情绪调节能力对酒精使用障碍患者抑制控制功能的影响

doi:10.3969/j.issn.1674-8115.2025.07.010

上海交通大学学报（医学版） ›› 2025, Vol. 45 ›› Issue (7): 883-891.doi: 10.3969/j.issn.1674-8115.2025.07.010

情绪调节能力对酒精使用障碍患者抑制控制功能的影响

程菲¹, 陈天真¹, 游旭², 薛保双², 杨云斌², 杜江¹()

^1.上海交通大学医学院附属精神卫生中心成瘾医学科，上海 200030
^2.云南省红河州第二人民医院精神科，建水 654313

收稿日期:2024-12-30 接受日期:2025-03-17 出版日期:2025-07-28 发布日期:2025-07-28
通讯作者: 杜　江，教授，主任医师，博士；电子信箱：dujiangdongfang@163.com。
基金资助:
国家自然科学基金(82171484);上海交通大学“交大之星”计划“医工交叉研究基金”(YG2023ZD25);上海市启明星计划(22YF1439200);上海市精神卫生中心“研究型医师培养和能力提升计划”(2021-YJXYS-01)

Effects of emotion regulation ability on inhibitory control in patients with alcohol use disorder

CHENG Fei¹, CHEN Tianzhen¹, YOU Xu², XUE Baoshuang², YANG Yunbin², DU Jiang¹()

^1.Department of Addiction Medicine, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
^2.Department of Psychiatry, The Second People's Hospital of Honghe Prefecture, Yunnan Province, Jianshui 654313, China

Received:2024-12-30 Accepted:2025-03-17 Online:2025-07-28 Published:2025-07-28
Contact: DU Jiang, E-mail: dujiangdongfang@163.com.
Supported by:
National Natural Science Foundation of China(82171484);Medical-Engineering Interdisciplinary Research Fund of Shanghai Jiao Tong University "Jiao Da Star" Program(YG2023ZD25);Shanghai Rising-Star Program(22YF1439200);Research-oriented Physician Training and Capability Enhancement Program of Shanghai Mental Health Center(2021-YJXYS-01)

摘要/Abstract

摘要：

目的·探究酒精使用障碍（alcohol use disorder，AUD）患者在不同情绪背景下的抑制控制表现及心理机制，了解情绪调节困难对抑制控制功能的影响。方法·招募28名男性AUD住院患者（AUD组）和28名年龄、受教育程度相匹配的健康对照（健康对照组）。采用情绪Go/Nogo任务（愤怒/中性表情面孔）评估被试行为抑制功能，结合层级贝叶斯漂移扩散模型（hierarchical drift-diffusion model，HDDM）量化他们的认知参数（漂移率、决策阈值、非决策时间）。通过情绪调节困难量表（Difficulties in Emotion Regulation Scale，DERS）和酒精使用障碍筛查量表（Alcohol Use Disorders Identification Test，AUDIT）进行临床评估，并运用bootstrap法检验有调节的中介效应模型。结果·AUD组在DERS总分及所有子维度（目标导向行为、冲动控制、策略获取、情绪清晰性）得分均高于健康对照组，差异有统计学意义（均P<0.05）。行为层面，与健康对照组相比，AUD组误按率［F_（1，54）=8.62，P=0.005］与遗漏率［F_（1，54）=4.28，P=0.043］更高，且愤怒面孔刺激反应时普遍延长［F_（1，54）=12.26，P=0.001］。认知建模显示AUD组漂移率显著低于健康对照组［F_（1，54）=15.56，P<0.001］，提示信息加工效率受损。有调节的中介模型显示，在愤怒面孔刺激条件下，漂移率部分中介组别对误按率的影响，总间接效应值为9.564（95%CI 3.874~16.387）；进一步分析表明，高水平情绪调节困难（比平均值高1个标准差）条件下间接效应增强至10.133（95%CI 3.963~17.927），而低水平（比平均值低1个标准差）时效应为9.011（95%CI 3.778~14.921）。结论·AUD患者信息加工效率的降低部分解释了患者的抑制控制功能障碍，且该影响与个体情绪调节能力存在关联。提示社会威胁信息加工异常可能是AUD患者，特别是在情绪调节能力较弱的个体抑制控制功能损害的重要影响因素。

关键词: 酒精使用障碍, 抑制控制, 情绪调节, 认知建模, 信息加工效率

Abstract:

Objective ·To investigate the performance and psychological mechanisms of inhibitory control in patients with alcohol use disorder (AUD) under different emotional contexts, and to examine the influence of emotion regulation difficulties on inhibitory control. Methods ·A total of 28 male AUD inpatients (AUD group) and 28 age- and education-matched healthy controls (HC group) were recruited. The emotional Go/Nogo task (angry/neutral facial expressions) was used to evaluate the subjects' behavioral inhibition, and the hierarchical drift-diffusion model (HDDM) was used to quantify the cognitive parameters (drift rate, decision threshold, and non-decision time). The Difficulties in Emotion Regulation Scale (DERS) and Alcohol Use Disorder Identification Test (AUDIT) were used for clinical evaluation. The moderated mediation effects were tested by bootstrap method. Results ·The AUD group scored higher than the HC group on the DERS total score and all sub-dimensions (goal-directed behavior, impulse control, strategy access, and emotional clarity), and the difference was statistically significant (all P<0.05). At the behavioral level, compared with the HC group, the AUD group had elevated commission error rates [F_(1,54)=8.62, P=0.005] and omission error rates [F_(1,54)=4.28, P=0.043], and the reaction time of angry face stimuli was generally prolonged [F_(1,54)=12.26, P=0.001]. Cognitive modeling showed that the drift rate of the AUD group was significantly lower than that of the HC group [F_(1,54)=15.56, P<0.001], indicating impaired information processing efficiency. The moderated mediation model showed that, under the condition of angry face stimuli, the drift rate partially mediated the relationship between group and commission error rate, and the total indirect effect value was 9.564 (95%CI 3.874‒16.387). Further analysis showed that the conditional indirect effect increased to 10.133 (95%CI 3.963‒17.927) at high levels of emotion regulation difficulty (one standard deviation above the mean), and to 9.011 (95%CI 3.778‒14.921) at low levels (one standard deviation below the mean). Conclusion ·The deficits in information processing efficiency of AUD patients partly explains the impairment of inhibitory control, and this effect is associated with individual emotion regulation capacity. It is suggested that abnormal processing of social threat information may be an important factor affecting the impairment of inhibitory control in AUD patients, especially in individuals with weak emotion regulation ability.

Key words: alcohol use disorder (AUD), inhibitory control, emotion regulation, cognitive modeling, information processing efficiency

中图分类号:

R749.6

程菲, 陈天真, 游旭, 薛保双, 杨云斌, 杜江. 情绪调节能力对酒精使用障碍患者抑制控制功能的影响[J]. 上海交通大学学报（医学版）, 2025, 45(7): 883-891.

CHENG Fei, CHEN Tianzhen, YOU Xu, XUE Baoshuang, YANG Yunbin, DU Jiang. Effects of emotion regulation ability on inhibitory control in patients with alcohol use disorder[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(7): 883-891.

图/表 9

图1 情绪Go/Nogo范式流程示意图

Fig 1 Schematic illustration of the emotional Go/Nogo task protocol

表1 AUD患者与健康对照人口统计学特征和临床评估结果比较

Tab 1 Comparison of demographic characteristics and clinical assessment results between AUD patients and healthy controls

Item	AUD (n=28)	HC (n=28)	t/U value	P value
Age/year	46.82±4.94	50.18±8.01	-1.89	0.065
Education/year	6.30±4.88	7.96±3.20	-1.50	0.138
Monthly income/yuan	1 000 (0, 5 250)	2 700 (2 000, 3 250)	300.00	0.132
AUDIT/score	29.61±6.14	1.21±2.30	1.00	<0.001
DERS/score	43.64±12.60	23.89±8.27	1.85	<0.001
Goal	9.75±3.40	5.61±2.77	1.34	<0.001
Impulse	9.00 (7.00, 11.00)	3.00 (3.00, 4.00)	684.00	<0.001
Strategy	12.21±3.81	6.57±2.47	0.78	<0.001
Clarity	5.25±2.72	3.61±1.87	0.34	0.011

表2 不同组别不同情绪条件下的Go/Nogo任务行为表现

Tab 2 Comparison of Go/Nogo task performance under different emotional conditions between the two groups

Item	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Reaction time/ms	Angry	545.80±106.08	492.67±87.66	Group: F_(1,54)=3.75, P=0.058, $η P 2$ =0.064 Emotion: F_(1,54)=12.26, P=0.001, $η P 2$ =0.003 Interaction: F_(1,54)=2.84, P=0.098, $η P 2$ =0.001
Reaction time/ms	Neutral	530.13±96.12	487.18±82.39
Comission error rate/%	Angry	6.25 (0, 12.50)	0 (0, 6.25)	Group: F_(1,54)=8.62, P=0.005, $η P 2$ =0.127 Emotion: F_(1,54)=1.12, P=0.295, $η P 2$ =0.002 Interaction: F_(1,54)=0.14, P=0.712, $η P 2$ <0.001
Comission error rate/%	Neutral	7.50 (0, 15.00)	0 (0, 5.00)
Omission error rate/%	Angry	0 (0, 2.23)	0 (0, 1.79)	Group: F_(1,54)=4.28, P=0.043, $η P 2$ =0.073 Emotion: F_(1,54)=1.90, P=0.173, $η P 2$ <0.001 Interaction: F_(1,54)=2.61, P=0.111, $η P 2$ =0.001
Omission error rate/%	Neutral	1.92 (0, 3.85)	0 (0, 1.92)

表2 不同组别不同情绪条件下的Go/Nogo任务行为表现

Tab 2 Comparison of Go/Nogo task performance under different emotional conditions between the two groups

Item	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Reaction time/ms	Angry	545.80±106.08	492.67±87.66	Group: F_(1,54)=3.75, P=0.058, $η P 2$ =0.064 Emotion: F_(1,54)=12.26, P=0.001, $η P 2$ =0.003 Interaction: F_(1,54)=2.84, P=0.098, $η P 2$ =0.001
Reaction time/ms	Neutral	530.13±96.12	487.18±82.39
Comission error rate/%	Angry	6.25 (0, 12.50)	0 (0, 6.25)	Group: F_(1,54)=8.62, P=0.005, $η P 2$ =0.127 Emotion: F_(1,54)=1.12, P=0.295, $η P 2$ =0.002 Interaction: F_(1,54)=0.14, P=0.712, $η P 2$ <0.001
Comission error rate/%	Neutral	7.50 (0, 15.00)	0 (0, 5.00)
Omission error rate/%	Angry	0 (0, 2.23)	0 (0, 1.79)	Group: F_(1,54)=4.28, P=0.043, $η P 2$ =0.073 Emotion: F_(1,54)=1.90, P=0.173, $η P 2$ <0.001 Interaction: F_(1,54)=2.61, P=0.111, $η P 2$ =0.001
Omission error rate/%	Neutral	1.92 (0, 3.85)	0 (0, 1.92)

表3 不同组别不同情绪条件下的认知参数比较

Tab 3 Between-group comparison of cognitive parameters across emotional conditions

Parameter	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Decision threshold	Angry	2.28±0.82	2.23±0.94	Group: F_(1,54)=0.31, P=0.582, $η P 2$ =0.006 Emotion: F_(1,54)=1.61, P=0.210, $η P 2$ =0.029 Interaction: F_(1,54)=1.11, P=0.298, $η P 2$ =0.020
Decision threshold	Neutral	1.96±0.69	2.20±0.86
Drift rate	Angry	3.13±2.00	4.39±1.61	Group: F_(1,54)=15.56, P<0.001, η $P 2$ =0.223 Emotion: F_(1,54)=2.66, P=0.108, $η P 2$ =0.047 Interaction: F_(1,54)=2.85, P=0.097, $η P 2$ =0.050
Drift rate	Neutral	3.12±1.32	5.12±1.98
Non-decision time/s	Angry	0.26±0.07	0.28±0.07	Group: F_(1,54)=0.47, P=0.494, $η P 2$ =0.009 Emotion: F_(1,54)=1.29, P=0.261, $η P 2$ =0.023 Interaction: F_(1,54)=0.02, P=0.880, $η P 2$ <0.001
Non-decision time/s	Neutral	0.25±0.10	0.27±0.09

表3 不同组别不同情绪条件下的认知参数比较

Tab 3 Between-group comparison of cognitive parameters across emotional conditions

Parameter	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Decision threshold	Angry	2.28±0.82	2.23±0.94	Group: F_(1,54)=0.31, P=0.582, $η P 2$ =0.006 Emotion: F_(1,54)=1.61, P=0.210, $η P 2$ =0.029 Interaction: F_(1,54)=1.11, P=0.298, $η P 2$ =0.020
Decision threshold	Neutral	1.96±0.69	2.20±0.86
Drift rate	Angry	3.13±2.00	4.39±1.61	Group: F_(1,54)=15.56, P<0.001, η $P 2$ =0.223 Emotion: F_(1,54)=2.66, P=0.108, $η P 2$ =0.047 Interaction: F_(1,54)=2.85, P=0.097, $η P 2$ =0.050
Drift rate	Neutral	3.12±1.32	5.12±1.98
Non-decision time/s	Angry	0.26±0.07	0.28±0.07	Group: F_(1,54)=0.47, P=0.494, $η P 2$ =0.009 Emotion: F_(1,54)=1.29, P=0.261, $η P 2$ =0.023 Interaction: F_(1,54)=0.02, P=0.880, $η P 2$ <0.001
Non-decision time/s	Neutral	0.25±0.10	0.27±0.09

表4 愤怒情绪条件下有调节的中介模型分析

Tab 4 Moderated mediation analysis of inhibitory control under the angry emotional condition

Variable	Drift rate			Commission error rate
Variable	B	z value	P value	B	z value	P value
Group	-2.443	-3.159	0.002	-2.624	-1.005	0.315
DERS	0.045	0.691	0.490	‒	‒	‒
Group×DERS	-0.264	-0.750	0.453	‒	‒	‒
Drift rate	‒	‒	‒	-3.914	-4.167	<0.001
Drift rate×DERS	‒	‒	‒	-0.148	-1.998	0.046
R² value		0.298			0.847
F value		7.220			16.040

表5 愤怒情绪条件下总效应、直接效应与调节中介效应分析

Tab 5 Total effect， direct effect， and moderated mediation analysis under the angry emotional condition

Effect type	Effect value	SE	95%CI	β	P value
Total effect	6.940	3.829	0.564‒14.021	0.202	0.018
Direct effect	-2.624	2.610	-7.232‒3.202	-0.077	0.315
Total indirect effect	9.564	3.177	3.874‒16.387	0.279	0.003
Conditional indirect effect
Low DERS	9.011	2.847	3.778‒14.921	-0.031	0.002
High DERS	10.133	3.555	3.963‒17.927	0.868	0.004

图2 不同情绪条件下的调节中介效应路径图Note： A. Under the angry emotional condition. B. Under the neutral emotional condition. Path coefficients are standardized regression coefficients. ①P<0.001, ②P=0.002, ③P=0.038.

Fig 2 Path analysis of the moderated mediation model under different emotional conditions

表6 中性情绪条件下有调节的中介模型分析

Tab 6 Moderated mediation analysis of inhibitory control under the neutral emotional condition

Variable	Drift rate			Commission error rate
Variable	B	z value	P value	B	z value	P value
Group	-1.074	-1.380	0.168	3.006	1.027	0.304
DERS	-0.007	-0.169	0.866	‒	‒	‒
Group×DERS	-0.018	-0.344	0.731	‒	‒	‒
Drift rate	‒	‒	‒	-3.308	-3.623	<0.001
Drift rate×DERS	‒	‒	‒	-0.430	-1.475	0.140
R² value	0.161			0.739
F value	3.260			11.010

表7 中性情绪条件下总效应、直接效应与调节中介效应分析

Tab 7 Total effect， direct effect， and moderated mediation analysis under the neutral emotional condition

Effect type	Effect value	SE	95%CI	β	P value
Total effect	6.558	4.221	-1.856‒14.972	0.224	0.123
Direct effect	3.006	2.926	-2.949‒8.704	0.103	0.304
Total indirect effect	3.552	3.066	-0.907‒11.000	0.121	0.247
Conditional indirect effect
Low DERS	3.372	2.936	-1.023‒10.458	-0.003	0.251
High DERS	3.737	3.214	-0.736‒11.654	0.332	0.245

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情绪调节能力对酒精使用障碍患者抑制控制功能的影响

Effects of emotion regulation ability on inhibitory control in patients with alcohol use disorder

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