超越认知与情感:在成瘾框架内分析神经性厌食症

IF 1.8 Q2 PSYCHOLOGY, MULTIDISCIPLINARY
Nevia Dolcini
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引用次数: 0

摘要

厌食症被广泛认为具有认知和情感两个层面。目前的研究通常通过强调厌食症的认知因素(尤其是与否认患者实际情况相关的错误信念)或情感因素(如对体重增加的强烈恐惧)来解释与这种饮食失调症相关的令人困惑的行为。我将论证这两种方法都不足以完全概括神经性厌食症的复杂性。本文探讨了一种更全面的方法,这种方法超越了认知与情感的二分法,更符合 DSM-5 关于神经性厌食症的标准。这些标准表明,虽然情感和认知因素都起着重要作用,但认知因素和情感因素都不是单独定义厌食症的必要或充分条件。我建议通过与成瘾进行类比来实现这一点,因为这两种病症都可以被看作是源于并由一种贯穿个人生活并深刻影响其行为的全然固着所维持的。在神经性厌食症中,这种固着表现为对体型和体重的普遍关注。这些行为的不同之处在于其内在的自我认可,这与有充分证据表明的神经性厌食症的自我同步性相一致:患者认为这些行为与他们的情感、价值观和理想相一致,从而使他们抗拒改变。在成瘾的框架内理解神经性厌食症,尤其是认识到自我同步固着的关键作用,可以更全面地看待这种疾病,从而揭示其治疗的高阻力以及临床干预所面临的挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Beyond Cognition and Affect: An Analysis of Anorexia Nervosa within the Framework of Addiction

Anorexia Nervosa is widely recognized as having both cognitive and affective dimensions. Current accounts typically explain the perplexing behaviors associated with this eating disorder by emphasizing either its cognitive components—particularly false beliefs related to the denial of the patient’s actual conditions—or its affective components, such as the intense fear of gaining weight. I will argue that neither approach is sufficient to fully capture the complexity of Anorexia Nervosa. This paper explores a more comprehensive approach that goes beyond the cognition-affect dichotomy, aligning better with the DSM-5 criteria for Anorexia Nervosa. These criteria suggest that while both affective and cognitive components play significant roles, neither the cognitive element nor the affective element is necessary or sufficient to define the condition on its own. I propose that this can be achieved by drawing an analogy with addiction, where both conditions can be seen as stemming from and maintained by an all-consuming fixation that permeates individuals’ lives and profoundly influences their behaviors. In Anorexia Nervosa, this fixation manifests as a pervasive preoccupation with body size and weight. What distinguishes these behaviors is their internal self-endorsement, aligning with the well-documented ego-syntonic nature of Anorexia Nervosa: sufferers perceive these behaviors as consistent with their feelings, values, and ideals, making them resistant to change. Understanding Anorexia Nervosa within the framework of addiction, particularly by recognizing the pivotal role of ego-syntonic fixation, allows for a more comprehensive approach to the disorder that sheds light on its high resistance to treatment and the challenges faced in clinical interventions.

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来源期刊
Review of Philosophy and Psychology
Review of Philosophy and Psychology PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
4.70
自引率
5.00%
发文量
60
期刊介绍: The Review of Philosophy and Psychology is a peer-reviewed journal focusing on philosophical and foundational issues in cognitive science. The aim of the journal is to provide a forum for discussion on topics of mutual interest to philosophers and psychologists and to foster interdisciplinary research at the crossroads of philosophy and the sciences of the mind, including the neural, behavioural and social sciences. The journal publishes theoretical works grounded in empirical research as well as empirical articles on issues of philosophical relevance. It includes thematic issues featuring invited contributions from leading authors together with articles answering a call for papers. The Review of Philosophy and Psychology is published quarterly and is hosted at the Jean Nicod Institute, a research centre of the French Centre National de la Recherche Scientifique. It was formerly published as the "European Review of Philosophy" by CSLI Publications, Stanford.
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