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Pensamiento metafórico en pacientes con psicosis

ABSTRACT Artículo original RESUMEN El pensamiento es la más compleja de las funciones mentales, puede entenderse como un proceso de asociación de ideas, que ocurre de acuerdo con distintas leyes, por ejemplo las que gobiernan las relaciones causa-efecto, que son incorporadas a la psicofisiología de un sujeto mediante procesos de aprendizaje. Sin embargo, existen maneras alternativas de realizar el proceso de asociación de ideas, por ejemplo mediante analogías, como ocurre en el caso del pensamiento meta-fórico, que tiene una faceta expresiva (formulación de metáforas) y una faceta interpretativa (identificación e interpretación de metáforas). Algunos estudios clínicos sugieren que en los pacientes con esquizofrenia podría existir una significativa dificultad para la interpretación de metáforas, quizás relacionada con los trastornos del contenido y la forma del pensamiento. Este estudio reporta la construcción de un instrumento clínico para evaluar las capacidades de procesamiento de metáforas y su aplicación en pacientes con trastornos psicóticos. ABSTRACT Human thought is the most complex mental function. It may be understood as an associative process involving images and verbal thoughts, according to certain laws, for instance those that rule the cause-effect relationships, which are incorporated to the individual psychophy-siology by means of learning processes. However, there are alternative ways to associate ideas, i.e. by means of analogies, as in the case of metaphors. Metaphorical thought has an expressive function (metaphor formation)

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    ABSTRACT: A main feature of schizophrenic thought and language disturbance is concretism, the inability to understand the figurative meaning of proverbs and metaphors. Although this is routinely tested during clinical interview, its neural basis is unknown. We investigated processing of metaphoric sentences with functional magnetic resonance imaging (fMRI) in 12 patients with schizophrenia and 12 control subjects. Stimuli consisted of 60 novel short sentences with either metaphoric or literal meaning presented visually, intersparsed by a low level baseline (grey background). Subjects read these sentences silently and judged by button press whether they had a positive or negative connotation. Reading metaphors in contrast to literal sentences revealed signal changes in the left inferior frontal gyrus in the control subjects (BA 45/47) and an area 3 cm dorsal to that in the patients (BA 45). Only activation in this area was negatively correlated with the severity of concretism rated with the PANSS. Comparison between groups for the contrast metaphors vs. low level baseline revealed stronger signal changes in the control group in the right superior/middle temporal gyrus (BA 39) and the left inferior frontal gyrus (BA 45) in the patients. The results in the control subjects are in line with studies showing an involvement of the left inferior frontal and right lateral temporal cortex during context processing. Failure to recruit these areas in the patients may underlie schizophrenic concretism.
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Jun 1, 2014