反社會人格障礙共病物質使用之機制探討

ASIA unversity > 醫學暨健康學院 > 心理學系 > 博碩士論文 > Item 310904400/114059

Please use this identifier to cite or link to this item: http://asiair.asia.edu.tw/ir/handle/310904400/114059

Title:	反社會人格障礙共病物質使用之機制探討 To study the mechanism among Antisocial Personality Disorder comorbid with Substance Use
Authors:	蕭銘毅 HSIAO, MING-YI
Contributors:	心理學系
Keywords:	反社會型人格障礙症;物質使用障礙症;三向度人格量表;認知量表;ALDH2;5-HTTLPR ASPD;SUD;TPQ;CBS;ALDH2;5-HTTLPR
Date:	2021-07-21
Issue Date:	2022-11-28 07:47:01 (UTC+0)
Publisher:	亞洲大學
Abstract:	研究背景：過去研究指出反社會型人格障礙症（Antisocial Personality Disorder，ASPD）具有高共病物質使用障礙症（Substance Use Disorders，SUD）的風險。然而，過去研究卻鮮少針對ASPD合併不同物質使用障礙症者之比較；因此本研究透過人格特質與基因的交互作用探討反社會型人格障礙症合併不同物質使用障礙症者在物質使用的認知信念，更全面釐清ASPD共病不同物質使用的機制。方法：此論文透過次級資料分析。每位參與者均經過DSM-IV與中文版的迷你國際神經精神會談工具確立。每個受試者接受血液抽檢，填寫中文版三向度人格量表（TPQ）、以及認知問卷（包含內在抑制力量表、用藥非理性信念量表、用藥渴求量表）。結果：本研究共分析478筆資料，包含48名健康控制者；90名單純ASPD；62名ASPD共病海洛因使用；92名ASPD共病安非他命使用；186名ASPD共病多重物質使用者。研究發現，（1）在與健康組相比下，TPQ之尋求新奇分數，不論有／無共病SUD，ASPD屬於高尋求新奇特徵，且使用物質種類越多，尋求新奇分數越高；逃避傷害分數則指出ASPD（共病安非他命與多重物質使用）者，逃避傷害分數均高於單純ASPD者；（2）與健康組相比之下，乙醛去氫? (Aldehyde dehydrogenase 2,ALDH2) 1/2或2/2基因型或血清素運送基因-5羥色胺(Serotonin Transporter-5HTTLPR) 高／低功能組與衝動控制差、高衝動有關；（3）ASPD共病SUD者相較無共病者對物質使用有認知偏誤。討論：ASPD有／無SUD不影響尋求新奇分數，不過，五組相比下，ASPD（共病安非他命使用、多重物質使用）具有逃避傷害分數。高尋求新奇分數或高逃避傷害分數，分別受到ALDH21/2或2/2和5-HTTLPR低功能組交互作用與ALDH21/1與5-HTTLPR低功能組交互作用影響。共病物質使用越多者，越具有偏誤的物質使用信念。 Background:Previous studies have reported a high comorbidity rate of Antisocial Personality Disorder (ASPD) with Substance Use Disorders (SUD). However, the mechanism between two disorders remains unclear. This study proposed to investigate the correlation between ASPD and SUD among genotypes and personality dimensions. Methods:This study was a secondary analysis study, data from Prof. Lu Ru-Band’s project. Each participant recruited in that project was from Tainan prison. They were interviewed by an attending psychiatrist and clinical psychologists using the Chinese version of the Mini-International Neuropsychiatric Interview (MINI) based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV). In addition, each participant was given blood drawn for DNA examination, and required to complete the Tridimensional Personality Questionnaire (TPQ), and Cognitive Behaviors Scale (CBS). Results:Total 478 participants were analyzed, including 48Healthy Control (HC); 90 ASPD;62 ASPD comorbid with amphetamine(ASPDam); 92 ASPD comorbid with heroin(ASPDhe);186 ASPD comorbid with multiple drug (ASPDmd).We found higher Novelty Seeking (NS) scores in ASPD groups compared to the HC. In addition, As the more types of substance they used, the higher NS scores would be found.Moreover, we also found higher harm avoidance scores (HA) in the ASPD with substance use than in the ASPD without comorbidity. Furthermore, comparing to the ASPD without SUD comorbidity, the pure ASPD were found to have higher tendency of cognitive biases than the ASPD comorbid with SUD. Conclusions:In conclusions, no difference of NS scores among the ASPD comorbid with substance use, but higher HA scores. Moreover the high NS scores were found associate with ALDH21/2 or 2/2 and 5-HTTLPRlow-function group. High HA scores are related with the interaction of ALDH21/1 and 5-HTTLPR low-function group.The more comorbidity of substance the ASPD has, the more biased beliefs in using substance.
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