Griffin Juliet D, Fletcher Paul C
Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom; email:
Annu Rev Clin Psychol. 2017 May 8;13:265-289. doi: 10.1146/annurev-clinpsy-032816-045145. Epub 2017 Mar 30.
A comprehensive understanding of psychosis requires models that link multiple levels of explanation: the neurobiological, the cognitive, the subjective, and the social. Until we can bridge several explanatory gaps, it is difficult to explain how neurobiological perturbations can manifest in bizarre beliefs or hallucinations, or how trauma or social adversity can perturb lower-level brain processes. We propose that the predictive processing framework has much to offer in this respect. We show how this framework may underpin and complement source monitoring theories of delusions and hallucinations and how, when considered in terms of a dynamic and hierarchical system, it may provide a compelling model of several key clinical features of psychosis. We see little conflict between source monitoring theories and predictive coding. The former act as a higher-level description of a set of capacities, and the latter aims to provide a deeper account of how these and other capacities may emerge.
神经生物学层面、认知层面、主观层面和社会层面。在我们能够弥合多个解释缺口之前,很难解释神经生物学扰动是如何表现为怪异信念或幻觉的,或者创伤或社会逆境是如何扰乱较低层次的大脑过程的。我们认为,预测处理框架在这方面有很大的贡献。我们展示了这个框架如何可能支撑和补充妄想及幻觉的源监测理论,以及当从一个动态和层次化系统的角度来考虑时,它如何可能为精神病的几个关键临床特征提供一个令人信服的模型。我们认为源监测理论和预测编码之间几乎没有冲突。前者是对一组能力的更高层次描述,而后者旨在更深入地解释这些能力以及其他能力可能是如何出现的。