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정신분열병 환자의 얼굴 정서 지각 결함에 관한 연구

Deficits of Facial Affect Perception in Patients with Schizophrenia

김명선|윤선아|박성희
한국임상심리학회 (Korean Clinical Psychology Association)|2007.11|Korean Journal of Clinical Psychology|제26권 제4호|pp. 845-865|DOI 10.15842/kjcp.2007.26.4.003

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키워드

schizophrenianeuropsychological test신경심리검사정신분열병얼굴정서 지각얼굴정서 변별과제얼굴정서 확인과제facial affect discrimination task. facial affect identification task
주제분류심리과학

초록

정신분열병 환자의 얼굴정서 지각 능력과 신경심리 기능 사이의 관련성, 특히 정신분열병 환자에서 관찰되는 얼굴정서 지각의 결함이 정서 장애 혹은 얼굴지각의 장애를 반영하는가와 얼굴정서 지각의 결함이 일반화된 인지 기능의 장애로 인한 이차적 장애인지 혹은 특정 인지 기능의 장애와 관련되어 있는가를 조사하였다. 20명의 정신분열병 환자들과 20명의 정상인들이 연구에 참여하였다. 얼굴정서의 지각은 얼굴표정 변별과제와 얼굴표정 확인과제를 사용하여 측정하였고 통제 검사로서 얼굴인식 과제가 실시되었다. 또한 주의, 언어/비언어 기억, 실행기능 등의 인지 기능을 신경심리검사를 사용하여 평가하였다. 얼굴 인식과제에서는 정신분열병 환자군과 정상통제군 사이에 유의한 차이가 관찰되지 않았으나, 얼굴정서 변별 및 확인 과제에서는 두 집단 간의 유의한 차이가 관찰되었다. 즉 정신분열병 환자군이 정상통제군에 비하여 유의하게 낮은 수행을 보였다. 정신분열병 환자군이 정상통제군에 비하여 주의, 언어/비언어 기억, 실행기능 등에서 유의하게 낮은 수행을 보였으나, Wisconsin Card Sorting Test의 보속오반응수와 Rey-Osterrieth Complex Figure Test의 즉각적 회상 점수가 얼굴정서 변별 과제의 수행을 가장 잘 예측한 한편 공간폭 검사의 점수가 얼굴정서 확인 과제의 수행을 가장 잘 예측하였다. 이러한 결과는 정신분열병 환자들에서 관찰되는 얼굴정서 지각의 결함이 얼굴 지각의 결함보다는 정서 지각의 결함을 반영하며 얼굴정서 지각의 결함이 실행기능, 시각 단기기억 및 시공간 주의의 결함과 관련되어 있다는 것을 시사한다.

Abstract

This study examined the relationship between the abilities of facial affect perception and neuropsychological functions in schizophrenic patients. In particular, this study investigated whether the observed facial affect deficit in schizophrenic patients reflects the facial perception deficit or affect perception deficit, and whether the facial affect deficit is related to the specific cognitive impairment or it is the secondary deficit of the generalized cognitive impairment. Twenty schizophrenic patients and twenty normal controls participated. For the measurement of the abilities of facial affect perception, facial affect discrimination and identification tasks were administered, and the facial recognition task was administered as the control task. The comprehensive neuropsychological tests were administered for the evaluation of executive function, verbal/nonverbal memory and attention. There was no significant difference between the patient and control groups in terms of facial recognition task, however, the schizophrenic patients showed significantly worse performance on the facial affect discrimination and identification tasks compared to the normal controls. Although the patients showed impaired performance in all cognitive areas evaluated in this study, the perseverative error response of WCST and immediate recall score of RCFT were the predictors of the performance on facial affect discrimination task, and the score of spatial test predicted the performance on facial affect identification task. These results indicate that impairment of facial affect perception in schizophrenic patients reflects the impairment of affect, and is related to the specific cognitive dysfunctions such as impairments of mental flexibility, nonverbal short-memory and spatial attention.

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