Advances in Psychology
Vol.08 No.03(2018), Article ID:24251,11 pages
10.12677/AP.2018.83053

Review on the Intervention of Attention Bias Modification Training on Obsessive-Compulsive Symptoms

Fangyuan Liu, Zhongming Zhang

Key Laboratory of Personality and Cognition (SWU), Ministry of Education, School of Psychology, Southwest University, Chongqing

Received: Mar. 15th, 2018; accepted: Mar. 21st, 2018; published: Mar. 28th, 2018

ABSTRACT

OCD symptoms may be the result of aberrant processing of threat-relevant information, such as recurrent intrusive thoughts compulsions, and its attentional biases are causal factors in the etiology and maintenance of Obsessive-Compulsive Disorders (OCD). In recent years, a large number of studies have begun to explore the effect of attentional bias modification (ABM) training on participants’ attentional bias towards threat information. In this article, we systematically clarify the characteristics of the attention bias of OCD and related theories, and we also demonstrate the main paradigm of ABM and its intervention effect. Based on the analysis and summary of previous studies, we put forward the questions needed to be resolved in the future research on the application of ABM on OCD.

Keywords:Attentional Bias Modification, Obsessive-Compulsive Disorder (OCD), Attentional Bias

注意偏向矫正训练对 强迫症的干预

刘方圆,张仲明

西南大学心理学部,认知与人格教育部重点实验室,重庆

收稿日期:2018年3月15日;录用日期:2018年3月21日;发布日期:2018年3月28日

摘 要

强迫症对不相关的信息的抑制困难表现为强迫性思维和冲动,其注意偏向会导致侵入性强迫思维的发病和维持。近年来有大量研究开始探索注意偏向矫正训练对个体注意偏向的影响效应。本文系统地阐述了强迫症个体的注意偏向特点和相关理论,以及注意偏向矫正训练的主要范式和干预效果,通过前人研究的分析总结,对未来的研究将注意偏向矫正训练运用于强迫症进行了展望。

关键词 :注意偏向矫正,强迫症,注意偏向

Copyright © 2018 by authors and Hans Publishers Inc.

This work is licensed under the Creative Commons Attribution International License (CC BY).

http://creativecommons.org/licenses/by/4.0/

1. 引言

强迫症是一种以反复出现、难以摆脱并且会引起显著痛苦或焦虑的闯入性想法、冲动或意向(强迫思维)和重复的过度的仪式性行为或心理活动(强迫观念)为主要表现的慢性精神性疾病(American Psychiatric Association, 2013)。

国内研究发现,9%的青少年(12~18岁)表现出强迫症临床症状(Sun, Boschen, Farrell, Buys, & Li, 2014),强迫症在个体一生中的任何时期都有发病的可能,其终身患病率高达2.3% (Ruscio, Stein, Chiu, & Kessler, 2010)。强迫症是最容易使人致残的十种疾病之一(Murray & Lopez, 1997)。63%的强迫症患者有自杀的想法,并且相比于其他精神类疾病,其社会功能更易受损(Jacoby, Leonard, Riemann, & Abramowitz, 2014)。强迫症的高发病率并没有伴随与之相应的高治愈率。

考虑到强迫症的严重性,以及其对随后个体功能的不利影响,预防和早期干预是非常重要的。现有的强迫症治疗方法主要有药物治疗和认知行为疗法。五羟色胺再摄取抑制剂(Selective serotonin reuptake inhibitors, SSRIs)是目前治疗强迫症运用比较多的药物,然而一些患者因为药物的副作用而拒绝服用该药物,并且该药物也不适用于青少年。认知行为疗法(Cognitive behavioral therapy, CBT)是心理治疗方法。患者一方面很难接触到专业正统的CBT治疗,另一方面即使接受了治疗也不能缓解所有患者的症状。因此需要探索新颖的治疗方法。

2. 注意偏向与强迫症

对威胁刺激的注意偏向包括注意易化(Facilitated Attention to Threat)、注意脱离困难(Difficulty in Disengaging Attention Away from Threat)和注意回避(Attention Avoidance of Threat)三个主要成分。注意易化是指相对于非威胁刺激,个体更易察觉威胁刺激的存在。注意脱离困难是指个体将注意力集中于威胁性刺激从而破坏了注意从威胁性刺激转移到其它刺激上。注意回避是近期发现的一种现象,是指个体将注意分配到威胁词线索的相反方向(Cisler & Koster, 2010; Sheppes, Luria, Fukuda, & Gross, 2013)。

警觉假说(vigilance hypothesis)假定在早期加工阶段,强迫症个体注意偏向的特征是对强迫相关刺激的自动探测,在识别和注意强迫相关刺激是表现出较低的感知阈限(Armstrong & Olatunji, 2012)。然而维持假说(maintenance hypothesis)假定在加工的后期阶段,强迫症个体很难将注意脱离威胁刺激或者在加工后期过度的将注意资源集中在威胁刺激上(注意解除困难) (Georgiou et al., 2005),这一阶段可能涉及更多的策略性的目标加工机制(Barhaim, Lamy, Pergamin, Bakermanskranenburg, & van IJzendoorn, 2007)。这些理论上的区别将会对治疗效果有影响。例如,注意偏向改变过程训练被试将注意脱离威胁刺激这一过程对许多情感障碍患者有较好的治疗效果(Koster, Fox, & MacLeod, 2009)。如果脱离困难是强迫症的基础那么注意训练过程可能会增强现有治疗的效果。

针对强迫症个体的注意偏向的研究包括行为学研究、眼动研究、事件相关电位(event related potential, ERP)以及功能性磁共振成像(functional magnetic resonance imaging, fMRI)研究。

2.1. 强迫症注意偏向的行为学研究

强迫症注意偏向的反应时测量包括,情绪 Stroop任务范式(emotional Stroop task)、点探测任务范式(dot probe task)、情绪空间线索任务范式(emotional spatial cueing task)等。已有研究综述对强迫症注意偏向的行为学研究方法进行了述评(汪孟允,苗小翠,李益娟,张仲明,2014)。目前对强迫症注意偏向的研究大多使用行为学研究,但是呈现出混合的不一致的研究结果。

在情绪Stroop反应时测量中,要求被试对不同颜色的中性和威胁相关词汇的颜色进行反应,而忽略其意义。一些研究表明强迫症个体对强迫症相关负性刺激表现出了注意偏向(Lavy, Oppen, & Hout, 1994; Rao, Arasappa, Reddy, Venkatasubramanian, & Reddy, 2010)。还有研究者发现强迫症清洗亚型对污染相关词语的反应时要长于非强迫清洗控制组(Foa, Ilai, Mccarthy, Shoyer, & Murdock, 1993)。然而,一些研究却没有发现这一注意偏向特点(Kampman, Keijsers, Verbraak, Näring, & Hoogduin, 2002; Kyrios & Iob, 1998; Moritz et al., 2004)。Moritz等(2008)的研究也发现强迫症个体并不存在注意偏向现象。但是,相对于正常人,只有清洗亚型对污染相关词表现出干扰效应,这也从另一方面说明,可能强迫症个体只对与自身相关的刺激产生注意偏向(Moritz et al., 2008)。

在空间搜索范式的反应时测量中,Moritz等(2008, 2009)发现,强迫检查患者对威胁词汇不存在注意偏向现象(Moritz & von Mühlenen, 2008),但清洗亚型对害怕和厌恶图片存在注意偏向现象(Moritz, von Mühlenen, Randjbar, Fricke, & Jelinek, 2009)。Cisler等(2010)研究发现,在500ms刺激间隔上,强迫清洗倾向相对于控制组表现出了注意脱离困难,但是对厌恶和害怕图片的反应时并没有表现出显著性差异;在100ms刺激间隔上,没有发现强迫清洗倾向个体的注意偏向现象(Cisler & Olatunji, 2010)。

在点探测范式的研究中,威胁刺激和中性刺激同时短暂地呈现,接着一个靶刺激出现在其中一个刺激的位置上。要求被试快速对靶刺激的位置做出按键反应。仅有的几篇相关文献,其研究结论也不一致。Tata等(1996)研究发现,强迫清洗亚型患者相对于高低特质焦虑对照组对污染相关词表现出了注意偏向,而对社交恐惧相关词并没有表现出注意偏向(Tata, Leibowitz, Prunty, Cameron, & Pickering, 1996)。但是,Harkness等(2009)发现,强迫检查亚型患者并没有表现出注意偏向。这些结果说明强迫症患者只对与自身相关的刺激表现出注意偏向(Harkness, Harris, Jones, & Vaccaro, 2009)。而Amir等(2009)发现亚临床强迫倾向个体对其个人相关的威胁词汇表现出注意偏向,并且随着实验的进程由于被试对威胁刺激越来越熟悉,该注意偏向表现出明显地衰退,这表明强迫症患者注意偏向的衰退可能是导致强迫症患者整体上没有表现出注意偏向的一个重要原因(Amir, Najmi, & Morrison, 2009)。

虽然强迫症个体的注意偏向行为学研究没有得出一致的结论,但较为一致的实验结果是强迫清洗亚型个体对威胁刺激表现出注意偏向,并且强迫清洗倾向个体的注意偏向成分为注意脱离困难。

2.2. 强迫症注意偏向的眼动研究

在与污染威胁相关的高低强迫倾向个体的研究中,Armstrong, Olatunji, Sarawgi, & Simmons (2010)采用自由观看任务进行眼动研究,发现高污染相关的强迫倾向被试仅对恐惧面孔表现出注意警觉,对厌恶面孔和恐惧面孔都有更高的注意维持(Armstrong, Olatunji, Sarawgi, & Simmons, 2010)。Armstrong等 (2012)用同样的方法将面孔刺激替换为图片场景刺激(污染威胁,一般威胁,愉快图片和中性图片),发现与污染相关的高强迫倾向组对污染威胁图片表现出注意警觉,但没有发现对污染刺激的注意维持(Armstrong, Sarawgi, & Olatunji, 2012)。熊玲(2016)的研究结果表明高强迫清洗倾向个体对污染威胁存在注意偏向,其成分包括注意定向偏向、注意解除困难及注意回避,其时间进程模式为最初的警觉(定向偏向)、早期的注意维持以及较晚期的总体注意回避(熊玲,2016)。Bradley等(2016)的结果表明高强迫倾向对强迫威胁图片有更多的意偏注视次数和注视时间,反应了注意维持(Bradley et al., 2016)。以上研究都表明高污染相关的强迫倾向被试对污染刺激表现出注意警觉,但是其对污染刺激是否存在注意维持和注意回避还有待考证。

在强迫倾向个体检查行为的眼动研究中,Toffol等人使用视觉搜索任务。在该任务中向被试展示50个视觉搜索列,要求被试在多个有开口的方形序列中对目标(闭合的方形)存在或不存在进行按键反应。目标存在时的trial是明显的,反应是基于对目标的感知,因此被称为确定情况(certain situations)。然而目标不存在时的trail是模糊的,被试不得不搜寻整个序列以免漏掉了目标,因此被称为不确定情况(uncertain situations)并且可以引起被试的不确定感。检查行为的测量是通过被试搜索序列的时间和搜索时的注视点数量来表示。Toffolo等(2013, 2016)的研究结果发现尽管在轻微不确定的情况下,强迫倾向个体和强迫症个体会表现出更多的检查行为(Toffolo, Hout, Engelhard, Hooge, & Cath, 2016; Toffolo, van den Hout, Hooge, Engelhard, & Cath, 2013)。Toffolo等(2014)重复了其2014年的研究,增加了不能忍受不确定情况的量表测量(Intolerance of Uncertainty Scale, IUS),发现目标不存在序列激起被试更多的不确定感。另外高强迫倾向被试比低强迫倾向被试在在目标不存在序列中搜索时间更长(Toffolo, Hout, Engelhard, Hooge, & Cath, 2014)。Choi and Lee (2015)对强迫检查倾向个体进行了眼动研究,该研究用药品分类任务将被试随机分为高低责任感,使用自由观看任务指导被试自由观看情绪词(强迫威胁相关,负性刺激,中性刺激)和中性词对并记录眼动数据。研究发现强迫检查倾向个体在高责任感情况下的焦虑感增加导致了对强迫威胁词汇的注意警觉和注意维持。以上研究都表明强迫倾向及强迫症个体在轻微的不确定感或者引起焦虑情绪的情境中表现出较长的注意维持(Choi & Lee, 2015)。

2.3. 强迫症注意偏向的ERP和fMRI研究

Thomas等(2013)使用ERP技术结合情绪Stroop范式的研究发现,强迫症患者对强迫症相关威胁词比中性词表现出了更大的P1振幅和更长的N1潜伏期,支持了强迫症患者早期注意的优势反应和警觉假设(Thomas, Gonsalvez, & Johnstone, 2013)。Fan等(2014)的研究发现,与正常被试相比强迫症患者对负性词汇表现出相似的干扰效应,但是总体上对所有词汇都有更长的反应时和更大的P2和P3振幅,说明强迫症患者在整个信息加工过程存在抑制功能缺陷,而没有表现出针对某一类刺激的特异性加工过程(Fan et al., 2014)。汪孟允等(2015)的研究结果发现,高强迫倾向个体对强迫症相关消极词表现出注意偏向,其成分为注意脱困,既表现在早期自动加工阶段的P2成分上也表现在晚期策略加工阶段的LPPs成分上(汪孟允,苗小翠,李益娟,胡思思,张仲明,2015)。

汪孟允等(2015)使用ERP技术结合点探测范式探讨强迫清洗倾向个体注意偏向的认知加工时间进程。研究结果表明高强迫清洗倾向个体对威胁刺激表现出更大的LPP成分,这种注意偏向的成分为注意的脱离困难,表现在个体信息加工的晚期策略加工阶段。虽然高强迫清洗倾向个体在行为学水平上并没有对威胁刺激表现出注意偏向,但是高强迫清洗倾向个体对情绪刺激存在优先加工的过程(汪孟允,2015)。

通过情绪Stroop任务的fMRI研究(van den Heuvel et al., 2005)探索不同焦虑症状对特定症状相关刺激的注意偏向和他们之间的功能性神经关联。虽然强迫症被试对与强迫相关的词汇没有表现出削弱的行为反应,但是其神经活动显示了独特的激活区域,包括前扣带皮层(anterior cingulate corex, ACC)和杏仁核(amygdala)的激活增强。这些效应被解释为强迫症和恐惧障碍被试对与其特定症状相关的刺激表现出独特的激活区域和注意偏向。说明边缘系统的功能异常对强迫症患者的症状维持起到了很重要的作用,并且可能与情绪信息加工异常有关(Jhung et al., 2014)。

另外,还有Stroop任务的fMRI研究发现,强迫症被试比控制组被试在Stroop任务干扰效应下表现出更多的错误和更慢的反应时(Hartston & Swerdlow, 1999; Martinot et al., 1990)。在焦虑状态下,这种干扰效应对强迫症被试的影响增强了(Cohen, Lachenmeyer, & Springer, 2003)。强迫症被试较差的Stroop行为表现与静息状态下侧额叶皮层的局部脑代谢率的减少有关(Martinot et al., 1990),支持了前额区对强迫症状发展中有重要作用的观念。

3. 强迫症与注意偏向矫正训练

通过了解维持强迫症的因素来发展新的有效的治疗方法是非常重要的。大量研究表明强迫症表现出对症状相关威胁刺激异常注意加工特征(Armstrong et al., 2012; Bradley et al., 2016)。其对不相关的信息的抑制困难,例如强迫性思维和冲动,是强迫症的重要特征。强迫症患者在与他们症状相关的威胁线索上集中大部分的注意资源,以至于限制了他们在注意相关信息的同时忽略不相关的矛盾信息的能力。也就是说强迫症的注意偏向会导致侵入性强迫思维的发病和维持。

近年来有大量研究开始探索注意偏向矫正(Attentional bias modification, ABM)训练对个体注意偏向的影响效应(Chen, Clarke, Watson, MacLeod, & Guastella, 2015; Hakamata et al., 2010; Hallion & Ruscio, 2011),由于认知训练的低门槛,低消费和匿名性,这可能是一个潜在的有效的治疗强迫症的方法,特别是对于青少年强迫症患者的治疗。ABM训练的目的是为了减少对症状相关信息过度的认知资源的分配,因此基于这一重要的认知过程,ABM训练可能是减轻症状和缓解情绪反应有效的干预方法(MacLeod & Mathews, 2012; Mobini & Grant, 2007)。但是目前大部分ABM训练研究都集中在对情感障碍(焦虑障碍和抑郁障碍)个体的注意偏向转变中,而对强迫症个体的注意偏向转变的研究较少(Najmi & Amir, 2010)。

目前仅有一篇研究探索ABM训练对与污染威胁相关的强迫倾向个体注意偏向矫正的效果。研究运用点探测范式任务训练被试的注意偏向,ABM任务是通过控制字母出现在一对词汇(中性或污染相关词汇)消失位置上的频率来建立与污染相关词汇位置的耦合性。研究发现,ABM组被试与控制足相比表现出对威胁刺激注意偏向的显著减少并且促进个体更多的接近污染威胁物体的行为(Najmi & Amir, 2010)。

4. 注意偏向矫正训练范式

目前,ABM训练有三种实验范式:点探测范式(dot-probe task)、情绪空间线索任务(emotional spatial cueing task)和视觉搜索任务(visual search task)。这些任务范式的共同点是训练被试将注意偏向远离症状相关刺激,通过将注意偏向集中在症状不相关的刺激上来促进被试完成症状相关任务时更快的反应以及更好的表现(Koster et al., 2009)。ABM训练是通过重复练习认知训练来矫正注意偏向(Barhaim, 2010; Beard, 2011; Browning, Holmes, & Harmer, 2010),已有研究中被试通过接受8次(一周两次)或者一次集中的ABM训练都有效地控制了其注意偏向,并在一定程度上缓解了症状(Chen et al., 2015; Liang & Hsu, 2016; Najmi & Amir, 2010; O’Toole & Dennis, 2012)。因此ABM训练与外显的口头的心理疗法相比是一个更内隐的实验性的程序。这个训练在改变注意加工时不需要被试进行意志控制,因此提供了与现存治疗方法不同的方法,通过影响个体的信息加工进而缓解个体的症状。

点探测任务:通过改变探测点和症状相关刺激的位置的耦合性,来改变注意偏向。在这个任务中两类刺激(症状相关刺激和症状不关刺激)同时出现在注视点的两侧(左/右或者上/下)。随后探测点(一个字母、一个 * 或者一个点)出现在其中一个刺激消失的位置上(左/右或者上/下)。被试需要尽快并且准确地对探测点的位置做出反应或者区分两个不同的探测字母(例如:E or F)。为了将注意远离症状相关刺激,那么在训练过程中探测点经常代替症状不相关刺激(积极或者中性),注意会直接远离症状相关的刺激。在这些中性或者积极的训练条件下,要求被试将注意偏向远离症状相关的刺激,那么在该任务上被试的反应时会更快(更好的表现)。类似地,当探测点经常出现在症状相关的刺激消失的位置上时,该任务也可以被用来诱导注意偏向朝向症状相关的刺激。点探测范式有独特的方法上的优势,即有与它高度匹配的控制条件。在控制条件中探测点出现在中性或者积极刺激和症状相关刺激位置上的概率相等,因此控制条件就是传统的点探测任务。大部分研究使用点探测范式强迫症对注意偏向的作用(Amir, Weber, Beard, Bomyea, & Taylor, 2008; MacLeod, Rutherford, Campbell, Ebsworthy, & Holker, 2002)来进行ABM训练。

情绪空间线索任务:在注视点两侧任意方框内呈现一个情绪线索,随后目标刺激出现在线索位置或者非线索位置。当目标出现在症状相关的线索位置上时个体对目标的反应加快,当目标呈现在症状不相关刺激的位置上时个体对目标的反应延迟。在训练个体注意偏向过程中,通过使目标刺激不再出现在症状相关线索的位置上来训练个体积极的注意偏向(Baert, De Raedt, Schacht, & Koster, 2010; Bar-Haim, Morag, & Glickman, 2011)。

视觉搜索任务:要求被试尽快并且准确地在症状相关的分心刺激(皱眉的表情)中搜索一个症状不相关的目标刺激(微笑的表情)。通过重复的练习,被试内隐地学会克服优先加工症状相关刺激的倾向。另外被试还学习到朝向积极信息的注意选择(Dandeneau, Baldwin, Baccus, Sakellaropoulo, & Pruessner, 2007)。

5. 研究展望

由于ABM训练任务可以被简单地传播,同时病人可以以最少的花费投入最少的时间通过有效地训练达到临床上的改善,有研究综述表明ABM训练有成为精神病理学疾病的治疗和干预方法的潜能(Beard, Sawyer, & Hofmann, 2012; Browning, Holmes, & Harmer, 2010; Hakamata et al., 2010; Mogoase, David, & Koster, 2014)。强迫症患者通常伴随有焦虑症、抑郁症等多种疾病并发(Torres & Lima, 2005),并且强迫症患者仍然会伴随有高焦虑水平,表现为对与症状相关的刺激有注意偏向(Muller & Roberts, 2005)。因此未来的研究可以利用ABM训练来探究强迫症个体注意偏向的矫正与其症状改善的因果关系。

第一、针对强迫症个体ABM训练的研究可以采用不同的认知工具

注意的认知神经理论提出两种注意信号决定对威胁刺激的选择性注意,即刺激驱动系统和注意控制系统。刺激驱动系统大部分集中在杏仁核,执行自下而上的加工。这个系统的功能是使注意主动朝向突出的刺激,特别是对威胁刺激的探测(Bishop, 2007; Davis & Whalen, 2001)。注意控制系统涉及到前额叶皮层(prefrontal cortex, PFC)和前扣带回(anterior cingulate cortex, ACC),对当前目标和任务需求进行一个较为灵活的自上而下的注意控制,例如对相关信息的抑制(Bishop, Duncan, Brett, & Lawrence, 2004; Vuilleumier, 2005)。近年来,许多学者通过使用事件相关电位(event related potential, ERP)、功能性磁共振成像(functional magnetic resonance imaging, fMRI)及神经心理学等方面的技术对强迫症患者的认知神经机制开展了广泛而深入地研究,表明强迫症患者在加工情绪信息时杏仁核,ACC,PFC等部位存在功能性损伤(Cardoner et al., 2011; Chamberlain, Blackwell, Fineberg, Robbins, & Sahakian, 2005; Linnman, Rougemontbücking, Beucke, Zeffiro, & Milad, 2011)。因此未来的研究可以采用ERP以及fMRI等认知工具更深入地研究ABM训练是否会对强迫症个体的脑机制产生影响。

第二、针对强迫症个体ABM训练的研究应考虑刺激材料呈现时间

就注意偏向的矫正成分来说,ABM任务对早期注意加工有调节作用(O’Toole & Dennis, 2012);ABM训练通过促进对症状相关刺激的脱离来起作用(Heeren, Lievens, & Philippot, 2011);ABM训练也会通过注意回避机制来起作用,而注意回避会导致强迫症状的长时间维持(Koster, Baert, Bockstaele, & De Raedt, 2010)。未来的研究需要具体的阐述ABM训练对强迫症个体注意偏向三种成分的哪一成分起作用。

具体来说,在较短的刺激呈现情况下(100 ms以下)个体对于威胁刺激表现出注意易化(Koster, Crombez, Verschuere, Van Damme, & Wiersema, 2006; Miskovic & Schmidt, 2012),在较长的刺激呈现情况下(300 ms以上)表现出对威胁刺激的注意脱离困难和注意回避(Amir, Elias, Klumpp, & Przeworski, 2003; Moriya & Tanno, 2011)。目前,ABM训练的大部分研究是使用500 ms的刺激呈现时间,研究表明ABM训练会促进焦虑个体将注意脱离于威胁刺激并且减轻他们的焦虑症状(Amir et al., 2009; Heeren, Reese, Mcnally, & Philippot, 2012)。然而,少有研究使用短的阈上的刺激呈现时间(100 ms)来探究ABM训练对个体注意易化效应的影响。因此未来的研究需要在短的和长的刺激呈现时间背景下研究ABM训练对强迫症个体注意偏向的影响效应。

第三、针对强迫症个体ABM训练的研究应考虑刺激材料的形式及内容的影响

刺激材料的形式包括了字词(Chen et al., 2015; Mogoase et al., 2014; Najmi & Amir, 2010)、图片(Liang & Hsu, 2016; O’Toole & Dennis, 2012)、声音以及视频,但研究者大多使用字词材料对强迫症个体注意偏向进行研究,其它诸如图片、声音的研究虽有涉及,但数量较少。未来研究可以使用多通道感官刺激对强迫症个体注意偏向进行研究。

对强迫症个体注意偏向的研究中可以使用强迫症相关的刺激,这样更能够引起强迫症个体的注意偏向,从而进一步探究ABM训练对强迫症个体注意偏向矫正的效应。有研究综述表明,使用图片来进行ABM训练比使用词汇的效果更好,上下呈现的刺激比左右呈现的刺激效果更好(Beard et al., 2012; Hakamata et al., 2010)。因此未来的研究可以通过柏林强迫症图片库(Berlin Obsessive Compulsive Disorder-Picture Set, BOCD-PS) (Simon, Kischkel, Spielberg, & Kathmann, 2012)以及莫兹利强迫刺激对(Maudsley Obsessive-Compulsive Stimuli Set, MOCSS) (Mataix-Cols, Lawrence, Wooderson, Speckens, & Phillips, 2009)选取特定强迫亚型相关的图片刺激,如强迫清洗亚型使用污染相关图片,强迫检查亚型使用检查或安全相关图片等。

文章引用

刘方圆,张仲明. 注意偏向矫正训练对强迫症的干预
Review on the Intervention of Attention Bias Modification Training on Obsessive-Compulsive Symptoms[J]. 心理学进展, 2018, 08(03): 431-441. https://doi.org/10.12677/AP.2018.83053

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