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自恋型人格障碍的概念——跨学科整合的三个分析层次

The concept of Narcissistic Personality Disorder-Three levels of analysis for interdisciplinary integration.

作者信息

Jacobs Kerrin A

机构信息

Department of Philosophy and Ethics, Faculty of Humanities and Human Sciences, University of Hokkaido, Sapporo, Japan.

Center for Human Nature, Artificial Intelligence, and Neuroscience (CHAIN), University of Hokkaido, Sapporo, Japan.

出版信息

Front Psychiatry. 2022 Nov 16;13:989171. doi: 10.3389/fpsyt.2022.989171. eCollection 2022.

Abstract

In this paper, I distinguish three different levels for describing, and three corresponding ways for understanding, deficient empathy as the core of NPD (Narcissistic Personality Disorder). On the macro level, deficient empathy can be explained as disturbed interpersonal functioning, and is understood as lack of cognition. On the meso-level, deficient empathy can be described as psychic disintegration, and can be understood specifically in its dissocial aspects. Psychic disintegration in NPD correlates with somatic changes, i.e., dysfunctional affective empathy and mind-reading on the micro level of description, which is the third level. The "core-deficit-model of NPD" that I outline, while not rejecting reductionist approaches outright, argues in favor of integrating (top-down/bottom-up) functionalist descriptions of empathy into a wider conceptual framework of bio-psycho-social functioning. The "core-deficit-model of NPD" is interdisciplinary, can bypass monodisciplinary skepticism, and removes purported barriers between explaining and understanding the "lack" of empathy as the core of pathological narcissism.

摘要

在本文中,我区分了描述自恋型人格障碍(NPD)核心——共情缺陷的三个不同层次,以及三种相应的理解方式。在宏观层面,共情缺陷可解释为人际功能紊乱,并被理解为认知缺失。在中观层面,共情缺陷可被描述为精神解体,且可具体从其反社会方面来理解。自恋型人格障碍中的精神解体与躯体变化相关,即在描述的微观层面上功能失调的情感共情和心灵感应,这是第三个层面。我所概述的“自恋型人格障碍的核心缺陷模型”,虽不彻底排斥还原论方法,但主张将(自上而下/自下而上)共情的功能主义描述整合到生物 - 心理 - 社会功能的更广泛概念框架中。“自恋型人格障碍的核心缺陷模型”具有跨学科性,可绕过单一学科的怀疑论,并消除在解释和理解作为病理性自恋核心的共情“缺失”之间所谓的障碍。

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