Cybernetics, activation, and drug effects.
Patients present unique combinations of familial relationships, developmental idiosyncrasies, social aberrations, affective states, cognitive abilities, symptoms, defects, and maladaptations. Psychopharmacological treatments form a useful approach to cutting through this complexity to the core pathophysiology. Focusing on disorders that can be brought to complete remission by medication suggests that retarded and agitated depressions, manic and angry hyperactive paranoid states, panic disorder, emotionally unstable character disorders and schizophrenias are governed by the degree of derangement of an affective-activation control system. Defects in this control system are best conceptualized in cybernetic terms rather than in terms of the current rheostat models. Conceptualization of cybernetic defects allows for understanding of psychopathological developments as well as give a framework for pharmacological benefits. One aspect of the activation-affective disorders, are disorders of two types of pleasure regulatory mechanism, here referred to as appetitive and consummatory. The relationship of disorders of these hedonic control mechanisms to affective states and those of drug abuse are considered. This schema also affirms a close relationship between the bipolar affective disorders and the schizophrenias.
Klein
D F
DF
New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, New York.
D001143:Arousal; D001714:Bipolar Disorder / Q000188:drug therapy; D001883:Borderline Personality Disorder / Q000188:drug therapy; D003491:Cybernetics; D003866:Depressive Disorder / Q000188:drug therapy; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy / Q000503:physiopathology*; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy; D010990:Pleasure-Pain Principle; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy
D011619:Psychotropic Drugs