Barsky A J, Klerman G L
Am J Psychiatry. 1983 Mar;140(3):273-83. doi: 10.1176/ajp.140.3.273.
Hypochondriasis can be conceptualized in four ways: 1) as a psychiatric syndrome composed of "functional" somatic symptoms, fear of disease, bodily preoccupation, and the persistent pursuit of medical care, 2) psychodynamically, as a derivative of aggressive or oral drives or as a defense against guilt or low self-esteem, 3) as a perceptual amplification of bodily sensations and their cognitive misinterpretation, and 4) as socially learned illness behavior eliciting interpersonal rewards. There is evidence supporting each of these views, but much more investigation is needed. The authors propose the general concept of somatic style--in particular, an amplifying style--which could be used to investigate symptom formation, bodily perception, and medical illness as a psychological and social event.
1)作为一种由“功能性”躯体症状、对疾病的恐惧、身体关注以及持续寻求医疗护理组成的精神综合征;2)从心理动力学角度来看,是攻击或口欲驱力的衍生物,或是对内疚或自卑的防御;3)作为躯体感觉的感知放大及其认知错误解读;4)作为引发人际奖励的社会习得性疾病行为。有证据支持上述每一种观点,但仍需要更多的研究。作者提出了躯体风格的一般概念——特别是一种放大风格——可用于研究症状形成、身体感知以及作为心理和社会事件的医学疾病。