RESUMO
Se revisa críticamente la posición atribuida en los últimos años a las ideas sobrevaloradas entre el delirio y la obsesión, y que deriva de la reducción del constructo mismo a una de sus características, el insight. A través de un caso con ideas dismorfofóbicas se plantearán las dificultades para delimitarlo y diferenciarlo del delirio y se esbozarán distintas aproximaciones psicopatológicas que permitan reconstruir el caso de modo distinto (AU)
The position attributed in recent years to overvalued ideas between delusion and obsession and that are derived from the reduction of the construct per se to one of its characteristics, that is, insight, has undergone a critical review. Using a case with dysmorphophobic ideas, the difficulties to define it and differentiate it from delusionare proposed and different psychopathological approaches are outlined that make it possible to reconstruct the case differently (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Delírio/psicologia , Comportamento Obsessivo/psicologia , Distorção da Percepção , AutoimagemRESUMO
BACKGROUND: Most current theories explaining theory of mind (ToM) rely on the concept of 'representation', as it is usually employed in cognitive science, and is thus affected by its epistemic shortcoming, namely its incapacity to use 'sub-signifier' level information. This shortcoming is responsible for the lack of specificity of ToM deficits, which are now found in very different syndromes, from schizophrenia to bipolar disorder or borderline personality disorder, in spite of its original formulation being restricted to childhood autism. METHOD: Representation, its shortcomings and the way they may affect clinical/research programs undergo a conceptual analysis, which shows how representational-founded semiology leave out information that is essential for symptom specificity and correct symptom assessment. Schizophrenic autism, delusional perception and axial syndromes are studied as examples of both the difficulties that have arisen and possible ways of dealing with them. RESULTS: Transfers of properties between different meanings of 'representation' together with a systematic ambiguity in the use of 'representation' are proposed as the main ways for representational approaches to assure stability to their proposals in spite of the violence exerted on clinical phenomena. CONCLUSIONS: It is exposed how systematic ambiguity and epistemic shortcomings both affect Leslie's formulation of ToM and, further, the importance of these characteristics of the concept of 'representation' for general issues in psychiatric semiology.
Assuntos
Transtorno Autístico/diagnóstico , Transtorno Bipolar/diagnóstico , Transtorno da Personalidade Borderline/diagnóstico , Formação de Conceito , Teoria da Construção Pessoal , Esquizofrenia/diagnóstico , Adulto , Transtorno Autístico/psicologia , Transtorno Bipolar/psicologia , Transtorno da Personalidade Borderline/psicologia , Criança , Delusões/diagnóstico , Delusões/psicologia , Humanos , Psicopatologia , Psicologia do Esquizofrênico , Semântica , SimbolismoRESUMO
La disfunción de la habilidad para adscribir estados mentales a otros, esto es, la posesión de una teoría de la mente, ha sido propuesta por Frith como condición necesaria, suficiente y específica de la esquizofrenia. Este artículo revisa los datos a favor y en contra de tal asunción, teniendo en cuenta su relación hipotética con otras variables cognitivas, si la falta de una teoría de la mente es un marcador de rasgo o de estado y si su rol causal implica el trastorno psicótico básico o sólo algunos síntomas psicóticos. Igualmente se considera si los recientes hallazgos de disfunción de la teoría de la mente en el trastorno bipolar y en la demencia frontotemporal podrían modificar las asunciones teóricas básicas sobre la teoría de la mente, la esquizofrenia y los trastornos relacionados
Malfunction of the ability to ascribe mental states to others, that is, possession of a Theory of Mind (ToM), was proposed by CD Frith as a necessary, sufficient and specific condition of schizophrenia. The present article reviews the evidence for and against this assumption, bearing in mind its putative relationship with other cognitive variables, whether the lack of a ToM is trait marker or rather a state marker and whether its causal role involves the underlying psychotic disorder or only some psychotic symptoms. Equally, whether the recent findings of ToM dysfunction in bipolar disorder and frontotemporal dementia could modify basic theoretical assumptions about ToM, schizophrenia and related conditions is also discussed
