32 33 Thus, not all of these conditions have to be fulfilled to assume automaticity of processing. 32 Automaticity is not a unitary construct but it can be diagnosed by considering the presence of single features or processing characteristics. Automaticity of processing can be assumed when processing occurs unintentionally, fast, efficient, uncontrollable, and with no or minimal attention. 31 Controlled processes are voluntary, slow, effortful, and controllable and require attentional resources. In cognitive psychology, a distinction is made between mental processes that are controlled and those that are automatic. Thus, samples encompassing a large proportion of patients with affective negative symptoms would be more likely to reveal hyperactivation of the amygdala and other limbic regions. The authors suggest that a reduced display of emotions might serve as a protective mechanism from emotional overstimulation. 24 25 That is, patients whose emotional expressivity is impaired show higher amygdala activation than patients with adequate expressivity. Within-group analyses of patients have consistently found a correlation between amygdala activation and negative symptoms, particularly flat affect. Specifically, the proportion of patients with flat affect might play an important role. 15 23 Another cause may reside in within-group differences for samples of patients with schizophrenia. Amygdala hyperactivation in patients is mainly found in studies using paradigms with minimal cognitive loads 23 and depends on the baseline condition used. First of all, differences between the functional magnetic resonance imaging (fMRI) paradigms seem to have a large impact on the outcome. Various reasons might account for these heterogeneous results.
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