et al.,2007)。此后,Onoda及其同事(2008)發(fā)現(xiàn)預(yù)期負(fù)性刺激不但誘發(fā)負(fù)性情緒相關(guān)腦區(qū),如杏仁核、島葉、腹外側(cè)前額葉(ventrolateral prefrontalcortex)等腦區(qū)的激活,也顯著激活了自上而下的認(rèn)知調(diào)節(jié)有關(guān)的腦區(qū)如上膝部前扣帶回(supragenual anterior cingulated cortex)與額葉皮層(frontal cortex)等(Onoda et al.,2008)。這一方面說明預(yù)期負(fù)性刺激本身足以誘發(fā)類似于觀看負(fù)性刺激的神經(jīng)生理反應(yīng),同時(shí)預(yù)期過程也啟動(dòng)了大腦的認(rèn)知控制機(jī)制以實(shí)現(xiàn)對(duì)隨后情緒影響的調(diào)控。近期研究顯示,對(duì)潛在負(fù)性刺激過強(qiáng)的心理預(yù)期是焦慮產(chǎn)生的重要來源(Carlson et al.,2011;Drabant et al.,2011;Simmons et al.,2011)。Grupe 和Nitschke(2013)進(jìn)一步揭示對(duì)負(fù)性刺激的預(yù)期除了反映對(duì)威脅的應(yīng)對(duì)準(zhǔn)備之外,也激活了內(nèi)側(cè)前扣帶回(anterior mid-cingulate cortex)、中腦與脈管周圍灰質(zhì)(periaqueductal gray matter)等與恐懼情緒喚起有關(guān)的神經(jīng)區(qū)域,更進(jìn)一步的證實(shí)對(duì)尚未發(fā)生的負(fù)性刺激進(jìn)行預(yù)先的心理準(zhǔn)備在預(yù)期階段具有負(fù)面情緒后果(Grupe &Nitschke,2013)。

盡管預(yù)期負(fù)性刺激這一過程本身具有類似于“負(fù)性刺激”的情緒后果,但對(duì)負(fù)性刺激的事先預(yù)期卻能在無需付出認(rèn)知代價(jià)的情況下有效降低負(fù)性事件所產(chǎn)生的情緒影響,以及情緒相關(guān)神經(jīng)環(huán)路的激活水平(Alvarez et al.,2011;Buodo et al.,2012;Herwig,Abler,et al.,2007;Yang,Yuan,&Li,2010;Yang,Yuan,&Li,2012)。眾多研究表明：事后的情緒調(diào)節(jié)方法,如注意控制、認(rèn)知重評(píng)與表達(dá)抑制,其調(diào)節(jié)作用均以意志努力與認(rèn)知資源消耗為代價(jià),因此其情緒調(diào)節(jié)的過程常常是困難的,或難以實(shí)現(xiàn)的(Denny et al.,2014;Sheppes &Meiran,2008;Shiota &Levenson,2009)。與此相反,無論被試在實(shí)驗(yàn)中完成什么樣的任務(wù),事前的預(yù)期均能顯著降低負(fù)性刺激所誘發(fā)的情緒強(qiáng)度及相應(yīng)神經(jīng)激活水平(Alvarez et al.,2011;Buodo et al.,2012;Galli et al.,2011;Herwig,Abler,et al.,2007;Yang,Yuan,&Li,2010;Yang,Yuan,&Li,2012)。并且,這一情緒調(diào)節(jié)效果僅需被試預(yù)先知道情緒刺激即將出現(xiàn)就可以發(fā)生,而無需被試進(jìn)行任何主動(dòng)的,消耗認(rèn)知資源的有意識(shí)情緒調(diào)節(jié)。例如,Onoda 等人(2006)采用線索目標(biāo)范式,利用腦磁圖技術(shù)研究發(fā)現(xiàn)可預(yù)期的負(fù)性目標(biāo)圖片所導(dǎo)致的視覺腦磁反應(yīng)強(qiáng)度顯著低于不可預(yù)期負(fù)性目標(biāo)圖片所誘發(fā)的反應(yīng)強(qiáng)度(Onoda et al.,2006)。Herwig等人(2007)采用fMRI技術(shù)與被動(dòng)觀看任務(wù)研究發(fā)現(xiàn)：相比預(yù)期厭惡圖片,觀看厭惡圖片時(shí)丘腦、島葉、前后扣帶回、內(nèi)側(cè)額葉、頂下回、頂枕聯(lián)合皮層的激活顯著降低,提示心理預(yù)期能降低負(fù)性刺激出現(xiàn)后對(duì)情緒神經(jīng)環(huán)路的激活水平(Herwig,Abler,et al.,2007)。這一結(jié)果得到了Alvarez等人(2011)近期研究的支持。Alvarez等人以電擊作為威脅刺激,并操縱電擊的可預(yù)期性(電擊可預(yù)期,電擊不可預(yù)期,無電擊三水平;被試對(duì)于電擊僅需被動(dòng)知覺)。研究結(jié)果發(fā)現(xiàn)：不可預(yù)期與可預(yù)期的電擊都導(dǎo)致了背側(cè)杏仁核區(qū)域的暫時(shí)激活。但不可預(yù)期的電擊導(dǎo)致了終紋床核區(qū)域,前島葉與額頂網(wǎng)絡(luò)等與警覺有關(guān)的神經(jīng)區(qū)域的持久性增強(qiáng),而該警覺網(wǎng)絡(luò)的激活在可預(yù)期條件下并未出現(xiàn)(Alvarez et al.,2011)。這提示心理預(yù)期降低了大腦對(duì)于威脅刺激的警覺水平。除被動(dòng)知覺狀態(tài)下觀測(cè)到心理預(yù)期的情緒調(diào)節(jié)效應(yīng)之外,采用主動(dòng)任務(wù)的研究一樣觀測(cè)到類似的效應(yīng)。例如,Galli等人(2011)采用情緒記憶任務(wù)發(fā)現(xiàn),在線索有效提示目標(biāo)圖片情緒效價(jià)的條件下,負(fù)性圖片刺激未能誘發(fā)出任何的情緒效應(yīng)(Galli et al.,2011)。近期,Yang等人的系列ERP研究顯示：無論被試對(duì)面孔圖片進(jìn)行主動(dòng)的認(rèn)知判斷(判斷面孔表情的情緒類別)還是被動(dòng)知覺(內(nèi)隱任務(wù),判斷面孔圖片的性別),事前的心理預(yù)期均顯著降低了個(gè)體對(duì)負(fù)性面孔的情緒反應(yīng)水平(Yang,Yuan,&Li,2012;楊潔敏,袁加錦,李紅,2009)。臨床研究指出：神經(jīng)性暈厥的病人相比健康個(gè)體在情緒刺激下更容易發(fā)生暈厥,而這一癥狀與其情緒預(yù)期功能的不足有密切關(guān)系(Buodo et al.,2012)。綜上可知：盡管對(duì)負(fù)性刺激的事先預(yù)期這一過程本身將導(dǎo)致情緒神經(jīng)環(huán)路的激活和負(fù)面情緒后果,但事前預(yù)期卻顯著減弱負(fù)性刺激出現(xiàn)時(shí)個(gè)體的情緒反應(yīng)水平,且這一情緒調(diào)節(jié)效應(yīng)無需以資源消耗和認(rèn)知努力為代價(jià),具有經(jīng)濟(jì),高效的特征。

2.2 過度負(fù)性預(yù)期與焦慮障礙

焦慮障礙是一組輕性精神障礙(如廣泛性焦慮等),其主要癥狀是廣泛和持續(xù)性的焦慮或反復(fù)發(fā)作的驚恐,而患者的焦慮與驚恐來自于對(duì)不確定事件的過度負(fù)性預(yù)期,并非由實(shí)際威脅所引起(American Psychiatric Press,2000)。既有研究指出：相比健康個(gè)體,高特質(zhì)焦慮個(gè)體是各類焦慮障礙的高發(fā)易感人群,并伴有相關(guān)腦區(qū)的功能性失調(diào)(Simmons et al.,2006;Simmons et al.,2011);其核心特征是對(duì)將來不確定情緒事件的過度負(fù)性預(yù)期(Grupe &Nitschke,2013;Simmons et al.,2006)。

行為研究一致發(fā)現(xiàn)：無論高特質(zhì)焦慮人群,還是廣泛性焦慮障礙、社交焦慮障礙及創(chuàng)傷后應(yīng)激障礙等臨床障礙人群,均過高地估計(jì)潛在負(fù)性事件的發(fā)生概率及其負(fù)面影響(Haenen,de Jong,Schmidt,Stevens,&Visser,2000;Nelson,Deacon,Lickel,&Sy,2010;Regambal &Alden,2012;Tripp,Tan,&Milne,1995),這使得他們即便在負(fù)性事件發(fā)生的概率非常小的情況下,也會(huì)出現(xiàn)強(qiáng)烈的預(yù)期性焦慮與憂慮(Grupe &Nitschke,2013;Loewenstein,Weber,Hsee,&Welch,2001)。有研究認(rèn)為焦慮本身是由將來事件所引發(fā)的的一種負(fù)性情緒,而將來事件具有不確定性的特點(diǎn)(Grupe &Nitschke,2013),研究顯示個(gè)體對(duì)將來事件不確定性的難以忍受(Intolerance of uncertainty)往往在焦慮障礙的發(fā)展和保持中起著十分重要的作用(Boelen &Reijntjes,2009;Carleton et al.,2012;Dugas et al.,2005)。焦慮癥患者在面對(duì)不確定將來事件時(shí)不僅表現(xiàn)出負(fù)性預(yù)期,更重要的是他們堅(jiān)信以情緒化的方式(如對(duì)將來事件的擔(dān)憂,恐懼與經(jīng)驗(yàn)性行為回避等)應(yīng)對(duì)這種不確定事件可以幫助他們更有效地應(yīng)對(duì)將來負(fù)性事件或避免負(fù)性事件的發(fā)生(Behar et al.,2009;Boelen &Reijntjes,2009;Davey,Tallis,&Capuzzo,1996)。

焦慮癥患者的過度負(fù)性預(yù)期特征也得到了來自腦成像研究結(jié)果的支持。前部島葉是個(gè)體情緒預(yù)期功能的核心神經(jīng)區(qū)域(Carlson et al.,2011;Simmons et al.,2006)。研究發(fā)現(xiàn),相比健康個(gè)體,高特質(zhì)焦慮個(gè)體預(yù)期負(fù)性圖片時(shí)其前部島葉出現(xiàn)過度激活。并且相比健康人群,高特質(zhì)焦慮人群在預(yù)期負(fù)性刺激時(shí),其左側(cè)前島葉與額-頂網(wǎng)絡(luò)的激活存在著顯著更強(qiáng)的共變關(guān)系,而與額-頂網(wǎng)絡(luò)的這種關(guān)系在左側(cè)前腦島上并無表現(xiàn)(Simmons et al.,2011);前部島葉皮層區(qū)域的激活水平可以正向預(yù)測(cè)負(fù)性預(yù)期所導(dǎo)致焦慮水平,并與個(gè)體的特質(zhì)焦慮水平呈正相關(guān)(Carlson et al.,2011)。在預(yù)期負(fù)性情緒圖片時(shí),高特質(zhì)焦慮個(gè)體(Simmons et al.,2006;Simmons et al.,2011) 與創(chuàng)傷后應(yīng)激障礙個(gè)體(Aupperle et al.,2012;Simmons et al.,2013),廣泛性焦慮障礙個(gè)體(Schlund,Verduzco,Cataldo,&Hoehn-Saric,2012)等焦慮障礙人群均出現(xiàn)了前部島葉顯著的過度激活。

綜上可知：對(duì)將來不確定情緒事件持有過度負(fù)性預(yù)期——不但作負(fù)面預(yù)期且采用情緒化方式應(yīng)對(duì)——是焦慮障礙產(chǎn)生的重要原因。

2.3 認(rèn)知方式與情緒健康

個(gè)體看待、認(rèn)識(shí)情緒事件的方式,即認(rèn)知方式,將顯著影響負(fù)性事件所產(chǎn)生的情緒影響(Chawla&Ostafin,2007;Riskind &Kleiman,2012)。研究表明,對(duì)負(fù)性事件采用適應(yīng)性的認(rèn)知方式,如分離式重評(píng)(detached reappraisal;將注意焦點(diǎn)從負(fù)性內(nèi)容解除,并指向事件的非情緒方面)、積極重評(píng)(positive reappraisal;對(duì)負(fù)性情緒事件進(jìn)行正向、積極的思考)與接受(acceptance;指接納負(fù)性事件及其情緒影響,而不是改變和拒絕負(fù)性情緒(Connor-Smith &Flachsbart,2007))等有利于心理健康的保持(Aldao &Nolen-Hoeksema,2010,2012;Hofmann,Heering,Sawyer,&Asnaani,2009;Shiota &Levenson,2009)。相反,適應(yīng)不良的認(rèn)知方式,如芻思(rumination;將注意聚焦于負(fù)性內(nèi)容本身及其情緒后果)、負(fù)面思考(以負(fù)面,消極的方式看待情緒事件)、經(jīng)驗(yàn)避免(拒絕,回避情緒事件及其后果(Chawla &Ostafin,2007))等卻增大了情緒障礙發(fā)生的可能性(Charoensuk,2007;Chawla&Ostafin,2007;Matud,2004)。

已有研究一致顯示:芻思將個(gè)體的注意焦點(diǎn)集中于負(fù)性事件的負(fù)性內(nèi)容本身及其情緒后果,顯著增強(qiáng)負(fù)面情緒和情緒記憶,從而增強(qiáng)了情緒障礙產(chǎn)生的可能性(Hankin &Abramson,2001;Matud,2004)。相反,若將注意指向于刺激的非情緒方面(如面對(duì)即將死亡的病人,注意到這是正常生命歷程的一部分而不是死亡本身是如何令人恐懼),則可降低情緒反應(yīng)水平(Kanske,Heissler,Schonfelder,Bongers,&Wessa,2011;Shiota &Levenson,2009)。此外,對(duì)負(fù)性事件的解釋方向與個(gè)體的心理健康狀況密切相關(guān)。相關(guān)研究表明積極重評(píng)能有效降低個(gè)體的負(fù)性情緒反應(yīng)(Gross &John,2003;Shiota &Levenson,2009,2012);并能預(yù)測(cè)個(gè)體更高的主觀幸福感(Gross &John,2003;Shiota,2006)。相反,負(fù)面思考增加了個(gè)體的負(fù)面情緒體驗(yàn),從而增大了情緒障礙發(fā)生的可能性(Charoensuk,2007;McEvoy &Mahoney,2013;Rosenberg,Jorgensen,&Sevaj,1997)。此外,個(gè)體對(duì)負(fù)性事件的態(tài)度,即傾向于接受該事件還是回避拒絕該事件,也對(duì)心理健康具有顯著影響。眾多研究表明對(duì)情緒事件持接受,接納的態(tài)度能有效降低個(gè)體的焦慮和抑郁水平(Beblo et al.,2011;Hofmann et al.,2009;Kashdan,Morina,&Priebe,2009;Kohl,Rief,&Glombiewski,2012);而回避與拒絕卻危害個(gè)體的心理健康(Chawla &Ostafin,2007;de la Cruz et al.,2013;Kashdan,Barrios,Forsyth,&Steger,2006;Schramm,Yenta,&Sharp,2013)。

盡管個(gè)體對(duì)情緒事件的認(rèn)知方式具有一定穩(wěn)定性(Connor-Smith &Flachsbart,2007;Hankin,2008;),但并不是無法改變的。近期研究證明,認(rèn)知訓(xùn)練可以改變與重塑個(gè)體對(duì)情緒事件的認(rèn)知方式：不但能減少個(gè)體對(duì)情緒內(nèi)容的注意而將注意指向事件的非情緒方面,也能使個(gè)體學(xué)會(huì)對(duì)負(fù)性事件進(jìn)行正向解釋,從而提高心理健康水平(Beard,2011; Macleod &Holmes,2012;Mobini,Reynolds,&Mackintosh,2013)。適應(yīng)性認(rèn)知方式的訓(xùn)練,如積極重評(píng)訓(xùn)練與接受訓(xùn)練等,不僅能降低負(fù)面情緒與情緒障礙易感性(Haeffel,Rozek,Hames,&Technow,2012;Lau,2013;MacLeod &Mathews,2012;Swain,Hancock,Hainsworth,&Bowman,2013),還能降低自我否定傾向,保護(hù)自尊在壓力情境下不受損害(Tran,Siemer,&Joormann,2011)。然而,盡管已有證據(jù)表明認(rèn)知訓(xùn)練(如注意訓(xùn)練)能有效干預(yù)臨床焦慮癥狀(Beard,2011;MacLeod&Mathews,2012),但其長(zhǎng)遠(yuǎn)療效仍存在爭(zhēng)議,需要更多證據(jù)來驗(yàn)證其可靠性(MacLeod &Holmes,2012;Mobini et al.,2013)。正如 Mobini等人(2013)以及Macleod等人(2012)所述：目前尚無法確定對(duì)焦慮癥患者負(fù)性認(rèn)知偏向的矯正訓(xùn)練對(duì)焦慮癥的臨床干預(yù)究竟能有多強(qiáng)的持久效果(Macleod &Holmes,2012;MacLeod &Mathews,2012;Mobini et al.,2013)。產(chǎn)生這種爭(zhēng)議的一個(gè)可能原因是：目前有關(guān)認(rèn)知訓(xùn)練干預(yù)臨床焦慮的研究都集中于事后認(rèn)知訓(xùn)練,即負(fù)性刺激呈現(xiàn)后訓(xùn)練被試改變對(duì)負(fù)性刺激的注意偏向與認(rèn)知偏向(MacLeod &Holmes,2012;Mobini et al.,2013);卻很少有研究關(guān)注事前認(rèn)知訓(xùn)練,即面對(duì)不確定性的,潛在的負(fù)性事件訓(xùn)練個(gè)體在預(yù)期階段便使用適應(yīng)性認(rèn)知方式?？紤]到心理預(yù)期本身是重要的情緒調(diào)控方法,且過度負(fù)性預(yù)期是各種焦慮障礙的核心特征,因此對(duì)焦慮癥患者進(jìn)行事前認(rèn)知訓(xùn)練減弱其負(fù)性預(yù)期程度,以充分發(fā)揮預(yù)期的情緒調(diào)控功能可能是增強(qiáng)認(rèn)知訓(xùn)練臨床干預(yù)效果的重要途徑。

3 問題提出

綜上可以看出,對(duì)負(fù)性刺激的心理預(yù)期能有效調(diào)控負(fù)性刺激所產(chǎn)生的情緒影響,且這一調(diào)控作用無需以主觀努力與資源消耗為代價(jià)(Alvarez et al.,2011;Buodo et al.,2012;Herwig,Abler,et al.,2007;Yang,Yuan,&Li,2010;Yang,Yuan,&Li,2012)。然而,盡管事前的預(yù)期對(duì)負(fù)性刺激的情緒調(diào)節(jié)效應(yīng)具有穩(wěn)定性,前人研究卻觀測(cè)到預(yù)期階段激活了上膝部前扣帶回與前額葉等認(rèn)知控制有關(guān)的區(qū)域(Onoda et al.,2008)。Scherpiet等人研究(2014)顯示：盡管未要求被試在預(yù)期階段使用情緒調(diào)節(jié)策略,健康人群在預(yù)期階段卻卷入認(rèn)知控制腦區(qū)的參與(如左外側(cè)前扣帶回,左內(nèi)側(cè)前扣帶回)以實(shí)現(xiàn)對(duì)情緒反應(yīng)的調(diào)節(jié);而邊緣性人格障礙患者的情緒失調(diào)癥狀與其情緒預(yù)期時(shí)認(rèn)知控制腦區(qū)的卷入程度過低有關(guān)(Scherpiet et al.,2014)。這些證據(jù)提示盡管未指示被試提前采取情緒調(diào)節(jié)策略,基于趨利避害的本能,個(gè)體很可能在預(yù)期階段業(yè)已無意識(shí)的卷入了情緒調(diào)節(jié)機(jī)制的參與。因此,盡管事先的心理預(yù)期對(duì)負(fù)性刺激情緒喚起的調(diào)節(jié)無需以資源消耗與主觀努力為代價(jià);然而究竟該調(diào)節(jié)效應(yīng)是否以預(yù)期階段提前的認(rèn)知調(diào)節(jié)的卷入為前提不得而知。由于有關(guān)心理預(yù)期調(diào)節(jié)情緒的既有研究均未在預(yù)期階段控制認(rèn)知調(diào)節(jié)因素,因此在排除預(yù)期階段認(rèn)知調(diào)節(jié)因素之后,預(yù)期策略還能否有效調(diào)控隨后刺激誘發(fā)的情緒水平不得而知,需要進(jìn)一步研究予以解決。這一問題的解決對(duì)于充分理解預(yù)期策略調(diào)節(jié)情緒的有效性,對(duì)于綜合評(píng)估預(yù)期策略的情緒調(diào)節(jié)效率與優(yōu)勢(shì)具有重要意義。我們前期工作發(fā)現(xiàn)即便線索呈現(xiàn)與刺激呈現(xiàn)之間的時(shí)間間隔僅在1 s左右,也能穩(wěn)定的觀測(cè)到預(yù)期降低了大腦對(duì)負(fù)性刺激的情緒反應(yīng)水平(Yang,Yuan,&Li,2010;Yang,Yuan,&Li,2012)。因此,能夠預(yù)測(cè)即便是排除了預(yù)期階段潛在的認(rèn)知調(diào)節(jié)因素后,也仍然能觀測(cè)到心理預(yù)期對(duì)負(fù)性刺激的情緒調(diào)節(jié)效應(yīng)。

此外,大量研究指出預(yù)期策略在有效調(diào)節(jié)刺激誘發(fā)的負(fù)性情緒的同時(shí),情緒預(yù)期過程本身卻導(dǎo)致情緒相關(guān)神經(jīng)環(huán)路(如杏仁核、島葉、腹外側(cè)前額葉)的激活(Aupperle et al.,2012;Carlson et al.,2011;Denny et al.,2014;Drabant et al.,2011;Herwig,Abler,et al.,2007;Nitschke et al.,2006;Onoda et al.,2008)。Golub 等人(2009) 研究指出:盡管心理預(yù)期能減弱負(fù)面事件的情緒影響,但預(yù)期負(fù)性事件本身產(chǎn)生的消極情緒影響不容忽視,甚至能抵消或高于該策略本身的情緒調(diào)節(jié)優(yōu)勢(shì)(Golub et al.,2009)。這進(jìn)一步說明：確實(shí)有必要考慮將適應(yīng)性的情緒調(diào)控方式應(yīng)用于預(yù)期過程,以保持或增大預(yù)期策略情緒調(diào)節(jié)功效的同時(shí)降低預(yù)期階段導(dǎo)致的負(fù)面效應(yīng),最終達(dá)到最優(yōu)化的情緒調(diào)節(jié)效果。由于大量研究指出適應(yīng)性的認(rèn)知方式如分離式重評(píng)(detached reappraisal)、積極重評(píng)(positive reappraisal)與接受(acceptance)均有利于減弱負(fù)性事件的情緒影響,從而維護(hù)心理健康(Aldao&Nolen-Hoeksema,2010,2012;Hofmann et al.,2009;Shiota &Levenson,2009)?？梢灶A(yù)測(cè)若將上述適應(yīng)性的認(rèn)知方式應(yīng)用于負(fù)性刺激的預(yù)期階段,從而改變被試對(duì)隨后負(fù)性刺激的認(rèn)知,可望得到最大化的情緒調(diào)控效果,從而充分發(fā)揮心理預(yù)期策略對(duì)于情緒調(diào)控的優(yōu)勢(shì)。事實(shí)上,已有少量研究提示將接受與分離式重評(píng)的認(rèn)知方式應(yīng)用于負(fù)性刺激預(yù)期階段,確能有效降低負(fù)性預(yù)期所導(dǎo)致的情緒神經(jīng)環(huán)路的激活水平(Herwig,Baumgartner,et al.,2007)。然而,由于上述工作關(guān)注的核心是認(rèn)知策略對(duì)負(fù)性預(yù)期及其神經(jīng)機(jī)制的影響,而未將預(yù)期作為調(diào)節(jié)策略予以系統(tǒng)操縱進(jìn)而對(duì)比有無預(yù)期條件下情緒喚起水平的差異。因此,有無預(yù)期條件下目標(biāo)刺激誘發(fā)的情緒水平有何差異,以及該差異是否及如何隨認(rèn)知方式的變化而變化不得而知。因此,需要系統(tǒng)操縱認(rèn)知方式因素與預(yù)期因素,從而探討認(rèn)知方式如何影響預(yù)期階段的情緒效應(yīng)以及預(yù)期策略對(duì)目標(biāo)刺激的情緒調(diào)節(jié)。已有證據(jù)表明：相比事后的認(rèn)知重評(píng),將認(rèn)知重評(píng)應(yīng)用于負(fù)性刺激的預(yù)期階段,有助于降低認(rèn)知重評(píng)所需要的認(rèn)知負(fù)荷,可以提高認(rèn)知重評(píng)成功的概率(Denny et al.,2014)。這提示認(rèn)知方式與心理預(yù)期的結(jié)合確實(shí)可能達(dá)到最優(yōu)的情緒調(diào)控效果。

第三,盡管對(duì)負(fù)性事件進(jìn)行情緒程度相當(dāng)?shù)男睦眍A(yù)期具有情緒調(diào)節(jié)的功能,過度的負(fù)性預(yù)期卻是臨床焦慮障礙產(chǎn)生的核心原因(Carlson et al.,2011;Drabant et al.,2011;Gingnell,Bannbers,Wikstrom,Fredrikson,&Sundstrom-Poromaa,2013;Grupe &Nitschke,2013)。Carlson 等人(2011)與Grupe和Nitschke(2013)等人共同指出：對(duì)不確定性的,潛在的威脅進(jìn)行超過其可能嚴(yán)重程度的預(yù)期——即過度負(fù)性預(yù)期——是焦慮癥的核心特征(Carlson et al.,2011;Grupe &Nitschke,2013)。因此,對(duì)不確定事件的過度負(fù)性預(yù)期有可能是焦慮及其負(fù)性情緒癥狀的主要來源;而改變焦慮癥患者的過度負(fù)性預(yù)期,可能是焦慮癥臨床干預(yù)的重要途徑。另一方面,大量研究顯示：焦慮癥患者對(duì)結(jié)果不確定的潛在負(fù)性事件均更容易采取擔(dān)憂、恐懼以及經(jīng)驗(yàn)回避等情緒化的方式進(jìn)行應(yīng)對(duì)。例如,擔(dān)憂可能出現(xiàn)的負(fù)面結(jié)果,將潛在負(fù)面結(jié)果想象比實(shí)際更恐懼;極力避免其負(fù)面情緒體驗(yàn)與軀體感覺(Behar et al.,2009;Boelen &Reijntjes,2009)。以往研究一致顯示：對(duì)壓力源采取擔(dān)憂、回避與恐懼等情緒化的應(yīng)對(duì)方式是適應(yīng)不良的應(yīng)對(duì)方式,往往具有損害情緒健康,導(dǎo)致情緒障礙等負(fù)面效應(yīng)(Hankin &Abramson,2001;Matud,2004)。通過上述綜合分析可以看出：對(duì)不確定性威脅的過度負(fù)性預(yù)期及相關(guān)焦慮癥狀,很可能是對(duì)該不確定事件進(jìn)行情緒化應(yīng)對(duì),如擔(dān)憂、恐懼與經(jīng)驗(yàn)回避的結(jié)果。因此,通過認(rèn)知訓(xùn)練程序,使得焦慮個(gè)體去除上述情緒化的,回避式的應(yīng)對(duì)方式;而習(xí)得適應(yīng)性的,有利于健康的認(rèn)知方式,如分離式重評(píng)、積極重評(píng)與接受的方式以應(yīng)對(duì)不確定性威脅;以最終減弱或消除焦慮癥患者的過度負(fù)性預(yù)期,從而達(dá)到有效干預(yù)的目的。

4 研究構(gòu)想

基于以上關(guān)于心理預(yù)期與認(rèn)知方式對(duì)負(fù)面情緒的交互調(diào)節(jié)的作用及其腦機(jī)制的研究現(xiàn)狀和尚存問題的綜述,在前期研究的基礎(chǔ)上,有必要綜合采用行為學(xué),外周生理測(cè)量與神經(jīng)成像技術(shù),解決如下三個(gè)方面的問題：1)排除預(yù)期階段使用其他調(diào)節(jié)策略的可能性后,心理預(yù)期本身能否有效減弱對(duì)隨后負(fù)性事件情緒喚起的調(diào)節(jié);2)認(rèn)知方式(適應(yīng)性認(rèn)知方式,適應(yīng)不良的認(rèn)知方式)對(duì)心理預(yù)期的情緒效應(yīng)及隨后情緒調(diào)節(jié)效應(yīng)的影響;3)適應(yīng)性認(rèn)知方式的訓(xùn)練對(duì)焦慮癥患者過度負(fù)性預(yù)期及其情緒影響的調(diào)節(jié)作用。

圍繞試圖解決的兩個(gè)核心科學(xué)問題：1)不同的認(rèn)知方式(分離式重評(píng) vs.冗思;積極重評(píng) vs.負(fù)向思考;接受vs.回避)對(duì)心理預(yù)期情緒調(diào)節(jié)效應(yīng)的影響。2)適應(yīng)性認(rèn)知方式的訓(xùn)練對(duì)焦慮癥患者過度負(fù)面預(yù)期及其情緒影響的調(diào)節(jié)。做出以下研究構(gòu)想：

4.1 無認(rèn)知策略參與下心理預(yù)期對(duì)負(fù)性刺激情緒喚起效應(yīng)的調(diào)節(jié)及神經(jīng)機(jī)制研究

為了考察在情緒預(yù)期階段若排除任何認(rèn)知策略卷入的條件下,心理預(yù)期對(duì)負(fù)性刺激情緒喚起效應(yīng)的調(diào)節(jié)及其相應(yīng)神經(jīng)機(jī)制。擬主要操縱目標(biāo)刺激的可預(yù)期性(可預(yù)期/不可預(yù)期)與目標(biāo)刺激的效價(jià)(負(fù)性/中性),實(shí)驗(yàn)任務(wù)是在負(fù)性線索出現(xiàn)后到負(fù)性目標(biāo)呈現(xiàn)前的這一預(yù)期階段,要求被試在觀看負(fù)性線索后僅僅注意屏幕中央的注視點(diǎn),不對(duì)隨后將呈現(xiàn)的負(fù)性刺激采取任何應(yīng)對(duì)策略。為了排除疲勞效應(yīng),實(shí)驗(yàn)等分為 4個(gè)小節(jié)。每小節(jié)結(jié)束均適當(dāng)休息,隨后對(duì)被試遵循實(shí)驗(yàn)指導(dǎo)語要求“在線索刺激呈現(xiàn)后到目標(biāo)刺激出現(xiàn)這一階段僅注意注視點(diǎn)”的成功程度進(jìn)行檢驗(yàn),用5點(diǎn)量表評(píng)分(1=非常不成功,5=非常成功),以評(píng)估無認(rèn)知操縱的成功程度。招募健康大學(xué)生被試36名,男女各 18人以排除情緒預(yù)期過程中可能存在的性別差異(Galli et al.,2011)。所有被試在參加實(shí)驗(yàn)之前填寫狀態(tài)-特質(zhì)焦慮問卷與貝克抑郁問卷,以排除被試存在焦慮障礙或具有抑郁傾向的可能。實(shí)驗(yàn)擬同時(shí)記錄事件相關(guān)腦電位(ERP)、皮膚電、心率、皮膚溫度等外周生理指標(biāo)與皺眉肌電(與負(fù)性刺激下被試的負(fù)性表情直接相關(guān)的肌電指標(biāo))活動(dòng)水平,以綜合揭示負(fù)性情緒相關(guān)的腦電、外周生理活動(dòng)水平與肌電活動(dòng)水平如何隨著預(yù)期因素而變化。

4.2 不同認(rèn)知方式(分離式重評(píng) vs.冗思;積極重評(píng)vs.負(fù)向思考;接受vs.回避)對(duì)負(fù)性預(yù)期及其情緒調(diào)節(jié)效應(yīng)的影響

如上所述,心理預(yù)期是調(diào)節(jié)情緒的有效手段,但同時(shí)也是誘發(fā)情緒的重要原因,而心理預(yù)期的兩個(gè)方面功能都可能受到認(rèn)知應(yīng)對(duì)方式的調(diào)控。因此,本研究擬考察認(rèn)知方式如何影響心理預(yù)期本身的情緒效應(yīng),預(yù)期對(duì)隨后刺激的情緒調(diào)節(jié)效應(yīng)。本研究根據(jù)認(rèn)知方式側(cè)重于注意方向(分離式重評(píng) vs.冗思)、解釋方法(積極重評(píng) vs.負(fù)向思考)還是行為態(tài)度(接受 vs.回避);分為三個(gè)實(shí)驗(yàn)分別進(jìn)行。

4.2.1 認(rèn)知方式與心理預(yù)期對(duì)負(fù)性情緒的交互影響：分離式重評(píng) vs.冗思

本實(shí)驗(yàn)重點(diǎn)考察分離式重評(píng)(適應(yīng)性認(rèn)知方式)與冗思(適應(yīng)不良的認(rèn)知方式)如何影響心理預(yù)期本身所產(chǎn)生的情緒效應(yīng)及預(yù)期對(duì)隨后負(fù)性刺激情緒喚起的調(diào)節(jié)作用。本實(shí)驗(yàn)擬操縱三個(gè)因素：預(yù)期(2水平：有預(yù)期/無預(yù)期)、目標(biāo)刺激的情緒效價(jià)(2水平：負(fù)性刺激/中性刺激)與認(rèn)知方式(3水平：分離式重評(píng),冗思與無應(yīng)對(duì))。采用 fMRI與外周生理記錄相結(jié)合的技術(shù)手段完成該研究。在實(shí)驗(yàn)過程中,記錄在不同實(shí)驗(yàn)條件下的皺眉肌活動(dòng)水平,以作為情緒表情變化的客觀指標(biāo)。擬招募健康大學(xué)生被試 36名參與實(shí)驗(yàn)(男女各 18人)。被試的情緒健康狀況通過實(shí)驗(yàn)前填寫狀態(tài)-特質(zhì)焦慮問卷與貝克抑郁問卷進(jìn)行篩查,以排除被試存在焦慮障礙或具有抑郁傾向的可能。在線索呈現(xiàn)到目標(biāo)刺激出現(xiàn)的這一預(yù)期階段,被試分別應(yīng)用相應(yīng)認(rèn)知方式。實(shí)驗(yàn)采用組塊設(shè)計(jì)的方法,按照認(rèn)知方式的不同,分別分為分離式重評(píng)組塊、無認(rèn)知應(yīng)對(duì)組塊與冗思組塊(即一個(gè)組塊只應(yīng)用一種給定認(rèn)知方式)。為了排除認(rèn)知方式組塊可能對(duì)無應(yīng)對(duì)組塊的實(shí)驗(yàn)操縱產(chǎn)生影響,無應(yīng)對(duì)組塊總是最先呈現(xiàn)。分離式重評(píng)與冗思組塊的順序被試間平衡。每個(gè)組塊開始之前先對(duì)預(yù)期階段將使用的認(rèn)知方式進(jìn)行練習(xí),在被試確認(rèn)熟練使用該認(rèn)知方式后開始實(shí)驗(yàn)。實(shí)驗(yàn)結(jié)束后通過5點(diǎn)量表(1=非常不成功,5=非常成功)讓被試評(píng)價(jià)成功使用該認(rèn)知方式的程度。三種認(rèn)知方式的指導(dǎo)語要點(diǎn)如下：1)無認(rèn)知應(yīng)對(duì)(作為控制條件)——紅色圓形出現(xiàn)提示隨后將出現(xiàn)負(fù)性情緒刺激。但我僅需注意屏幕中央的注視點(diǎn),不用采取任何方式應(yīng)對(duì);2)分離式重評(píng)——紅色圓形出現(xiàn)提示隨后將出現(xiàn)負(fù)性情緒刺激。雖然不知道具體內(nèi)容是什么,但負(fù)性刺激無疑也是真實(shí)的現(xiàn)實(shí)世界的一部分,因此無需大驚小怪;3)冗思——紅色圓形出現(xiàn)提示隨后將出現(xiàn)負(fù)性刺激。雖然不知道具體內(nèi)容是什么,但我應(yīng)該反復(fù)思考它們可能是什么刺激以及會(huì)對(duì)我產(chǎn)生什么樣的影響。

4.2.2 認(rèn)知方式與心理預(yù)期對(duì)負(fù)性情緒的交互影響：積極重評(píng)vs.負(fù)向思考

招募未參加研究4.2.1的被試36名(男女各半)參加本研究。實(shí)驗(yàn)設(shè)計(jì)、被試篩查方式、因變量指標(biāo)與實(shí)驗(yàn)方法同研究4.2.1。積極重評(píng)指語如下：紅色圓形出現(xiàn)提示隨后將出現(xiàn)負(fù)性情緒刺激。雖然不知道具體內(nèi)容是什么,但好壞通常是相互依存相互轉(zhuǎn)化的,即便是負(fù)性刺激,也必然有積極的一面。負(fù)向思考的指導(dǎo)語如下：紅色圓形出現(xiàn)標(biāo)志著隨后將出現(xiàn)負(fù)性刺激內(nèi)容,雖然還不知道具體內(nèi)容是什么,但這些刺激都反映了威脅性的內(nèi)容,都是對(duì)人們的正常生活有傷害的。

4.2.3 認(rèn)知方式與心理預(yù)期對(duì)負(fù)性情緒的交互影響：接受vs.回避

招募未參加研究4.2.1以及4.2.2的被試36名(男女各半)參加本研究。實(shí)驗(yàn)設(shè)計(jì)、被試篩查方式、因變量指標(biāo)與實(shí)驗(yàn)方法同上。接受指導(dǎo)語示例如下：紅色圓形出現(xiàn)提示隨后將出現(xiàn)負(fù)性情緒刺激,即便這讓我感到不愉快,這也是很正常,我應(yīng)當(dāng)完全接納不愉快的感覺,讓我的感受自然流露而不控制它?；乇艿闹笇?dǎo)語如下：紅色圓形出現(xiàn)提示隨后將出現(xiàn)負(fù)性情緒刺激,雖然不知道具體內(nèi)容是什么,我都應(yīng)該盡力在內(nèi)心回避這種刺激并避免這種負(fù)面的情緒感受。

4.3 適應(yīng)性認(rèn)知方式的訓(xùn)練對(duì)高特質(zhì)焦慮人群過度負(fù)性預(yù)期及其情緒影響的調(diào)節(jié)

研究 4.2的系列實(shí)驗(yàn)旨在探討健康個(gè)體其不同認(rèn)知方式如何影響預(yù)期所導(dǎo)致的情緒效應(yīng)以及預(yù)期對(duì)隨后刺激情緒喚起的調(diào)節(jié)。研究 4.3擬進(jìn)一步考察適應(yīng)性認(rèn)知方式的訓(xùn)練是否能以及如何改變焦慮癥患者(以高特質(zhì)焦慮為例)的過度負(fù)性預(yù)期,從而干預(yù)臨床焦慮癥狀。本研究擬從大學(xué)生人群中篩查并招募高特質(zhì)焦慮被試180名(男女各90名)。根據(jù)以往研究(Simmons et al.,2011),擬在大學(xué)生人群中進(jìn)行狀態(tài)-特質(zhì)焦慮問卷(測(cè)狀態(tài)焦慮與特質(zhì)焦慮水平)與正性情緒-負(fù)性情緒量表(測(cè)心境狀態(tài))的測(cè)量。以特質(zhì)焦慮得分正態(tài)分布85%百分位點(diǎn)以上的被試作為高特質(zhì)焦慮被試。將上述被試隨機(jī)等分為四組：分離式重評(píng)訓(xùn)練組,積極重評(píng)訓(xùn)練組,接受訓(xùn)練組與各自的控制組(每組30,男女各半)。其中在開始接受認(rèn)知方式訓(xùn)練程序之前,先對(duì)實(shí)驗(yàn)組與控制組被試的負(fù)性預(yù)期及其情緒效應(yīng)(以行為,皮電與腦電作為指標(biāo))進(jìn)行前測(cè)。負(fù)性預(yù)期強(qiáng)度的測(cè)量采用不確定線索提示方法。實(shí)驗(yàn)組被試隨后接受認(rèn)知方式訓(xùn)練,控制組被試接受對(duì)照訓(xùn)練3個(gè)月。訓(xùn)練結(jié)束之后,對(duì)四組被試分別再次進(jìn)行狀態(tài)—特質(zhì)焦慮的測(cè)量,負(fù)性預(yù)期強(qiáng)度的測(cè)量,心境狀態(tài)的測(cè)量(Positive Affect and Negative Affect Scale)。通過實(shí)驗(yàn)組與控制組前后的對(duì)比,最后綜合評(píng)估認(rèn)知方式的訓(xùn)練對(duì)于過度負(fù)性預(yù)期與特質(zhì)焦慮癥狀的干預(yù)效果。

5 總結(jié)

通過對(duì)以往研究調(diào)查發(fā)現(xiàn)：不管是在日常生活中還是在實(shí)驗(yàn)室情景中,個(gè)體對(duì)于負(fù)性生活事件或是負(fù)性刺激均難以進(jìn)行事后的情緒調(diào)控。大量研究證明,這種事后的情緒調(diào)控需要以消耗大量的認(rèn)知與抑制控制資源為代價(jià),甚至有的時(shí)候非但不能達(dá)到對(duì)不良情緒進(jìn)行調(diào)控的目的,而且產(chǎn)生更為消極的情緒后果。所以,我們認(rèn)為對(duì)潛在負(fù)性事件進(jìn)行事前情緒調(diào)節(jié)——心理預(yù)期,利用“心理預(yù)期”這一事前調(diào)節(jié)策略能夠有效地降低負(fù)性情緒事件發(fā)生后對(duì)個(gè)體的情緒影響,且適應(yīng)性的認(rèn)知方式可能克服該策略在預(yù)期階段的負(fù)面影響。此外,適應(yīng)性認(rèn)知方式的訓(xùn)練可能減弱焦慮障礙個(gè)體的過度負(fù)面預(yù)期,從而降低焦慮個(gè)體的臨床癥狀。

綜合起來,上述研究構(gòu)想的創(chuàng)新意義在于：1)通過實(shí)驗(yàn)方法考察在排除預(yù)期階段使用其他調(diào)節(jié)策略的可能性后,心理預(yù)期本身能否有效減弱對(duì)隨后負(fù)性事件情緒喚起的調(diào)節(jié)。2)通過操縱預(yù)期階段被試對(duì)即將出現(xiàn)的負(fù)性刺激的認(rèn)知方式,考察適應(yīng)性與適應(yīng)不良的認(rèn)知方式對(duì)預(yù)期調(diào)節(jié)負(fù)性情緒效果的影響。3)將適應(yīng)性認(rèn)知方式的訓(xùn)練用于焦慮障礙易感群體過度負(fù)性預(yù)期的干預(yù),以揭示各種適應(yīng)性認(rèn)知方式的訓(xùn)練能多大程度能減弱其過度負(fù)性預(yù)期,并最終減輕其臨床焦慮癥狀。

日常生活中,我們難免會(huì)遭遇一些突發(fā)性負(fù)性事件。如果對(duì)自己的不良情緒狀況無法進(jìn)行有效調(diào)節(jié)的話,將可能產(chǎn)生非常嚴(yán)重的后果。所以運(yùn)用一些科學(xué)有效的調(diào)節(jié)策略就顯得尤為重要。鑒于以上論述可以看出“心理預(yù)期”這一事前策略能有效減弱負(fù)性事件發(fā)生后的情緒影響,且該策略能有效避免事后情緒調(diào)節(jié)所需要付出的認(rèn)知代價(jià)。但是“心理預(yù)期”這一策略也有一定缺陷,即個(gè)體對(duì)潛在負(fù)性事件進(jìn)行預(yù)期時(shí)伴隨著不良情緒體驗(yàn)。鑒于此,我們?cè)陬A(yù)期階段引入一些適應(yīng)性認(rèn)知方式的參與。通過考察“心理預(yù)期和認(rèn)知方式對(duì)負(fù)性情緒的交互調(diào)節(jié)”,期望在認(rèn)知代價(jià)最小化的情況下實(shí)現(xiàn)最優(yōu)的情緒調(diào)節(jié)效果,從而為心理健康的維護(hù)提供有意義的指導(dǎo)。

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