The phenomenology of deep brain stimulation-induced changes in OCD: an enactive affordance-based model.
The phenomenology of deep brain stimulation-induced changes in OCD: an enactive affordance-based model.
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DOI：
10.3389/fnhum.2013.00653
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发表时间：
2013
影响因子：
2.9
通讯作者：
Denys D
中科院分区：
文献类型：
--
作者：
de Haan S;Rietveld E;Stokhof M;Denys D
患有强迫症(OCD)的人会做他们不想做的事情，和/或他们想他们不想想的事情。在大约10%的强迫症患者中，可用的治疗方案都不有效。其中一小部分患者目前正在接受脑深部刺激(DBS)治疗。DBS涉及在大脑中植入电极。这些电极向植入电极的大脑区域发出持续的电脉冲。原来，患者可能会因为星展银行的治疗而经历深刻的变化。改变的不仅仅是症状；患者似乎体验到了一种不同的生活方式。传统的精神病学量表主要包括对症状严重程度的行为测量，不能充分反映这些全球影响。在这篇文章中，我们的目标是捕捉患者现象学中的变化，并理解他们报告的广泛变化。为此，我们引入了一个主动的、基于启示的模型，该模型从四个方面充实了人与世界之间的动态交互。第一个方面是患者对世界的体验。我们建议用负担的范围来确定患者的世界，包括范围的广度(范围的宽度)、时间范围(深度)和感知到的负担的相关性(高度)这三个维度。第二个方面是互动的人与人之间的互动，即患者的自我体验，特别是他们的情绪和感受。第三，我们指出了患者与世界交往方式的不同特点。最后，存在主义立场是指患者对他们所经历的变化所采取的立场：与他们的互动和他们自己的二级评估关系。通过我们的模型，我们打算具体说明存在于世界中的概念，以便公正地解释DBS治疗的现象学影响。
People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10% of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). DBS involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioral measures of the severity of the symptoms. In this article we aim to capture the changes in the patients' phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients' experience of the world. We propose to specify the patients' world in terms of a field of affordances, with the three dimensions of broadness of scope (“width” of the field), temporal horizon (“depth”), and relevance of the perceived affordances (“height”). The second aspect is the person-side of the interaction, that is, the patients' self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take toward the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment.
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DOI：
10.1159/000351929
发表时间：
2013-01-01
期刊：
ANXIETY DISORDERS
影响因子：
--
作者：
de Haan, Sanneke;Rietveld, Erik;Denys, Damiaan
通讯作者：
Denys, Damiaan
影响因子：
158.5
作者：
Mallet, Luc;Polosan, Mircea;Pelissolo, Antoine
通讯作者：
Pelissolo, Antoine
影响因子：
16.2
作者：
Mayberg, HS;Lozano, AM;Kennedy, SH
通讯作者：
Kennedy, SH
影响因子：
3.7
作者：
Borsboom D;Cramer AO;Schmittmann VD;Epskamp S;Waldorp LJ
通讯作者：
Waldorp LJ
影响因子：
3.8
作者：
Kiverstein J;Rietveld E
通讯作者：
Rietveld E