Kesner Ladislav, Horáček Jiří
National Institute of Mental Health, Klecany, Czechia.
Faculty of Arts, Masaryk University, Brno, Czechia.
Front Psychiatry. 2022 Jan 10;12:809239. doi: 10.3389/fpsyt.2021.809239. eCollection 2021.
Global communities are currently confronted with a number of complex problems and threats, the reality of which is amplified by the media. These environmental and socio-political stressors have been accompanied by the spread of problematic psychological and behavioural tendencies, such as the growing polarisation of opinions and values, online radicalisation and extremism, deepening xenophobia and nationalism, the proliferation of irrational beliefs and conspiracy theories, and resistance to rational public policy measures. Here we argue that although they fall outside the scope of psychopathology, they nevertheless currently constitute a major challenge for psychiatry as a research domain and a clinical practise. To substantiate this claim, we outline the mechanisms by which media-transmitted stressors impact mental well-being and possibly psychopathology. The common denominator of these global problems and the media's construction of reality is the increase in uncertainty, unpredictability, and uncontrollability, which prompts defensive responding and, in predisposed individuals, functions as a potent source of chronic stress. These contribute to cognitive inflexibility, a strong predisposing factor for the development of rigid beliefs and attitudes, which to varying degrees underlie the adverse psychological and behavioural tendencies mentioned above. We suggest that the tightening of beliefs and ideas that is the result of cognitive rigidity may correspond to the clinical characteristics of induced delusional disorder. This can be seen as a (ultimately maladaptive) defensive strategy for coping with a high degree of uncertainty and unpredictability. We conclude by briefly outlining the possible ways in which psychiatry can face this challenge.
全球社会目前面临着一些复杂的问题和威胁,媒体的传播放大了这些问题的现实影响。这些环境和社会政治压力源伴随着一些有问题的心理和行为倾向的蔓延,比如观点和价值观的两极分化加剧、网络激进化和极端主义、仇外心理和民族主义的加深、非理性信念和阴谋论的泛滥,以及对合理公共政策措施的抵制。在此我们认为,尽管这些问题不属于精神病理学范畴,但它们目前对作为一个研究领域和临床实践的精神病学构成了重大挑战。为了证实这一观点,我们概述了媒体传播的压力源影响心理健康以及可能影响精神病理学的机制。这些全球问题以及媒体对现实的建构的共同特征是不确定性、不可预测性和不可控性的增加,这促使人们做出防御性反应,并且在易感个体中,成为慢性压力的强大来源。这些因素导致认知僵化,而认知僵化是形成僵化信念和态度的一个重要诱发因素,上述不良心理和行为倾向在不同程度上都以此为基础。我们认为,认知僵化导致的信念和观念的固化可能与诱发妄想障碍的临床特征相符。这可以被视为一种(最终适应不良的)应对高度不确定性和不可预测性的防御策略。我们最后简要概述了精神病学应对这一挑战的可能方式。