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精神分裂症与偏执过程

The schizophrenic and the paranoid process.

作者信息

Meissner W W

出版信息

Schizophr Bull. 1981;7(4):611-31. doi: 10.1093/schbul/7.4.611.

Abstract

Data are presented in support of an understanding of schizophrenic and paranoid processes as operating relatively independently in the formation and deformation of human personality. The schizophrenic process derives from a genetically determined diathesis in combination with a range of factors involving environmental stress. The effects of the schizophrenic process in the organization and integration of internal structure and the differentiation of psychic functions are found at multiple levels, including negative consequences for the integration between cognitive and affective capacities, between conceptual and perceptual functions, and in the integration and stabilization of psychic structures. The schizophrenic process is envisioned as having disorganizing and disruptive effects on different levels of psychic organization, including the levels of the organization of cognitive processes, the formation and integration of representational systems (both self and object, and the structural integration of the self-system. In contrast, the paranoid process is thought to operate in the shaping and internal patterning of the personality organization, particularly by way of crucial forms of internalization. The interaction of introjection and projection shapes the individual's self-organization and contributes to the quality of interaction with significant objects. The impact of the paranoid process in both its positive function of contributing to the building up and integration of a meaningful and constructive sense of self and capacity for psychological functioning, as well as its deviant forms of expression in the development of paranoid pathology, is discussed. Although the schizophrenic and paranoid processes operate relatively independently, their interaction and intermingling contributes to the spectrum of forms of psychopathology that characterize the schizophrenic spectrum.

摘要

本文所呈现的数据支持这样一种理解,即精神分裂症和偏执过程在人类人格的形成与变形中相对独立地发挥作用。精神分裂症过程源于遗传决定的素质,再加上一系列涉及环境压力的因素。精神分裂症过程在内部结构的组织与整合以及心理功能的分化方面的影响,在多个层面都能发现,包括对认知与情感能力之间、概念与感知功能之间整合的负面影响,以及对心理结构的整合与稳定的负面影响。精神分裂症过程被设想为对不同层面的心理组织具有瓦解和破坏作用,包括认知过程的组织层面、表象系统(自我和客体)的形成与整合以及自我系统的结构整合。相比之下,偏执过程被认为在人格组织的塑造和内部模式形成中发挥作用,特别是通过关键的内化形式。内摄和投射的相互作用塑造了个体的自我组织,并影响与重要客体的互动质量。本文讨论了偏执过程在其积极功能(有助于建立和整合有意义且建设性的自我意识及心理功能能力)以及在偏执病理发展中其异常表达形式方面的影响。虽然精神分裂症和偏执过程相对独立地发挥作用,但它们的相互作用和交织促成了精神分裂症谱系所特有的一系列精神病理学形式。

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