Schnell Knut
Department of General Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany.
Psychopathology. 2014;47(6):408-16. doi: 10.1159/000366134. Epub 2014 Nov 7.
The review presents a research perspective that defines mentalizing functions as a very promising topic to bridge psychopathology and neurobiological foundations of mental disorders. However, the high diversity of existing observations in mentalizing research calls for a structured assessment of functional mentalizing subdomains. A notable problem is the overlap of functional systems involved in mentalizing and emotion processing. A proposed solution is to conceptualize mentalizing functions due to their content (visuospatial vs. emotional) perspective and substrates (cognitive or explicit signals). This conceptual organization is mirrored in functional imaging experiments dissociating anteromedial and posterolateral brain regions, especially the involvement of the medial prefrontal cortex in mentalizing emotions and the temporoparietal cortex in visuospatial perspective taking. The present state and perspectives of mentalizing research are demonstrated in two major fields of mental disorders, depression and schizophrenia. In depression the existent contradictory findings demand a control of cognitive impairments, which are frequently associated with depressive disorders. In schizophrenia there is already consistent evidence that defines mentalizing functions as promising endophenotype, which can possibly link psychopathology to its neurobiological foundations.
该综述提出了一种研究视角,即将心理化功能定义为一个非常有前景的主题,可用于架起精神障碍的精神病理学与神经生物学基础之间的桥梁。然而,心理化研究中现有观察结果的高度多样性要求对功能性心理化子领域进行结构化评估。一个显著的问题是心理化和情绪加工中涉及的功能系统存在重叠。一个提议的解决方案是从心理化功能的内容(视觉空间与情绪)视角和基质(认知或显性信号)来对其进行概念化。这种概念性组织反映在功能性成像实验中,这些实验区分了前内侧和后外侧脑区,特别是内侧前额叶皮质在心理化情绪中的作用以及颞顶叶皮质在视觉空间视角采择中的作用。心理化研究的现状和前景在抑郁症和精神分裂症这两种主要精神障碍领域中得到了展示。在抑郁症中,现有的矛盾发现需要控制认知障碍,而认知障碍常与抑郁症相关。在精神分裂症中,已有一致的证据将心理化功能定义为有前景的内表型,这可能将精神病理学与其神经生物学基础联系起来。