Barnard Philip J
MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 2EF, UK.
Behav Res Ther. 2004 Sep;42(9):977-1000. doi: 10.1016/j.brat.2004.04.002.
This paper articulates and discusses the parts played by different processes and representations in the overall conduct of applied clinical science. It distinguishes two sorts of representation, theories in the science base and bridging representations needed to map from real world behaviour to basic theory and from theory back to the real world. It is then argued that macro-theories of the "normal" human mental architecture could help synthesise basic theoretical accounts of diverse psychopathologies, without recourse to special purpose clinical cognitive theories of particular psychopathologies or even specific symptoms. Using the Interacting Cognitive Subsystems model [Affect, Cognition and Change: Re-modelling Depressive Thought, Lawrence Erlbaum Associates, Hove, 1993], some specific macro-theoretic variables are identified. Concrete illustrations are given of how the essence of quite complex basic theory can be translated into a simpler representational format to help clinicians conceptualise a psychopathological state and pinpoint relevant variables that might be changed by therapeutic interventions. Some suggestions are also offered about how the inevitable problem of complexity in multiple component theories might be directly confronted.
本文阐述并讨论了不同过程和表征在应用临床科学整体实践中所起的作用。它区分了两种表征,即科学基础中的理论,以及从现实世界行为映射到基础理论并从理论回到现实世界所需的桥梁性表征。接着有人认为,“正常”人类心理结构的宏观理论有助于综合各种精神病理学的基础理论解释,而无需借助特定精神病理学甚至特定症状的特殊临床认知理论。利用交互认知子系统模型(《情感、认知与变化:重塑抑郁思维》,劳伦斯·埃尔鲍姆联合出版社,霍夫,1993年),确定了一些具体的宏观理论变量。文中给出了具体示例,说明相当复杂的基础理论的精髓如何能够转化为更简单的表征形式,以帮助临床医生概念化一种精神病理状态,并确定可能因治疗干预而改变的相关变量。还就如何直接应对多成分理论中不可避免的复杂性问题提出了一些建议。