Conversion Disorder: A Cognitive Neuropsychiatric Approach

转换障碍（？歇斯底里？）是一种非常常见的，非常残疾的条件，这是认为发生时，情绪问题是？皈依了吗转化为身体症状如瘫痪或失明。虽然它和以往一样普遍和致残，但自世纪以来，对它的研究很少。它发生的过程仍然是神秘的，没有既定的治疗方法。大多数患有这种疾病的患者不相信他们有这种疾病，并且根本不认为他们的问题是精神问题。我们希望研究这个转换过程，看看它是否有现代神经科学的基础。如果转换模型是正确的，那么我们可以预期患者会有更多的某些类型的生活压力，从而导致他们发展出这种疾病。这可能很难证明，因为人们的不可靠？这是因为我们知道这一群体倾向于否认这种压力的相关性。我们建议解决这一问题的标准化面试，生活事件和困难的时间表，这是一个有效的和可靠的方式访问问题的主题？过去转换模型认为，这些经历是情感压抑的。通过大脑扫描，我们希望在患者回忆这些经历时对其进行检查，看看他们是否以比其他人更少的情感方式回忆这些经历，即使这可能是他们不承认的。我们还将研究回忆是否会引起他们的症状-例如使他们的瘫痪恶化。如果这是成功的，我们希望它将使诊断更容易接受和理解的病人，并打开了领域的研究，它迫切需要。

Conversion disorder (?hysteria?) is a very common, very disabling condition, which is thought to occur when emotional problems are ?converted? into physical symptoms such as paralysis or blindness. Though it is as common and as disabling as ever, there has been very little research on it since the 19th century. The process by which it occurs remains mysterious, and there are no established treatments. Most patients with the disorder do not believe they have it, and do not see their problems as mental at all. We wish to examine this conversion process to see if it has some basis in modern neuroscience. If the conversion model is correct, then we would expect patients to have more life stresses of certain types leading up to their developing the disorder. This can be difficult to prove because of the unreliability of people?s recall, and because we know this group tend to deny the relevance of such stresses. We propose to address this with a standardised interview, the Life Events & Difficulties Schedule, which is a valid and reliable way of accessing problems from subjects? pasts. The conversion model proposes that these experiences are emotionally repressed. Using brain scanning, we wish to examine patients while they recall those experiences to see if they do recall them in a less emotional way than other people, even though this may be something they do not acknowledge. We will also examine whether recall brings on their symptoms - making their paralysis worse, for example. If this is successful we expect it will make the diagnosis much more acceptable and understandable to patients, and open the field to the research it sorely needs.