妄想是坚定的错误信念。它们与许多疾病有关,包括精神分裂症和妄想障碍,但在情感障碍和痴呆症患者中也可以发现。认可了几种不同类型的妄想,包括狂热的妄想,宏伟的妄想,嫉妒的妄想,迫害的妄想,控制妄想,虚无主义的妄想,内gui或罪恶的妄想,躯体妄想,躯体妄想和妄想。妄想的评估涉及确定病因以及症状表现的严重性和坚韧性。治疗取决于症状的病因,可以包括抗精神病药,抗抑郁药或稳定药物以及认知疗法。
妄想的定义
Delusions are fixed beliefs that are false and have no basis in reality. Delusions can be either bizarre, such as thinking that aliens are controlling your thoughts and behaviors, or nonbizarre, such as believing that one is being watched or spied on. In addition, delusions can be mood congruent, in which the delusion is consistent with the emotional state—such as depression or mania, or mood incongruent, whereby the delusion is not consistent with the emotional state. An example of a mood-congruent delusion would be believing oneself to be God during the height of a manic episode; an example of a mood-incongruent delusion would be a depressed person’s belief that his or her thoughts are being controlled by the Central Intelligence Agency. For a belief to be considered a delusion, it must be pathological in nature.
与妄想有关的疾病
妄想是几种心理疾病的症状,表明精神病精神疾病。除了幻觉外,妄想是精神分裂症最可识别的症状。但是,仅凭妄想的存在不足以诊断精神分裂症。在精神分裂症中,妄想可以是怪异的或无骨的。
妄想是妄想障碍的主要症状,这是一种精神障碍,在没有任何其他精神病理学的情况下,该人持有一种或多种非骨质妄想。此外,该人一定不能满足精神分裂症的任何诊断标准。在许多情况下,妄想障碍的人通常在生活的大多数方面都可以发挥作用,而精神疾病的唯一迹象是直接来自妄想信念的行为。例如,一个人可以相信他或她正在通过房屋中的电源插座进行监视,因此该人用电胶带覆盖了所有插座。除了这种行为与妄想思想直接相关的行为外,该人能够维持工作和关系。从历史上看,妄想症被称为妄想症。
妄想也与痴呆症,严重抑郁症和躁郁症的躁狂相有关。
妄想的类型
There are several different types of delusions, such as erotomanic delusions, delusions of grandiosity, jealous delusions, persecutory delusions, delusions of control, nihilistic delusions, delusions of guilt or sin, somatic delusions, and delusions of reference.
狂热的妄想
An erotomanic delusion is a delusion in which the individual believes that he or she has a special, loving relationship with another person, who is usually a famous individual or someone of high standing. The subjects of delusions are often popular media figures such as politicians, actors, and singers. In certain instances, the delusional individuals believe that the subject of their delusion is communicating secret love messages to them through signals such as gestures and body posture. As part of the delusion, the delusional individuals believe that their feelings are reciprocated by the subject of their delusion. In the case of celebrities, these gesture are usually transmitted to the delusional individual through the radio or television. In most cases, the subject of the delusion has no contact with, or awareness of, the delusional individual. Erotomanic delusions are most often found in individuals diagnosed with schizophrenia or delusional disorder.
狂热的妄想会导致缠扰或其他潜在的危险行为。在某些极端情况下,妄想的人闯入了妄想的众议院,甚至杀死了该人。许多广泛报道的罪行与狂热的妄想有关:1989年,年轻的女演员丽贝卡·舍弗(Rebecca Schaeffer)被一个对她有Ero-tomanic Delusion的人开枪打死。另外,据报道,对前美国总统罗纳德·里根(Ronald Reagan)的暗杀企图受到了狂热的妄想的驱使:小约翰·欣克利(John Hinckley Jr.
对于那些被诊断出具有异性恋妄想的人来说,预后存在一些争议。据一些研究人员说,这样的人对治疗的反应不佳,而其他研究人员认为妄想是一种潜在的精神病症状,通常会对抗精神病药物反应和支持性心理治疗。有证据表明,患有妄想障碍的人对治疗的依从性不佳,因为他们经常对自己的妄想感到如此着迷,以至于不能说服他们服用可能减轻症状的药物。
宏伟的妄想
具有宏伟性妄想的个人通常具有夸张的自我重要性或夸张的价值感。他们可能会坚信自己拥有卓越的知识或技能,或者与神或名人有特殊的关系。在某些情况下,妄想个体实际上可能会相信自己是神(例如耶稣基督)或名人。更常见的是,那些充满宏伟幻想的人可能会认为,他们取得了一项伟大的成就,他们没有得到足够的赞赏和尊重。
一些理论家认为,由于低自尊和负面情绪而导致宏伟的妄想。这被称为妄想假设。其他研究人员认为,宏伟的妄想是个人的真实情感和信仰的夸大体现。这被称为情感一致的假设。一项研究调查了20名具有Grandiose妄想的患者样本中的两个假设,发现样本中隐秘和公开自尊之间没有差异。研究的作者得出的结论是,宏伟的妄想可能是个人情绪状态的夸大。宏伟的妄想可能与精神分裂症或妄想障碍有关,是双相情感障碍躁狂阶段的常见症状。
嫉妒的妄想
Jealous delusions, or delusions of infidelity, involve the false belief that the delusional individual’s spouse or sexual partner is unfaithful or having an affair. Delusional jealousy can involve stalking or spying on the spouse/lover as the delusional individual seeks evidence to confirm the existence of the affair. This type of delusion often stems from pathological jealousy and can seriously affect romantic relationships, and in certain cases the delusional individual’s jealousy can escalate into violence and even murder.
迫害妄想
有迫害妄想的人认为,特定的个人或一般人“要获得他们”。遭受迫害的妄想的人怀疑其他人正在参加复杂的阴谋来迫害他们。在某些情况下,他们可能会认为自己正在监视,吸毒或中毒。在更极端的情况下,个人可能会认为他们是阴谋的主题,某人(通常是政府机构)希望他们死。对迫害的一些妄想更加模糊,更笼统,例如虚假的信念,即一个人的同事给一个困难。在其他情况下,妄想可以是一个高度错综复杂和参与的众多形成良好的虚假信念的网络,例如可以解释个人生活的各个方面的详尽的政府阴谋。
Persecutory delusions are a hallmark symptom of several disorders, including paranoid schizophrenia; delusion disorder, paranoid type; and paranoid personality disorder. Paranoid delusions have also been noted in cases of severe depression and dementia.
其他妄想
Other types of delusions include delusions of control, nihilistic delusions, delusions of guilt or sin, somatic delusions, and delusions of reference. Those with delusions of control have the false belief that someone else is controlling their thoughts, emotions, and behaviors. This can include the belief that outside forces are inserting or removing thoughts from their mind, that their thoughts are being broadcast out loud, or that someone is controlling their bodily movements. Nihilistic delusions refer to false beliefs that the world is coming to an end. Delusions of sin or guilt refer to intense feelings of guilt or sin for something the person has not done; for example, individuals with such delusions may falsely believe that they have committed a horrible crime for which they should be punished or that they are somehow responsible for natural disasters, even though this is impossible. Somatic delusions usually involve the false belief that the individual has a medical disorder or a physical deformity. These beliefs differ from hypochondriasis, as somatic delusions are often very specific and in some cases quite strange. Finally, individuals who experience delusions of reference believe that they may be receiving special messages from the television, newspaper, radio, or the way things are arranged around them. Individuals with this disorder may believe that people are talking about them or taking special notice of them even when that is not the case.
控制,虚无妄想和参考妄想被认为是奇怪的妄想。然而,迫害的妄想,躯体妄想,宏伟的妄想以及大多数嫉妒和内gui的妄想通常被认为是无界的。
评估妄想
如果怀疑妄想症,应由医生评估一个人,以排除任何有机病因(例如痴呆症)。这可能包括彻底的病史,对患者服用的药物的综述,血液检查以及可能的脑部扫描。如果妄想似乎与有机原因无关,那么患者应接受精神科医生或心理学家的评估。该评估通常涉及访谈和心理评估。心理学家使用了几种仪器来评估妄想。其中包括MacArthur-Maudsley妄想评估时间表,信念量表的棕色评估,正面和负面综合征量表以及评估正症状的量表。
妄想的治疗
精神分裂症症状的妄想通常会对抗精神病药,硫代嗪,氯氮平,氟哌啶醇或利病酮等抗精神病药的治疗有反应。与精神分裂症无关的妄想可能无法对抗精神病药物反应,在这种情况下,除了或除了与抗精神病药外药物外,还应使用其他药物。作为情绪障碍症状的妄想应用抗精神病药以及抗抑郁药或情绪稳定剂治疗。如果妄想的病因是医学的,那么治疗疾病的解决应减轻妄想症状。此外,建议对经历妄想的人进行认知疗法作为辅助疗法。
参考:
- 美国精神病学协会。(2000)。精神障碍的诊断和统计手册(第4版,文本修订)。华盛顿特区:作者。
- Appelbaum,P。S.,Robbins,P。C.和Monahan,J。(2000)。暴力和妄想:来自麦克阿瑟暴力风险评估研究的数据。美国精神病学杂志,157,566-572。
- Eisen,J。L.,Phillips,K。A.,Baer,L.,Beer,D.A.,Atala,K。D.,&Rasmussen,S.A。(1998)。信念量表的棕色评估:可靠性和有效性。《美国精神病学杂志》,155(1),102-108。
- Leeser,J。和O’Donohue,W。(1999)。什么是妄想?认识论维度。异常心理学杂志,108,687-694。
- Mullen,P。E.和Pathe,M。(1994)。爱的病理扩展。英国精神病学杂志,165,614-623。
- Smith,N.,Freeman,D。和Kuipers,E。(2005)。宏伟的妄想:对妄想作为防御的实验调查。精神障碍杂志,193(7),480-487。
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