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定义和“诊断”想象缺失症:病症还是个体差异?

Defining and 'diagnosing' aphantasia: Condition or individual difference?

作者信息

Blomkvist Andrea, Marks David F

机构信息

Centre for Philosophy of Natural and Social Sciences, Department of Philosophy, Logic and Scientific Method, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK.

13200 Arles, Bouches-du-Rhône, Provence-Alpes-Côte d'Azur, France.

出版信息

Cortex. 2023 Dec;169:220-234. doi: 10.1016/j.cortex.2023.09.004. Epub 2023 Sep 29.

Abstract

Research into the newly-coined 'condition' of 'aphantasia', an individual difference involving the self-reported absence of voluntary visual imagery, has taken off in recent years, and more and more people are 'self-diagnosing' as aphantasic. Yet, there is no consensus on whether aphantasia should really be described as a 'condition', and there is no battery of psychometric instruments to detect or 'diagnose' aphantasia. Instead, researchers currently rely on the Vividness of Visual Imagery Questionnaire (VVIQ) to 'diagnose' aphantasia. We review here fundamental and methodological problems affecting aphantasia research stemming from an inadequate focus on how we should define aphantasia, whether aphantasia is a pathological condition, and the extensive use of VVIQ as a 'diagnostic test' for aphantasia. Firstly, we draw attention to 'literature blindness' for visual imagery research from the 1960s-1990s concerning individual differences in visual imagery vividness. Secondly, despite aphantasia being defined as a 'condition' where voluntary visual imagery is absent as indicated by the lowest score on the VVIQ, aphantasia studies inconsistently employ samples comprised of a mixture of participants with no visual imagery and low visual imagery, and we argue that this hinders the uncovering of the underlying cause of aphantasia. Thirdly, the scores used to designate the boundary between aphantasia and non-aphantasia are arbitrary and differ between studies, compromising the possibility for cross-study comparison of results. Fourthly, the problems of 'diagnosing' aphantasia are not limited to the academic sphere, as one can 'self-diagnose' online, for example by using the variant-VVIQ on the Aphantasia Network website. However, the variant-VVIQ departs from the original in ways likely to impact validity and accuracy, which could lead people to falsely believe they have been 'diagnosed' with aphantasia by a scientifically-validated measure. Fifthly, we discuss the hypothesis that people who believe they have been 'diagnosed' with aphantasia might be vulnerable to health anxiety, distress, and stigma. We conclude with a discussion about some fundamental aspects of how to classify a disorder, and suggest the need for a new psychometric measure of aphantasia.

摘要

对新出现的“phantasia”(心象失认症)“病症”的研究近年来迅速兴起,这是一种个体差异,表现为自我报告称缺乏自主视觉意象,越来越多的人“自我诊断”为心象失认症患者。然而,对于心象失认症是否真的应被描述为一种“病症”,目前尚无定论,也没有一套心理测量工具来检测或“诊断”心象失认症。相反,研究人员目前依靠视觉意象生动性问卷(VVIQ)来“诊断”心象失认症。我们在此回顾影响心象失认症研究的基本和方法问题,这些问题源于对如何定义心象失认症、心象失认症是否为病理状况以及广泛使用VVIQ作为心象失认症的“诊断测试”关注不足。首先,我们提请注意对20世纪60年代至90年代关于视觉意象生动性个体差异的视觉意象研究的“文献盲视”。其次,尽管心象失认症被定义为一种“病症”,即VVIQ得分最低表明缺乏自主视觉意象,但心象失认症研究不一致地采用了由无视觉意象和低视觉意象参与者混合组成的样本,我们认为这阻碍了对心象失认症潜在原因的揭示。第三,用于划定心象失认症与非心象失认症界限的分数是任意的,且不同研究之间存在差异,这损害了跨研究结果比较的可能性。第四,“诊断”心象失认症的问题不仅限于学术领域,因为人们可以在网上“自我诊断”,例如通过使用心象失认症网络网站上的变体VVIQ。然而,变体VVIQ在可能影响有效性和准确性的方面与原始问卷不同,这可能导致人们错误地认为他们已通过科学验证的测量方法“诊断”为心象失认症。第五,我们讨论了这样一种假设,即认为自己已被“诊断”为心象失认症的人可能易患健康焦虑、痛苦等问题。我们最后讨论了如何对一种病症进行分类的一些基本方面,并建议需要一种新的心象失认症心理测量方法。

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