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[人格障碍中的最小情感功能障碍与第一印象形成]

[Minimal emotional dysfunction and first impression formation in personality disorders].

作者信息

Linden M, Vilain M

机构信息

Forschungsgruppe Psychosomatische Rehabilitation an der Charité Universitätsmedizin Berlin und Abteilung für Verhaltenstherapie und Psychosomatik am Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, Teltow/Berlin, Lichterfelder Allee 55, Teltow, Germany.

出版信息

Nervenarzt. 2011 Jan;82(1):25-36. doi: 10.1007/s00115-010-3160-z.

Abstract

"Minimal cerebral dysfunctions" are isolated impairments of basic mental functions, which are elements of complex functions like speech. The best described are cognitive dysfunctions such as reading and writing problems, dyscalculia, attention deficits, but also motor dysfunctions such as problems with articulation, hyperactivity or impulsivity. Personality disorders can be characterized by isolated emotional dysfunctions in relation to emotional adequacy, intensity and responsivity. For example, paranoid personality disorders can be characterized by continuous and inadequate distrust, as a disorder of emotional adequacy. Schizoid personality disorders can be characterized by low expressive emotionality, as a disorder of effect intensity, or dissocial personality disorders can be characterized by emotional non-responsivity. Minimal emotional dysfunctions cause interactional misunderstandings because of the psychology of "first impression formation". Studies have shown that in 100 ms persons build up complex and lasting emotional judgements about other persons. Therefore, minimal emotional dysfunctions result in interactional problems and adjustment disorders and in corresponding cognitive schemata.From the concept of minimal emotional dysfunctions specific psychotherapeutic interventions in respect to the patient-therapist relationship, the diagnostic process, the clarification of emotions and reality testing, and especially an understanding of personality disorders as impairment and "selection, optimization, and compensation" as a way of coping can be derived.

摘要

“轻度脑功能障碍”是基本心理功能的孤立损害,而这些基本心理功能是诸如言语等复杂功能的组成要素。描述得最为充分的是认知功能障碍,如读写困难、计算障碍、注意力缺陷,还有运动功能障碍,如发音问题、多动或冲动。人格障碍可表现为与情绪适当性、强度和反应性相关的孤立情绪功能障碍。例如,偏执型人格障碍可表现为持续且不适当的不信任,这是一种情绪适当性的障碍。分裂样人格障碍可表现为情感表达淡漠,这是一种情感强度的障碍,或者反社会人格障碍可表现为情感无反应性。由于“第一印象形成”的心理机制,轻度情绪功能障碍会导致人际互动中的误解。研究表明,在100毫秒内,人们就能对他人形成复杂且持久的情感判断。因此,轻度情绪功能障碍会导致人际互动问题和适应障碍以及相应的认知模式。从轻度情绪功能障碍的概念出发,可以推导出针对患者与治疗师关系、诊断过程、情绪澄清和现实检验的具体心理治疗干预措施,尤其是将人格障碍理解为一种损害,以及将“选择、优化和补偿”作为一种应对方式。

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