Bell Vaughan, Raihani Nichola, Wilkinson Sam
Research Department of Clinical, Educational and Health Psychology, University College London.
Psychological Interventions Clinic for Outpatients with Psychosis, South London and Maudsley NHS Foundation Trust, London, England.
Clin Psychol Sci. 2021 Jan;9(1):24-37. doi: 10.1177/2167702620951553. Epub 2020 Nov 20.
Because of the traditional conceptualization of delusion as "irrational belief," cognitive models of delusions largely focus on impairments to domain-general reasoning. Nevertheless, current rationality-impairment models do not account for the fact that (a) equivalently irrational beliefs can be induced through adaptive social cognitive processes, reflecting social integration rather than impairment; (b) delusions are overwhelmingly socially themed; and (c) delusions show a reduced sensitivity to social context both in terms of how they are shaped and how they are communicated. Consequently, we argue that models of delusions need to include alteration to coalitional cognition-processes involved in affiliation, group perception, and the strategic management of relationships. This approach has the advantage of better accounting for both content (social themes) and form (fixity) of delusion. It is also supported by the established role of mesolimbic dopamine in both delusions and social organization and the ongoing reconceptualization of belief as serving a social organizational function.
由于传统上将妄想概念化为“非理性信念”,妄想的认知模型主要关注一般领域推理的损伤。然而,当前的理性损伤模型并未考虑以下事实:(a) 等效的非理性信念可通过适应性社会认知过程诱发,反映的是社会整合而非损伤;(b) 妄想绝大多数以社会为主题;(c) 妄想在形成方式和传播方式上对社会背景的敏感性均降低。因此,我们认为妄想模型需要纳入对联盟认知过程的改变,这些过程涉及归属、群体认知以及关系的战略管理。这种方法具有更好地解释妄想的内容(社会主题)和形式(固定性)的优势。中脑边缘多巴胺在妄想和社会组织中的既定作用以及信念正在被重新概念化为具有社会组功能,也支持了这一观点。