目的：探讨冠心病伴发抑郁情绪者注意偏向的特点。方法选取2012年9月—2014年12月在潍坊医学院附属医院住院的冠心病患者40例，根据 Zung 氏抑郁自评量表（SDS）将患者分为单纯冠心病组和冠心病伴发抑郁情绪组，各20例。患者均参加注意返回抑制试验，记录其反应时，并分析返回抑制效应。结果对反应时进行多因素重复测量方差分析发现，组别主效应显著（F =94.44，P <0.01），冠心病伴发抑郁情绪组反应时长于单纯冠心病组；间隔时间（SOA）主效应显著（ F =57.98，P <0.01）；组别×面孔性质×提示类型× SOA 交互作用显著（ F=10.09，P <0.01）。当 SOA 为14 ms 时，组别主效应显著（ F =22.68，P <0.01）；提 示 类 型 主效应显著（ F=13.90，P <0.01），无效提示反应时短于有效提示；组别×面孔性质×提示类型交互作用显著（ F =10.84，P <0.01），简单效应分析发现：冠心病伴发抑郁情绪组对悲伤面孔无效提示的反应时短于中性面孔（ F =15.19，P <0.01）。SOA 为750 ms 时，组别主效应显著（F =37.89，P <0.01）；提示类型主效应显著（F =5.01，P <0.05），无效提示反应时短于有效提示；组别×面孔性质×提示类型交互作用显著（ F =7.92，P <0.01），简单效应分析发现：冠心病伴发抑郁情绪组对悲伤面孔无效提示的反应时短于高兴面孔和中性面孔（F =6.92，P <0.05）。对返回抑制效应（无效提示反应时-有效提示反应时）进行多因素重复测量方差分析发现：SOA 为14 ms 时，冠心病伴发抑郁情绪组对悲伤面孔的返回抑制效应小于单纯冠心病组（F =5.61，P <0.05）；SOA 为250 ms 时，冠心病伴发抑郁情绪组对悲伤面孔的线索效应大于单纯冠心病组（F =6.49，P <0.05）；SOA 为750 ms 时，两组对3种不同性质的面孔图片均出现返回抑制效应。结论冠心病伴发抑郁情绪者存在注意偏向，表现为对负性情绪刺激的注意偏倚和解除困难。%Objective To explore the characteristics of attentional bias in coronary heart disease(CHD)combined with depressive mood patients. Methods 40 CHD patients who were admitted to the Affiliated Hospital of Weifang Medical University from September 2012 to December 2014,were selected as study subJects. According to the score of Zung self - rating depression scale,cases were divided into the simple CHD group and CHD with depression mood group,and 20 cases in each group. All cases underwent the attention return inhibition experiments,the reaction time was recorded,and the return inhibition effect was analyzed. Results The repeated measures analysis of variance(RANOVA)on reaction time showed the main effect among groups was significant(F = 94. 44,P < 0. 01),the reaction time in the CHD with depression mood group was longer than that in the simple CHD group;the main effect of SOA was significant(F = 57. 98,P < 0. 01);and group × face type × clue type × SOA interaction was significant(F = 10. 09,P < 0. 01). When SOA reached 14 ms,the main effect among groups was significant(F = 22. 68,P < 0. 01);the main effect of clue type was significant(F = 13. 90,P < 0. 01),the reaction time of invalid clue was shorter than that of effective clue;there was a significant group × face type × clue type interaction( F= 10. 84,P < 0. 01),simple effect analysis showed that the reaction time invalid cue to sad faces was significant shorter than that to neutral faces in the CHD with depressive mood group(F = 15. 19,P < 0. 01). When SOA reached 750 ms,the main effect among groups was significant( F = 37. 89,P < 0. 01);the main effect of clue type was significant( F = 5. 01,P <0. 05),the reaction time of invalid clue was shorter than that of effective clue;there was a significant group × face type × clue type interaction( F = 7. 92,P < 0. 01),simple effect analysis showed that the reaction time invalid cue to sad faces was significant shorter than that to happy faces and neutral faces in the CHD with depressive mood group(F = 6. 92,P < 0. 05). The results of RANOVA on the effect of inhibition of return( reaction time of invalid clue - reaction time of effective clue) showed that the effect of inhibition of return for sad faces in the CHD with depressive mood group was significant smaller than that in the simple CHD group when the SOA reached 14 ms(F = 5. 61,P < 0. 05),and the clue effect of sad faces in the CHD with depressive mood group was significant greater than that in the simple CHD group when the SOA reached 250 ms(F = 6. 49,P <0. 05);besides,the effect of inhibition of return for three types of face images exists both in the CHD with depressive mood group and the simple group. Conclusion Attentional bias exists in CHD combined with depressive mood patients,which appears as attentional bias to emotionally negative stimuli,and the relief of attentional bias is difficult.
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