精神分裂症中的自我与他人：认知神经科学视角
Self and other in schizophrenia: a cognitive neuroscience perspective.
作者信息
Fisher Melissa, McCoy Kelly, Poole John H, Vinogradov Sophia
机构信息
Department of Psychiatry, University of California, San Francisco, , CA 94121, USA.
出版信息
Am J Psychiatry. 2008 Nov;165(11):1465-72. doi: 10.1176/appi.ajp.2008.07111806. Epub 2008 Aug 15.
OBJECTIVE
Recent basic science data indicate that in healthy individuals, self-referential processing and social cognition rely on common neural substrates. The authors assessed self-referential source memory and social cognition in a large sample of schizophrenia outpatients and healthy comparison subjects in order to compare how these critical processes are associated in the two groups.
METHOD
Ninety-one schizophrenia outpatients and 30 healthy comparison subjects were assessed on measures of basic social cognition and source memory for previously learned word items: self-generated, externally presented, and new words. Partial correlations and multiple regression analysis were used to test the association between social cognition measures and source memory performance and the contributions of source memory and general cognitive abilities to a social cognition composite score.
RESULTS
Schizophrenia patients demonstrated significantly lower source memory for self-generated items (self-referential source memory) relative to comparison subjects but showed intact external source memory. In both groups, self-referential source memory and social cognition showed strong correlations. When the effects of general cognitive abilities were controlled for, these correlations were attenuated in the schizophrenia patients. Regression analysis revealed discrepancies between groups in the cognitive functions contributing to social cognition performance.
CONCLUSIONS
Impaired self-referential source memory represents a unique cognitive deficit in schizophrenia. Moreover, the strong association between self-referential source memory and social cognition seen in healthy subjects is reduced in schizophrenia and is moderated by general cognitive abilities. Impairments in the neurocognitive system that underlies both self-referential and social cognition provide a parsimonious explanation for the disturbances in the sense of self and other that characterize schizophrenia.
目的
近期基础科学数据表明，在健康个体中，自我参照加工和社会认知依赖于共同的神经基质。作者对大量精神分裂症门诊患者和健康对照受试者进行了自我参照源记忆和社会认知评估，以比较这两个关键过程在两组中的关联方式。
方法
对91名精神分裂症门诊患者和30名健康对照受试者进行了基本社会认知和对先前学习的单词项目的源记忆评估：自我生成的、外部呈现的和新单词。使用偏相关和多元回归分析来测试社会认知测量与源记忆表现之间的关联，以及源记忆和一般认知能力对社会认知综合评分的贡献。
结果
与对照受试者相比，精神分裂症患者对自我生成项目的源记忆（自我参照源记忆）显著更低，但外部源记忆完好。在两组中，自我参照源记忆和社会认知均显示出强相关性。当控制一般认知能力的影响时，精神分裂症患者中的这些相关性减弱。回归分析揭示了两组在对社会认知表现有贡献的认知功能方面的差异。
结论
自我参照源记忆受损代表了精神分裂症中一种独特的认知缺陷。此外，健康受试者中所见的自我参照源记忆与社会认知之间的强关联在精神分裂症中减弱，并受一般认知能力调节。自我参照和社会认知所依赖的神经认知系统的损害为精神分裂症所特有的自我和他人感知障碍提供了一个简洁的解释。
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