重新构建持续性头晕的生活体验：来自主动推理的洞见。

文献信息

中文摘要

我们提出一种基于生成主义与生态心理学模型的持续性头晕的主动推理解释；其中包括患者生活体验的第一手叙述。在机制层面，我们认为持续性头晕反映了前庭及其他感觉预测误差的初始感觉衰减失败。如果患者推断或习得未衰减的预测误差无法通过行动解决，这种失败便会自我维持。由此形成的表述为头晕的病理生理学提供了整合性解释，并说明其如何支撑情感推理以及塑造头晕患者体验的能动感改变，同时又如何被后者所维持。我们从临床视角突出所提供的一种整体、以人为中心的方法，并在该理论框架下考虑互补层面的治疗干预。

英文摘要

We present an active inference account of persistent dizziness predicated on models of enactivism and ecological psychology; including first-hand accounts of the patient's lived experience. Mechanistically, we consider persistent dizziness to reflect an initial failure of sensory attenuation of vestibular and other sensory prediction errors. This failure becomes self-maintaining if the patient infers-or learns-that unattenuated prediction errors cannot be resolved through action. The ensuing formulation provides an integrative account of the pathophysiology of dizziness and how it underwrites-and is maintained by-affective inference and an altered sense of agency that shapes the experience of the person with dizziness. We foreground the holistic person-centered approach on offer from a clinical perspective, and consider complementary levels of therapeutic intervention under this theoretical framework.