Mier Daniela, Kirsch Peter
Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Curr Top Behav Neurosci. 2017;30:397-409. doi: 10.1007/7854_2015_427.
Patients with schizophrenia not only suffer from prototypical psychotic symptoms such as delusions and hallucinations and from cognitive deficits, but also from tremendous deficits in social functioning. However, little is known about the interplay between the cognitive and the social-cognitive deficits in schizophrenia. Our chapter gives an overview on behavioral, as well as functional imaging studies on social cognition in schizophrenia. Main findings on cognitive and motivational deficits in schizophrenia are reviewed and introduced within the context of the dopamine hypothesis of schizophrenia. The reviewed findings suggest that disturbed "social brain" functioning in schizophrenia, depending on the specific context, can either lead to a neglect of the emotions and intentions of others or to the false attribution of these emotions and intentions in an emotionally neutral social content. We integrate these findings with the current knowledge about aberrant dopaminergic firing in schizophrenia by presenting a comprehensive model explaining core symptoms of the disorder. The main implication of the presented model is that neither cognitive-motivational, nor social-cognitive deficits alone cause schizophrenia symptoms, but that symptoms only emerge by the interplay of disturbed social brain functioning with aberrant dopaminergic firing.
精神分裂症患者不仅遭受妄想和幻觉等典型的精神病性症状以及认知缺陷的折磨，还存在严重的社会功能缺陷。然而，对于精神分裂症中认知缺陷与社会认知缺陷之间的相互作用，我们知之甚少。我们这一章概述了关于精神分裂症社会认知的行为学以及功能影像学研究。在精神分裂症多巴胺假说的背景下，回顾并介绍了精神分裂症中认知和动机缺陷的主要研究结果。所回顾的研究结果表明，精神分裂症中“社会脑”功能紊乱，根据具体情境的不同，要么导致对他人情绪和意图的忽视，要么导致在情感中立的社会情境中对这些情绪和意图的错误归因。我们通过提出一个解释该疾病核心症状的综合模型，将这些研究结果与当前关于精神分裂症中多巴胺能异常放电的知识相结合。所提出模型的主要意义在于，认知 - 动机缺陷和社会认知缺陷单独都不会导致精神分裂症症状，而是只有在社会脑功能紊乱与多巴胺能异常放电的相互作用下症状才会出现。
