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精神分裂症的认知方法:理论与治疗

Cognitive approaches to schizophrenia: theory and therapy.

作者信息

Beck Aaron T, Rector Neil A

机构信息

Psychopathology Research Unit, University of Pennsylvania, Philadelphia, Pennsylvania 19104-3309, USA.

出版信息

Annu Rev Clin Psychol. 2005;1:577-606. doi: 10.1146/annurev.clinpsy.1.102803.144205.

Abstract

A theoretical analysis of schizophrenia based on a cognitive model integrates the complex interaction of predisposing neurobiological, environmental, cognitive, and behavioral factors with the diverse symptomatology. The impaired integrative function of the brain, as well as the domain-specific cognitive deficits, increases the vulnerability to aversive life experiences, which lead to dysfunctional beliefs and behaviors. Symptoms of disorganization result not only from specific neurocognitive deficits but also from the relative paucity of resources available for maintaining a set, adhering to rules of communication, and inhibiting intrusion of inappropriate ideas. Delusions are analyzed in terms of the interplay between active cognitive biases, such as external attributions, and resource-sparing strategies such as jumping to conclusions. Similarly, the content of hallucinations and the delusions regarding their origin and characteristics may be understood in terms of biased information processing. The interaction of neurocognitive deficits, personality, and life events leads to the negative symptoms characterized by negative social and performance beliefs, low expectancies for pleasure and success, and a resource-sparing strategy to conserve limited psychological resources. The comprehensive conceptualization creates the context for targeted psychological treatments.

摘要

基于认知模型对精神分裂症的理论分析,整合了易感性神经生物学、环境、认知和行为因素与多样症状学之间的复杂相互作用。大脑整合功能受损以及特定领域的认知缺陷,增加了个体对厌恶性生活经历的易感性,进而导致功能失调的信念和行为。紊乱症状不仅源于特定的神经认知缺陷,还源于可用于维持定势、遵循交流规则以及抑制不适当想法侵入的资源相对匮乏。妄想可从主动认知偏差(如外部归因)与节省资源策略(如草率下结论)之间的相互作用来分析。同样,幻觉的内容以及关于其起源和特征的妄想可从有偏差的信息加工角度来理解。神经认知缺陷、人格和生活事件的相互作用导致以消极的社会和表现信念、对愉悦和成功的低期望以及节省有限心理资源的资源节省策略为特征的阴性症状。这种全面的概念化为有针对性的心理治疗创造了背景。

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