Harris Hebert W
Private Practitioner, Arlington, VA, United States.
Front Psychiatry. 2025 Aug 19;16:1630858. doi: 10.3389/fpsyt.2025.1630858. eCollection 2025.
This paper introduces Active Intersubjective Inference (AISI), a novel framework that integrates psychodynamic theory with predictive processing to explain self-identity construction and psychopathology. AISI posits that the self emerges from recursive inferences about how others perceive us (second-order self), interacting bidirectionally with interoceptive processes. We map psychodynamic phenomena (e.g., transference, projection) onto neurocomputational mechanisms and apply AISI to Major Depressive Disorder (MDD) and Post-Traumatic Stress Disorder (PTSD), highlighting distorted second-order inference as a core dysfunction. Therapeutic implications include psychodynamic therapy, cognitive-behavioral approaches, and psychedelic-assisted treatments to enhance inference flexibility. AISI bridges psychodynamic insights with the NIMH Research Domain Criteria, offering a testable model for precision psychiatry and future clinical trials.
本文介绍了主动主体间推理(AISI),这是一个将心理动力学理论与预测性处理相结合的新颖框架,用于解释自我认同构建和精神病理学。AISI假定自我源于关于他人如何看待我们的递归推理(二阶自我),并与内感受过程进行双向交互。我们将心理动力学现象(如移情、投射)映射到神经计算机制上,并将AISI应用于重度抑郁症(MDD)和创伤后应激障碍(PTSD),强调扭曲的二阶推理是核心功能障碍。治疗意义包括心理动力学疗法、认知行为方法以及迷幻辅助治疗,以提高推理灵活性。AISI将心理动力学见解与美国国立精神卫生研究所(NIMH)的研究领域标准相联系,为精准精神病学和未来临床试验提供了一个可测试的模型。