Delusions: A Cognitive Perspective
Delusions: A Cognitive Perspective
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妄想：认知视角
DOI：
10.1891/jcop.16.4.455.52522
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发表时间：
2002
影响因子：
0.7
通讯作者：
N. Rector
中科院分区：
文献类型：
--
作者：
A. Beck;N. Rector
对妄想的理解虽然历史上集中在神经心理学缺陷上，但可以从与其他形式的精神病理学相同的认知角度来理解。妄想思维的横断面分析显示出几个认知特征：自我中心偏见（不相关的事件被解释为与自身相关）；外化偏见（强烈的内部感觉或症状归因于外部因素）；故意偏见（其他人的行为被认为是基于对患者的意图——通常是恶意的）。此外，有缺陷的现实测试可以防止重新评估和拒绝错误的结论。因此，诸如选择性抽象、过度概括和武断推理等认知扭曲十分普遍。从发展的角度来看，宏伟的妄想似乎源于早期的荣耀白日梦，作为对孤独、不足和自卑感的补偿。白日梦对患者来说变得越来越真实，直到变成明显的妄想。被害妄想通常始于害怕报复或歧视。由于注意力偏差，这些恐惧会得到伪确认，直到它们成为完全形成的信念，抢占正常的信息处理并取代更现实的信念。
The understanding of delusions, while historically focused on neuropsychological deficits, can be approached from the same cognitive perspective as that applied to other forms of psychopathology. The cross-sectional analysis of delusional thinking shows several cognitive characteristics: egocentric bias (irrelevant events are construed as self-relevant); externalizing bias (strong internal sensations or symptoms are attributed to external agents); and intentionalizing bias (other people’s behaviors are believed to be based on intentions—usually malevolent—towards the patient). In addition, defective reality testing precludes reevaluation and rejection of erroneous conclusions. Consequently, cognitive distortions such as selective abstraction, overgeneralization, and arbitrary inferences are prevalent. From a developmental perspective, grandiose delusions appear to arise from earlier daydreams of glory, serving as a compensation for feelings of loneliness, inadequacy, and inferiority. The daydreams become increasingly real to the patient until they become overt delusions. Persecutory delusions typically begin as a fear of retaliation or discrimination. Because of attentional bias, these fears receive pseudoconfirmation until they become fully formed beliefs that preempt normal information processing and displace more realistic beliefs.