McConaghy N, Catts S V, Michie P T, Fox A, Ward P B, Shelley A M
Department of Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia.
J Nerv Ment Dis. 1993 Mar;181(3):176-82. doi: 10.1097/00005053-199303000-00005.
Loosening of thinking as assessed by the Object Sorting Test (OST) has been found in a percentage of normal subjects but in a higher percentage of schizophrenics, and is familially transmitted in both groups. Loosening of thinking in normal subjects is not associated with evidence of impaired function or increased psychopathology, and in recognition of this, it was termed allusive thinking rather than thought disorder. Both OST-assessed loosening and concreteness of thinking were found to be present independently in a high percentage of schizophrenics, so that both were considered to contribute to schizophrenic thought disorder. The presence of OST-assessed loosening in schizophrenics would, therefore, be predicted to correlate partially rather than totally with measures of schizophrenic thought disorder. It has been suggested that OST-assessed loosening in normal subjects is due to a genetically determined reduction in strength of an inhibitory process that limits the spread of activation of semantic associations and results in a predisposition to schizophrenia. The brain event-related potential P300, which is, in part, under genetic control, may index this inhibitory process. Therefore, it was predicted that in normal subjects, P300 would correlate with OST-assessed loosening of associations. If schizophrenic thought disorder is due to a further weakening of this inhibitory process, it can be predicted that P300 in schizophrenics correlates only weakly with OST-assessed loosening of thinking, but more strongly with schizophrenic thought disorder. In a study in which P300 was elicited using a difficult selective attention task with 15 unmedicated schizophrenics and 22 healthy subjects, all three predictions were supported.
通过物体分类测试(OST)评估发现,思维松弛在一定比例的正常受试者中存在,但在精神分裂症患者中比例更高,且在两组中都具有家族遗传性。正常受试者的思维松弛与功能受损或精神病理学增加的证据无关,鉴于此,它被称为暗示性思维而非思维障碍。研究发现,在高比例的精神分裂症患者中,OST评估的思维松弛和思维具体性是独立存在的,因此两者都被认为是导致精神分裂症思维障碍的因素。因此,可以预测精神分裂症患者中OST评估的思维松弛与精神分裂症思维障碍的测量指标部分相关而非完全相关。有人提出,正常受试者中OST评估的思维松弛是由于遗传决定的抑制过程强度降低,该抑制过程限制了语义联想激活的传播,从而导致精神分裂症的易感性。部分受基因控制的脑事件相关电位P300可能反映了这一抑制过程。因此,预测在正常受试者中,P300将与OST评估的联想松弛相关。如果精神分裂症思维障碍是由于这一抑制过程的进一步减弱所致,那么可以预测,精神分裂症患者的P300与OST评估的思维松弛仅存在微弱相关性,但与精神分裂症思维障碍的相关性更强。在一项研究中,使用一项困难的选择性注意任务对15名未服药的精神分裂症患者和22名健康受试者进行P300诱发实验,所有这三个预测都得到了支持。