寻找镜中的自我：精神分裂症患者的视觉观点采择

精神分裂症患者的视觉观点采择影响其必要的社交活动和生活质量。本文通过对精神分裂症患者视觉观点采择的研究进行梳理，总结出相关的心理特点：精神分裂症患者的视觉观点采择过程受损，表现出自我中心性和他人中心性。在神经生理上表现出与视觉观点采择相关的脑区激活减弱。可能的原因是患者认知功能中反应抑制能力和心理旋转能力的受损所致，建议采用认知干预疗法可能会改善患者的视觉观点采择能力。目前的研究论证了精神分裂症患者视觉观点采择过程的损伤，对于不同水平的视觉观点采择下精神分裂症患者的认知模式还未有明确的定论，未来的研究可以从该角度入手，更加明确精神分裂症患者不同水平视觉观点采择的特点和神经生理活动。

Visual Perspective Taking of Patients with Schizophrenia

Visual perspective-taking (VPT) is ability predict the visual experience of another agent (their meaning, intentions, desires, and knowledge). It could help people to understand others’ standpoint, thereby increased relations with others. VPT is typically divided into one of two dimensions: one that simply assesses what someone else can see (“Level 1” perspective taking), and another that requires participants to adopt someone else’s spatial point of view to judge how that person sees a particular visual stimulus (“Level 2” perspective taking). If someone lose the ability of VPT, symptoms characteristic of psychopathy may occur, such as delusion, hallucination. Social function of patient with schizophrenia would influence by VPT. The present study analyzed the mental mechanisms and neural mechanism of VPT in patient with schizophrenia. The result showed that the ability of VPT in patient with schizophrenia have certain defects. More concretely, in VPT task, patients with schizophrenia display increased egocentric intrusion and decreased altercentric intrusion compared to controls, it means patients may failure to inhibit one’s own perspective when trying to take another’s. It fit the core symptom of self-disorder model of schizophrenia, hyper-reflexivity, refers to an exaggerated self-consciousness, a tendency (fundamentally nonvolitional) for focal attention to be directed toward processes and phenomena that would normally be “inhabited” or experienced (tacitly) as part of oneself. The process of VPT usually need the synergy work with right temporo-parietal junction, ventral medial prefrontal cortex and ventral precuneus. Patients with schizophrenia showed revealed hypoactivity in the medial prefrontal (anterior cingulate) and orbitofrontal cortices during VPT trials compared to control trials relative to healthy controls. It would manifest disruptions are present in the most fundamental aspects of VPT in patients with schizophrenia, and that these disruptions impact higher-order social information processing. There are two possible factor that could influent the VPT of patients with schizophrenia. Accumulating evidence suggests that patients with schizophrenia exhibit deficits in response inhibition. During VPT, patient may could not suppress an irrelevant response or impulse from self. As a concrete manifestation of extremely egocentric intrusion when need to take others perspective. The deficit would affect both level 1 and level 2 VPT. On the other hand, VPT also need the ability of mental rotation, it may only affect level 2 VPT, because of level 2 VPT requires participants to adopt someone else’s spatial point of view to judge how that person sees a particular visual stimulus. Patients with schizophrenia have been proved deficit in mental rotation task, they showed lower responses and poorer accuracy compared to control group. Exhibit and mental rotation are considered an important component of executive function and influences daily functioning. The ability of VPT could be improve if the ability of exhibit and mental rotation were improved. At present, cognition training is an effective means which could improves cognitive function (e.g., exhibit, mental rotation) of patients with schizophrenia. Future studies should explore the effect of cognition training on VPT in schizophrenia and adopt neuro-physiological methods to explore other factor which may affect the ability of VPT in patients with schizophrenia.