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自闭症的精神分析与神经生物学融合理解:综合治疗方法的前景

Converging Psychoanalytic and Neurobiological Understanding of Autism: Promise for Integrative Therapeutic Approaches.

作者信息

Giannopoulou Ioanna, Lazaratou Helen, Economou Marina, Dikeos Dimitris

机构信息

Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital.

First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Vasilisis Sofias St 72-74, Athens, Greece.

出版信息

Psychodyn Psychiatry. 2019 Fall;47(3):275-290. doi: 10.1521/pdps.2019.47.3.275.

Abstract

Autism spectrum disorders (ASDs) are a group of heterogeneous neu-rodevelopmental conditions characterized by deficits in social communication and social interaction and restricted, repetitive patterns of behaviors, interests, or activities. For many years, psychoanalysis and neurobiology have been in opposite camps regarding the understanding of autism in terms of causation and treatment. This paper aims to highlight converging points between neurobiological and psychodynamic understanding of autism, which could be useful in designing more effective early interventions. For this purpose, we give a brief overview of the psychoanalytic conceptualization of autism since its first description as well as present the most pertinent neurobiological findings underlying the disorder; both these approaches are pointing to a dysfunction in caregiver-child interactions. In the last few decades, the convergence of the psychoanalytical with the neurobiological perspectives of the disorder enhances further our understanding of the dynamic interplay among biological and psychological processes in autism. This integrative approach, grounded in both theoretical perspectives, could inform future research focusing on interpersonal neurobiology, but also provide a base for developing multi-level and multi-component early interventions, which should start as early as possible, most appropriately during infancy.

摘要

自闭症谱系障碍(ASD)是一组异质性神经发育疾病,其特征为社交沟通和社交互动缺陷,以及行为、兴趣或活动的局限、重复模式。多年来,在自闭症的病因和治疗理解方面,精神分析和神经生物学一直处于对立阵营。本文旨在强调神经生物学和精神动力学对自闭症理解的交汇点,这可能有助于设计更有效的早期干预措施。为此,我们简要概述自首次描述自闭症以来的精神分析概念化,并呈现该疾病背后最相关的神经生物学发现;这两种方法都指向照顾者与儿童互动中的功能障碍。在过去几十年里,该疾病的精神分析视角与神经生物学视角的融合进一步增进了我们对自闭症中生物和心理过程动态相互作用的理解。这种基于两种理论视角的综合方法可为未来聚焦人际神经生物学的研究提供信息,也可为开发多层次、多成分的早期干预措施提供基础,这些干预措施应尽早开始,最适宜在婴儿期进行。

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