Study On Symptom Accommodation Of Depression And Its Physiological Mechanism

Symptom accommodation refers to the phenomenon that relatives of patients or other caregivers(partners,friends,classmates,etc.)change their behaviors to adapt to patients in order to alleviate and avoid the sufferings caused by mental or psychological diseases(calvocorsesi et al.,1995;lebowitz et al.,2016).This concept originates from the clinical treatment of obsessive-compulsive disorder,which refers to the process in which individuals help patients to perform compulsive behaviors,provide reassurance,or change their own behaviors to assistant patients in avoiding or reducing the sufferings caused by mental or psychological diseases.In depression,it is a symptom accommodation behavior that the family members help the patient to reject social activities that may cause him to feel anxious or depressed,or directly replace him to complete tasks that should be completed by oneself.Clinical studies have confirmed that symptom accommodation is common in obsessive-compulsive disorder,anxiety disorder,autism,post-traumatic stress disorder,hoarding disease and other psychological and mental disorders,and it has been found to be related to the severity of symptoms of mental disorders,the degree of social function damage,and poor treatment effect.In recent years,there are more and more intervention researches about symptom accommodation on OCD,anxiety,autism,hoarding,PTSD and so on.At the same time,researchers begin to pay attention to the potential mechanism of symptom accommodation and the explanation of individual differences of symptom accommodation.In this paper,we recruited depression patients and their family members or friends as our research objects to explored the cognitive and physiological mechanism of depression symptom accommodation through scale measurement and physiological experiments.Based on the somatization of depression in China and the previous research about accommodation of obsessive-compulsive disorder and anxiety disorder,this paper attempts to explore the accommodation mechanism of depression symptoms and the accommodation difference among different symptom types of depression.Using the methods of questionnaire,scale and preliminary interview,the first section of this study explored the phenomenological law of depression symptom accommodation from the perspective of depression patients and their relatives or friends.Using descriptive statistics,correlation analysis,independent sample t-test and paired sample t-test and other statistical analysis methods,we found that:(1)in depression,the common accommodation behavior are "give more attention and sympathy","do something that may make the patient happy","adjust their daily work and habits to meet the requirements of the patient",in the patient's own report,it was also found that " complete a task that should be done by patients" and "repeatedly discussing emotional problems rather than solving problems" were also common ways of accommodation;(2)depression accommodation was positively related to the severity of depression,positively related to the anxiety severity of relatives and friends of patients,and negatively related to family function;(3)in patients with moderate or above severity of depression,there are differences about accommodations between physical symptoms and psychological symptoms of depression,and the accommodation of physical symptoms was significantly greater than that of psychological symptoms.In Study 2,Cue-target paradigm was used to explore the difference of depression symptom accommodation in different symptoms from the perspective of attention bias.22 relatives and friends of patients were selected as the experimental group and 23 general individuals as the control group.The results of repeated measurement analysis of variance showed that:(1)relatives and friends of depression were more sensitive to the symptoms of depression than the general individuals because of facilitated attention,and this kind of attention was difficult to transfer;(2)although there was no significant difference in attention bias between physical symptoms and psychological symptoms,the response time of physical symptoms in the valid position was lower than the psychological symptoms,and the response time under the invalid cue was also higher than the psychological symptoms,which reflected that the relatives and friends of the patients were more aware of the physical symptoms of depression and the difficulty of attention transfer.In Study 3,we used the supraliminal emotional priming paradigm to explore the difference of depression symptom accommodation in different symptoms from the perspective of emotion processing and brain electrophysiological response.We obtained the following conclusions through repeated measurement of variance analysis:(1)Both the control trials and the patient's relatives and friends showed more alertness to negative emotions,specifically in behavior results and P3 brain waves;(2)Compared with the control trials,relatives and friends of depression patients showed more sensitivity to emotional face recognition under the initiation of somatic symptoms;(3)Psychological symptoms of depression as priming stimulation,the control trials needs more cognitive resources to process positive emotions,showing that the N2 amplitude induced by psychological symptoms priming is larger than that induced by physical symptoms priming,that is,the mixed emotions is produced while the experiment group only produced single emotion.In this study,patients with clinically confirmed depression and their families are recruited as the research objects to ensure the validity and representativeness of the research results;the phenomenological law of depression symptom accommodation is explored from the two roles of patients and their families,making the research conclusion more comprehensive and objective;this is the first empirical study of depression symptom accommodation,and also the first physiological study.It is an innovation of research topic and research method to explore the mechanism of depression symptom accommodation by experimental method;the research results may provide basis for future clinical intervention of depression,especially family therapy.In addition,the follow-up study can expand the sample size,and comprehensively use f MRI,Mirror infrared and other research methods to verify the conclusions of this study.