心理学导论梁宁建教授经典语录
1.（学思维那一章里的推理的时候）人都是会死的，那么现在站在华东师大正门口那个穿蓝色衣服的男人&&必死无疑！！！（我们笑）笑什么！我们都是殊途同归的！但是，我一定比你们早死，对吗？（梁老师笑）&&那可不一定啊&&
2.所以我的观点，一定不要打游戏！打游戏有什么用呢？它只会激发人的劣根性，会耽误你的个人成长。（梁老师万分痛恨当今的电视电影游戏以及音乐产业，一有机会就跟我们灌输不要看电视打游戏的观念）
3.现在你们不打游戏了，去偷菜！！！（然后我们狂笑&&）
4.&&男生女生塞的那些表达情感的纸头&&（我们一致怀疑梁老师当年也干过这类塞纸条的事情，要不然他怎么这么清楚！！！）
&&& 你们以后都会写一些纸头,写什么呢?某某?&哎呀不好不好&亲爱的某某?哦哟不好不好&某某同学？哎哟太不好啦&(我们笑抽了)笑什么啦,记住,根据抑制理论(复习一通)&所以开头结尾一定要好好写,中间的其实都记不住的..不相信试试看咯&(严肃的)不光是写小纸头哦&
5.鸟的本质是什么？是会飞不啦？是有羽毛不啦？要是会飞的话，那飞机会不会飞？飞机是鸟吗？要是有羽毛的话，那鸡毛掸子是鸟吗？（我们沉默）&&&&好，鸟的本质，同学们可以参考大英百科全书。那么，人的本质是什么呢？（我们继续沉默）这就是我们学心理学的同学需要自己去悟的道理了！（他几乎每讲一章之前都要重复这个问题&&）
6.学心理学的人知识要渊博！
7.当今市场上泛滥的心理学是心理学吗？不是！！！那是伪科学！！！（他这话攻击了星座，血型，以及什么趣味心理测试，导致我们现在一看到有人在看星座书或讨论星座血型就窃笑&伪科学&，虽然我们自己仍然乐此不疲&&）
8.心理学专业的人要对人好奇！（这句话还挺正常，然后他停了一会儿）&&不是只对异性好奇！！！（我们。。。。。。）
9.人一辈子恋爱只有一次！其他的，那不叫谈恋爱，叫谈朋友。所以哦，你们要多谈朋友。
10.你在恋爱的时候一定要慎重，因为你是在挑选相伴终生的伴侣。
11.车的特征是什么？有轮子吧！那么磁悬浮交通工具就不叫车了，因为它没有轮子。磁悬浮交通工具应该叫什么呢？（冷场）叫磁悬浮交通工具！！！（我们&&）
12.这个人要是&&（代表某些不正常举动），就说，他该到零陵路去了！（零陵路６０４号是上海精神卫生中心&&）
13（不正常的人类）那么，这个人就有有三条路可以走，一条，就是零陵路，一条，就是万青松路，一条，就是绝路&&（万青松路是上海的监狱集中路）后来，这句话被我们改成了一条是零陵路，一条是万青松路，一条，就是我们的文科大楼（华师大文科大楼，跳楼绝佳圣地，曾经还有人专门来到华师大文科大楼来跳楼）
14 所以你们啊，学了记，记了背，背了考，考了忘，忘了再学。学再记，记再背，背再考，考再忘&所以要命不啦,还美其名曰活到老学到老(每节课必讲)
15 心理学&好难哟~~~失眠,看导论;严重失眠,读导论;失眠得不行了,学导论
还有众多只能口述不能光用文字的&呵呵
16，&&所以哦，我只喝茶叶水（然后淡定的喝了一口茶叶水&）
17,三轮车好骑,好难哦，我骑着骑着就骑到丽娃河边上了，同学把我拉回来了，我再骑，又骑到丽娃河了,还好没有掉下去&（笑抽）
18.（在讲到记忆时）你们都碰到过的咯,在地铁上，上来一个人，&啊，你好你好，&（语风一转，很严肃）&他是谁&，&哎呀，好久不见，身体好哇&(语气又转)&他到底是谁&
19.不要把我的话发到网上，仅代表个人观点！
分享这篇日志的人也喜欢
又重来！！第二次！新人新人求关注
逗姐首秀，怼起来吧
分享每天求关注
今天能不能过试播捏~~
热门日志推荐
人人最热标签
北京千橡网景科技发展有限公司：
文网文[号··京公网安备号·甲测资字
文化部监督电子邮箱：wlwh@··
文明办网文明上网举报电话： 举报邮箱：&&&&&&&&&&&&
请输入手机号，完成注册
请输入验证码
密码必须由6-20个字符组成
下载人人客户端
品评校花校草，体验校园广场心理学入门书籍
核心提示：近年来，心理问题越来越成为社会关注的热点，追求幸福的现代人不时需要求助于心理学，国内心理学的高等教育与研究也迎来了发展的新阶段。在这个背景下，“心理学”图书——无论是专业的还是通俗的，出版量非常巨大。应一些朋友的需求，现介绍一篇心理学入门书籍导读文章，以供心理学爱好者作为阅读参考。
　　近年来，心理问题越来越成为社会关注的热点，追求幸福的现代人不时需要求助于心理学，国内心理学的高等教育与研究也迎来了发展的新阶段。在这个背景下，“心理学”图书——无论是专业的还是通俗的，出版量非常巨大。应一些朋友的需求，现介绍一篇心理学入门书籍导读文章，以供心理学爱好者作为阅读参考。
　　心理学导论
　　心理学发展至今，内容已经极为丰富。为了对心理学有全面的了解，最好从一本心理学导论或普通心理学入手。
　　《心理学与生活》是一本优秀的、经典的心理学教科书，不仅在美国，在全世界许多国家的心理学界都有着极高的知名度。
　　《心理学导论——思想与行为的认识之路》(中国轻工业出版社，2004)，是另一本美国著名心理学教科书。本书译自原著最新修订的第9版，并由中国科学院心理研究所人员组织翻译。
　　这两本书都是大部头，但写得深入浅出，贴近生活，同时其内容又都包含最新研究成果和学科前沿信息，实为心理学爱好者最佳的入门书。
　　《心理学——一条整合的途径》(上、下)(华东师范大学出版社，2001)，是在英国心理学家M.W.艾森克主持下由众多专家参与完成的。这本名著侧重对欧洲心理学的发展与贡献做介绍，因而可以给读者提供另一个视角。
　　《普通心理学》(北京大学出版社，2003年)，这本由孟昭兰主编的教材自1994年第一版问世后，迄今已多次印刷，是深受欢迎的国内普通心理学教材之一。
　　台湾张春兴著的《现代心理学》(上海人民出版社，1994)
　　崔丽娟等著的《心理学是什么》(北京大学出版社，2003)对普通读者而言亦是一本很不错的入门读物。
　　心理学史
　　《心理学史导论》(上、下)(华东师范大学出版社，2004)，这本由B.R.赫根汉所著的心理学史详细考察了心理学的起源，对西方各种心理学思想及流派做了全面描述。
　　在国内，著名心理学家车文博的专著《西方心理学史》(浙江教育出版社，1998)，可基本代表国内这方面研究的最新水平。
　　张春兴著《心理学思想的流变——心理学名人传》(上海教育出版社，2002)则从心理学名人传角度入手，介绍了西方心理学思想的流变。
　　而墨顿·亨特的《心理学的故事》(海南出版社，1999)，更是把心理学名人作为故事中的人物，以故事的形式把心理学的发展历史讲得生动有趣。
　　上个世纪还出过几本这类书籍，如黎黑的《心理学史》(浙江教育出版社,1998)，波林的《实验心理学史》(商务出版社，1981年)，柯瓦奇的《近代心理学历史导引》(商务出版社，1980年)等。
　　中国心理学思想史方面，可以阅读《中国心理学史》(浙江教育出版社，1998年)。作者按照对历史上心理学思想家或及其著作加以剖析的方式详细描述了中 国古代心理学的发展历程，并对中国近现代心理学发展史及其背景作了深入的分析。《心理学通史》(山东教育出版社，2000年)，此套书共五卷，其中一、二 卷是中国古代及近代心理学思想史。
　　工具书
　　《中国大百科全书》(心理学卷)(中国大百科全书出版社，1994)，由300多位专家、学者编纂而成，内容全面，书中关于中国心理学史、汉字心理学等方面的条目，突出了中国特色。 而由我国著名心理学家林崇德、杨治良和黄希庭三位教授领衔编纂的《心理学大辞典》上海教育出版社，2003则是目前为止国内收词规模最大、内容最新的一部心理学专科辞典，可以反映出心理学前沿动态。
　　新世纪版《国际心理学手册》(上、下)(华东师范大学出版社，2002)由世界多国的著名学者共同完成，可反映国际水平的权威性工具书，是献给2004年在中国北京召开的第28届国际心理学大会的一份厚礼。 心理学的分支
　　心理学理论研究涵盖面很广，由此形成了众多的基础心理学分支，如感觉心理学、记忆心理学等等。在这些分支中，人格心理学是心理学中系统探讨人性的心理学分支，普通人比较感兴趣。
　　在这方面，《人格心理学》(中国轻工业出版社，2000)内容新颖而全面，引人入胜。
　　译著《人格科学》(华东师范大学出版社，2001)作者使用了人格研究专题为结构的布局，很值得推荐。
　　发展心理学是一般读者感 兴趣的另一心理分支。这方面既有比较全面的论著《人生发展心理学》(学林出版社，1997)与《发展心理学与你》(北京大学出版社，2000)，也有仅取 人生发展某一阶段的论著，如孟昭兰著的《婴儿心理学》(北京大学出版社，2001)等。岳晓东著的《少年我心——一个心理学者对自我成长的回顾与分析》一 书记述了作者中小学的一些往事并加以心理分析，是一本独具特色的读物。
　　智力也是人们普遍关注的话题。在这方面，华东师范大学出版社引 进了两本可反映最新智力理论进展情况的学术名著：《超越IQ——人类智力的三元理论》(2001)，《认知过程的评估——智力的PASS理论》 (2001)。世界畅销书《情感智商》(上海科学技术出版社，1997)则拓宽了智力的内涵。
　　情绪心理学方面有辽宁人民出版社引进的 《情绪心理学》(1987)与国内著名心理学者孟昭兰著的《人类情绪》(上海人民出版社，1989)可做推荐。意识心理学方面一本综合性的新作是人民出版 社推出的《意识与大脑——多学科研究及其意义》(2003)，另外《大脑如何思维——智力演化的今昔》
　　(上海科学技术出版社，1996)、《动物有意识 吗?》(北京理工大学出版社，2004)等都是很好的科普读物。在记忆心理学方面，既有一些如何提高记忆的通俗读物如《记忆术：心理学发现的20种记忆妙 法》
　　如果您对这篇文章感兴趣，相信你会对PSYTOPIC同样感兴趣，网址是 ，这次点击不会浪费您的时间。这是Psytopic的指纹密码：aHR0cDovL3d3dy5wc3l0b3BpYy5jb20v，您可以凭这个指纹在google搜索到我们的网站。
　　(中国青年出版社，1998)等，又有专著如《记忆心理学》(华东师大出版社，1999)，此外还有一本非常耐读的关于记忆的科普读物《找寻逝去的自 我：大脑、心灵和往事的记忆》(吉林人民出版社，2001)，此书对人类记忆的最新研究进展做了翔实而富有趣味的阐释。
　　在社会心理学方面，时蓉华著的《现 代社会心理学》(华东师范大学出版社，1997)是比较流行的教材之一。教育心理学方面已有了一本相当出色的引进书：《教育心理学：理论与实践》 (2004)，人民邮电出版社引入的是原著第7版。宗教心理学方面的书籍以《宗教心理学》(四川人民出版社,1992)内容最为详尽。
　　弗洛伊德
　　西方现代心理学在发展过程中，产生了众多的流派和学说，迄今为止，多途径研究仍是现代心理学的现状。这其中以精神分析学派、行为主义、人本主义心理学影响最大，被称为心理学的三大主要势力。
　　精神分析由弗洛伊德开创，其后被不断修正与发展，影响力远远超出心理学，所以读者群相应更为广泛。《精神分析引论》(商务出版社，1995)，是弗洛伊 德本人对其前期精神分析理论的一个精要总结，可以作为了解弗洛伊德本人观点的最佳入门。《释梦》(商务出版社，2001)是弗洛伊德最有影响力的经典著 作，为深入了解弗洛伊德之必读。近年来翻译弗洛伊德著作最成规模的是长春出版社的《弗洛伊德文集》(2004)全八册。
　　弗洛伊德的传记可以看欧文·斯通的《心灵的激情》(上、下)(中国文联出版公司，1986)，该书属于传记小说，内容翔实而且可读性强。另一本比较注重阐述弗洛伊德思想的传记是由高宣扬编著的《弗洛伊德传》(自华书店，1986)，这是繁体版，不容易买到。
　　要想对弗洛伊德的思想有清晰的认识，还可以读几本介绍其思想的著作。查尔斯·布伦纳所的《精神分析入门》(北京出版社，2000)概括了弗洛伊德的基本 思想与精神分析的主要内容，阐述明确贴切，在同类书中极为难得。《弗洛伊德和马克思》(中国人民大学出版社，2004)，阐述了精神分析学与马克思主义的 关系。书虽写于上世纪30年代，却仍不失其价值。
　　荣格与荣格学派
　　《东洋冥想的心理学——从易经到 禅》(社会科学文献出版社，2000)，是荣格几篇文章的合集。《分析心理学的理论与实践》(三联书店，1991)，《寻求灵魂的现代人》(贵州人民出版 社，1987)出版时间都较早。前者是荣格的演讲集，是了解荣格前期思想的不错的入门书。
　　荣格传记以荣格自传《回忆、梦、思考》(辽 宁人民出版社，1988)为最佳。《荣格的生活与工作——传记体回忆录》(东方出版社，1998)，作者芭芭拉·汉是荣格的女弟子，仰视的成份多了些。另 有刘耀中著的《建造灵魂的庙宇——西方著名心理学家荣格评传》(东方出版社，1996)，温森特·布罗姆著文楚安译的《人与神话》(新华出版社， 1997)可作参考。
(实习编辑：张曼)
分享到微信朋友圈
“扫一扫”分享
女性在孕期情绪上的“癫狂”多少和体内荷尔蒙的变化有关，因为那个小家伙也要算是个“外来异物”，心理上的接受与排斥会同时存在。为了让宝贝成长顺利，丈夫帮助妻子通过发泄来达成情绪的舒缓是非常重要的。
约会是谈情说爱的一种浪漫方式，爱情也常因约会而不断升温。但在约会恋爱中的男女总会不断地猜测对方的心思，其实，对方的每一个细微的动作和表情，都能反映出对方的内心世界，与其盲目猜测，何不留意对方的表情及其肢体语言？
你有没有发现，在公交或地铁里似乎每个人的火气都很大，即便平时脾气很好的人，也容易因芝麻大的小事而大动肝火。西装革履的帅小伙在地铁里因为被挤了一下与人大打出手，白衣飘飘的淑女在公交车上因抢座而与人恶语相向。
六一儿童节是充满欢声笑语的一个节日，它的专属性会…… []
饮茶也是一门学问，不仅要分季节饮茶，还要依据个人…… []
肺功能失常是一种很常见的健康现象，肺功能失常引起…… []
乳头内陷怎么办？乳头内陷日常要注意这样护理。…… []
每年11月中旬左右，北方地区都会开始室内供暖，但随…… []
自立秋以来小编跟大家介绍过几道关于胡萝卜以及山药…… []
本期是由三公仔小儿七星茶联合39育儿为您推出的参与…… []
随着人们对心理健康问题的关注和重视，越来越多的人在出现情绪问题和心理压力而又无法自我宣泄时，选择向心理咨询专业医师求助。可是由于心理咨询行业尚属新兴行业，很多求助者并不了解心理咨询专业医师的判断标准，精神健康网特别为有心理咨询意愿的朋友搜集了相关的辨别标准，希望为心理咨询专业医师的选择提供一些参考。小木虫 --- 700万学术达人喜爱的学术科研平台
热门搜索：
&&求助~~！投过《应用心理学》杂志的亲~编辑部收到稿件后会给文章编号吗？？
求助~~！投过《应用心理学》杂志的亲~编辑部收到稿件后会给文章编号吗？？
如题~！本人心理学研一学生，第一次投稿，恳请各位哥哥姐姐的帮助~~2个月前向《应用心理学杂志》投稿，至今一点音讯都没有。问下投过该杂志的亲，这个杂志编辑部收到纸质稿后会以电子邮件的形式通知文章编号之类的吗？？万分感激~~~:hand:
谢谢前辈的经验！确实觉得他们不怎么正规呢~！如果我现在改投其他杂志的话，是不是要给他们编辑部发邮件问下具体情况哇？
其实问也白问，他们一般不回。不过你最好还是给他们邮箱发个邮件，就说已经改投它刊了，这样即便以后（当然以后到什么程度也不好说了）他们忽然想起来还有这么一篇文章的时候追问起来，你也好解释说已经发邮件说明情况了。
好好，谢谢！！
学术必备与600万学术达人在线互动！
扫描下载送金币
北京学而思教育科技有限公司 地址：北京市海淀区北三环甲18号中鼎大厦A座1层102室 电话：010-登录 | 注册
没有账号？
下次自动登录
心理学导论 中英字幕 [第18课]当事情不顺的时候会发生什么事情：精神病 第一部
我很高兴为大家介绍本学期第四个也是最后一个I am extremely pleased to introduce the fourth and final guest lecture客席讲座of the semesterSusan Nolen-Hoeksema教授Professor Susan Nolen-HoeksemaSusan是心理系的教授Susan is a professor in the Department of Psychology研究生院的主任and the Director of Graduate Studies她在临床心理学的研究非常著名She is well known for her work in clinical psychology尤其是对抑郁症的研究and especially her research in depression抑郁症的性质和病因the nature and causes of peopl...
我很高兴为大家介绍本学期第四个也是最后一个I am extremely pleased to introduce the fourth and final guest lecture客席讲座of the semesterSusan Nolen-Hoeksema教授Professor Susan Nolen-HoeksemaSusan是心理系的教授Susan is a professor in the Department of Psychology研究生院的主任and the Director of Graduate Studies她在临床心理学的研究非常著名She is well known for her work in clinical psychology尤其是对抑郁症的研究and especially her research in depression抑郁症的性质和病因the nature and causes of people with depression她尤其专注于研究抑郁症的性别差异with special focus on sex differences in depression几乎方方面面她都有所涉猎She basically does everything someone can do她是一个著名的科学家 获奖良多She is a noted scientist, winning many awards在科学期刊上发表了大量的著作and publishing massive amounts of work in scientific journals她是一个获奖的教师 她写过She is an award-winning teacher and has authored她的研究领域里我认为最好的教科书what in my mind, is the very best textbook in her area她是一个著名的畅销作家 她写的书很受欢迎And she's a noted popular writer who has written popular而且通俗易懂 把临床心理学的and accessible books bringing the message and ideas消息 想法和理论带给普罗大众and theories of clinical psychology to the broader public在我们欢迎她之前 我还有一件事要说The only other thing I'll mention before we welcome her明年她将会开一门临床心理学的课is that she's going to teach next year her course in clinical psychology这门课以有趣生动著称which has a superb reputation as an extremely interesting course如果你对今天的内容有兴趣If you are interested in what you hear today想深入了解的话and you want to learn more about it你应该报这门课that's the course you should take现在 请大家欢迎Susan Nolen-Hoeksema博士So, let's please welcome Dr. Susan Nolen-Hoeksema谢谢你 保罗 大家听得到吗? 很好Thank you Paul. Can everybody hear me okay? Okay今天我想为大家简单介绍一下So, what I want to do today is to give you a very brief overview现在临床心理学是如何研究精神疾病的of how modern clinical psychology looks at mental disorders我们如何界定精神病some of the ways we think about what constitutes a mental disorder以及精神病普遍具有的特征some of the characteristics that kind of cut across mental disorders然后我会讲一些情绪障碍的病例and then I'm going to use the case of mood disorders包括抑郁病 以及现称的两极型异常that is depression and what is now called bipolar disorder它另一个更为流行的名字是躁狂抑郁症what you may know more popularly as manic-depression我会借这些例子告诉大家 我们是怎么看某一类as sort of examples of how we think about a particular set精神病的 以及我们研究理论的一些方法of disorders and some of the ways we go about researching the theories精神病的各种理论 以及现今一些精神病的different theories for the disorders and some of the prominent treatments主要疗法 明白吗?for disorders these days. Okay?所以我既会讲很多内容So, I'm going to do both a fair amount of lecturing然后还会让大家看很多视频and then I've got lots of video clips to show you as well所以我会在各个话题间切来换去So, I'm going to be roaming around and changing venues here fairly often在临床心理学 第一个也是最基本的一个问题是So, the first and most fundamental question in clinical psychology is"什么是变态?""What is abnormality?"我们如何界定什么是正常 健康 典型行为Where do we draw the line between normal, healthy, typical behavior什么是变态 非典型 异常 不健康and what we might want to call abnormal, atypical, deviant, unhealthy适应性差的精神问题?maladaptive mental problems?我们通常都会觉得 我们所说的变态We tend to have an intuitive sense of what we mean by abnormality我们都以为…很多来听我的课的同学会说and we'd like to believe--a lot of people who come into my course say"你们当然已经研究出来了"Well, of course, you know, you guys have figured it out你们知道怎么界定 你们有判断标准You know where to draw the line. You have criteria你们会检查血液You have blood tests, right?这样就能查出我有没有抑郁症或精神分裂that tell me whether I have depression or schizophrenia或者其他我听说过的病"or one of the things I've read about."事实上 我们没有Well, the reality is that we don't首先 目前已知的所有精神病First of all, there is no biological test都没有生物测试for any of the known mental disorders right now我们只有一套行为标准And instead what we have is a set of behavioral criteria来判定各种精神病for how to diagnose different mental disorders我所说的行为标准是指And what I mean by behavioral criteria is a set of symptoms病人跟你说的一系列症状 他们有什么感觉that the person reports to you about how they feel他们有什么思想 以及对他们行为的一系列观察how they think, and a set of observations about their behavior观察什么是典型的 什么是非典型的and how typical or atypical it is你用这个人表现出来的 或者跟你说的And you take the sort of set of symptoms the person一系列症状 然后用它们shows or reports, and you match them up跟现存的各种精神病标准作对比against the existing criteria for different mental disorders而这个人符不符合这些标准And then it comes down to a fairly subjective judgment call最终是要由一个很主观的判断来决定的about whether the person meets the criteria or not很不幸 这些判断Unfortunately, these judgment calls因为它们太主观because they are so subjective可能会受到很多因素的影响can be influenced by a lot of factors我们今天没有时间深入讲这些因素And we won't have a chance to go into these too much today但我会简单提几个but just to highlight a few of them第一个是社会规范The first is social norms你会不会被打上精神病或者精神问题的标签Whether you get labeled as having a mental disorder or a problem很大程度上决定于你的社会和文化规范depends very heavily on what your social or cultural norms are所以 在穆斯林社区或文化中 女人戴面纱So, a woman wearing a veil in a Muslim community or culture会被视为一种典型甚至规定的行为would be seen as typical, even prescribed, behavior但在非穆斯林文化里 一个女人戴面纱Whereas a woman wearing a veil in a non-Muslim culture尤其是最近几十年especially until fairly recently会被视为一个非典型或者变态行为was often looked upon as very atypical or abnormal behavior第二个The second kind of thing that gets影响我们判断是正常还是变态的因素that influences whether something is called normal or abnormal就是目标对象的某些特征is certain characteristics of the target person例如 我这里高亮出来的 性别In particular, I've highlighted here, gender你的性别真的能决定Whether you're a man or you're a woman really influences某些行为到底有多异常how unusual a certain behavior is哭就是一个好例子So, crying is a good example在我们的文化里 一个男人哭是很异常的A man crying in our culture is seen as fairly unusual而一个女人哭就正常很多了whereas a woman crying is seen as much less unusual或者说 一个女人打人On the other hand, a woman beating up someone会被视为很异常的行为 而男人打人则没那么异常is taken as quite unusual behavior where it's less unusual for a man所以 我们都有性别刻板印象So, we have gender stereotypes可接受行为是有性别角色之分的gender roles for what is acceptable behavior我们判断什么行为是正常and our judgments as to whether something is normal或者变态 就要受这些性别角色影响or abnormal get influenced by those gender roles第二个能够影响And the third thing that can influence什么行为是变态的因素 就是环境whether something is labeled abnormal or not is the context我给大家举"偏执症"这个例子And here I'm giving you the example of "paranoia."如果你偏执 过度警觉If you're paranoid and hyper-vigilant在巴格达市中心提防威胁looking for threat in downtown Baghdad这在今天会被视为非常适应性的行为that's considered very adaptive behavior these days因为它能帮助你避免受伤或被杀because it could prevent you from getting hurt or killed但是 如果你是在康涅狄格州中央一个安静的小农场Whereas, if you're in a quiet little farm in Central Connecticut你表现得极度偏执 相信being extremely paranoid and believing有人躲在角落里用枪打你there's someone who's going to shoot you around the corner这就不会被视为正常 或可接受 或适应性的行为is not considered as normal or as acceptable or adaptive behavior所以你表现出某种行为时所处的环境So, the context in which you exhibit a particular behavior同样能很大程度地影响别人把你视为also can heavily influence whether it gets labeled by others正常还是变态as normal or abnormal在临床心理学领域 我们有很多In the field of clinical psychology we have a number of different ways探索式的方法用来判定kind of heuristics that we use to label things什么是变态 不健康 令人不安的行为as abnormal or unhealthy or troubling其中有三个特征And three of these characteristics我们通常称之为3Ds:痛苦 功能失常 异常are what we often call the three Ds: distress, dysfunction, and deviance给当事人或者他人So, behaviors that cause the individual造成痛苦的行为 通常都会被视为变态或不健康or others significant distress often get labeled as abnormal or unhealthy抑郁症就是一个好例子Depression is a prime example等一下我们讲到它的特征时就会知道as we'll see when we talk about the characteristics of it它是一种痛苦的状态 你不快乐 你悲伤It's a mise you're unhappy, you're sad你甚至伤心到想自杀you may even feel so badly you want to kill yourself这种高度的痛苦是它被列为精神病的And that very, very high level of distress is part of the reason原因之一why it's labeled as a mental disorder其他精神病不会造成患者痛苦Other mental disorders don't cause the individual distress但它们会造成别人痛苦but they may cause other people distress其中一个例子就是我们所说的So, one example of this is something called反社会人格障碍"antisocial personality disorder,"患者不顾他人的权益where the individual has no regard for the rights of other people毫不犹豫地偷别人的东西 或者伤害别人has no hesitation to steal or--steal from or hurt other people对别人的感觉没有一点移情或同情心has no empathy or sympathy for other people's feelings所以他们会对别人造成伤害and so can inflict a lot of harm on other people而且对自己的所作所为没有丝毫痛苦and has absolutely no distress over this whatsoever但这种行为会造成别人痛苦But this behavior causes other people distress这就是它被列为变态行为或精神健康问题的and that's one of the reasons why that's labeled an abnormal behavior原因之一or a mental health problem第二个普遍标准是"功能失常"The second general criterion is "dysfunction."如果一系列行为使个人无法在日常生活中正常运作If a set of behaviors prevents the person from functioning in daily life那么它会被称为变态行为then it might be labeled as abnormal或者精神健康问题or might end up being labeled as a mental health problem在这点上 抑郁症也是一个好例子Again, depression is a good example抑郁症患者通常会完全丧失功能People who are depressed often become completely non-functional他们起不了床 上不了学 上不了班They can't ge they can't go to work他们无法和别人互动they can't interact with their friends他们退回自己的世界 完全与社会隔绝they withdraw and become totally isolated socially所以他们可能会丢掉工作 被学校开除So, they
they might flunk out of school功能完全衰退And this complete decline in functioning是我们把抑郁症视为伤害力最强的is one of the major reasons that we consider depression精神病之一的原因之一one of the most debilitating disorders最后是"异常"And then finally, "deviance,"行为或感觉非常异常the behaviors or feelings are highly unusual这是三个标准里最有争议的一个This is probably the most controversial of the three因为它受社会规范的影响太大了because it weighs, it is so heavily influenced by the social norms在一个文化里异常的行为 在另一个文化里并不异常What's deviant in one culture is not deviant in another culture但如果一种行为在一种文化里完全不可接受But if a set of behaviors is completely unacceptable to a culture非常异常 这种行为很可能highly unusual, they're more likely to end up被视为变态行为getting labeled as abnormal那么 怎么把它们结合起来?Okay. So, how do we pull this all together?今天美国临床心理学和精神学的Well, these days the manual for making diagnoses诊断手册in clinical psychology and psychiatry in the United States是《诊断与统计手册》 简称DSMis called the Diagnostic and Statistical Manual or the DSM现在已经是第四版了and it's in its fourth revision它是50年代出台的It's been around since the, I believe the '50s五六十年代的最早版本and the early editions in the '50s and '60s非常主观 以弗洛伊德理论为基础were highly subjective and based on Freudian theory但自1980年以来 学界就致力于But since 1980 there's been real effort让标准变得更客观to make the criteria much more objective规定用来诊断患者的行为和观察to make the set of behaviors or observations必须是观察得到的东西that are required to diagnose someone be things that are observable你从患者身上可以看到的 他们可以告诉你的that you can see in other people that they can report on reliably而且这个临床学家和那个临床学家都会同意的东西and that one clinician and another clinician will agree upon所以 DSM列出一系列症状So, the DSM gives lists of symptoms诊断某一种精神病所需要的症状with the required symptoms for a diagnosis某一种精神病必须要有的症状the number of symptoms that have to be present以及异常and the notions of deviation功能失常 痛苦要建立在这些标准之上dysfunction and distress are built into these criteria我给大家说几个标准的例子And I'm going to give you a couple of examples of these criteria当我们讲某种情绪障碍时when we talk about the specific types of mood disorder我说过 我会用情绪障碍So as I said, I'm going to use mood disorders作为一个病例 讲解我们怎么诊断as kind of a case example here of how we go about diagnosing以及了解精神病理学and understanding psychopathology但我也想在这里讲一下这个病but I also just want to impart some information因为情绪障碍是最常见的because mood disorders are one of the most common problems精神病之一that people face高达四分之一的女性As many as one in four women will have an episode在人生某个时期都会患上抑郁症of serious depression at some time in her life男性大约有13%会在人生中患上and about 13% of men will have an episode of serious depression严重抑郁症in their lives所以这是一种极度常见的疾病So, these are extremely common kinds of problems尤其是在你们这个年纪that people experience, particularly at your age大学时期是疾病初发的高峰期The college years are one of the peak times of onset特别是抑郁症的初发first onset, of depression in particular还有两极型异常And also, for bipolar disorder即躁郁症 通常在青春期后期or manic-depression, the late adolescent20出头时是这种疾病的初发高峰期early 20s are the peak onset times for these disorders as well情绪障碍被分为So, the mood disorders divide into单极抑郁症what's called unipolar depression disorders即抑郁症 另一种就是两极型异常which is depression only and then bipolar disorders一个人在抑郁和躁狂中转换where the person cycles between depression and mania这里是DSM给严重抑郁症列出的标准And here are the DSM criteria for major depression最严重的一种抑郁症one of the most severe forms of depression我说过 DSM规定了这些相对来说可观察的标准And as I said, the DSM sets up these relatively observable criteria规定患者要有几个症状and how many you have to have and what absolutely而且必须要有什么症状 才算患了抑郁症has to be present in order to get the diagnosisDSM给严重抑郁症列出的第一条标准是So, the first criterion in the DSM for major depression病人必须或者表现出悲伤is that the individual has to either show sadness或者对平时的活动兴趣和乐趣减退or a diminished interest or pleasure in their usual activities也就是指快感缺失which is referred to as anhedonia所以你必须要有其中一个So, you have to have one or the other of these才能通过第一条标准to sort of pass the first criterion所以 你可能会觉得伤心忧郁So, you might say that you feel sad and blue and just或者觉得抑郁or actually say you feel depressed有些人这样的感觉很强烈Some people feel those feelings very strongly但有些人不觉得伤心忧郁Other people don't really feel so sad or blue他们只是什么兴趣都没有了but what they'll say is that nothing interests them anymore就像这种情绪把他们的生活都抽空了It's like the emotion has been sucked out of their life altogether他们以前喜欢做的事 现在做一点都不快乐They don't have any fun doing the activities they used to do before他们不想和朋友出去玩They don't want to hang with their friends他们不想吃东西They just--they don't care about eating什么都觉得不对劲 觉得不好Just nothing feels right, feels good, anymore接着 这个人还必须要有And then the individual has to have four of the除了悲伤和快感缺失以外的at least four of the following symptoms以下另外至少四个症状in addition to sadness or anhedonia第一个 他们会有显著的体重或胃口变化First, they can show significant weight or appetite change也就是说 你可能完全失去食欲So, you may completely lose your interest in eating体重骤减 也有些人会狂吃狂喝and lose a lot of weight, or some people go on eating binges我有一个好朋友 她患了一年的抑郁症I had a very good friend who was depressed for about a year胖了50磅 因为她不停地吃and she gained fifty pounds because she would just eat她狂吃狂喝 尤其是在晚上She would binge eat, especially at night还会有睡眠障碍 失眠There are sleep disturbances--insomnia也就是难以入睡 或者嗜睡which is having trouble sleeping, or hypersomnia00:13:54,100 --> 00:13:56,700也就是不停地睡which is sleeping all the time患上抑郁症时 有一种失眠是特别常见的There's a particular form of insomnia that's especially likely你晚上能睡着in depression where you can go to sleep at night但你会在凌晨三四点醒来but then you wake up at about three or four每天晚上都如此 醒来后就再也睡不着了in the morning every night and you can't go back to sleep at all睁着眼睛看天亮You're just up for the rest of the night但有些人会整天都想睡觉But other people want to sleep all day long我等一下会给大家看一段视频and in the clip I'm going to show you in just a minute里面有个女人说她一天睡20到24个小时the woman talks about sleeping twenty, twenty-two hours a day起床 吃点东西getting up, eating a little bit然后又上床睡觉 因为她还是觉得累and then going back to bed because she was exhausted still第三个标准是精神运动迟缓或激越The third criterion is psychomotor retardation or agitation精神运动迟缓更为常见The retardation is much more common它的意思是and what this means is that sort of everything一个人的所有动作都慢下来了about the person's movement is slowed down他们会慢慢走路They'll walk more slowly他们的反应时间慢了Their reaction times will be slowed down因为他们的动作迟缓了很多And because they're so much more slow moving抑郁症患者更容易出事故depressed people are often more prone to accidents他们不能快速反应They just can't react as quickly as they need当他们开车时 或者当他们过马路时to when they're driving or when they're crossing the road有车突然向他们冲来and a car is coming at them suddenly于是他们就发生车祸了So, they get into more accidents他们说话也会慢下来And their speech may be slowed down他们会说得很慢 就像They may talk very, very slowly and it's as though it要花非常大的力气just takes a tremendous amount of energy才能说完一句平常的话to get even a common sentence out但也有相对很少一部分的人A much more, much smaller number of people会有激越 而不是迟缓get agitated instead of slow down他们会非常亢奋They may be hyper and just feel like就像他们坐不住一样they can't sit still and such但激越比迟缓少见得多but the agitation is much more rare than the retardation患者会觉得很累People feel really tired疲劳 就像他们一点力气都没有fatigued and like they have absolutely no energy他们起不了床 动不了They can't get up and can't get moving我说过 他们可能会想睡一整天As I said, they may want to just sleep all of the time第五个标准是无价值感和过分内疚Number five is feelings of worthlessness or excessive guilt他们可能会觉得所有事都是他们的错They may feel as though everything is their fault这种内疚感或者无价值感and the guilt feelings or sense of worthlessness可能会严重到精神错乱can even get psychotic他们可能会脱离现实They can lose touch with reality当一个抑郁症患者脱离现实时When a person loses touch with reality when they're depressed通常都会有一个抑郁主题的it typically has really depressing themes他们可能相信他们是撒旦They may believe that they are Satan他们必须要自杀and that they have to commit suicide因为他们给这个世界带来苦难because they're inflicting evil on the world他们可能觉得连随机事件都是他们的错They may believe as though random events are their fault例如刚发生的某场洪灾是他们造成的you know, that a flood that just happened somehow they caused所以无价值感和内疚So, the feelings of worthlessness and guilt可以使人完全脱离现实 变成精神错乱can get completely out of touch with reality, psychotic更为常见的是 他们只是不切实际More commonly, they're just unrealistic他们有消极自尊 看不起自己They're negative self-esteem, just being down on yourself觉得自己笨 没用 丑 恶毒feeling stupid and worthless and ugly and bad第六个标准是注意力不集中和优柔寡断Number six is diminished ability to concentrate or indecisiveness抑郁症患者很难集中注意力When you are depressed it's really hard to pay attention同一段字你会看了一遍又一遍You'll read a passage over and over again你根本看不进去and you just can't process it at all你听课不集中 所以上课都是没用的You can't concentrate on a lecture so going to class is just useless你要决定论文写什么题目You have to make a decision about what a paper topic is你会觉得这是世界上最难做的事and it just seems like the most monumental thing on earth你什么都决定不了 你什么都想不了You just can't decide anything, you can't think anything你的思想压抑 不知所措your thoughts are completely clouded and overwhelmed还有自杀念头或者自杀行为And then suicidal ideation or behavior也就是说 你想着怎么自杀 想着怎么死it means you think about committing suicide, you think about dying有一部分人会付诸行动And a subset of people actually take action伤害自己或者杀死自己to try to hurt themselves or kill themselves应该说 自杀念头和行为Now, it should be said that suicidal thoughts and behavior不限于抑郁症don't only happen in depression各种各样的精神病都会有They actually happen in all types of psychopathology但抑郁症特别常见but they're particularly common in depression所以你必须至少符合So, you have to have at least one这四个症状中的一个 再加上悲伤或快感缺失four of those symptoms plus sadness or anhedonia这些症状…如果你只是某天过得不顺利才有 那不算and these symptoms--it can't just be a bad day that you're having这些症状必须要持续These symptoms have to be present persistently至少两周 才算患有严重抑郁症for at least two weeks to get the diagnosis说实话 大部分严重抑郁症病例Now, truth be told, most episodes of major depression持续时间远远超过两周actually last a lot longer than two weeks事实上 发作一次的平均时间In fact, the average length of an episode如果不接受冶疗的话 至少是半年if it's not treated, is at least six months所以患者这种痛苦状态会持续一段很长的时间So, people stay this miserable for a very long period of time但DSM里的最低标准是至少两周but the minimum criterion in the DSM is at least two weeks我想给大家看一段视频So, what I want to do is to just show you a short clip一个抑郁症发作多次的女人of a woman who has had a lot of episodes of depression幸好 拍这段频视时她没有发作Fortunately, at the moment she's not in an episode她能清楚地说出抑郁症发作时But she can speak very articulately about what it's like是怎么样的to be in the midst of an episode以及她有过的一些明显症状and some of the significant symptoms that she had好的 她讲了几件事Okay. There are couple of things she talks about我想评论一下that I just want to comment on其中一个是日常生活的心情不好One is this differentiation between everyday sad mood我们都会有的郁闷and the kind of depressions we all experience和她患上的那种伤害力很大的and the kind of debilitating严重抑郁症 这两者之间的区别overwhelming depression that she experiences确实 我们都会出现And it is true that there is this continuum坏心情 可能因为你考试没考好from getting bummed out because you didn't do well因为你和男朋友分手了on a test or because you broke up with a boyfriend或者和女朋友分手了 诸如此类的原因or girlfriend or something like this这种坏心情会恶化为完全功能丧失 像植物人一样and being completely not functional, vegetative就像那个女人抑郁症发作时那样the way that this woman becomes whenever she gets depressed如果我们能确定地And it would be nice if we were really sure划清普通的日常抑郁和精神病的抑郁之间的界线where the cutoff was between those normal everyday depressions这会是一件好事and what's really a disorder但现实是 我们并没有一条清晰地界线But the reality is we don't really have real clear demarcation lines有很多人的抑郁症要轻于There are a lot of people who have more moderate视频里的Tara所说的那种抑郁症forms of depression than Tara here talks about但他们仍然符合抑郁症的标准but who still would qualify for a diagnosis仍然被他们的症状所折磨and are still suffering and impaired by their symptoms所以我不想你们觉得So, I don't want you to get the sense如果你没有Tara那种that if you don't have the kind of horrible version恶化到极端的严重抑郁症on the extreme end of the continuum of depression that Tara has那就觉得自己没问题 因为不是这样的then there's nothing wrong with you, because that's not the case那些真的迟缓的人People who are really slowed那些功能受阻的人whom their functioning is interfered with他们生活过得很不开心they're just really unhappy with life他们确实有问题 需要冶疗have problems that can be helped and do need attention因为如果不治疗 轻度抑郁症And it is the case that much more moderate forms of depression可以变为严重的抑郁症can morph into more serious forms if they're left untreated所以它是会恶化的So, there is this continuum我想评论的另一件事是The other things I wanted to comment她在视频里说on that she talks about early on in this piece00:20:31,000 --> 00:20:35,600她会迫使自己振作起来过完一天is the fact that she hauls herself up and goes through her day即使她觉得很抑郁even when she's feeling really, really depressed这是很多抑郁症患者的一个特点And there is this characteristic of a lot of depressed people我称之为"行尸走肉"that I call the "walking wounded."他们迫使自己装作正常地过日子They just haul themselves through the day trying to act normal试图不让别人知道他们出了问题trying not to let anybody know that there's anything wrong with them试图跟上功课和工作trying to keep up with their schoolwork or their employment但他们很痛苦 他们无法But they're miserable and they're not functioning像正常那样运作at the level that they're capable of and such这是很常见的一种现象And that's something that's very, very common部分是因为这些人不觉得and it's in part because people don't feel as though他们应该接受治疗 或者他们羞于they should have to get treatment or they're ashamed求助治疗抑郁症of getting treatment or seeking help for depression所以他们就一直拖着And so, they just keep going on and going on有时一拖就是几年 病情非常差sometimes for years, in a very sorry state before有时他们最后会崩溃sometimes they just--they end up actually falling apart不得不去求助to the point where they have to get help好的 我提过的另一类情绪障碍Okay. The other category of mood disorders就是两极型异常that I mentioned is bipolar disorders我说过 两极型异常包括抑郁症症状And as I said, bipolar disorder involves symptoms or periods或一段抑郁症时期 也包括一段明显的of depression but then also distinct periods与抑郁症相反的时期 即我们所称的"躁狂症"of the opposite of depression, which we call "mania."病人在这两种状态中反复转换So, the person cycles back and forth一时是伤害性很大的抑郁症 一时是躁狂不安between debilitating depressions and manic episodes现在我讲大家讲躁狂发作So, let me describe manic episodes to you now第一个标准时 患者没有继续So, the first criterion is that instead of feeling down心情低落或抑郁 而是有一个不正常的blue or depressed the person has an abnormally持续加强的高涨或者易怒情绪and persistently elevated expansive or irritable mood这种情绪不…再一次that isn't just, again赢了个奖 心情很兴奋 这种不算a good day because you won a prize or got an "A," but rather这种异常地积极it's this unusually positive高涨的心情至少要持续一周expansive mood for at least one week persistently然后这个人还要有以下三个以上的症状And then the person has to have three or more of the following symptoms第一个自尊膨胀或自尊自大First, inflated self-esteem or grandiosity患者会觉得自己是地球上最聪明The individual may feel as though they are the smartest最有创意 最有见解 最强大的人the most creative, insightful, powerful person on earth他们可以毫不犹豫地这样告诉你and they are perfectly happy to tell you this所以他们的自尊没有问题 "非常谢谢你So, there is no problem with self-esteem, thank you very much如果你帮不了我 那是你的错""If you can't keep up with me it's your fault."他们对睡眠的需求减少There's a decreased need for sleep他们可能一晚只睡几个小时they may only sleep a couple of hours a night然后就急切地起床了and get up raring to go他们往往会比平常更健谈They tend to be more talkative than usual而且他们说话时明显有压力and there's a really pressure to their talk他们说话时会很紧张They'll talk really pressured他们会说得很快and they'll talk really, really fast他们说话这么快的原因之一And one of the reasons they're talking really, really fast就是他们觉得is they have this flight of ideas想法会很快地飞过他们的头脑The thoughts are just racing through their mind他们说得不够快 就不能把话都说出来and they can't talk fast enough to get them out如果你跟不上他们And if you can't follow them, that--well那是因为你不够聪明that's because you're not smart enough to follow them他们有太多好主意了But they've just got too many good ideas他们必须讲出来and they've got to get them out他们很容易分心They're highly distractible还会出现越来越多And then there is this increase in thisDSM所称的"目标性活动"what the DSM calls this "goal-directed activity."由于他们自尊心膨胀 他们会想出很多大计Out of their grandiosity will come these grand schemes for--通常都是赚大钱often for making a lot of money他们会以极大的热情追求这些目标and they'll pursue these with great vigor不管这些目标有多么不切实际no matter how totally irrational they are所以 比较常见的是他们提光了So, it's not at all uncommon for them to cash out家庭银行帐户的钱 卖房了all the family bank accounts, to sell the house卖车 卖孩子to sell the car, to sell the kids这样他们就能钱资助他们的大计so that they can finance this great scheme明天在网上赚几百万亿的钱for making a zillion dollars on the Internet tomorrow. Right?他们会以极大的热情追求这个目标Okay. And they'll pursue this with tremendous vigor他们还会参加They'll also get involved in all kinds ofDSM所称的"愉快但危险的活动"what the DSM discreetly calls "pleasurable but dangerous activities."大量的性滥交 滥用药物There's a lot of sexual promiscuity, a lot of drug abuse到处去赌钱a lot of, as I said, getting--going and gambling相信自己走大运 没什么能阻止你的believing that you're on a hot streak, there's nothing can stop you你太聪明了 你胸怀大计You know, you're just so brilliant and you've got this scheme你想好计划了 你一定会成功的you've got the plan. You're going to make it. Okay?所以一个人如果符合了这些症状的So, the individual has three of more of these kinds三种以上 再加上心情高涨of symptoms plus this elevated通常还有易怒的情绪expansive and often quite irritable mood这并不是因为他们很快乐It's not just that they're happy很乐观you know, and sort of upbeat而因为他们没耐心 易怒 动不动就大发脾气It's just that they're just impatient and irritable and trigger-fire有时还会变得暴力And sometimes they can become violent因为他们太不安和易怒了because they're just--they're so incredibly agitated and irritable我给大家看几段视频So, let me show you a couple of clips有一个很短的I have one really short one不是高清视频It's not a real high quality clip但是一个很好的病例 一个老太太but it's a very, very nice example of an older woman正处于躁狂症发作期who is in the midst of a manic episode我们可以看到 这种激动And it shows what this kind of agitation想法 拼命地赶上他们的想法 是怎么样的and flight of ideas and racing thoughts can look like另一个是…我会在…放来看看And then the other one is--I'll introduce whenever you--we do it好的 她在发型屋时Okay. So while she was at the hairdresser's这是一个好例子 可以看出她在压力支配下说话it's a nice example of how she was just pressured to speak没有人告诉她要说这些东西Nobody was telling her that she had to say all of these things他们只是拿着摄像机站在那里They were just standing there with a camera她就不停地说这些东西and she was going on and on and on about these things你们可以看到她讲她的故事时And as you could see she was getting more and more agitated变得越来越激动 越来越不安and more and more irritated as she was retelling her story然后呢?And then what?最后你们看到她从躁狂变换为In the last little bit there you saw her flip from her mania一种更为抑郁的状态into a more depressed state这个可怜的女人 很不幸And this poor lady, unfortunately她很难找到稳定点is having a hard time finding a stable point他讲了锂He talked about lithium there我等一下也会讲一下and I'll talk about it in a little bit--用锂作为一个药物去稳定这些情障变换about the use of lithium as a drug to try to stabilize these mood swings但在拍这段视频时But at this point in this video这种药对她没有效果it's not working for this lady所以 她还是反复变换And so, she's flipping back and forth他们很难找到中间点but they're having a hard time finding that middle ground我想让大家看另一段视频So, I want to show you another clip--比刚才的长了一点 一个患有躁郁症的男人it's a little bit longer--of a man who has bipolar disorder他拍视频时既没有抑郁症发作也没有躁狂症发作He is not currently in an episode of either depression or mania他也可以说一些but again, he can talk about some of the things他经历的事情 怎么表现在他的行为上he got himself into and how it manifested in his behavior刚才Bernie说的几件事Okay. Just a couple of things that Bernie talks about我想评论一下that I want to comment on其中一件是 就像抑郁症一样One is that just as in depression躁狂症也有一个恶化过程mania has--runs along a continuum它可以从比较轻微一直发展到So, it can be relatively mild all the way极度严重 甚至精神错乱to extremely severe and even psychotic当一个躁狂症患者脱离了现实So, when a person with mania loses touch with reality他们不会相信自己是撒旦instead of having beliefs that they are Satan或者自己做了什么可怕的事or they've done some horrible thing他们会相信自己是超自然的东西they'll believe that they are some supernatural being他们可能相信自己是救世主They may believe that they are the Messiah或者爱因斯坦or that they are Albert Einstein复活了you know, come back to life或者他们有超自然力量 诸如此类的or that they have supernatural powers or something of this sort所以他们的虚假信念so that their false beliefs他们的错觉 他们的幻觉their delusions and their hallucinations他们看到听到的东西the things that they see and hear这些不真实的东西通常主题都很夸张that aren't really there tend to be very grandiose in their themesBernie的躁狂症绝对算不上严重Bernie's mania is not on the far end of the continuum by any stretch但你可以看到他还是因此陷入困境了but you can see it still gets him into trouble有些人Now, there are people who have--他们反复变换的是很轻微的躁狂症who cycle between fairly low levels of mania和很轻微的抑郁症and fairly low levels of depression回来反复 有人认为back and forth. And there's been some argument有些人长期有that people who are kind of chronically轻微的躁狂症 尤其是当他们是很聪明的人时mildly manic--especially if they're really smart或者他们有特殊才能时 这个病可以为他们所利用or they have a special talent, can make it work for themKay Jamison写了一本很棒的书And there is a wonderful book by Kay Jamison她是约翰霍普金斯的教授 她编写了…who is a professor at Johns Hopkins where she chronicles--她写了一本类似于历史传记的书She does sort of historical biographies书中写了几个著名的作家 诗人 音乐家on a number of well-known authors and poets and musicians修曼 还有几个政治家Robert Schumann and a number of politicians丘吉尔等等Winston Churchill and such她认为他们其实都有轻微的两极型异常arguing that they actually had mild forms of bipolar disorder他们能够通过非凡才能和智力and that they were able to sort of channel the manic episodes把躁狂症转化为through extraordinary talent or intelligence in ways可以利用的东西that made it work for them还有很多人认为There are also a number of arguments有些很成功的CEO都是that very, very successful CEOs sometimes are people长期患有轻微躁狂症的人who are chronically slightly manic他们可以连续几晚只睡几小时They can go on a couple of hours a night of sleep他们明显自尊心膨胀 自信they're obviously really quite grandiose and self-confident他们可以维持这种适度的躁狂症and that they can maintain this kind of moderate level of mania不让它们恶化 并把将之加以利用keep it under control and channel it in ways that work for them所以如果你们对这本书有兴趣So, if you're interested in that book发封邮件给我 我很乐意发里面的一些内容给你们send me an email and I'm happy to send you the citation for it但大多数情况下But for the most part躁狂症可以让人陷入可怕的困境mania can get people into tremendous trouble我说过 他们会有大量的性滥交They can, as I said, get involved in sexual promiscuity这让他们有患上性病的风险that puts them at risk for sexually transmitted diseases他们会滥用药物They can get involved in drug activity他们可能会害自己被拘捕起来They can get themselves arrested他们绝对可以害自己和家人破产They can certainly send themselves and their family into bankruptcy躁狂症的这些负面影响And these kinds of negative consequences of the mania通常是病人求助的原因often are what motivates the person to get help因为躁狂症本身可以是一种让人愉快的病because the mania itself can be rather pleasurable to have另一个促使他们求助的原因是抑郁症发作Also, what motivates them to get help is the plunge into depression他们知道在某个时候the knowledge that they will, at some point躁狂症会停止发作 伤害性大的抑郁症会发作come out of the mania and go into a debilitating depression躁郁症比抑郁症要少见得多Bipolar disorder is much less common than depression我说过 大约22%的女性和13%的男性I said that about 22% of women and about 13% of men会在一辈子当中will have an episode of serious depression发作一次严重抑郁症at some time in their lives躁郁症的发病率只占人口的1%Bipolar disorder occurs in only about 1% of the population男女的患病率差不多and it's equally prevalent in women and men这是一种很多地方So, it's a really quite different disorder都不同于抑郁症的精神病in many ways from depression alone我想给大家看一下抑郁症的其他一些数据I want to give you some other statistics about depression per se这些数据只属于抑郁症and this only applies to depression抑郁症的患病情况有很大的年龄差距There are quite large age differences in the prevalence of depression这些是一个全国范围内展开的These are data from a nationwide study of people针对15到55岁年龄段的研究所得到的数据between the ages of fifteen and fifty-five这些是这次研究对象所占的人口百分比and these are the percentages of people in this study这个研究的对象有几千人And there were several thousand people in the study他们不是接受抑郁症治疗的人These are not people who have sought treatment for depression只是在社区随机抽样的but just a random community sample这是在过去一个月发作过And this is the percentage who've had an episode严重抑郁症的百分比of major depression in the past month你可以看到 24岁这个年龄有15%的人And as you can see, the fifteen to twenty-four age range是发病率最高的 然后发病率下降has the highest rates, and then they go down somewhat但在35到44这个年龄段although the thirty-five to forty-four会随着年龄增大而升高is fairly high as well with age你们可能会很惊讶地发现You might be surprised to learn that老年人的严重抑郁症发病率the rates of major depression in the elderly其实很低 大部分全国数据都是这样are actually quite low by most national statistics一直到80或85岁 都是这样And that's true up to about age eighty or eighty-five为什么会有这样情况 有些人提出一些有趣的解释And the arguments for why this is the case are very interesting有人认为人越老就越有智慧There are some people who argue that as you get older you get wiser所以老年人的抑郁症患病率更低and so that's why we see lower rates of depression in older age还有人认为 现在这一代There are other people who argue that current generation--现在这一代年轻人younger generations now你们这一代 以及你们对上的一代your generation and the one above you--更容易患上抑郁症are more prone to depression and will be跟你们祖父母那辈相比 一辈子都更容易患上for the rest of your life compared to your grandparents因为现代的社会支持和家庭网络because of historical changes in the kinds of social support已经发生了历史性的改变and family networks available还有其他很大的历史文化变化and a number of other historical cultural changes也有人认为The other sort of side of the argument is that因为大家都知道抑郁症because depression is known会对你的身体健康产生负面影响to impact negatively your physical health有抑郁症的人 更容易有depression is associated with higher rates心血管疾病 中风 免疫系统疾病of cardio-vascular disease, stroke, immune system diseases还有其他各种各样致命疾病a whole host of diseases that people die from--那些终生患有抑郁症的人that people who have a lifelong history of depression其实很可能比较年轻时就死了are actually more likely to die at an earlier age所以老年人当中的抑郁症患病率相对比较低and that's why we see relatively low rates in older age people我们不知道哪种解释才是正确的We don't know yet which of these explanations is true可能某种程度上都对It may be that they're all true to some extent抑郁症还有性别差异There are also gender differences in depression我们通过收集几百个以儿童和青少年为对象的These are data from a compilation of hundreds of studies研究 得出这些数据of children and adolescents这些研究并不是研究严重的抑郁症looking at not full-blown depression而是通过自答问卷调查抑郁症的程度but levels of depression on self-report questionnaires很可能在座大部分同学都有份回答这些问卷Probably most of you have filled out these questionnaires像上个月调查你们情绪的like the Beck Depression Inventory那个贝克抑郁量表一样that ask you how you've been feeling in the last month这个就像是它的儿童版And there's a kiddy version of this这些是从几千个孩子的问卷中得到的数据and these are data from that, from several thousand children大家可以看到 在13岁以前And as you can see here, prior to the age of about thirteen男孩和女孩的抑郁症水平相近boys and girls have relatively similar levels of depression但在青春期初期But beginning around the pubertal years女孩的抑郁症患病率发生急剧变化girls' rates of depression go up quite dramatically男孩的持平 或者下降and boys' rates stay the same or go down但当他们长到18或20岁时And by the time they're eighteen or twenty女孩和男孩的患病率几乎到达2:1的比例you get almost a two-to-one ratio of depressed girls to depressed boys在接下来的成年人时期差不多都是这个比例And then this is true for the rest of the adult age span我们提出了很多假设来解释这种情况There are lots of hypotheses about this, why it's true有些生物学的假设 认为跟荷尔蒙有关There are biological hypotheses that have to do with hormones有些社会学的假设 认为There are sociological hypotheses that have to do跟压力有关 尤其是跟with the kinds of stress, and particularly abuse女孩和男孩的受虐比例有关in girls' lives relative to boys'我们也不知道确切原因We don't know exactly why很可能是很因素共同作用的结果It's probably a lot of these things coming together使得产生了这个2:1的比例that make this huge two-to-one ratio true我们来讲一下几个重要理论So, let's talk a little bit about the major theories以及情绪障碍的治疗and treatments for the mood disorders我们有一些生物学理论和疗法There are biological theories and treatments称为认知行为理论和疗法what are known as cognitive behavioral theories and treatments还有人际关系理论和疗法and then interpersonal theories and treatments我会每个理论举一些例子And I'll walk you through examples of each of these第一个 基因因素So, first, genetics很明显情绪障碍跟基因有关It's pretty clear that genetics are involved in the mood disorders尤其是躁郁症especially bipolar disorder躁郁症有很确凿的证据There is very strong evidence in bipolar disorder还有几个方法…and there are a number of ways--你们有没有讲过怎么做遗传研究? 好的Have you talked about how you do genetic studies? Okay所以你们知道 例如 双胞胎研究So, you guys know about twin studies和家庭历史研究for example and family history studies这里是很多研究的集合So, this is actually a compilation of a group of studies有些是双胞胎研究And here you've got some of them, twin studies--compared对于同卵双胞胎So, in monozygotic twins如果你的双胞胎兄弟姐妹有躁郁症if your identical twin has bipolar disorder你有60%的几率患上这种病you have over a 60% chance of having the disorder yourself00:35:04,200 --> 00:35:05,800相比之下In contrast, if it's your--如果你只是异卵双胞胎 另一个双胞胎患有躁郁症if you're just a fraternal twin of a person with bipolar disorder你患这种病的几率只有12%you only have about a 12% chance of having the disorder所以这种巨大的差异是一个很明显的证据So, that massive difference there is very strong evidence证明这种病的传播是跟基因有关的that there's a genetic component to the transmission of the disorder同样道理 如果你和这个躁郁病患者的Similarly, the more distant you get in terms of your biological relation血缘关系越疏to a person with bipolar disorder你患这种病的几率就越低the lower your rate or your risk of the disorder is所以 躁郁症患者的So, the of a person二级亲属只有2%的患病几率with bipolar disorder only have about 2% chance of getting the disorder比平均人口患病率只高了一点点And that's barely above what's in the general population平均人口患病率大约为1%which is about a 1% chance of getting the disorder所以很明显躁郁症跟基因因素有关So, it's very clear that bipolar disorder has a genetic component to it单就抑郁症而言 严重抑郁症With depression alone, major depression很可能某些类型的抑郁症there are probably versions of the disorder它受基因的影响会比其他类型的强that have a stronger genetic component to them than others举个例子 患有早发性抑郁症的人And in particular, folks who have what's called "early onset depression,"也就是第一次发病是在童年where their first episodes come on in childhood或者青春期刚开始的时候or very early adolescence他们的抑郁症似乎seem to have a form of depression受遗传的影响更强烈that has a stronger genetic component to it而那些明显是被人生重大事件Whereas, people who have depression that is clearly triggered引发的抑郁症 例如创伤或痛失…by a major life event like a trauma or a loss--这种抑郁症与基因因素的关系those types of depression are less clearly就明显没有那么强烈了linked strongly to genetic factors还有一些神经递质There are also a number of neurotransmitters与情绪障碍有关that have been implicated in the mood disorders被研究得最多的一类神经递质And the class of neurotransmitters that's been researched叫做单胺most often is what's called the monoamines你们都听说过血清素与抑郁症的联系I'm sure you've heard about the link between serotonin and depression但还有两种单胺 降肾上腺素和多巴胺but there are two other monoamines, norepinephrine and dopamine它们也和情绪障碍有关that have also been linked to both of the mood disorders与躁郁症和抑郁症都有关both bipolar disorder and depression过去认为在抑郁症患者体内And it used to be thought that it was just that in people没有足够的神经递质with depression they didn't have enough of these neurotransmitters没有足够的血清素 尤其是在大脑enough serotonin, in particular, in the system, in the brain帮助他们正常运作in order to function normally但现在有关神经递质作用的理论But now the theories on what the role of neurotransmitters认为原因更在于神经递质的is have a lot more to do with the receptors受体和它们的运作for these neurotransmitters and their functioning这些理论认为 神经递质受体And the notion is that the receptors for neurotransmitters例如血清素 运作低效like serotonin don't function efficiently所以即使大脑的突触So, even if there's enough of the chemicals有足够的神经递质in the synapses in the brain神经元也用不了它们the neurons can't make use of them因为受体没有发挥该有的作用because the receptors aren't functioning appropriately所以有些缓解抑郁症的药物And so what the drugs that help relieve depression do就是改善这些神经递质的运作is to improve the functioning of these neurotransmitters目前学界有一系列非常有趣的研究There's a very interesting line of work专门研究基因易感性神经递质运作that's going on right now looking at the intersection与压力的共同作用of genetic predisposition neurotransmitter functioning and stress我们现在有一个世界级专家And we have one of the world's experts正在从事这种研究 耶鲁的Julia Kim-Cohenon this kind of work now here at Yale, Julia Kim-Cohen她去年加入耶鲁who just joined us in the last year我们最近还有几个研究But there are several recent studies精神病学界的另一个人Joan KaufmanThere's another person in psychiatry, Joan Kaufman他已经做过一些这样的研究who's done some of this work最近有几个研究But there are several recent studies发现血清素转运基因上的that find that certain variations某些变异或者多态性 能够预测or polymorphisms on the serotonin transporter gene predict谁遇到压力时会患上抑郁症who will become depressed in the face of stressAvshalom Caspi和同事做了一个经典研究So, a classic study was done by Avshalom Caspi and colleagues他们发现血清素转运基因上有and they found that people who have one or two一或两个短等位基因的人of what's called the short allele on the serotonin transporter gene--这是血清素转运基因上的一种变异so this is a particular variation on the serotonin transporter gene--如果他们有一或两个这样的短等位基因if they had one or two of these short alleles当他们遇到压力时and they were confronted with stress他们更可能患上抑郁症they were more likely to develop depression但我们很有必要细仔分析一下这点But it's important to sort of dissect this有些人有…重点不在So people who had--it didn't really matter这些基因上which of these genes you had如果你从没遇到过重大压力If you were never confronted with major kinds of stress例如虐待 如果你从没遇到过压力like maltreatment, if you weren't confronted with stress你就不太可能患上抑郁症you were no more likely to have depression regardless即使你有这种血清素基因of what kind of serotonin gene you had但如果你有其中一种短等位基因But if you had either one short allele或者两种都有 而且你童年受过虐待or two short alleles and you were confronted with maltreatment你人生中某个时期患上抑郁症的as a child, you had a much greater probability of becoming depressed可能性就要太很多at some time in your life换成是其他类型的重大创伤And this has been replicated with other samples结果也是一样with other forms of major trauma所以这个理论是说And basically the story is既要有基因易感性it takes the intersection of a genetic predisposition又要有重大压力 才会使某些人患上严重抑郁症and major stress to create full-blown depression in some people但这个理论并不一定适用于所有的基因易感性Now, that may not be true for all genetic predispositions或者所有类型的抑郁症or all forms of depression但现在至少有四个不同的研究都得出but this serotonin finding has actually been replicated now in这个血清素结论at least four different studies所以它应该是一个很可靠的理论So, it seems to be a pretty reliable effect重申一次 基因决定不了抑郁症So again, genes do not determine the disorder但如果基因和压力同时作用but the intersection of genes and stress就会导致很高的抑郁症患病风险seems to be a major risk factor for the disorder我们有一些大脑区域There are a number of brain areas似乎与情绪障碍有关that seem to be involved in the mood disorders这些区域出现调节异常或功能障碍where there is just dysregulation or dysfunction大家可能学过 前额皮质层The prefrontal cortex, as you probably have studied是大脑里一个负责is an area of the brain that's very involved高阶复杂思考 解决问题in higher order complex thinking and problem solving目标性行为的区域and in goal-directed behavior抑郁症患者In people with depression他们的前额皮层活动减少there's lowered activity in the prefrontal cortex这表明也许它跟suggesting that--which may play a role in the difficulties注意力集中 目标性行为in concentration, in goal-directed behavior计划 解决问题 和调节情绪等问题有关in planning and problem solving and in regulating emotion杏仁体是大脑里一个The amygdala is an area of the brain负责处理情绪信息的区域that is involved in the processing of emotional information有情绪障碍的人杏仁体对情绪信息作出的反应And people with mood disorders show overactive amygdala responses会过度活跃to emotional information躁郁症和抑郁症都是这样This is true in both bipolar and in depression海马体是大脑里一个The hippocampus is an area of the brain负责处理记忆和注意力的区域that's very involved in memory and in concentration患有慢性抑郁症的人And in people with chronic depression通常海马体都会缩小you often see shrinkage in the hippocampus这可能与他们无法集中注意力的问题有关and this may be related to their problems in concentration and attention最后是前扣带回And then finally, the anterior cingulate这是大脑里一个负责处理不同活动的区域is an area of the brain that's involved in a lot of different activities但它与情绪障碍有关but pertinent to the mood disorders尤其是对痛苦 压力particularly in responses to distress--以及行为选择上作出的反应to stress and in sort of the choice of behaviors734也许是前扣回带的功能障碍And it may be that dysregulation of the anterior cingulate导致病人难以ma}