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[述情障碍。评估、定量及临床数据]

[Alexithymia. Evaluation, quantitative and clinical data].

作者信息

Bertagne P, Pedinielli J L, Marliere C

机构信息

Unité de Recherche Interdisciplinaire en Psychopathologie, Université de Lille III.

出版信息

Encephale. 1992 Jan-Feb;18(1):121-30.

PMID:1600893
Abstract

Alexithymia is a concept created by Sifneos in 1972 to describe a disturbance in affective and cognitive functions characterised by an inability to find words to describe feelings or emotions. The term "alexithymia" is derived from the Greek and means "no words for feelings". The salient clinical features of alexithymia include difficulties recognizing and verbalizing feelings, endless description of physical symptoms instead of emotions, concrete speech and thougth closely tied to external events, paucity of fantasy life. Precisely, alexithymia is an inability to associate one's visual image, thoughts and fantasies with a specific emotional state. For Sifneos, "emotions" and "feelings" are different facts. He differentiates "visceral emotions" (biologic side of the affect and lying in structures of the limbic system as the hippocampus and the amygdaloid complex) and "feelings emotions" (psychologic side of the affect). For him, animals experience "visceral emotion", but only human experience "feeling emotions". Alexithymia is regarded as one of several possible risk factors that seem to increase the susceptibility to physical disease. Alexithymia describes some psychological features which has been initially described by Marty and Psychosomatic French School: a specific cognitive style characterized by a lack of absence of fantasies and a preoccupation with the minute details of external events ("pensée opératoire"). Alexithymia is a difficult concept to operationalize and only few instruments are sufficiently reliable and valid. Several scales are used to measure alexithymia but only the Beth Israel Questionnaire (BIQ) and the Toronto Alexithymie Scale (TAS) can be regarded as having sufficient psychometric properties. The first questionnaire, the BIQ--a scale created by Sifneos--, is the most widely used instrument which is a 17-items forced-choice questionnaire completed by the interviewer. The TAS is a 26-items self-report measure rated on a five-point Likert scale. The Shalling Sifneos Psychosomatic Scale (SSPS) and the M.M.P.I. Alexithymia Scale lack of validation and reliability. Furthermore the SSPS and the MMPI AS show little or no relation with BIQ or with TAS, thus limiting the comparability and generalizability of results from the studies that use them. The TAS is considered as internally consistent and to have a stable, replicable factor structure. Other measures as content analysis test, projective test (Rorschach, T.AT., SAT9) or others self-assessment questionnaires are not frequently used.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

述情障碍是西夫neos于1972年提出的一个概念,用于描述情感和认知功能的紊乱,其特征是无法找到合适的词语来描述感受或情绪。“述情障碍”一词源于希腊语,意为“无法表达情感”。述情障碍的显著临床特征包括难以识别和表达情感、无休止地描述身体症状而非情绪、具体的言语和思维与外部事件紧密相连、缺乏幻想生活。确切地说,述情障碍是指无法将自己的视觉形象、思维和幻想与特定的情绪状态联系起来。对西夫neos来说,“情绪”和“感受”是不同的概念。他区分了“内脏情绪”(情感的生物学方面,存在于边缘系统结构如海马体和杏仁核复合体中)和“感受情绪”(情感的心理学方面)。对他而言,动物体验“内脏情绪”,但只有人类体验“感受情绪”。述情障碍被视为似乎会增加身体疾病易感性的几种可能风险因素之一。述情障碍描述了一些最初由马蒂和法国心身学派描述的心理特征:一种特定的认知风格,其特点是缺乏幻想且专注于外部事件的细微细节(“操作性思维”)。述情障碍是一个难以操作化的概念,只有少数工具具有足够的可靠性和有效性。有几种量表用于测量述情障碍,但只有贝丝以色列问卷(BIQ)和多伦多述情障碍量表(TAS)可被视为具有足够的心理测量特性。第一个问卷,即BIQ——由西夫neos创建的量表——是使用最广泛的工具,它是一个由访谈者完成的17项强制选择问卷。TAS是一个26项的自我报告量表,采用五点李克特量表评分。沙林西夫neos心身量表(SSPS)和明尼苏达多相人格调查表述情障碍量表缺乏效度和信度。此外,SSPS和MMPI AS与BIQ或TAS几乎没有关系,因此限制了使用它们的研究结果的可比性和普遍性。TAS被认为具有内部一致性,并且具有稳定、可复制的因子结构。其他测量方法如内容分析测试、投射测试(罗夏墨迹测验、主题统觉测验、句子完成测验9)或其他自我评估问卷并不常用。(摘要截选至400字)

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