Palomo T, Beninger R J, Kostrzewa R M, Archer T
Servicio Psiquiatrico, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.
Neurotox Res. 2008 Aug;14(1):1-20. doi: 10.1007/BF03033572.
Symptoms and syndromes in neuropathology, whether expressed in conscious or nonconscious behaviour, remain imbedded in often complex diagnostic categories. Symptom-based strategies for studying brain disease states are driven by assessments of presenting symptoms, signs, assay results, neuroimages and biomarkers. In the present account, symptom-based strategies are contrasted with existing diagnostic classifications. Topics include brain areas and regional circuitry underlying decision-making and impulsiveness, and motor and learned expressions of explicit and implicit processes. In three self-report studies on young adult and adolescent healthy individuals, it was observed that linear regression analyses between positive and negative affect, self-esteem, four different types of situational motivation: intrinsic, identified regulation, extrinsic regulation and amotivation, and impulsiveness predicted significant associations between impulsiveness with negative affect and lack of motivation (i.e., amotivation) and internal locus of control, on the one hand, and non-impulsiveness with positive affect, self-esteem, and high motivation (i.e., intrinsic motivation and identified regulation), on the other. Although presymptomatic, these cognitive-affective characterizations illustrate individuals' choice behaviour in appraisals of situations, events and proclivities essentially of distal perspective. Neuropathological expressions provide the proximal realities of symptoms and syndromes with underlying dysfunctionality of brain regions, circuits and molecular mechanisms.
神经病理学中的症状和综合征，无论表现在有意识还是无意识行为中，都常常包含在复杂的诊断类别中。基于症状的研究脑疾病状态的策略是由对呈现的症状、体征、检测结果、神经影像和生物标志物的评估驱动的。在本报告中，基于症状的策略与现有的诊断分类形成对比。主题包括决策和冲动行为背后的脑区和区域神经回路，以及显性和隐性过程的运动和习得表达。在三项针对年轻成年人和青少年健康个体的自我报告研究中，观察到在积极和消极情绪、自尊、四种不同类型的情境动机（内在动机、认同调节、外在调节和无动机）与冲动性之间的线性回归分析预测，冲动性一方面与消极情绪、缺乏动机（即无动机）和内控点显著相关，另一方面与非冲动性与积极情绪、自尊和高动机（即内在动机和认同调节）显著相关。尽管这些认知-情感特征处于症状前阶段，但它们说明了个体在对情境、事件和倾向进行评估时的选择行为，本质上是从远端视角出发的。神经病理学表现为症状和综合征提供了近端现实，同时也揭示了脑区、神经回路和分子机制的潜在功能障碍。
