An inhibited neural response to reward is typical of clinical depression and can predict an individual's overall depressive symptoms. However, the mechanism underlying this are unclear. Previous studies have found that anhedonia and inattention may mediate the relationship between reward sensitivity and depressive symptoms. Therefore, this study aimed to verify the relationship between reward sensitivity and overall depressive symptoms in a depressive tendency sample as well as to explore the mechanism underlying the ability of neural responses to reward to predict overall depressive symptoms via a mediation model. Sixty-four participants (33 with depressive tendencies and 31 without; dichotomized by BDI-II) finished simple gambling tasks while their event-related potential components (ERPs) were recorded and compared. Linear regression was conducted to verify the predictive effect of ERPs on overall depressive symptoms. A multiple mediator model was used, with anhedonia and distractibility as mediators reward sensitivity and overall depressive symptoms. The amplitude of reward positivity (ΔRewP) was greater in healthy controls compared to those with depressive tendencies ( p = 0.006). Both the gain-locked ERP component ( b = − 1.183, p = 0.007) and the ΔRewP ( b = − 0.991, p = 0.024) could significantly negatively predict overall depressive symptoms even after controlling for all anxiety symptoms. The indirect effects of anhedonia and distractibility were significant (both confidence intervals did not contain 0) while the direct effect of reward sensitivity on depressive symptom was not significant (lower confidence interval = − 0.320, upper confidence interval = 0.065). Individuals with depressive tendencies display impaired neural responses to reward compared to healthy controls and reduced individual neural responses to reward may reflect the different biotypes of depression such as anhedonia and inattention.

主导感(sense of agency)是个体感知到的对自身行为及行为后果的控制感.主导感的产生既基于内部的感觉运动信息,也基于动作系统以外的外部信息.寻求内部状态的代理模型(seeking proxies for internal states,SPIS)提出,强迫症(obsessive-compulsive disorder)个体会削弱对自身内部状态的访问,转而寻求外部代理,因此,强迫症患者的主导感较低.未来研究可以尝试将主导感分解为不同的维度或通过追踪研究探索主导感降低是否能够预测强迫症的发病.

目的:采用元分析方法探究国内认知行为疗法联合药物干预强迫症的效果及其影响因素.方法:通过系统检索多个中文数据库,共计纳入文献62篇,总样本量N= 7476,运用R软件(V3.6.3)进行效应量合并以及调节效应分析.结果:国内认知行为疗法联合药物干预强迫症的合并效应量为g =-0.73(填补发表偏倚后g=-0.5),合并比值比OR =3.25(填补发表偏倚后OR =2.83);仅考虑单个变量的调节作用时,干预效果受被试平均年龄、干预周期、药物类型和盲法使用四个因素调节;在多元回归模型中,干预周期、药物类型和盲法使用对干预效果的调节效应仍然显著,其余变量的调节效应均不显著.结论:国内认知行为疗法联合药物干预强迫症的治疗效果较好,且优于单纯药物治疗或单纯认知行为治疗.