Conversion Disorder: A Cognitive Neuropsychiatric Approach

转换障碍(歇斯底里？)是一种非常常见的、非常致残的情况，被认为是当情绪问题被转化时发生的？转化为瘫痪或失明等身体症状。尽管它一如既往地常见和致残，但自19世纪以来，对它的研究很少。它发生的过程仍然是个谜，也没有既定的治疗方法。大多数患有这种疾病的患者不相信自己患有这种疾病，也根本不认为自己的问题是精神问题。我们希望研究这一转化过程，看看它是否有现代神经科学的一些基础。如果转换模型是正确的，那么我们预计患者会有更多某些类型的生活压力，从而导致他们患上这种疾病。这可能很难证明，因为人们的可靠性？S回忆道，而且因为我们知道这一群体倾向于否认这种压力的相关性。我们建议通过标准化的访谈来解决这个问题，生活事件和困难时间表，这是一种从受试者那里获取问题的有效和可靠的方式？都过去了。转换模型认为，这些经历在情感上是被压抑的。通过脑扫描，我们希望在患者回忆这些经历的同时对他们进行检查，看看他们是否确实以一种比其他人更不情绪化的方式回忆他们，即使这可能是他们不承认的事情。我们还将检查回忆是否会导致他们的症状-例如，使他们的瘫痪恶化。如果这是成功的，我们预计它将使诊断更容易被患者接受和理解，并为它迫切需要的研究打开领域。

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.