Brenner H D, Böker W, Müller J, Spichtig L, Würgler S
Acta Psychiatr Scand. 1987 Apr;75(4):405-14. doi: 10.1111/j.1600-0447.1987.tb02809.x.
Autoprotective efforts of schizophrenics have hardly been systematically investigated until now, although the role of coping processes in regard to numerous psychic disorders is increasingly recognized. The investigation of autoprotective efforts, however, is of special significance in view of the different current formulations of the vulnerability stress concept of schizophrenia. Thus the cognitive disorders in the sense of information processing deficits among schizophrenics deserve our special attention, since they are described consistently as vulnerability characteristics and as cause of a heightened susceptibility to stress, and since they can be considered an explanatory basis for a wide range of subjectively experienced basic disorders of schizophrenia. In the present study the two disorder dimensions and the corresponding autoprotective efforts were investigated among 60 schizophrenic patients, 30 neurotic patients and 30 healthy controls. The schizophrenic patients had both significantly more experimental psychologically operationalized dysfunctions in information processing and subjectively experienced basic disorders. However, we found no correlation between the two levels of investigation. This may mainly be attributed to the fact that on the level of subjective experience the primary disorder, the perception of the disorder and the individual response to the disorder cannot be differentiated unequivocally. All of the schizophrenic patients reported consciously performed autoprotective efforts in regard to basic disorders. In this connection it is of interest that the schizophrenic patients had a significantly higher percentage of problem solving oriented attempts in comparison with the two non-schizophrenic comparison groups, and that this percentage even increased by a progressive amount of disorders. The schizophrenic patients experienced basic disorders with much more emotional tension and existential, ego-threatening anxiety. They were interpreted by the schizophrenic patients as danger signals, by the neurotic patients, however, predominantly as concomitant symptoms of their neurosis, whereas healthy persons comprehended them within the framework of ordinary psychological explanatory models. The relevance of these results in regard to further research in autoprotective efforts of schizophrenic patients and in their possible therapeutic implications is discussed.
迄今为止，精神分裂症患者的自我保护努力几乎未得到系统研究，尽管应对过程在众多精神障碍中的作用日益得到认可。然而，鉴于目前对精神分裂症易感性应激概念的不同表述，对自我保护努力的研究具有特殊意义。因此，精神分裂症患者在信息处理缺陷意义上的认知障碍值得我们特别关注，因为它们一直被描述为易感性特征以及应激易感性增加的原因，并且因为它们可被视为精神分裂症广泛主观体验到的基本障碍的解释基础。在本研究中，对60名精神分裂症患者、30名神经症患者和30名健康对照者的两种障碍维度及相应的自我保护努力进行了调查。精神分裂症患者在信息处理方面有明显更多经实验心理学操作化的功能障碍以及主观体验到的基本障碍。然而，我们发现这两个研究层面之间没有相关性。这可能主要归因于这样一个事实，即在主观体验层面，原发性障碍、对障碍的感知以及个体对障碍的反应无法明确区分。所有精神分裂症患者都报告针对基本障碍有意识地进行了自我保护努力。在这方面有趣的是，与两个非精神分裂症对照组相比，精神分裂症患者以解决问题为导向的尝试比例显著更高，并且这一比例甚至随着障碍程度的加重而增加。精神分裂症患者体验基本障碍时伴有更多的情绪紧张以及存在性、威胁自我的焦虑。精神分裂症患者将其解释为危险信号，而神经症患者则主要将其解释为神经症的伴随症状，健康人则在普通心理学解释模型的框架内理解这些症状。讨论了这些结果对于精神分裂症患者自我保护努力的进一步研究及其可能的治疗意义的相关性。
