摘要:
目的 探讨强迫型人格障碍(OCPD)的执行功能和决策功能特点.方法 本研究为横向随机对照实验研究,以人格障碍诊断问卷(PDQ-4+)OCPD分量表为筛查工具对654例大学生进行筛查,根据美国精神障碍诊断与统计手册第5版(DSM-V)对筛查阳性者(PDQ-4+ OCPD分量表得分≥4分)进行明确诊断.对确诊的33例OCPD大学生,和随机挑选的35例正常对照大学生,分别进行Stroop色词任务(SCWT)、连线任务(TMT)、威斯康星卡片分类任务(WCST)、爱荷华博弈任务(IGT)、骰子任务(GDT)的测试,用来测试两组的执行功能和决策功能,利用帕多瓦量表-华盛顿州立大学修订版中文版(PI-WSUR)评估两组强迫症状.结果 OCPD组的PI-WSUR的总分和因子分(污染/清洗强迫、穿衣/打扮、检查、伤害他人/自己的强迫想法、伤害他人/自己的强迫冲动)均高于正常对照组,且差异有统计学意义(P<0.01);在SCWT中,OCPD组的Stroop C时间和干扰效应的数值大于正常对照组,差异有统计学意义(P<0.05);在WCST中,OCPD组持续性错误数低于正常对照组,差异有统计学意义(P<0.05);而在IGT中,OCPD组的block3和总净得分低于正常对照组,差异有统计学意义(P<0.05).而TMT和GDT差异无统计学意义.结论 本研究提示OCPD组的执行功能水平异于正常对照组,OCPD者在风险不明确情境下决策受损,而在风险明确情境下决策未受损,即在风险明确和不明确的情境下的决策出现分离.%Objective To investigate the features of executive and decision making function in patients with obsessive-compulsive personality disorder(OCPD).Methods This study is cross-sectional randomized controlled experiment research.Thirty three OCPD subjects were screened from 654 college students.According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition(DSM-V) to interview college students whose Personality Diagnostic Questionnaire-4+ scores more than 4 to ensure diagnosis for OCPD,and randomly selected 35 healthy controls.All subjects were assessed with Padua Inventory-Washington State University Revision Chinese version(PI-WSUR),Stroop Colour Word Test(SCWT),Trail Making Test(TMT),Wisconsin Card Sorting Test(WCST),Iowa Gambling Task(IGT) and Game of Dice Test(GDT).Results The total score and factor scores(Pollution/cleanin force,dress,check,hurt others/own obsessions,hurt others/own obsessive impulse)of PI-WSUR(P<0.01) in OCPD group were higher than those in normal control group.The value of Stroop C and SIE(P<0.05) of SCWT in OCPD group was higher than those in normal control group,and perseverative errors(P<0.05) of WCST in OCPD group was lower than those in normal control group.And in IGT,the OCPD group''s block3 scores and total net-scores(P<0.05) were lower than normal control group.There were no differences in TMT and GDT between two groups.Conclusion This study suggests that the level of executive function in the OCPD group is different from the normal control group.OCPD in the risk of ambiguous situation decision-making is impaired,while risk-free situation decision-making is not damaged,which indicating a decision-making capacity separation under these two different situations.