Toifl Karl, Kimmel Barbara, Mayring Philipp, Mörth Hans Marlies
Univ. Klinik für Neuropsychiatrie des Kindes- und Jugendalters, Medizinische Universität Wien.
Neuropsychiatr. 2007;21(4):275-83.
Nowadays the multifactorial genesis of psychotic illnesses is undisputed. The question of the integration of the multilayered results is open from the biological, emotional and social area. Based on the results of the complexity research (chaos theory, theory of the self organisation) the hypothesis was formulated for the emergence of psychotic illnesses that these are understood themselves as an expression of a dysfunctional self. Such a dysfunctional self arises in a self organizing process.
The definition of the self was newly formulated. This happened on the knowledge of the complexity research and a bio- psycho-social model of illness and health. Ten main categories were defined, which seem essential for the development of a healthy, this means a flexible and autonomous self. In further consequence, based on these categories, a semistructured interview guide was developed. With this interview guide the information about the quality of the self organising process of the development of the self was collected. This guide was tested in the context of a master thesis in a multidimensional interview with a schizophrenic patient and his family. This interview was taken on video tap. The information on video became transcribed. Than the information was examined qualitatively to two aspects. This happened with the help of a qualitative contents analysis. The first aspect concerned the decision of the assignment to one or several of the ten categories. In a 2nd step it was judged, whether the examined information has to be classified as beneficial for the development of a healthy self or as impeding.
The developed and used examination model is suitable to make the investigation of a self organizing self possible. At the individual case analysis of a patient with a schizophrenic psychosis the inhibiting influences for the development of a healthy self predominated at a large part of the 10 categories. This corresponded to the hypothesis.
The used examination model seems suitable, to examine qualitatively the development of the self in psychotic people. At a more comprehensive study it is necessary to shorten the duration of the interview and to carry out the evaluation directly of video or CD-ROM The result of the qualitative contents analysis showed obviously, in which categories the impeding effect on the development of a healthy self outweighed. This result supports the idea of an individualized multidimensional therapeutic concept, which supports the development of a healthy self. Out of this could surrender to consequences regarding an individual, multidimensional therapy which promotes the development of a healthy itself.
如今，精神疾病的多因素成因已无可争议。生物、情感和社会领域中多层研究结果的整合问题仍未解决。基于复杂性研究的结果（混沌理论、自组织理论），提出了关于精神疾病发生的假说，即这些疾病本身被理解为功能失调的自我的一种表现。这种功能失调的自我出现在一个自组织过程中。
对自我的定义进行了重新阐述。这是基于复杂性研究以及疾病与健康的生物 - 心理 - 社会模型的知识而进行的。定义了十个主要类别，这些类别对于健康（即灵活且自主的）自我的发展似乎至关重要。进而，基于这些类别，开发了一份半结构化访谈指南。通过这份访谈指南，收集了关于自我发展的自组织过程质量的信息。该指南在一篇硕士论文的背景下，对一名精神分裂症患者及其家人进行的多维访谈中进行了测试。这次访谈进行了录像。录像中的信息被转录下来。然后从两个方面对这些信息进行定性分析。这借助定性内容分析来完成。第一个方面涉及将信息归入十个类别中的一个或几个的判定。第二步是判断所审查的信息应被归类为对健康自我的发展有益还是有阻碍。
所开发和使用的检查模型适用于对自组织自我进行调查。在对一名患有精神分裂症精神病患者的个案分析中，在十个类别中的大部分类别中，对健康自我发展的抑制性影响占主导。这与假说相符。
所使用的检查模型似乎适用于定性地研究精神病患者自我的发展。在更全面的研究中，有必要缩短访谈时长，并直接对录像或光盘进行评估。定性内容分析的结果明显显示了哪些类别中对健康自我发展的阻碍作用占优。这一结果支持了个性化多维治疗概念的观点，即支持健康自我的发展。由此可得出关于促进健康自我发展的个体化、多维治疗的相关结论。
