  .         
  

  


         ,        .     ,      ,      .     ,       .                         .              .              .     ⠖ , ,  ,                  .          ,   ,              .





 ,  

  .         



 .., .., 2015

  ̻, 2015







         ,     -      . ..,   ..,   .          ,      .        115-   ,          .

        (    . ..  ),                    .                  蠖   ,         .

            ,               ,          : .., .., ..  ...      ..,          ,           ,         .

         4 . .. ..,     ,   ..       ,       ..          .    ,        ,           .

      ,                      1990- .       ..,          ..              [1 -            .].        ,    .         1.        ,            .

,     ,      ,         .



           ( 1-4),    ( 5, 6),       ( 7)        ( 14-18-03461)     . ..  .




.        :   ?


    ,     ,     .    XX     ,         XXI.               ,   -      ,                   .          ,  ,         ,   .

  ,   ,     .,     ,         .        . .        .     ,          ,           ,       ,      .      .,    .    ,         ,          , ,    ,    ,    .

           . ,     ,       ,              , ..   ,  , , .       ,              .

                  ,            ,         .             ,        .              1970- .        ,     ,          .

         ,      ,     ,      .           ,                .

                              .                ,     ,  ,  .   ,                    ,   .

     ,     ,    :         ?     ,         ?  ,       -         . ,  - ,  .              ,   ..  ,      ,   , , ,     ,   (.  .., 1990, . 41).

              -      ,  ,   ,         .         ,        ,     (, , 2012),    -     (, 2014 , );  -    ..        (, 2015; , , , 2015).

                            ,  ..      :     ,        .




 1.         :  


     ,    ,  ,         .

 




1.1.     


 ,  .        dementia praecox ( ),     XIX.   .  dementia praecox    (  ), .       ,    .               . ,   .       蠖   ,          ,         .          頖  , ,     ,       , , ,  .   ,  ,    .      ,      ,  , .

   .          (    .). .          ,    (    ),     ,     .     ,  ,   ,        .        (Bleuler, 1920, . 314).       ,     ,    堖     ,    .         ,     ,  . ,  .    ,        ,     ,             (  ),     .  , .        .

             .. 3. ,          ,      (, 2004),         .           ,     .

      3.    ( , .: , 2007). , ,   ,     ,  ,        .      :     ,  ,  .           :    , ,   ,      .  ,                .

  .  .            , 3.  (2003)               ,    .        ,  ,           .   ,         ,           .    .,          (        )          . ,              , , ,    .

        3.     ,        ,   .        ,  ,        , ,          ,    .      ,    .      .

         .  .   .    .       , .    , ,  ,          .          .   .,    ,   ,       ,     .     ,          ,       .       ,           (  ., ., ., .).

.                ,      .    ໠     ,                ,     . .          , ,   ,    :      , ,  ,       ,        ,     ,   ,  ,  (, 1997, 2002).             ,      .

      ,           .   .,    ,   (  )       ,    頖    (, 2002).           ,  ,           .              ,      ,  ,       .       ,    ,      .

.,          ,    ,    ,  ,      ,        ,       .        (   )     ,   , ,  .      .      (, 2002).

               ( )   .    ⠖     (., ., ., ., .)        (  .  ., ., .-  )      ,             .         ,      ,   ,   ,         ,  ,      .

 ,    - (., ., X. , .),        ,     ,        .     ,           ,      ,    ,        .       , ,       ;    .        ; , L. Bellak (.: Goldstein, 1978)  :

    ,   (reality testing),  ( )  (sense of reality);

      (impulse control),    ,  , , ,   ;

       (object relations);

      (,  ,      , , , ,  );

  (autonomous functions),      , , ,  堖      ;

  (synthetic functions),           ,   ;

   (defensive functioning).

  ,          ,   . ,      -       ,       .

           (., .-, ., ., ..  ),     ()   ().     (schizis),  ,     ,  ,  ()  (-, 1998).         ,    ,    ,      (  )   .

        ,    ., .-, .         ,   ,    ,   .   .-, ,      ,      ,         (  ) (-, 1998, . 84).

 ,       ,      , ,    -,   -,           . S. Akhtar :   -       .                      (Akhtar, 1984, . 1382).         ,  ,     .

       .ࠖ  ,         .   ,  ,        ,   ,   蠖     ,    ( ),    (, 1995).         ,   ()        ,    .   ,   .      ,     ,   , .       .            .     ,                    .

            ,                     ,   - /    .       ,            . (, 2008).       (      )    , , ,  ,     ,    ,          ,      (Armelius, Granberg, 2000).

 ,              ,       .        ,              (.: R. Lucas, 2003).

                          ,         , ,    (Horowitz, 1987).       ,    ,            .     ,            ,               (, , 2008; , , 2000, 2010; , 2015; , 2009).




1.2.  -          


  ,      ,   (   )    ,     -   ,    .         ,  .  .,    ,     ,    .  ,    ,          ,  ,             ,    (,      )    (.: Rutherford, 2003).              ( )    (.   Salzinger et al., 1970).             ,     ,       ,     .

           , ,   (.  Leitenberg (Ed.), 1976).         ,      (token economy) (Ayllon, Azrin, 1965, 1968);          , ,   , ,         .

            ,     ,              ,      .      ,         (Paul, Lentz, 1977),       (Wakefield, 1977).

             , .. ,      (Liberman, 1972).      ,       .             ( ),           .          (      ,     ,  ).    ,    ,   , ,    ,      ,     ,   ,      (Wykes, Gaag, 2001).   ,        , ,      ,   ,   .            ,        .

        ,  ,             :   ,    (    ) , ,  .    ,        ,    ,    ,     ,    (Liberman et al., 1994; Smith et al., 1996).             ,         .

       (social skills training)  :

   (stress management training) (Meichenbaum, Cameron, 1973)       (Bradshaw, 1996; Tarrier et al., 1998),

   (assertiveness training) (Degleris et al., 2008),

   (communication skills training) (Wallace, 1984; Smith et al., 1996; Liberman et al., 1989),

    (problem solving skills) (Liberman et al., 1986).

   :  ,        ,      (Nicol et al., 2000;    , 2002).          (Wallace et al., 1992; Pilling et al., 2002; Heinssen et al., 2000; , 1993).

 ,    .,      ,         .   70- . XX ,               .              ,       . -  ()   ,       ,       ,     ,     (Handbook of Cognitive-Behavioral Therapies, 2000, p. 8);                (, , 2000; , 2011).

      .   ,   ,    ,    ࠖ   ,   .  ࠖ   ,      ,      ,          -    (Bellack et al., 1999; Green, 1993-1999; Wykes et al., 1999, 2003).      , ,    ;     Cognitive remediation (Green, 1993; Wykes, 2003), Neurocognitive remediation (Wykes et al., 1999), Neurocognitive Engagment Therapy (Bell et al., 2005; Hogarty, Flesher, 1999a, b), Schematic cognitive therapy (Kingdon, Turkington, 2005), Cognitive-Behavioural Group Therapy (Veltro et al., 2006)  .              ;      ,       .

      ,          (social cognition)      ,       .         ,      ,    ,     .            , ,   (Eack et al., 2007).

                (Davidson, Strauss, 1995; Hogarty et al., 2004; Strauss, 1994; .).  ,        ,       ; , -     ࠖ Cognitively-oriented psychotherapy for early psychosis (Jackson et al., 1998; 1999)     Integrated Neurocognitive Therapy (Mullier, Roder, 2010).

     (Gould et al., 2001; Rector, Beck, 2001; Pilling et al., 2002; Tarrier, Wykes, 2004)      ,   ,        .                ,                 (Lynch et al., 2010).

   20    ,    頖 Integrated Psychological Therapy (IPT) (Brenner et al., 1994; Spaulding et al., 1999),    (.:   ., 2007).              .               ,           .       (Addington, Saeedi, Addington, 2006; Green et al., 2004; Roder et al., 2006).             (Roder et al., 2006).   IPT         ()   ,      ( , )    ( ,  ),              (  , 2007; . ).

          .        1950- .  .,        (Beck, 1952),          .          ,    ;                       ,     .        .

     ,         (Kingdon, Turkington, 2005).       :   ,            ,        ,         .       (Bentall et al., 1994; Trower et al., 2004),   (Chadwick et al., 1996; Fowler et al., 1995; Kingdon, Turkington, 2000, 2005; Turkington et al., 1998-2006;   ., 2011),       (Perivoliotis, Cather, 2009),              (Turkington, Siddle, 1998; Turkington, Kingdon, 2000).

   ,             ,   ,     ..             :      ,      ,        (Bentall et al., 1989, 1991, 1999).           ,  堖     (Bentall et al., 1991; Kinderman, Bentall, 1996).   ,           ,        , ..       .

      㠖 Metacognitive Training (Moritz, Woodward, 2007a,b; Moritz et al., 2010),             ;          .          ,             (   ),         ,     .                      .

 ,       ,      (, 2012;   ., 2011),        .           (recovery)   (Deegan, 1997: McGorry, 1992; Perivoliotis, Cather, 2009).     ,      .    (Turkington, McKenna, 2003) ,   -     ,     :     ,        ,      ,            .

                 ,       , ,   ,    ,  ,       .      ,           .            ,       (Lynch et al., 2010; Velligan et al., 2009; Mullier, Roder, 2010;   ., 2007, , 2012).         7.




1.3.            


     ,        .           ,  .-.   XX          , , ,       ,           (.),      (.),     (.). .-,   .        (, 2004)  ,            ,    ;       ,   ,   , ,   , , .      -  ,  ,        (, , 1998).

,    ,       ,          (Neill, 1990),   ,       ,      (Hartwell, 1996).

   T. Lidz,    ,            (Schizophrenia and the Family, 1965).         ,      :   (marital schism)    (marital skew),         .           . T. Lidz       ,      ,       (folie ? deux),     (folie en famille).                        ,       .

         .,                 .        Steps to an Ecology of Mind (, 2000).      ., .,   ,          .  ,            ,          (      , , );       , .     ,         ,        ,          (   ,      ..).    .         ,     ;      ,    ,          ( , .231232).      ,   ,          (double bind),      (, 2000).

.   ,      ,      .   ,  ,     ,     ,    ,      .,      ,     ,   .     ,         .    .,    ,   (   )      :   ,         (  ., 2000).   3.         ,          ,   ,   , , ,  , .

           (  ., 2010)        .    .  . ,   ,          ,          . ,     ,    (  )   ,  , ,  , , ..  ,      堖  .

.,      ,     ,      ,    --   .        (Bowen, 1978),   :

         ,        (emotional divorce);

 ,  ,            (   -        );

       ,       ;

    (multigenerational transmission process),                 ;

   (emotional cut off);

       .

.      , ,   젖    .           ,  ,     ,   .   ,   ,  .,             .

        (   ),       (  ,  ) (Brown et al., 1958, 1972).   ,             ( ) :       頖   (expressed emotion ),      (Brown et al., 1958, 1972; Vaughn, Leff, 1976).         (Camberwell Family Interview CFI),       (Rutter, Brown, 1966; Vaughn, Leff, 1976).         , ,   , ,  , ,       (Platman, 1983).

        ,     (Doane et al., 1981),    (Diamond, Doane, 1994),   (Lewis et al., 1981; Miklowitz, Stackman, 1992).       ,       (Valone et al., 1983; Jones et al., 1994; Cannon et al., 1999),        (Hooley et al., 1986; Hodes, LeGrange, 1993),       (Vaughn et al., 1984);       ,    (Isohanni M. et al., 2001; Wearden et al., 2000; Kymalainen et al., 2008).

            ,    ,            .       .. (, 1960, 1995)         .. (, 1969).  ..         ,      ;          (, 1995).  ,          ,   .     ,      ,   ,  -  - (, 1960, . 21).         (  ,     ),         .    ,         (, 1978, 1980; , 1973; , 1988),               (  ., 1988; , , 1984  ).

              ,    :  ,     ,    (Migone, 1991),      (Miklowitz et al. 1989; Moore, Kuipers, 1992).       ,     ,       (  ,      ),        (   ).                 .




1.4.    


                      (Hollingshead, Redlich, 1958);        (social stress)    (social causation) ( ),      (social drift) (Clark, 1949; Dohrenwend, Shrout, 1985).

   ,    .      .,           (Folkman, Lazarus, 1988; Lazarus, 1990).                 (Dohrenwend, Shrout, 1985),       ,         ( )   (,     ).

                (life events),        ,             (, 2012; Malla et al., 1990).           (Brown et al., 1972).                (.  Jarvis, 1998; Sharpley et al., 2001).         ,  ,       ,   蠖      - (Cooper, 2005; Selten, Cantor-Graae, 2005; Hjern, 2004).     ,   (Fossion et al., 2004),    (Mallett et al., 2004),    (Patino et al., 2005),     ,      (Cooper, 2005).  -            ,    ,          (Cantor-Graae, Selten, 2005; Selten et al., 2007).

           ,           ( , 2001).            ,  ,      ,       ,    .




  .


   .

   ,     (https://www.litres.ru/a-b-holmogorova/narusheniya-socialnogo-poznaniya-novaya-paradigma-v-issledovaniyah-centralnogo-psihologicheskogo-deficita-pri-shizofrenii/)  .

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