同一性与他异性的紊乱--精神分裂症社会感知障碍的神经现象学分析

The Disorder of Identity and Alterity--A Neurophenomenological Perspective on Social Cognition Impairment in Schizophrenia

精神分裂症是一种常见的病因未明的精神障碍,表现出稳定的社会认知障碍。现象学精神病理学使用自我与他人同一性和他异性的紊乱来描绘精神分裂症上述障碍。神经现象学的介入有助于澄清交互主体性层面上精神分裂症患者的自我干扰与社会缺陷之间的关系。精神分裂症患者在多感觉整合上存在脑功能异常,主要表现为腹前运动皮层的多感觉表征受损。这种异常会影响连贯、原真的身体体验,从而产生自我干扰。扣带回皮层和腹侧前运动皮层之间的异常功能连接导致精神分裂症患者内在自我与外在自我之间的交互异常,破坏了自我与他人关系中的不对称性,加剧了同一性与他异性的紊乱,表现出超反思、自我感减弱与激进的他异性。

Schizophrenia is a common mental disorder with unknown etiology.Its symptoms are grouped as positive,negative,and cognitive,while its prominent social cognition deficits exist and persist.Inspired by classical phenomenology,phenomenological psychopathology uses the disorder of self-other identity and alterity to describe interpersonal interaction deficits in schizophrenia.It helps to clarify the relationship between self and others in schizophrenia patients at the level of intersubjectivity,and meanwhile provide the brain and neural basis for the in-depth study of the relationship between self-disturbances and social deficits.Current neurophenomenological evidence suggests that patients with schizophrenia have abnormal brain function in multisensory integration,mainly manifested by impaired multisensory representation in the ventral premotor cortex.This anomaly can interfere with the coherent,primordial physical experience,causing selfdisturbance.Furthermore,the abnormal functional connections between the cingulate cortex and the ventral premotor cortex lead to abnormal interactions between the inner and outer selves,breaking the asymmetry between the self and others,and exacerbating the disorder of identity and alterity.In the end,patients with schizophrenia show hyper-reflexivity,diminished self-affection and radical alterity.