Импульсивность при шизофрении: феноменология и подходы к исследованию

Импульсивность при шизофрении не является единым феноменом как на уровне поведен-

ческих проявлений, так и с точки зрения психологических механизмов и биологических оснований, которые их обеспечивают. В статье рассматриваются различные подходы к изучению импульсивности, и на основании особенностей метода и объекта исследования выделены три ее типа: импульсивность как аспект клинического состояния, импульсивность как личностная характеристика и импульсивность, выявляемая в эксперименте. Импульсивность в клиническом смысле чаще всего проявляется в виде немотивированных вспышек агрессии и разрядки аффекта, а также может быть следствием психотической симптоматики.

Основанием для квалификации служит информация, полученная от пациента и его родственников и

в ходе наблюдения; для стандартизованной оценки используются специализированные шкалы. Импульсивность как личностная характеристика изучается главным образом при помощи шкал, опирающихся на субъективную оценку (самоопросников), и описывает различные аспекты личности и когнитивного стиля, связанные с импульсивным поведением. По результатам исследований, в группе пациентов с шизофренией могут быть обнаружены как более высокие показатели субъективной импульсивности, так и сопоставимые с нормативными данными. Третий тип — это импульсивность, выявляемая в ходе контролируемого эксперимента, условия задачи которого провоцируют те или иные проявления импульсивного поведения. Данные в отношении больных шизофренией по исследованию импульсивности в экспериментальной парадигме также неоднозначны. В статье обсуждаются взаимосвязи между различными типами импульсивности и возможные подходы к терапии и коррекции ее проявлений в клинике шизофрении.

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