Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, Perth, Australia.
Acta Psychiatr Scand. 2011 Jun;123(6):475-84. doi: 10.1111/j.1600-0447.2010.01651.x. Epub 2010 Dec 19.
The 'embodied cognition' hypothesis suggests a close relationship between internal self-representations and the outward expression of social behaviours and emotions. Given self-awareness disturbances in patients with first-rank symptoms (FRS), we hypothesized that these patients would show abnormal social behaviours. In this study, we examined the social interactive skills of patients with first-episode psychosis during an interview, together with changes in performance over time.
We analysed previously unreported data from 227 patients with first-episode psychosis (90 with, and 137 without, FRS) who took part in the WHO multicentre study on the Determinants of Outcome of Severe Mental Disorders. They were assessed on the Psychological Impairment Rating Schedule (PIRS) and examined again after 2 years.
A principal component analysis on the Psychosocial Impairment Rating Schedule produced two factors (interactive skills; withdrawal from interactions). Patients with FRS showed greater impairments in the domain linked to 'interactive skills', which remained 2 years after the first experience of a psychotic illness. These findings were not explained by clinical characteristics, or presence of non-FRS delusions.
Self-awareness deficits, as indexed by the FRS symptom cluster, are linked to deficits in social interactive behaviours. These abnormalities are indicative of 'social dysmetria' in this group, which involves difficulties conveying motor aspects of behaviours, volition and affect to facilitate mutual communication. These findings point to the utility of behavioural assessment scales in clinical and research settings.
“具身认知”假说表明，内部自我表征与社会行为和情绪的外在表现之间存在密切关系。鉴于一级症状（FRS）患者的自我意识障碍，我们假设这些患者会表现出异常的社会行为。在这项研究中，我们在访谈中检查了首发精神病患者的社交互动技能，以及随时间的变化。
我们分析了参加世界卫生组织多中心严重精神障碍结局决定因素研究的 227 名首发精神病患者（90 名有 FRS，137 名无 FRS）的未报告数据。他们接受了心理障碍评定量表（PIRS）的评估，并在 2 年后再次接受评估。
对心理社会障碍评定量表的主成分分析产生了两个因素（互动技能；从互动中退缩）。有 FRS 的患者在与“互动技能”相关的领域表现出更大的障碍，这种障碍在首次出现精神病后 2 年仍然存在。这些发现不能用临床特征或非 FRS 妄想来解释。
自我意识缺陷，如 FRS 症状群所指出的，与社交互动行为的缺陷有关。这些异常表明该组存在“社交失调”，这涉及到难以传达行为、意志和情感的运动方面，以促进相互沟通。这些发现表明行为评估量表在临床和研究环境中的实用性。
