衝動的精神病理學

The Psychopathology of Impulsivity

10.29478/TJP.200503.0003

吳其炘(Chi-Shin Wu)；廖士程(Shih-Cheng Liao)；李宇宙(Yue-Joe Lee)

衝動性 ； 人格疾患 ； 物質濫用 ； 衝動控制疾患 ； impulsivity ； personality disorder ； impulse control disorder

台灣精神醫學

19卷1期（2005 / 03 / 01）

19 - 32

繁體中文

衝動性是相當重要的精神病理現象，在一般醫學而言，衝動性與意外的發生、創傷、自殺、及暴力有關。對精神科而言，衝動性更是許多精神科疾病的核心症狀。然而，衝動性並沒有一個完整的定義，這歸因於衝動性本身具有多樣性。回顧現象學、精神分析理論、心理學、生物學、以及精神醫學關於衝動性的研究，發現衝動性包含了兩種主要成份，一種是行為不經抑制。在臨床上，會廣泛地表現出不經思索、不加計劃的行動。另一種衝動性，則是導因於衝動過強而無法阻抗，即使經過思考，也知道負面的後果，但仍會產生衝動行為。這兩種衝動性各自表現在不同的精神疾症，在行為實驗測驗上也有不同的表現。未來的研究，依據這兩種不同的衝動性病理，以更多的實驗與臨床應用來加以驗證。

Impulsivity is an important psychopathology. Impulsivity is related to accident, trauma, suicide, and violence, and is a core symptom of several psychiatric disorders. However, impulsivity is not well defined because of the variety of its manifestations. Our review of impulsivity-related articles from phenomenology, psychoanalysis, psychology, biology, and psychiatry revealed two major components of impulsivity. The first component of impulsivity is behavioral disinhibition, which may manifest as acts performed without any reflection. The second component of impulsivity is irresistible impulse, which may occur even after reflection and understanding of the overt negative consequence. These two components of impulsivity exist in different psychiatric disorders and have been demonstrated by behavioral studies. (Full text in Chinese)

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