述情障礙者的情緒認知偏誤與社交功能之神經基礎

Neural Basis of Cognitive Bias for Emotions and Social Functioning in Alexithymia

述情障礙為精神疾患的危險因子且與生理和心理健康問題有關。此外，述情障礙者常以缺乏適應性的策略因應人際問題，使其主觀幸福感遭致損傷。目前尚未釐清述情障礙者因應情緒的認知偏誤的神經機制及此神經機制與其社交能力（與他人溝通、同理能力）關係。因此，本研究以功能性磁振造影檢驗述情障礙者進行情緒語意作業時的情緒因應特性。研究操弄情緒（正向、負向、中性）和語意關聯強度（強、弱）來檢驗情緒語意處理。受試者需判斷兩個中文情緒詞是否意義相關並以社交能力問卷檢驗溝通及同理能力。研究結果顯示相較於低述情障礙者，高述情障礙者在負向弱語意關聯情緒詞，相較於中性弱語意關聯詞有較少杏仁核和楔前葉活化，反映出覺察情緒訊息的早期迴避反應。另外，由於高述情障礙者對於正負向情緒訊息的敏感度，致使個體得以在語意判斷進行快速反應，因此有較少額下迴和顳中迴活化。更重要的是高述情障礙者在負面刺激的額顳葉活化與社交功能及同理能力相關，反映出對於情緒線索的早期警覺性能助其迴避不愉快的社交情境，例如：自我揭露，損害社交關係。本研究顯示採用早期迴避的認知偏誤可能短暫降低面對社交情境壓力但致終對於個體幸福感可能造成傷害。

Alexithymia has been identified as a risk factor for a variety of psychiatric disorders and physical and mental health problems. Moreover, alexithymics often exhibit maladaptive coping strategies when addressing interpersonal problems, which can damage their subjective well-being. To date, the neural basis of alexithymics’ cognitive bias in processing emotions is unclear. Additionally, it remains unknown whether this neural basis of coping with emotion is associated with their ability to communicate and empathize with others. Thus, we used functional magnetic resonance imaging (fMRI) to examine the neural correlates of alexithymics’ emotional coping styles in an emotional semantic judgment task. Emotional valence (positive, negative, neutral) and association strength (strong, weak) were independently varied to study emotional semantic processing. Participants were asked to decide whether two emotional words presented in Chinese were related in meaning. The social functioning questionnaires further evaluated their social communication performance and empathetic abilities. First, compared to individuals with low alexithymia (LA), those with high alexithymia (HA) exhibited lower activation in the amygdala and precuneus in response to negative related pairs than neutral related pairs when the association was weak, reflecting the early avoidance of perceiving negative information. Additionally, the early prioritization of both positive and negative emotions enabled quick responses and required less involvement of the inferior frontal gyrus (IFG) and middle temporal gyrus (MTG) in individuals with HA in judging the meaning when the association was weak. Moreover, frontotemporal activation in response to unpleasant stimuli was correlated with abilities to socialize/empathize with others, which suggests that early vigilance to emotional cues may cause individuals with HA to avoid unpleasant social situations, such as self-disclosure, potentially hindering their abilities to socially interact. In summary, the cognitive bias of early avoidance may bring temporary relief by allowing individuals to escape from social interactions, but, ultimately, this damages well-being.