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反人格紊乱(APD)

作者:佚名    文章来源:转载    点击数:    更新时间:2011-8-1


    2000214(波士顿)-南加州大学(
USC)的研究人员说他们已经首次辨认出一个至少部分与某些人的极度暴力犯罪行为和反社会行为有关的大脑缺陷。反社会人格紊乱(APD)是一种经常发生在连环杀手和有暴力和侵略性倾向,冲动危险人物身上的一种心理疾病。患有APD的人大脑前额皮层的某个组织(灰质)的体积与正常人或者有吸毒酗酒史但没有APD 的人比起来减少了11%。
研究人员已经确认前额皮层是与情感,激发,注意力,良知道德和自制有关的脑区。极度暴力倾向和反社会行为和由于疾病或外伤造成的大脑前额皮层损害之间的关系很早以前就已经为人们所认识。

最著名的病例是美国佛蒙特州一个名叫Phineas Gage的铁路工人。1848年他从一次可怕的事故中幸免遇难并且很快地康复了。在这次事故中,一根三英尺多长的沉重的小铁棒被爆炸气流炸飞起来穿透了他的头骨。事故过后,他的人格发生了明显的变化,表现出很多APD的特征,包括反社会行为,使用下流的语言,明显缺乏道德感,冲动,易怒,有侵略倾向,工作不能集中注意力以及对未来缺乏计划等。据美国精神病协会报道,虽然儿童要等到成年才能表现出典型的人格紊乱症状,一些表现出与APD相似的特征的儿童与其他儿童比起来尤其可能违反纪律和具有侵略倾向,比如折磨小动物或周围的人,经常威胁恐吓别人,使用会引起严重伤害的武器,撒谎,损坏公物,偷窃等。患有APD的成年人经常做出触犯法律的举动,斗殴,欺骗,漠视本人和他人的安全,对自己的行为不悔改等。但是USC的研究结果也从法律和道德角度对这一现象提出了疑问,一些暴力倾向者是否可以对自己的行为负完全责任,人们是否应该采用特殊方式对待他们,阻止他们的冲动行为,减轻他们的侵略性倾向,使他们即使在无人监护时也不会对社会构成威胁。
      芝加哥西北大学精神病学和行为科学教授M. Marsel Mesulam在接受WebMD网采访时就这一问题寻求客观分析的时候说,我想任何人都不会把将这些人锁起来作为阻止极度反社会行为的方法,那该怎么对待这些人呢,有没有可能把这些行为控制在刚出现的时候呢?汉密尔顿McMaster 大学特殊儿童研究中心主任David R. Offord对这一看法表示同意,这一发现令人激动的地方在于它是一个参量,这个参量可以帮助我们辨认出那些正逐步走向危险,在成人后会产生这一令人棘手地结果的儿童,可以帮助我们准确地发现处于潜伏期儿童。如果发现了产生这一问题的原因,医生就可以找到治疗方法来医治这种大脑损伤,比如药物或手术治疗,或结合其他的方法如精神治疗和行为疗法。Raine说,我们试图发现前额额叶损伤的原因所在,但目前我们还找不到答案。损伤可以由环境因素引发,如出生时的并发症会损伤大脑。几年前我们进行的相关研究显示出生时的并发症会导致成年后的暴力倾向。如果我们给妇女更好的产前和产后照顾,我们就有可能减少造成对额叶造成损伤的原因之一。他还说,另外一个原因可能是婴儿早期受到虐待。如果婴儿被反复摇晃,连接前额皮层的白神经纤维就会断裂,从而前额皮层与大脑其余部分的联系也断开,导致一些神经细胞的衰退。所以问题就是我们应该怎样防止婴儿在早期受到虐待Raine告诉WebMD网说,虽然现在医治患有APD的成年人几乎没有什么希望,但我们已经知道十年内我们会把第一块微芯片植入人脑代替大脑中与情感和记忆有关的海马区,并且科学家正在试验植入微芯片代替其他受损害的大脑组织。所以在十五到二十年之内我们应该可以为这些大脑组织受到损伤的人做些事情
    重要信息:反社会人格紊乱(APD)是一种经常发生在连环杀手和有暴力侵略性倾向和冲动危险的人物身上的一种心理疾病。 研究人员发现患有APD的人大脑前额皮层的某种组织减少了11%-这一脑区与情感,激发,注意力,良知道德和自制有关。 这一脑区受到损伤的原因究竟是什么,答案包括环境因素如出生时的并发症,和婴儿在早期受到虐待。

 

How Emotions Strengthen Memory
James L. McGaugh, Ph.D.
California
     From both human and animal studies, we know that a certain class of anxiety-reducing drugs called benzodiazepines (Valium and Halcion, for example) impair memory consolidation. Other classes of drugs have the opposite effect and can enhance memory, but only if they are administered shortly after learning, when memory consolidation is occurring. If the injections occur more than six hours after training, memory is not enhanced.Both kinds of drugs work on the same receptors in the basolateral nucleus of the amygdala, receptors for the inhibitory neurotransmitter GABA, which blocks the firing of the receiving neuron or moderates the strength of its firing. The amnesia-inducing drugs are GABA agonists: they act like GABA itself to activate the GABA receptors. The memory enhancing drugs are GABA antagonists: they block activation of the GABA receptors.
    Memory also is enhanced by hormones that are released when we experience stress. This explains why emotional arousal has such a powerful influence on how well we remember things. When the brain senses danger, the instant fight-or-flight response involves the hypothalamus sending signals along the sympathetic nervous system to the adrenal glands, specifically to the adrenal medulla, which secrete the hormones epinephrine (also called adrenaline) and norepinephrine into the blood stream. Adrenaline raises the heart rate; norepinephrine raises blood pressure.If the threat continues for more than a few seconds, the HPA (hypothalamus-pituitary-adrenal) axis is activated. The hypothalamus releases a hormone called CRH (corticotropin releasing hormone), which stimulates the pituitary gland to secrete ACTH (adrenocorticotropic hormone), which in turn stimulates the outer part of the adrenal glands, the adrenal cortex, to produce cortisol. Cortisol, among other things, increases the supply of blood glucose to make more energy available, enabling the fight and/or the flight. Both epinephrine and cortisol play a very powerful role in regulating the strength of memory by regulating the release of norepinephrine in the basolateral nucleus of the amygdala.
    Even though the amygdala is crucial to the consolidation of emotional memories, it is not the site of long-term storage of the memories. Animal studies show that when animals are trained with mild foot shocks (a sufficiently negative experience to induce the stress response) and then have their amygdalas inactivated by injections of lidocaine, they can still perform the training task; their memory is not affected.We know from human experiments that the strength of a memory is regulated by the significance of the experience. The regulation involves the release of stress hormones. In one experiment, two groups of subjects were read a story and shown a series of slides. They all saw the same slides, but they heard two different stories. One story was flat and neutral; the other story matched it except for an emotionally arousing description in the middle.Two weeks later, the subjects were asked to state what they remembered of the slides. The group that heard the neutral story remembered the slides from all parts of the story equally well (or poorly); there was no difference in recall of the slides from the beginning, middle, or end of the story. The other group, however, had significantly enhanced recall of the slides in the middle, the ones they were looking at when they heard the emotionally arousing description.
    In a subsequent experiment, half the subjects were given a beta blocker (to block epinephrine effects) before the experiment started. For those who heard the neutral story, the beta blocker made no difference in their recall of the slides. But in those who heard the emotional story, the beta blocker completely blocked the arousing effect of emotion on memory, preventing the memory from becoming strong.These results have clear implications for people who are plagued by vivid memories of a trauma and are suffering from post-traumatic stress disorder. pharmaceutically--blocking the effects of stress hormones in the brain. If we can reduce the emotional charge of the memory of an assault or an accident, we can reduce the long-term anxiety.When the connection between emotion and memory works well, the results are very satisfying: we remember the important and good things that we want and need to remember.

 When the system is overworked, we may remember too much, or too intensely, and the result may be debilitating.

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