Blatt S J
Department of Psychiatry, Yale University, New Haven, Connecticut.
J Nerv Ment Dis. 1991 Aug;179(8):449-58. doi: 10.1097/00005053-199108000-00001.
In contrast to contemporary approaches to psychopathology that establish diagnostic taxonomies derived primarily from differences in manifest symptoms, this paper, based on an integration of cognitive and psychoanalytic developmental theory, proposes a structural cognitive morphology for understanding and assessing differences among various forms of psychopathology, from schizophrenia to the neuroses. A theoretical model based on the development of cognitive schema, consistent with clinical and research data, considers schizophrenia and paranoid schizophrenia as involving fundamental disturbances in boundary articulation and recognition constancy, and considers borderline personality disorders as involving disturbances in evocative constancy. Also, a lack of integration of object and self-schema, expressed in either a distorted and exaggerated preoccupation with interpersonal relatedness or self-definition, defines two primary personality configurations that have implications for understanding the neuroses and subtypes of depression, as well as differential response to various types of psychotherapeutic intervention.
与当代主要基于明显症状差异建立诊断分类法的精神病理学研究方法不同,本文基于认知和精神分析发展理论的整合,提出了一种结构性认知形态学,用于理解和评估从精神分裂症到神经症等各种精神病理形式之间的差异。一个基于认知图式发展的理论模型,与临床和研究数据相一致,认为精神分裂症和偏执型精神分裂症涉及边界清晰度和识别恒常性的基本障碍,而边缘型人格障碍涉及唤起恒常性的障碍。此外,客体和自我图式缺乏整合,表现为对人际关联或自我定义的扭曲和过度关注,定义了两种主要的人格结构,这对于理解神经症和抑郁症亚型以及对各种心理治疗干预的不同反应具有重要意义。