Physiological Psychology, University of Bielefeld, Bielefeld, Germany; Department of Psychology, University of Bucharest, Bucharest, Romania; Sunnybrook Health Sciences Centre, Traumatic Brain Injury Clinic, Toronto, Canada; University of Toronto, Department of Psychiatry, Toronto, Canada; Oberbergklinik Hornberg, Germany.
Physiological Psychology, University of Bielefeld, Bielefeld, Germany.
Neuropsychologia. 2018 Feb;110:134-147. doi: 10.1016/j.neuropsychologia.2017.10.017. Epub 2017 Oct 16.
Autobiographical amnesia is found in patients with focal or diffuse brain damage ("organic amnesia"), but also without overt brain damage (at least when measured with conventional brain imaging methods). This last condition is usually named dissociative amnesia at present, and was originally described as hysteria. Classically and traditionally, dissociative amnesia is seen as a disorder that causes retrograde amnesia in the autobiographical domain in the aftermath of incidents of major psychological stress or trauma. In the present study one of the probably largest published collections of patients (28) with psychogenically caused autobiographical amnesia, who were assessed with comprehensive neuropsychological tests, will be described and documented in order to identify variables which are central for the occurrence of dissociative amnesia. The presented cases demonstrate that autobiographical amnesia without direct brain damage can have very mixed clinical presentations, causes and consequences. The described cases of psychogenic amnesia are clustered according to a number of manifestations and features, which include a reduced effort to perform cognitively at a normal level, a forensic background, anterograde (instead of retrograde) autobiographical amnesia, the fugue condition, concurrent somatic diseases, and their appearance in childhood and youth. It is concluded that autobiographical amnesia of a psychogenic origin may occur within a variety of symptom pictures. For all patients, it probably serves a protective function by offering them a mechanism to exit a life situation which appears to them unmanageable or adverse.
自传性遗忘症见于局灶性或弥漫性脑损伤患者（“器质性遗忘症”），但也见于无明显脑损伤患者（至少当使用常规脑成像方法测量时）。目前，这种情况通常被命名为分离性遗忘症，最初被描述为癔症。经典和传统上，分离性遗忘症被视为一种在重大心理压力或创伤后自传体领域引起逆行性遗忘的障碍。在本研究中，将描述和记录目前可能发表的最大的一组患者（28 例）的案例，这些患者因心理因素导致自传性遗忘症，并用全面的神经心理学测试进行评估，以确定对分离性遗忘症发生具有核心意义的变量。所呈现的病例表明，没有直接脑损伤的自传性遗忘症可能具有非常混杂的临床表现、病因和后果。所描述的心理性遗忘症病例根据一些表现和特征进行聚类，包括认知表现水平降低、法医学背景、顺行性（而非逆行性）自传性遗忘症、神游状态、同时存在的躯体疾病，以及它们在儿童和青少年时期的出现。结论是，心理性起源的自传性遗忘症可能出现在多种症状图中。对于所有患者，它可能通过为他们提供一种机制来退出他们认为无法或不利的生活状况，从而起到保护作用。
