教授:下一题 若父母之一患有精神分裂症 Prof: Ok, if one of your parents has schizophrenia
那么孩子也很可能患上这种病 you are likely to develop schizophrenia
学生:错误 Student: False
教授:没错 Prof: False
这些孩子相比其他人的确有更高的患病风险 You are at risk for sure, greater than everybody else
但不一定会罹患上精神分裂症 but not likely to develop schizophrenia
还是很少发生的 It's a fairly rare thing
下一题 一项纵向研究中 李﹒罗宾斯分析了 In a longitudinal study, Lee Robins examined
精神分裂症成人患者 童年期的性格特点 the childhood characteristics of adults schizophrenics
下列哪一项是最可能出现的童年期表现 Which of the following were they more likely to display as children?
学生:B Student: B
教授:品行问题 Prof: Conduct problems
相对于精神分裂症 as opposed to schizophrenia
精神分裂的症状一般始于青少年时期 schizophrenic symptoms typically appear at adolescence
青少年时期发病 the onset of adolescence
但是当你回过头看他们的童年 but you can see, especially retrospectively
情况是完全不同的 things are different in their childhoods
不一定是 but not necessarily the kind of
童年和青少年时期发病典型的 delusions, hallucinations, hearing voices
妄想症 幻觉 幻听等 that you see, you know, at the onset of adolescence and puberty
我住的街区有个孩子 In fact, I remember there was a kid on my block growing up
长大之后患上了精神分裂症 that later developed schizophrenia
他和我们提到的状况相似 and he actually fit this example very well, which is...
他就是当地的小霸王 you know, the kid he was just kind of a bully
比我 我哥哥和其他孩子 and he was a couple of years older
要大好几岁 than my brother and I and some others
他简直就是 and so he was just kind of a...you know
我们那一区的捣蛋鬼 troublemaker in the neighborhood
之后 他发展出了精神分裂症状 But then, later in life developed schizophrenic symptoms
再演变成精神分裂症 General schizophrenia...
我住在巴尔的摩地区 like actually, I live in the city in Baltimore area
一个叫联邦山的城市 called like Federal Hill
街上总是有一名 and there's this one guy, schizophrenic guy
精神分裂症患者在游荡 who's on the street all the time
我想他应该无家可归 I assume he's homeless;
他会就这么出现 站在街角 he just comes, stands on the street corner
大声地自言自语 talking out loud to himself
我认识的人们总是很担心 and... you know, people I know are often concerned about
因为街上有个精神病 you know, like, schizophrenics
那我们住在这里安全么 you know, are we safe, kind of, in the neighborhood?
精神分裂症以及偏执型精神分裂症患者在周围 Schizophrenics, the paranoid schizophrenics
是不是真的需要引起我们的担心呢 are ones that you have to have that particular kind of concern about
因为他们有种观点 because they have these kind of ideas
会认为周围人都对他们抱有敌意 that people are out to get in
并因此变得暴力 and they may become violent because of that
但另一方面 But otherwise
精神分裂症患者未必比其他人更暴力 schizophrenics aren't necessarily more violent than anybody else is
我们已经了解一些 We know a little something
以后还会了解更多精神分裂症的信息 or we're starting to know a little something about schizophrenia
它和潜在遗传学相关 and, kind of, potential genetics involved with it
旁白:不知为何 艾德霍利斯特开始抽烟后 Narrator: For some reason when Ed Hollister smokes cigarettes
这似乎反而可以抑制他头脑中的那个声音 it helped dampen the voices that grow in his head
艾德:有一次我甚至拿起一把枪对准了自己的脑袋 Ed: At one point I actually put a 20-gauge to my head
正是那时我才意识到 and it was at that time when I realized that
我不能这样下去了 there was too much here that I didn't wanna miss
旁白:霍利斯特患有精神分裂症 Narrator: Hollister suffered from schizophrenia
精神疾病可以由药物控制 the brain disorder which can be controlled by drugs
大概400万美国人都因精神分裂症而产生幻觉 causes frightening hallucinations in an estimated four million Americans
艾德:就好象你内心有个声音 Ed: It was, kinda' like something inside that's
在对这世界上所有的一切不公嚎叫 yelling about all the bad things that there were in this world
旁白:精神分裂症患者一般吸烟都很厉害 Narrator: Schizophrenics tend to be heavy smokers
医生们已经找到这个问题的答案了 Now doctors think they know why
尼古丁能短暂地弥补某条明显的缺陷基因 Nicotine temporarily makes up for an apparently defective gene
正常情况下该基因会响应一种重要的人脑化学物 It normally responds to an important brain chemical
尼古丁可模仿该种化学物 that nicotine can imitate
弗里德曼博士:他们告诉我们 吸烟的时候 Dr. Freedman: They report to us that when they've smoked
刚吸完烟后 声音会有所减退 immediately after the smoking the voices decrease
他们更有方向感 能够专注做点事 and they all much more oriented and are able to attend to things
旁白:一项调查研究了九个 Narrator: A new study done of
有着精神分裂患者的家庭 nine families with schizophrenic members
显示很多精神分裂患者 shows that the difficulty many schizophrenics have
都不能分辨声音 in sorting out sounds
这和这条能控制尼古丁的基因有联系 is connected to this gene controlling nicotine
研究称 这是人类第一次将精神分裂症状 It's the first time a schizophrenia symptom
追溯到一个特定的基因上 has been traced to a specific gene, researchers say
弗里德曼博士:90%的精神分裂症患者 Dr. Freedman: We know the defect
都存在这一基因缺陷 is present in 90% of schizophrenics
当我们追溯家族中这一缺陷的遗传时 and when we traced the inheritance of this defect to the families
就发现 精神分裂症也以同样的模式遗传 the inheritance of schizophrenia seems to follow the same pattern
旁白:但科学家还没弄清楚到底是什么缺陷 Narrator: While scientists haven't found the exact defect yet
只知道缺陷存在于第15对染色体中 they know it's on Chromosome 15
该址上 已经有其他基因被认为会导致精神疾病 already a site of other genes suspected in mental illness
对这种基因受体的初步研究显示 Based on the preliminary link to this so-called receptor gene
仿尼古丁药物可以用于治疗精神分裂症 nicotine-like drugs could be used to treat schizophrenia
弗里德曼博士:现在我们既然 Dr. Freedman: We're hoping that
理解了这其中的机制 now that we understand that this mechanism is involved
就可以设计出更好的疗法 that we can devise treatments that are better
至少要比抽烟更健康更长寿 in terms of being safer and longer lasting than cigarettes
现有的精神分裂症药物也很有用 The current drugs to combat schizophrenia are useful
但却不能根治精神分裂症 but nothing at the moment comes close to a cure
CNN电视台 杰夫·莱文报道 Jeff Levine, CNN, reporting
教授:书中提到的自闭症例子是什么 Prof: What was the example of autism in the book?
学生:艾伦 Student: Aaron
教授:艾伦沉迷于星际迷航（一种游戏） Prof: Aaron, who is obsessed with Star Trek
选项B里提到 拍鞋子的孩子 "B" is actually the tapping on the shoe whether with foot...
实际上是我诊治过的一位... is a kid I knew and worked...
我不是他的家庭诊疗师 well, I wasn't the primary therapist
不过 这孩子算得上是强迫症患者的典型了 but, an example of a kid with Obsessive Compulsive Disorder that...
我之前上课提到过他么 did I mention this kid in the classroom?
我想因为一些原因 我(听不清) Thought I (INAUDIBLE) for some reason
但他会 嗯 常见的强迫症 But he would... Obsessive Compulsive Disorder is the one
包括 人们不由自主的不停洗手 where you think of people washing their hands a lot
还有事情必须得按特定方式完成 You know, they need things in very particular ways
但我要说的这一例...... But this guy that I was working with...
他住在康涅狄格州 this was up in Connecticut
他十分恐惧 he had a thing about walking through
穿门而过这类事情 the kind of phobia about walking through the doors
他会先走到门边 And so, he would like walk up
但在跨过门槛之前 and before he'd go through a door
一定要拍拍自己的鞋或者别人的鞋 he would just need to tap his shoes, somebody else's shoe
不然是不会走过去的 and then he could go through the door
不知怎么的 You know, somehow that
他只是需要这种方式 he had in some point in his life associated that with, kind of
就能够抑制生活中的恐惧 you know, that curbs his fears
就不会有不良后果 and nothing bad happens
他实际上 And he actually...
治疗患有强迫症的孩子 you know, one thing that makes it hard
比较麻烦的地方在于 working with Obsessive Compulsive Disorder-type kids
他本身是没有错的 is that, he's right
他拍拍别人的脚 You know, he taps somebody's foot
然后跨过门槛 什么都没有发生 he goes through the door and nothing happens
这逐渐形成了一种定势 You know, so... so, it's reinforcing to itself
他每做一次这个动作 脑海里就会强调一遍 because every time he does it, he reinforces in his head
噢 你看 我摸了别人的鞋子 就没事儿了 "oh, look, when I touch somebody's shoe, nothing happens."
当然啦 他知道 But, of course, he's got this...
如果一开始就形成了错误的观念 you know, the association's wrong in the first place
那么日后就只会日渐加深 but it's reinforcing every time he does it
好了 这个强迫症的极端例子就到这里 So... anyway, just a kind of extreme example of OCD
当然 和注意力缺陷多动症(ADHD)相比 And of course, again, like we were talking about with ADHD
强迫症更具有连续性 Obsessive Compulsive Disorder is something that's a continue
我们每个人都有些强迫症状 And we're all like obsessive compulsive
也可以称之为"肛门阶段" or anal, you might call it
我们都或多或少有些"肛门阶段" You know, we're all different degrees of anal
我自己也有 You know, I have, myself, have
一定程度的强迫倾向 certain obsessive compulsive tendencies
但还不到称之为疾病的程度 Not that I'm disordered or anything
这个课堂上的我们 but in the spectrum of all of us
正在一起讨论疾病 kind of being along here with this being disorder
我站在这个地方 I'm on this half somewhere
我不知道你们注意到没有 I don't know if you noticed
我会将椅子推到教室边上 like the way I've pushed the chairs to the side of the room
让它们有序地摆放在那里 You know, they're kind of organized
而不是随意扔在角落里 as opposed to just randomly putting them in the corner
虽然这不是什么起眼的事情 I mean, it's not a big deal
我们不少人都会这样做 It's something a lot of us could do
谁不愿意保持东西的整洁呢 but... or, like, you know, keeping things certain neat
这里有一堆很杂乱的东西 I have piles here that are pretty...
我就很自然地想把它们摆放整齐 you know, I know where things are here
这没什么 So, I mean, again, that's not a big deal
但我们或多或少都喜欢东西整洁 but we have different levels of kind of being organized
并会开始整理 and to begin
因此强迫症是持续性的 So, it's something that's kind of on a continuum
而最极端的情况 可能会被视为带有 with the most extreme being labeled a disorder
强迫特质的精神障碍 with those kind of traits
那既然我们提到了ADHD And, of course, as we've talked about with ADHD
这里的底线就在于 它是否影响你的正常生活 the real dividing line is, does it interfere with your functioning?
强迫症是人可以适应的 I mean, being obsessive compulsive is adaptive
它甚至可以帮你迈向成功 and it helps you be successful
例如可以使你有条理的生活 工作 like, in terms of organizing your life or your work
学习或者其他事物 or your schoolwork, or whatever
但有的时候 But, when the point where
比如说你整理的需求已经开始 like your kind of need to organize outweighs
降低你的工作效率 kind of your ability to be productive
学习效率 或其它效率的时候 whether it be at work or school, or whatever
这时强迫症就对你适应不良了 that's when it starts becoming maladaptive for you
现在的问题是ADD这类障碍 The question is like ADD, you know
是否是有潜在益处的 is some of it potentially a good thing
也有很多人是这么说的 And people certainly suggest it is
有些人提到创造力 Other people talk about creativity
ADHD不一定会让人有创造力 And not that being ADHD necessarily makes you creative
但它在某种意义上确实能够发散思维 but it's kind of looseness of thoughts, you know, in a sense
有很多艺术家就是这样 A lot, some, you know, certain artists
有些患有ADHD的人的确是很有创意的人 you know, other types that are ADHD are very creative types
因此有人认为 You know, and so people suggest that, you know
这种障碍还是有正面影响的 there are some positive aspects to this thing
好的 Yeah
哪一项是自闭症儿童的特征 Characteristic of autistic children
学生:思维盲区 Student: Mind blindness
教授:对 有人能描述一下思维盲区么？ Prof: Mind blindness. Can somebody describe what that is?
什么是思维盲区？ What is mind blindness?
请说 Yeah
学生:就是他们无法意识到 Student: They're not aware that
其他人也是有思想有感情的 like, other people have thoughts and feelings and things
或者不能理解这之间的联系 or don't understand association with their...
教授:是的 大多数自闭症儿童的特征 Prof: Yeah, and a big part of the characteristic of autistic children
就是社交障碍 不通情理 is the kind of impaired social interactions, the non-contingencies
有一部分就属于思维盲区 And a part of that is mind blindness
也就是说 meaning autistic children
自闭症儿童感受不到他人的情感 have not aware of whether other people's feelings
也无法理解其他人行为背后 or the reasons why the kind of intentions
的意图 behind what other people do things
这些孩子从自我的不断发展 There's different reasons why...
到变得不那么自我中心 I mean, there's a developmental trajectory
是有发展轨迹可寻的 where those kids go through where they progress through ego
当中的原因不尽相同 you know, are able to be less egocentric
但自闭症还和生理原因相关 But there seems to be, kind of, biological reasons behind autism
不能简单地归结成 It's not as simple as saying
自闭症儿童还没有经过 they haven't passed the developmental stage
具体运行期的发展阶段 不能这么说 of being, of getting into, like, concrete operations. Yeah
学生:还有 我认为自我中心的孩子们 Student: Also, it kind of seems to me
和正常人不一样在于 with the egocentric kids
正常儿童可能会这样思考说 a lot of these folks who are, like, kids saying
比如说 如果我不开心 我就想要一个玩偶 "well, I know that I would want a doll if I was upset
因为我认为 so I'll give this person a doll
别人的感觉和我应该是一样的 because I'm assuming that
所以如果他不高兴 我也要给他一个玩偶 this person feels that everything is exact same thing that I do"
但我觉得自闭症儿童则选择逃避这一切 But, autistic children, seems to me they prefer t o avoid it altogether
教授:是的 他们有一定的疏离感 Prof: Yeah, there's a detachment, in a sense
有多少人了解自闭症儿童 How many know autistic kids?
谁能描述一些相应的行为呢？ Just some, couple of examples of descriptions of behaviors?
好吧 他们对事物有着特定要求 Right, so, yeah, the very kind of needing things in a certain...
一旦事情和他们脑海里设定的不一样 when things aren't the way they have in their head
他们就会变得很失落 they get very upset about that
女士:停下来 数数来 一 Woman: Stop, no. Count. Count, one...
别咬手 从一开始数数 一 no biting. Count, one... you say one
孩子:一 Child: One
女士:二 Woman: Two
孩子:T Child: T
女士:是三 Woman: Three
孩子:Fow Child: Fow
女士:是四 Woman: Four
孩子:Fun Child: Fun
女士:是五 Woman: Five
孩子:十六 Child: sixteen
女士:六 Woman: Six
孩子:七 Child: Seven
女士:七 Woman: Seven
孩子:八 Child: Eight
女士:八 Woman: Eight
孩子:九 Child: Nine
女士:九 Woman: Nine
孩子:十 Child: Ten
女士:十 Woman: Ten
孩子:斯一 Child: evan
女士:十一 Woman: Eleven
孩子:十二 Child: Twelve
女士:就我们目前的情形而言 Woman: There wasn't anything really obviously wrong
还没有什么需要担心的 at least as far as we were concerned
想想当初 有人跟我说过这样的话 Now, looking back, I've had people tell me
这个宝宝真是安静得要命啊 "yeah, she was an awfully quiet baby"
她从来不哭 She never cried
我们还以为是自己教导有方 We thought we're great parents, you know
但后来才知道是她得了自闭症 呵呵 But, turns out something's wrong, hehe
维诺妮卡不怎么和别人接触 Veronica doesn't really relate to other people
她也不怎么开朗 She never has been very social
我听说 I've heard and read about
自闭症的孩子不愿和人眼神交流 autistic children have a very poor eye contact
虽然她这方面并不怎么样 Her certainly isn't the best
但在我看来已经算不错了 but it's pretty good from what I understand
维诺妮卡也能够将单词和词所代表的事物 I think that Veronica has successfully attached
正确的联系起来 the meaning of certain words to the objects
比如水 薯条这些基本的东西 such as water, chip, a few very basic things
她知道汉堡包和热狗的区别 She knows that ham and hot dog are different
她还会提出自己的要求 and she'll actually ask for things
她有时候会... She has attached...
解读他们想要表达的意思 it's funny trying to unlock the mystery of
是一个有趣的过程 what they're trying to say
她可能会拿着鞋出现在你面前 She'll come with her shoes
把鞋交给你 让你帮她穿上 She'll give you her shoes and she'll want her shoes on
但她的目的不是穿鞋 而是想出去玩 She doesn't want her shoes on; she just wants to go outside
她知道我们出门的时候需要穿鞋 And she knows that you put your shoes on before you go out
维诺妮卡会用伤害性行为来表达自己 Veronica has expressed herself with injurious behavior
我曾经因为这样的症状而觉得气馁 and I was dismayed to see that surface
因为我读过相关材料 还挺庆幸她没这么干过 because I had read about it and I was glad she wasn't doing it
她在塔吉特超市的时候会突然发脾气 As a matter of fact, she was having a tantrum in the Target store
用力的把脑袋砸到地上 and she banged her head on the floor
然后用眼神告诉我她很疼 and gave me a look, as if to say, "that hurt!"
随即就停止了 她不会继续下去 And she stopped. She wouldn't do it
她生气的时候 会拿自己的拼图砸脑袋 When she is angry, she'll take her puzzle and bang her head
如果拼图进展不顺利 她也会砸脑袋 If the puzzle isn't working right, she'll bang
还有她不想理我的时候也这样 or if I tell her to come and she doesn't wanna to come...
狠狠的砸下去 Bang! Bang! Bang!
教授:很显然 Prof: Clearly
作为自闭症儿童的家长会遇到很多困难 being a parent of an autistic child is challenging
自闭症也有不同的等级 There's certainly... there's different degrees of autism
有非常轻微的自闭症状 You know, there's some very mild forms of autism
例如她的这些脾气 You know, you saw the tantrum she threw
但也有情形严重的 But there are even more severe
例如砸脑袋这种事情 You heard her talking about head banging
这算是很严重的情况了 That's a common problem that's very severe
家长要教孩子处理情绪 You gotta teach kids to kind of work on that
这位母亲应该还算应付得来 This mom seems to have, you know, have taken things well
大多数母亲也做得到 就是太辛苦了 Most moms do but it can be very challenging
学生:我妈妈负责教育自闭症儿童 Student: My mom works with autistic children
在特殊学校里接受特殊教育的孩子 and, special education children, and, like at a special school
其中有不少是自闭症儿童 and she had a lot of autistic children
有些人随年龄增长越发趋向暴力 and some of them, as they get older, they become more violent
她告诉我 有一个孩子 Like, she told me one time this kid
曾经掀翻了教室里的课桌和其他东西 he threw desks across the classroom and everything
这时的孩子是很难掌控的 And, at times they're very hard to handle
他们会用拳头打 会咬你 很难应付 because they punch, they bite, and it's very difficult
家长必须有耐心才行 You have to have patience with them
教授:是的 我在在康涅狄格州工作的时候 Prof: Yeah, one girl, when I was working at a, up in Connecticut
在精神病住院病房里工作 an inpatient unit, meaning psychiatric...
孩子们在那里住院 you know, where kids stayed there
有一个小姑娘 我也不记得具体年龄 But she was a little girl; I forget how old
大概7岁左右吧 but probably like seven or so
但是也患有这种社交缺陷 But, you know, this impaired social interactions
见到陌生人会变得紧张 and maybe a nervousness about meeting new people
她第一次见你 可能会踢你 甚至咬你 Like, when she would meet you, she would kick you, or bite you
可这只是她和人打招呼的方式 So, you know, that was, kind of, her way to say "hello"
只有很少人能够 And so, it just takes a certain person to be able to
理解他们的这些行为 kind of, you know, not get frazzled and you know, do that
并且对他们不离不弃 and, you know, kind of stay with that kid
视频里面也提到了这一点 You see, by the way... well, the video talked about this
这当中存在一种高相关性 You know, there is a high correlation
不是相关性 是一种伴随疾病 not correlation, correspondence, co-morbidity?
伴随疾病就是说 What co-morbidity means is, like
如果你患有某种情绪障碍 if you have one emotional disorder
则也有可能也患有另一种情绪障碍 you also have another
例如ADHD和品行障碍 Between ADHD and conduct disorder
我们很容易发现 and not surprisingly, you know
那些行为冲动的孩子 kids who kind of are impulsive in their behaviors
更容易和其他孩子产生负面互动 will tend to get into negative kind of interactions with other kids
这也许就是其中的主要原因 And that's probably the main reason