Csulak Tímea, Herold Róbert
Pecsi Tudomanyegyetem, AOK, Klinikai Idegtudomanyok Doktori Iskola, Pecs, Hungary, E-mail:
Psychiatr Hung. 2021;36(1):67-80.
The ability to mentalize is essential during social interactions. Mentalization can be divided into two separate systems: to an explicit part characterized by being conscious, reflective, verbal, and to an implicit part that is unconscious, automatic, non-verbal, intuitive. The term spontaneous mentalization is also used for the attribution of mental state that appears without explicit instruction. In schizophrenia, several studies have confirmed the deficit of explicit mentalization, but little data are available on non-explicit mentalization. Our aim is to provide a narrative review of the literature on this issue.
Based on the methodology used in different publications, we examined implicit and spontaneous mentalization separately. To search for publications on the topic, we performed a PubMed database search.
A total of 26 studies, 9 studies examining implicit and 17 studies examining spontaneous mentalization were found.
Based on the results, implicit mentalization is relatively retained, but the effectiveness of implicit detec - tion of intentionality may be significantly influenced by other factors (e.g., neurocognitive deficits). In contrast, studies clearly report a deficit in spontaneous mentalization. Patients with schizophrenia are less sensitive to situations requiring spontaneous mentalizing activity. Interactions are less described by complex intentional mental states, and the descriptions often do not correspond to the particular interaction. Overall, in addition to the deficit of explicit mentalization, implicit or spontaneous mentalization performance is also affected in schizophrenia, if not to the same extent. These different deficits can also have potential therapeutic consequences.
心理化能力在社交互动中至关重要。心理化可分为两个独立的系统：一个是明确的部分，其特点是有意识、反思性、言语性；另一个是隐性的部分，它是无意识的、自动的、非言语的、直觉性的。自发心理化这一术语也用于指在没有明确指令的情况下出现的心理状态归因。在精神分裂症中，多项研究已证实明确心理化存在缺陷，但关于非明确心理化的数据却很少。我们的目的是对关于这个问题的文献进行叙述性综述。
基于不同出版物中使用的方法，我们分别研究了隐性心理化和自发心理化。为了搜索关于该主题的出版物，我们进行了PubMed数据库搜索。
共找到26项研究，其中9项研究考察隐性心理化，17项研究考察自发心理化。
基于研究结果，隐性心理化相对得以保留，但隐性意向性检测的有效性可能会受到其他因素（如神经认知缺陷）的显著影响。相比之下，研究明确报告了自发心理化存在缺陷。精神分裂症患者对需要自发心理化活动的情境不太敏感。互动较少用复杂的意向心理状态来描述，且这些描述往往与特定互动不相符。总体而言，除了明确心理化存在缺陷外，精神分裂症患者的隐性或自发心理化表现也受到影响，即便程度不同。这些不同的缺陷也可能产生潜在的治疗后果。
