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精神分裂症中的控制幻觉:抵抗心智的最佳把戏?

Delusions of control in schizophrenia: Resistant to the mind's best trick?

机构信息

German Center for Neurodegenerative Diseases (DZNE), Aging & Cognition Research Group, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany.

出版信息

Schizophr Res. 2018 Jul;197:98-103. doi: 10.1016/j.schres.2017.11.032. Epub 2017 Dec 6.

Abstract

The existence of a free will is fiercely debated in neuroscience and philosophy. The debate has great impact on society and our self-understanding as human beings. Behavioral and electrophysiological data have challenged the intuitive assumption that human behavior is the result of conscious intentions. This notion has important implications for delusions of control in schizophrenia, where patients experience bodily movements as not being controlled by themselves. Current theories explain control delusions as a deficit to perceive certain aspects of motor control, but many findings are inconsistent with this idea. Here, an alternative view is proposed: Control delusions might be triggered by an even more veridical perception of the temporal order of intentions and actions. This hypothesis is supported by evidence that (a) conscious intentions in healthy subjects are often based on retrospective inferences, (b) temporal recalibrations of conscious percepts occur in healthy subjects and are disturbed in schizophrenia and (c) basic perceptual functions of schizophrenic patients are less influenced by expectations and therefore they can sometimes be closer to physical reality than those of healthy subjects.

摘要

自由意志的存在在神经科学和哲学领域中备受争议。这场辩论对社会和我们作为人类的自我理解产生了重大影响。行为和电生理数据挑战了这样一种直观假设,即人类行为是有意识意图的结果。这一概念对精神分裂症中的控制妄想有重要影响,在这种病症中,患者感到自己的身体运动不受自己控制。目前的理论将控制妄想解释为无法感知运动控制的某些方面,但许多研究结果与这一观点不一致。在这里,提出了一种替代观点:控制妄想可能是由对意图和行动的时间顺序的更真实感知触发的。这一假设得到了以下证据的支持:(a) 健康受试者的有意识意图通常基于回溯推理,(b) 健康受试者的意识知觉会发生时间校准,而在精神分裂症中则会受到干扰,(c) 精神分裂症患者的基本感知功能受期望的影响较小,因此他们有时比健康受试者更接近物理现实。

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