Langdon R, Michie P T, Ward P B, McConaghy N, Catts S V, Coltheart M
Cogn Neuropsychiatry. 1997 Aug;2(3):167-93. doi: 10.1080/135468097396324.
The mentalising abilities of schizophrenic patients and normal controls were tested using picture sequencing and story-telling tasks that required subjects to infer causal mental states in story characters, and a recall task that required subjects to dissociate subjective mental states from objective realities. Selective mentalising deficits were found in some patients. For other patients, general sequencing errors, "sensory" mentalising, and poor recall of symbolic representations suggested more profound problems. Task results were best accounted for by dissociable cognitive abnormalities, rather than graded dysfunction of a central mentalising mechanism. Symptom profiles of patient subgroups and correlations between task measures and clinical ratings linked these cognitive abnormalities to specific symptoms. General sequencing difficulty was associated with both poverty symptoms and reality distortion, suggesting that two mechanisms may underpin such errors: one, inability to manipulate symbolic representations, being linked to poverty; the other, failure to critically evaluate plausible cause-and-effect, being linked to reality distortion. There was some evidence that defective self-monitoring underpins thought disorder. Impaired metarepresentation was linked to the autisticlike symptoms of flat affect, social dysfunction, and alogia, rather than reality distortion. Implications of these findings are discussed with respect to theoretical and methodological issues confronting current schizophrenia research.
使用图片排序和讲故事任务对精神分裂症患者和正常对照者的心理化能力进行了测试，这些任务要求受试者推断故事人物中的因果心理状态，还有一个回忆任务要求受试者将主观心理状态与客观现实区分开来。在一些患者中发现了选择性心理化缺陷。对于其他患者，普遍的排序错误、“感觉”心理化以及对符号表征的回忆不佳表明存在更严重的问题。任务结果最好由可分离的认知异常来解释，而不是由中央心理化机制的分级功能障碍来解释。患者亚组的症状特征以及任务测量与临床评分之间的相关性将这些认知异常与特定症状联系起来。普遍的排序困难与思维贫乏症状和现实扭曲都有关联，这表明可能有两种机制导致此类错误：一种是无法操纵符号表征，与思维贫乏有关；另一种是未能批判性地评估合理的因果关系，与现实扭曲有关。有一些证据表明自我监测缺陷是思维障碍的基础。元表征受损与情感平淡、社会功能障碍和言语贫乏等类似自闭症的症状有关，而不是与现实扭曲有关。针对当前精神分裂症研究面临的理论和方法问题，讨论了这些发现的意义。
