Neurokognitive Grundlagen von Positivsymptomatik

Zusammenfassung

Positivsymptome psychotischer Erkrankungen, wie Wahn und Halluzinationen, entwickeln sich auf der Grundlage neurobiologischer Prädispositionen, fehlerhafter kognitiver Verarbeitungsstile und ungünstiger sozialer Umweltbedingungen. Diese Übersicht stellt die Ergebnisse von Studien aus dem Bereich der experimentellen Neuropsychologie vor, welche ein besseres Verständnis der Grundlagen von Kernsymptomen psychotischer Patienten ermöglichen sollen. Im Zentrum stehen dabei die Symptomkomplexe von Wahn, Halluzination und formaler Denkstörung. Die darauf fußenden kognitionspsychologischen Modelle bilden die Basis kognitiv-verhaltenstherapeutischer Interventionen bei Positivsymptomen.

Summary

Positive symptoms in psychotic disorders such as delusions and hallucinations develop on the basis of the interaction of biological vulnerability, cognitive biases and unfavourable social environmental conditions. This overview presents results from the field of experimental neuropsychology. They allow a better understanding of the mechanisms underlying core symptoms of psychotic patients. We focus on the symptoms of delusions, hallucinations and formal thought disorder. Comprehensive cognitive psychological models based on the results of such studies guide current attempts of ameliorating positive symptoms by cognitive-behavioural interventions.

Schlüsselwörter

Psychose - Positivsymptome - Neuropsychologie - kognitive Modelle

Keywords

Psychosis - positive symptoms - neuropsychology - cognitive models

• Literatur

• 1 Adler A. Melancholia and paranoia. In: Adler A. (ed.). The practice and theory of individual psychology. London: Routledge & Kegan Paul; 1914. /1929
• 2 Allen PP. Misattribution of external speech in patients with hallucinations and delusions. Schizophr Res 2004; 69: 277-287.
• 3 American Psychiatric Association.. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington DC: American Psychiatric Association; 2000
• 4 Badcock JC, Waters FAV, Maybery MT, Michie PT. Auditory hallucinations: failure to inhibit irrelevant memories. Cognit Neuropsychiatry 2005; 10: 125-136.
• 5 Baker CA, Morrison AP. Cognitive processes in auditory hallucinations: attributional biases and metacognition. Psychol Med 1998; 28: 1199-1208.
• 6 Barrera A, McKenna PJ, Berrios GE. Formal thought disorder in schizophrenia: an executive or a semantic deficit?. Psychol Med 2005; 35: 121-132.
• 7 Beck AT, Rector NA. A cognitive model of hallucinations. Cognit Ther Res 2003; 27: 19-52.
• 8 Bentall R. Madness explained: why we must reject the Kraepelinian paradigm and replace it with a complaint-orientated< approach to understanding mental illness. Med Hypotheses 2006; 66: 220-233.
• 9 Bentall RP. The illusion of reality: a review and integration of psychological research on hallucinations. Psychol Bull 1990; 107: 82-95.
• 10 Bentall RP, Corcoran R, Howard R, Blackwood N, Kinderman P. Persecutory delusions: a review and theoretical integration. Clin Psychol Re 2001; 21: 1143-1192.
• 11 Bentall RP, Kaney S. Content specific information processing and persecutory delusions: an investigation using the emotional Stroop test. Br J Med Psychol 1989; 62: 355-364.
• 12 Blackwood NJ, Howard RJ, Bentall RP, Murray RM. Cognitive neuropsychiatric models of persecutory delusions. Am J Psychiatry 2001; 158: 527-539.
• 13 Brüne M. Emotion recognition, ´theory of mind̀, and social behavior in schizophrenia. Psychiatry Res 2005; 133: 135-147.
• 14 Colbert SM, Peters ER. Need for closure and jumping- to-conclusions in delusion-prone individuals. J Nerv Ment Dis 2002; 190: 27-31.
• 15 Corcoran R, Mercer G, Frith CD. Schizophrenia, symptomatology and social inference: Investigating “theory of mind” in people with schizophrenia. Schizophr Res 1995; 17: 5-13.
• 16 David AS. The cognitive neuropsychiatry of auditory verbal hallucinations: an overview. Cognit Neuropsychiatry 2004; 9: 107-123.
• 17 Dudley REJ, Over DE. People with delusions jump to conclusions: a theoretical account of research findings on the reasoning of people with delusions. Clin Psychol Psychother 2003; 10: 263-274.
• 18 Fine C, Gardner M, Craigie J, Gold I. Hopping, skipping or jumping to conclusions? Clarifying the role of the JTC bias in delusions. Cognit Neuropsychiatry 2007; 12 (Suppl. 01) 46-77.
• 19 Freeman D, Garety P, Fowler D, Kuipers E, Dunn G, Bebbington P, Hadley C. The London-East Anglia randomized controlled trial of cognitive-behaviour therapy for psychosis. IV. Self-esteem and persecutory delusions. Br J Clin Psychol 1998; 37: 415-430.
• 20 Freeman D, Garety P, Kuipers E, Colbert S, Jolley S, Fowler D, Dunn G, Bebbington PE. Delusions and decision-making style: use of the Need for Closure Scale. Behav Res Ther 2006; 44: 1147-1158.
• 21 Frith CD. The cognitive neuropsychology of schizophrenia. Hove, UK: LEA; 1992
• 22 Frith CD, Blakemore S, Wolpert DM. Explaining the symptoms of schizophrenia: abnormalities in the awareness of action. Brain Res Brain Res Rev 2000; 31: 357-363.
• 23 Gallagher AG, Dinan TG, Baker LJV. The effects of varying auditory input on schizophrenic hallucinations: a replication. Br J Med Psychol 1994; 67: 67-75.
• 24 Garety PA, Freeman D. Cognitive approaches to delusions: a critical review of theories and evidence. Br J Clin Psychol 1999; 38: 113-154.
• 25 Green MJ, Phillips ML. Social Threat perception and the evolution of paranoia. Neurosci Biobehav Rev 2004; 28: 333-342.
• 26 Harrington L, Langdon R, Siegert RJ, McClure J. Schizophrenia, theory of mind, and persecutory delusions. Cognit Neuropsychiatry 2005; 10: 87-104.
• 27 Hubl D, Koenig T, Strik W, Dierks T. Halluzinationen – Psychologie. In: Kircher T, Gauggel S. (Hrsg.). Neuropsychologie der Schizophrenie: Symptome, Kognition und Gehirn. Heidelberg: Springer; 2008
• 28 Huq SF, Garety PA, Hemsley DR. Probabilistic judgement in deluded and non-deluded subjects. Quart J Exp Psychol 1988; 40A: 801-812.
• 29 Jones SR, Fernyhough C. Thought as action: inner speech, self-monitoring, and auditory verbal hallucinations. Conscious Cogn 2006; 16: 391-399.
• 30 Kerns JG, Berenbaum H. Cognitive impairments associated with formal thought disorder in people with schizophrenia. J Abnorm Psychol 2002; 111: 211-224.
• 31 Kinderman P. Attentional bias, persecutory delusions and the self-concept. Br J Med Psychol 1994; 67: 53-66.
• 32 Kinderman P, Bentall RP. Causal attributions in paranoia and depression: internal, personal, and situational attributions for negative events. J Abnorm Psychol 1997; 106: 341-345.
• 33 Kircher T. Neuronale Korrelate psychopathologischer Symptome. Denk- und Sprachprozesse bei Gesunden und Patienten mit Schizophrenie. Darmstadt: Steinkopff; 2003
• 34 Kircher T, Gauggel S. (Hrsg). Neuropsychologie der Schizophrenie: Symptome, Kognition und Gehirn. Heidelberg: Springer; 2008
• 35 Kirner A, Zellagui N, Kircher T. Formale Denkstörungen – Psychologie. In: Kircher T, Gauggel S. (Hrsg.). Neuropsychologie der Schizophrenie: Symptome, Kognition und Gehirn. Heidelberg: Springer; 2008
• 36 Knoblich G, Stottmeister F, Kircher T. Self-monitoring in patients with schizophrenia. Psychol Med 2004; 34: 1561-1569.
• 37 Lincoln T. Kognitive Verhaltenstherapie der Schizophrenie. Ein individuenzentrierter Ansatz zur Veränderung von Wahn, Halluzinationen und Negativsymptomatik. Göttingen: Hogrefe; 2006
• 38 Lincoln TM, Rief W. Kognitive Verhaltenstherapie von Wahn und Halluzinationen. Eine kritische Bewertung der Übereinstimmung von Grundlagenbefunden und Interventionen. Zeitschrift für Klinische Psychologie und Psychotherapie 2007; 36: 164-175.
• 39 Manschreck TC, Maher BA, Milavetz JJ, Ames D, Weisstein CC, Schneyer ML. Semantic priming in thought disordered schizophrenic patients. Schizophr Res 1988; 1 (Suppl. 01) 61-66.
• 40 McGrath J, Allman R. Awareness and unawareness of thought disorder. Aust N Z J Psychiatry 2000; 34: 35-42.
• 41 McKay R, Langdon R, Coltheart M. Paranoia, persecutory delusions and attributional biases. Psychiatry Res 2005; 136: 233-245.
• 42 Moritz S, Burlon M, Woodward TS. Metacognitive Skill Training for Patients with Schizophrenia (MCT) Manual. Hamburg: VanHam Campus; 2005
• 43 Moritz S, Laudan A. Attention bias for paranoiarelevant visual stimuli in schizophrenia. Cognit Neuropsychiatry 2007; 12: 381-390.
• 44 Moritz S, Lincoln T. Wahn – Psychologie. In: Kircher T, Gauggel S. (Hrsg.). Neuropsychologie der Schizophrenie: Symptome, Kognition und Gehirn. Heidelberg: Springer; 2008
• 45 Moritz S, Werner R, Von Colani G. The inferiority complex in paranoia readdressed: a study with the Implicit Association Test. Cognit Neuropsychiatry 2006; 11: 402-435.
• 46 Moritz S, Woodward TS. A generalized bias against disconfirmatory evidence in schizophrenia. Psychiatry Res 2006; 142: 157-165.
• 47 Moritz S, Woodward TS, Burlon M, Braus D, Andresen B. Attributional style in schizophrenia: evidence for a deceased sense of self-causation in currently paranoid patients. Cognit Ther Res 2007; 31: 371-383.
• 48 Moritz S, Woodward TS, Hausmann D. Incautious reasoning as a pathogenetic factor for the development of psychotic symptoms in schizophrenia. Schizophr Bull 2006; 32: 327-331.
• 49 Moritz S, Woodward TS, Küppers D, Lausen A, Schickel M. Increased automatic spreading of activation in thought-disordered schizophrenic patients. Schizophr Res 2003; 59: 181-186.
• 50 Rankin PM, O’Carroll PJ. Reality discrimination, reality monitoring and disposition towards hallucination. Br J Clin Psychol 1995; 34: 517-528.
• 51 Seal ML, Aleman A, McGuire PK. Compelling imagery, unanticipated speech and deceptive memory: neurocognitive models of auditory verbal hallucinations in schizophrenia. Cognit Neuropsychiatry 2004; 9: 43-72.
• 52 Spitzer M, Braun U, Maier S, Hermle L, Maher BA. Indirect semantic priming in schizophrenic patients. Schizophr Res 1993; 11: 71-80.
• 53 Stirling J, Hellewell J, Blakey A, Deakin W. Thought disorder in schizophrenia is associated with both executive dysfunction and circumscribed impairments in semantic function. Psychol Med 2006; 36: 475-484.
• 54 Van Dael F, Versmissen D, Janssen I, Myin-Germeys I, Van Os J, Krabbendam L. Data gathering: biased in psychosis?. Schizophr Bull 2005; 32: 341-351.
• 55 Van der Gaag M. A neuropsychiatric model of biological and psychological processes in the remission of delusions and auditory hallucinations. Schizophr Bull 2006; 32: S113-S122.
• 56 Van der Gaag M, Hageman MC, Birchwood M. Evidence for a cognitive model auditory hallucinations. J Nerv Ment Dis 2003; 191: 542-545.
• 57 Vauth R, Stieglitz R-D. Chronisches Stimmenhören und persistierender Wahn. Göttingen: Hogrefe; 2007
• 58 Woodward TS, Moritz S, Cuttler C, Whitman JC. The contribution of a cognitive bias against disconfirmatory evidence (BADE) to delusions in schizophrenia. J Clin Exp Neuropsychol 2006; 28: 605-617.
• 59 Pauly K, Kircher T. Zerebrale Korrelate von Positivsymptomatik bei Patienten mit Schizophrenie. Nervenheilkunde 2008; 27: 1027-1031.
• 60 Klingberg S. et al. Kognitiv-verhaltenstherapeutische Behandlung von Positivsymptomatik psychotischer Störungen. Nervenheilkunde 2008; 27: 1014-1020.