Defective Self and/or Other Mentalising in Schizophrenia: A Cognitive Neuropsychological Approach.
Defective Self and/or Other Mentalising in Schizophrenia: A Cognitive Neuropsychological Approach.
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DOI：
10.1080/135468097396324
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发表时间：
1997-08-01
影响因子：
1.7
通讯作者：
Coltheart, M
中科院分区：
文献类型：
--
作者：
Langdon, R;Michie, P T;Coltheart, M
精神分裂症患者和正常对照组的精神化能力进行了测试，使用图片排序和讲故事的任务，要求受试者推断因果心理状态的故事人物，和回忆任务，要求受试者解离主观心理状态的客观现实。在一些患者中发现了选择性心智缺陷。对于其他患者来说，一般的测序错误、“感官”心理化以及对符号表征的记忆差表明存在更严重的问题。任务结果最好解释为可分离的认知异常，而不是中央心智化机制的分级功能障碍。患者亚组的症状特征以及任务测量和临床评级之间的相关性将这些认知异常与特定症状联系起来。一般排序困难与贫困症状和现实扭曲有关，这表明两种机制可能支持这种错误：一种是无法操纵象征性的表示，与贫困有关;另一种是未能批判性地评估合理的因果关系，与现实扭曲有关。有一些证据表明，有缺陷的自我监控是思维障碍的基础。受损的元表征与孤独症样的情感平淡、社交功能障碍和失语症有关，而不是与现实扭曲有关。这些研究结果的影响进行了讨论，目前精神分裂症研究所面临的理论和方法问题。
The mentalising abilities of schizophrenic patients and normal controls were tested using picture sequencing and story-telling tasks that required subjects to infer causal mental states in story characters, and a recall task that required subjects to dissociate subjective mental states from objective realities. Selective mentalising deficits were found in some patients. For other patients, general sequencing errors, "sensory" mentalising, and poor recall of symbolic representations suggested more profound problems. Task results were best accounted for by dissociable cognitive abnormalities, rather than graded dysfunction of a central mentalising mechanism. Symptom profiles of patient subgroups and correlations between task measures and clinical ratings linked these cognitive abnormalities to specific symptoms. General sequencing difficulty was associated with both poverty symptoms and reality distortion, suggesting that two mechanisms may underpin such errors: one, inability to manipulate symbolic representations, being linked to poverty; the other, failure to critically evaluate plausible cause-and-effect, being linked to reality distortion. There was some evidence that defective self-monitoring underpins thought disorder. Impaired metarepresentation was linked to the autisticlike symptoms of flat affect, social dysfunction, and alogia, rather than reality distortion. Implications of these findings are discussed with respect to theoretical and methodological issues confronting current schizophrenia research.