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[乳腺癌中的影响因素与心理结构]

[Influences and psychological structures in breast cancer].

作者信息

Bucher R, Rodovalho J C, Ferreira T C

出版信息

Acta Psiquiatr Psicol Am Lat. 1986 Dec;32(4):271-80.

PMID:3591399
Abstract

A sample of 16 patients with malignant breast tumors were examined by means of an interview, a questionnaire, and the Szondi Test together with a comparison group of 56 patients with benign breast tumors. The patients were divided into two age groups, those below and above 40 years of age. In this way studies done in other countries to investigate the personality structure of cancer patients were replicated. Emphasis was given to the following issues: self-destructive and/or masochistic tendencies, attitudes of depressive resignation, and conflicts with respect to femininity and motherhood. The results showed several significant differences by which benign tumor patients can be better characterized. These patients presented symptoms, experiences and structures of the neurotic type. The cancer patients presented structures closer to the psychosomatic type, with rigid negation of conflicts (in relation to sex, identification, violence and aggression), and with an unreal insertion in the world. Their somatizations are not conversive; they are interpreted as effects of the destructive and violent tendencies which, without release for the lack of adequate contacts with objects, are directed toward themselves. However, this cannot properly be called a masochistic structure because the destructive tendencies do not have a sexual origin, rather they are part of a vehement negation of others and of life itself, in the sense of a primary death drive. It is impossible to tell, however, to what point these characteristics are already the effects of the breast problems, or whether they have more causal relevance as certain previous personal experiences indicate.

摘要

对16例恶性乳腺肿瘤患者进行了访谈、问卷调查和松迪测验,并与56例良性乳腺肿瘤患者组成的对照组进行了比较。患者被分为两个年龄组,40岁以下和40岁以上。通过这种方式,重复了其他国家为研究癌症患者人格结构所做的研究。重点关注以下问题:自我毁灭和/或受虐倾向、抑郁顺从态度以及与女性气质和母性相关的冲突。结果显示出一些显著差异,通过这些差异可以更好地描述良性肿瘤患者的特征。这些患者表现出神经症类型的症状、经历和结构。癌症患者表现出更接近身心类型的结构,对冲突(与性别、认同、暴力和攻击有关)持僵硬的否定态度,并且在现实世界中存在不真实的融入。他们的躯体化不是转换性的;它们被解释为破坏性和暴力倾向的结果,由于缺乏与客体的充分接触而无法释放,这些倾向转而指向自身。然而,这不能恰当地被称为受虐结构,因为破坏性倾向并非源于性,而是在原发性死亡驱力的意义上,是对他人和生命本身强烈否定的一部分。然而,无法确定这些特征在多大程度上已经是乳腺问题的结果,或者是否如某些先前的个人经历所表明的那样,它们具有更多的因果相关性。

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