Aligning Computational Psychiatry With the Hearing Voices Movement: Hearing Their Voices.
Aligning Computational Psychiatry With the Hearing Voices Movement: Hearing Their Voices.
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将计算精神病学与聆听声音运动结合起来：聆听他们的声音。
DOI：
10.1001/jamapsychiatry.2018.0509
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发表时间：
2018
期刊：
影响因子：
25.8
通讯作者：
Corlett,PhilipR
中科院分区：
文献类型：
--
作者：
Powers3rd,AlbertR;Bien,Claire;Corlett,PhilipR
诊断和治疗精神病的既定方法面临着越来越大的挑战。关键精神病学要求我们把病人的权利，自主权和恢复在治疗的最前沿。他们低估了大脑在病因学中的作用，从而低估了药物治疗的疗效，他们认为这种治疗弊大于利1。这可能会被当代精神病学家立即驳回：虽然抗精神病药物有副作用，但这些药物在对照临床试验中优于安慰剂-认知疗法没有达到的标准1。然而，一些批判性精神病学的观点得到了经验的支持：精神病症状在社会孤立的背景下恶化2，他们对家庭成员表达的情绪很敏感，并且他们与创伤有统计学上的联系3。我们认为新兴的计算精神病学（CP）领域可能会调和生物精神病学与批判性精神病学以及那些有精神病生活经历的人的价值观和目标。我们将专注于听觉语言幻觉或“声音”。我们将重点介绍听觉声音网络（HVN），一个不断发展的以恢复为导向的组织，强调接受语音听觉体验4，以及一个新的幻觉预测处理帐户5，可能会提供类似的见解。鉴于HVN倾向于淡化声音的生物医学解释，HVN和基于大脑的CP似乎是奇怪的伙伴。然而，CP的出现是出于对跨多个层次解释的一致性的渴望，无论是神经生物学的，认知的还是社会的。通过跨越和统一解释的层次，CP拥抱了HVN核心的多元主义，并将这种多元主义的力量带到临床护理服务中。
Established approaches to the diagnosis and treatment of psychosis face a growing challenge. Critical Psychiatry demands we put patient rights, autonomy, and recovery at the forefront of treatment. They downplay the role of the brain in etiology and, thus, the efficacy of pharmacological treatments, which they argue do more harm than good1. This may be dismissed out of hand by the contemporary psychiatrist: while there are adverse effects of antipsychotics, these drugs outperform placebos in controlled clinical trials—a bar that is not met by cognitive therapies1. However, some critical psychiatry views find empirical support: psychotic symptoms worsen in the context of social isolation2, they are sensitive to the emotionality expressed by family members, and they are statistically associated with trauma3.We suggest the burgeoning field of computational psychiatry (CP) may reconcile biological psychiatry with critical psychiatry as well as the values and goals of those with lived experience of psychosis. We will focus on auditory verbal hallucinations or ‘voices.’We will highlight how the Hearing Voices Network (HVN), a growing recovery-oriented organization that emphasizes accepting voice-hearing experiences4, and a new predictive processing account of hallucinations5, might offer similar insights. Given the HVN’s tendency to downplay biomedical explanations of voices, it may seem that the HVN and brain-based CP make strange bedfellows. However, CP emerged from a desire for consilience across multiple levels of explanation, whether neurobiological, cognitive, or social. It is about modeling the world and the brain within it. By spanning and uniting levels of explanation, CP embraces the pluralism central to the HVN, and brings the power of this pluralism to the service of clinical care.