Pontius A A
Percept Mot Skills. 1984 Aug;59(1):299-333. doi: 10.2466/pms.1984.59.1.299.
A recently proposed diagnostic class, psychotic trigger reaction, is deduced from careful clinical studies of eight white men, who upon a very specific trigger stimulus committed murder or attempted to (and in one case also rape). The new class is defined as a sudden ego-alien, motiveless (at least with respect to aggression), motor-wise well organized, violent complex action without emotional concomitants. The action is evoked (not provoked) by an individually unique stimulus within a specific context reviving repeated past traumatic experience. Typically there is no (significant) loss of consciousness and practically full recall. Observed are first-time hallucinations (visual, auditory, tactile, somesthetic, but not olfactory as in temporal lobe epilepsy) and signs of imbalance in the autonomic nervous system (loss of bladder control, ejaculation, profuse sweating, nausea). Only four of these men had previous psychiatric diagnoses (and then various ones) or abnormal EEGs at some time in their lives. Variety in prior diagnoses would be consistent with a seizure-like disorder, here specifically implicating an imbalance in functioning between limbic and frontal lobe systems. Clinical tests for the latter were prevailingly indicative of dysfunctioning. A detailed clinical analysis of the violent acts within their context suggests behaviors are analogous to certain limbic system mechanisms, especially the kindling phenomenon.
最近提出的一种诊断类别——精神病性触发反应，是从对八名白人男性的仔细临床研究中推导出来的。这些男性在受到非常特定的触发刺激后实施了谋杀或企图谋杀（其中一例还包括强奸）。新类别被定义为一种突然的、与自我疏离的、无动机的（至少在攻击方面）、动作上组织良好的、没有情感伴随的暴力复杂行为。该行为是由特定情境中独特的个体刺激引发（而非挑衅）的，这种刺激会唤起反复出现的过去创伤经历。通常没有（明显的）意识丧失，并且几乎能完全回忆起来。观察到首次出现幻觉（视觉、听觉、触觉、本体感觉，但不像颞叶癫痫那样有嗅觉幻觉）以及自主神经系统失衡的迹象（膀胱控制丧失、射精、大量出汗、恶心）。这些男性中只有四人曾有过精神科诊断（而且诊断各不相同），或者在其生命中的某个时候脑电图异常。先前诊断的多样性与癫痫样障碍相符，在此具体暗示边缘系统和额叶系统之间功能失衡。针对后者的临床测试大多表明功能失调。对暴力行为在其背景下进行的详细临床分析表明，这些行为类似于某些边缘系统机制，尤其是点燃现象。
