Tanaka K
Department of Neuropsychiatry, Kameda Hospital.
Seishin Shinkeigaku Zasshi. 1991;93(8):617-44.
It is suggested that "schizophrenic color", as the impression of schizophrenic disturbance of rapport, is closely related to the disturbance of communication, especially metacommunication, by many researchers. So the author defined a symptom named "the cognitive schema of others' position", which means others' time-space position in a patient's delusional world, as the symptom being expected to be closely related to the disturbance of the patient's metacommunication at the interaction with others in his delusional world. Then the author examined statistically the relationship of "schizophrenic color" (or the operational diagnosis of schizophrenia according to DSM-III) to "the cognitive schema of others' position" and at the same time to several forms of auditory hallucination having been considered to be significantly related to schizophrenia. 58 hallucinatory-delusional states (29 schizophrenia, 29 non-schizophrenia) were actually examined and some results were pointed out as follows. Observation of the "improper cognitive schema of others' position", which means the fantastic and impossible, for a human being, time-space position of others in a patient's delusional world, was statistically related to the deterioration of "schizophrenic color" or the operational diagnosis of schizophrenia according to DSM-III. This result was considered to be related to the supposition that the "improper cognitive schema of others' position" is a symptom representing the schizophrenic collapse of the cognitive time-space construction as well as the schizophrenic disturbance of metacommunication. Otherwise, the observation of hallucinatory voices speaking and answering directly to the patient, which has been expected to be one of the most important symptoms of schizophrenia, was not statistically related to the deterioration of "schizophrenic color" or the operational diagnosis of schizophrenia according to DSM-III. And the observation of hallucinatory voices arguing about the patient in the third person was statistically related to the improvement of "schizophrenic color" or the operational diagnosis of the non-schizophrenic hallucinatory-delusional state according to DSM-III. Both statistical relationship above were considered to be explained generally from the relationship of "the cognitive schema of others' position" to schizophrenia. According to these results it was finally concluded that the "improper cognitive schema of others' position" is one of the most significant symptoms of the schizophrenic situation represented by the deterioration of "schizophrenic color" or the operational diagnosis of schizophrenia according to DSM-III.
许多研究者认为，“精神分裂症色彩”作为精神分裂症中情感协调障碍的表现，与沟通障碍，尤其是元沟通障碍密切相关。因此，作者定义了一种名为“他人位置认知图式”的症状，即患者妄想世界中他人的时空位置，认为该症状可能与患者在妄想世界中与他人互动时的元沟通障碍密切相关。随后，作者对“精神分裂症色彩”（或根据《精神疾病诊断与统计手册》第三版对精神分裂症的操作性诊断）与“他人位置认知图式”之间的关系进行了统计学检验，同时也检验了与几种被认为与精神分裂症显著相关的幻听形式之间的关系。实际检查了58例幻觉妄想状态（29例精神分裂症，29例非精神分裂症），并指出了以下一些结果。观察到“他人位置认知图式不当”，即在患者妄想世界中他人呈现出对人类而言荒诞且不可能的时空位置，在统计学上与“精神分裂症色彩”的恶化或根据《精神疾病诊断与统计手册》第三版对精神分裂症的操作性诊断相关。这一结果被认为与以下假设有关，即“他人位置认知图式不当”是一种症状，既代表了认知时空结构的精神分裂症性崩溃，也代表了元沟通的精神分裂症性障碍。否则，观察到幻听直接对患者说话并回应，这一直被认为是精神分裂症最重要的症状之一，但在统计学上与“精神分裂症色彩”的恶化或根据《精神疾病诊断与统计手册》第三版对精神分裂症的操作性诊断无关。而观察到幻听以第三人称议论患者，在统计学上与“精神分裂症色彩”的改善或根据《精神疾病诊断与统计手册》第三版对非精神分裂症性幻觉妄想状态的操作性诊断相关。上述两种统计关系一般都可从“他人位置认知图式”与精神分裂症的关系来解释。根据这些结果，最终得出结论：“他人位置认知图式不当”是由“精神分裂症色彩”恶化或根据《精神疾病诊断与统计手册》第三版对精神分裂症的操作性诊断所代表的精神分裂症状况的最显著症状之一。
