Kaprinis George St, Fountoulakis Kostas N, Kaprinis Stergios G
Aristotle University of Thessaloniki, Greece.
Percept Mot Skills. 2002 Jun;94(3 Pt 1):975-84. doi: 10.2466/pms.2002.94.3.975.
Recently, the 'cognitive dysmetria' theory for schizophrenia has been formulated. According to this theory, a primary neurocognitive dysfunction is the core of schizophrenia and underlies symptom formation. The suggested perceptual fragmentation of external stimuli and inability to connect such perceptions with internal schemata is suggested to lead to positive symptoms, while defensive self-restriction and the exhaustion of the mental apparatus lead to negative symptomatology. Objections to this theory include observations (i) that patients with dominant positive symptoms, e.g., delusions, hallucinations, manifest better neurocognitive function and (ii) that typically antipsychotics significantly reduce positive symptoms and thus improve both the clinical picture and the functioning (to the extent it is reduced with positive symptoms) of the patients, yet have little or no effect on negative, e.g., loss of volition, emotional blunting, and neurocognitive symptomatology, e.g., attentional and memory deficit. The literature suggests that neurocognitive symptoms group independently of other symptomatology. It is suggested that there is currently more evidence against than in favor of the 'cognitive dysmetria' theory.
最近，精神分裂症的“认知失调”理论已经形成。根据这一理论，原发性神经认知功能障碍是精神分裂症的核心，也是症状形成的基础。外部刺激的感知碎片化以及无法将这些感知与内部模式联系起来，被认为会导致阳性症状，而防御性自我限制和心理机制的耗竭则会导致阴性症状。对该理论的反对意见包括以下观察结果：（i）以妄想、幻觉等为主导阳性症状的患者表现出更好的神经认知功能；（ii）典型的抗精神病药物能显著减轻阳性症状，从而改善患者的临床表现和功能（在阳性症状导致功能降低的程度上），但对阴性症状（如意志缺失、情感迟钝）和神经认知症状（如注意力和记忆缺陷）几乎没有影响。文献表明，神经认知症状独立于其他症状群。目前，反对“认知失调”理论的证据比支持该理论的证据更多。
