The Psychopathological Process as a System of Dysfunction and Systemic Compensation with Top-Down Modulation

Abstract

In agreement with a systemic approach to mental illness, it is possible to detect five components in the pathogenesis of a psychiatric disorder: overload/subjective discomfort, relational disorders/social disorder, loss of emerging functions, appearance of less adaptable primary functions, activation of top-down reactions with the emergency of compensatory activities of collateral systems At the base of these processes it could be the reduced integration of a subsystem, which would lead to the loss of flexibility of the entire mind system, with the appearance of the five psychopathological components described above. To confirm this hypothesis we have observed data got from some studies performed with high-density EEG recording during neuropsychological tests. In these studies, subjects with a history of maltreatment (having problems in error management, meaning attribution, and social relations) resulted in a different brain integration than controls, with a reduction in the level of integration in some areas and with an appearance of new integrations in different areas; at the same time, behavioral response tends to extend over time with late aware operations, corresponding to the time window of the LPP event related potential (450–1000 ms), while controls seem perform quicker evaluations, in the time windows of the P3 wave (250–450 ms). Differently from control subjects, maltreated people have a greater difficulty also in distinguishing non-significant stimuli and in inhibiting unnecessary responses, although the presence of a warning stimulus supports the strengthening of the self-control functions. These responses would therefore confirm the reference theoretical model, as the loss of integration of some brain areas results in a loss of efficiency in the cognitive performance with less mind control in the responses. The possibility to reach comparable performances with those of control subjects seems to relate to a different resource use (collateral compensation) and to a greater consequent response delay (loss of efficiency). The presence of a collateral compensation may be explained with the presence of top-down modulation functions of emerging properties, which in the specific case may be represented by conscious mental activities and by the need for warranting congruity with the external request.