PAIN SENSITIVITY AND AFFECTIVE DEFICITS IN SCHIZOPHRENIA

情感缺陷一直被认为是一个突出的特点， 精神分裂症 情感平淡是唯一的负面症状 包括在每一个主要的评级量表，以评估负面的 症状，并根据对解决有效性的研究的回顾， 阳性和阴性症状之间的区别，McGlashan和 芬顿（1992年）最近建议，单位的影响，包括在 精神分裂症的定义标准 鉴于这种认识 情感缺陷在精神分裂症中的重要性， 令人惊讶的是，这些症状的特征并不好 介绍了 最近有人认为，目前的方法， 情感扁平化被社会和神经运动缺陷所混淆 这在精神分裂症中也很普遍（Dworkin，1992）。 如果 情感缺陷背后的神经生物学和心理学过程 应该理解，研究情感扁平化的方法， 相对不受社会和神经运动过程的干扰， 开发 精神分裂症患者疼痛不敏感性的研究 这是一种研究情感扁平化的方法。 不敏感 据报道，精神分裂症患者经常出现疼痛，但 这一现象从未得到系统的研究。 主 拟议研究的目的是仔细描述疼痛的特征， 精神分裂症患者不敏感性及其与情感因素关系 并检查这两个变量之间的关系 以及社交和神经运动缺陷。 这将使测试成为可能 疼痛不敏感是情感性的表现的假设 精神分裂症的扁平化，一个相对独立的 社会和神经运动过程。 此外，数据将使其 可以评估在何种程度上不同的措施，情感 缺陷与社会和神经运动缺陷混淆， 不仅使情感的概念更加清晰， 精神分裂症的扁平化，但也将提高结构效度 评估方法。 该研究还提出了 对精神分裂症患者福利的重要影响; 许多临床报告表明，疼痛不敏感性是非常 对精神分裂症患者的健康有害， 结果，疼痛不敏感也可能解释各种自我- 精神分裂症患者的伤害行为， 包括无家可归的精神分裂症患者的某些行为 一 疼痛不敏感性和情感的更完整的表征 精神分裂症的扁平化不仅有助于研究 他们潜在的神经生物学和心理过程， 还应该能够制定更有效的方法， 改善这些重要的症状及其负面后果， 精神分裂症患者的健康和幸福。

Affective deficits have long been considered a prominent feature of schizophrenia. Affective flattening is the only negative symptom included in every major rating scale for the assessment of negative symptoms, and based on a review of research addressing the validity of the distinction between positive and negative symptoms, McGlashan and Fenton (1992) recently suggested that flat affect be included among the defining criteria for schizophrenia in DSM-IV. Given this recognition of the importance of affective deficits in schizophrenia, it is surprising that the characteristics of these symptoms have not been well described. It has recently been argued that current approaches to affective flattening are confounded by the social and neuromotor deficits that are also prevalent in schizophrenia (Dworkin, 1992). If the neurobiological and psychological processes underlying affective deficits are to be understood, approaches for examining affective flattening that are relatively unconfounded by social and neuromotor processes must be developed. The investigation of pain insensitivity in schizophrenia is one such approach to examining affective flattening. Insensitivity to pain has been reported frequently in individuals with schizophrenia, but this phenomenon has never been systematically investigated. The primary aims of the proposed research are to carefully characterize pain insensitivity in schizophrenia and its relationship to affective flattening and to examine the relationships between these two variables and social and neuromotor deficits. This will make it possible to test the hypothesis that pain insensitivity is a manifestation of affective flattening in schizophrenia, one which is relatively independent of social and neuromotor processes. In addition, the data will make it possible to evaluate the extent to which different measures of affective deficits are confounded with social and neuromotor deficits, which will not only lead to greater clarity in the conceptualization of affective flattening in schizophrenia but will also improve the construct validity of approaches to its assessment. The proposed research also has important implications for the welfare of individuals with schizophrenia; numerous clinical reports have suggested that pain insensitivity is very detrimental to health in schizophrenia and can have life-threatening consequences, and pain insensitivity may also account for various self- injurious behaviors that are found in individuals with schizophrenia, including some aspects of the behavior of homeless schizophrenics. A more complete characterization of pain insensitivity and affective flattening in schizophrenia will not only facilitate the investigation of their underlying neurobiological and psychological processes, but should also make it possible to develop more effective methods for ameliorating these important symptoms and their negative consequences for the health and well-being of individuals with schizophrenia.