Department of Psychiatry, University of California, San Diego, California, USA.
Department of Psychiatry, Washington University at St Louis, St Louis, Missouri, USA.
Behav Sci Law. 2021 Apr;39(2):170-189. doi: 10.1002/bsl.2486. Epub 2020 Oct 19.
Pathological fixation - preoccupation with a person or a cause that is accompanied by deterioration in social and occupational functioning - has been found to precede most cases of targeted violence. It is clinically observed and theorized to have three different cognitive-affective drivers: delusion, obsession, or extreme overvalued belief. Each driver is explained, and case examples are provided in the context of threat assessment. Extreme overvalued belief as a new concept is discussed in detail, both its historical provenance and its demarcation from delusions and obsessions. Threat management for each separate cognitive-affective driver is briefly summarized, based upon current clinical findings and research. Emphasis is placed upon understanding both the categorical and dimensional nature (intensity) of these cognitive-affective drivers, and suggested guidelines are offered for the assessment of such in a clinical examination by a forensic psychiatrist or psychologist.
病理性固着 - 对一个人或一个原因的过分关注，同时伴有社会和职业功能的恶化 - 已被发现存在于大多数有针对性暴力的病例之前。临床上观察到并理论上认为有三种不同的认知情感驱动因素：妄想、痴迷或极端高估的信念。每个驱动因素都有解释，并在威胁评估的背景下提供了案例示例。作为一个新概念，极度高估的信念被详细讨论，包括其历史渊源及其与妄想和痴迷的区别。根据当前的临床发现和研究，简要总结了每种单独的认知情感驱动因素的威胁管理。重点是理解这些认知情感驱动因素的类别和维度性质（强度），并提供了评估临床检查中这些因素的建议指南，由法医精神病学家或心理学家进行。
