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Sistemas dinâmicos não lineares em doença mental
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A mente humana é uma estrutura dinâmica complexa e o seu adoecer deverá ser estudado como o são processos em outras estruturas dinâmicas complexas. Os processos de mudança que operam na mente manifestam-se tipicamente por transições qualitativas e súbitas, sensibilidades específicas a certas influências, e também por resiliência perante a adversidade. Todas estas são manifestações de sistemas não lineares. O propósito desta investigação foi entender as mudanças que operam na mente e que conduzem à doença mental, e concretamente à emergência de perturbações do humor. Os indivíduos com perturbações de humor mostram perdas de complexidade da sua variação de humor, ou seja, maior rigidez, regularidade e previsibilidade. A hipótese central desta investigação é que, face à adversidade, os indivíduos resilientes recrutam estratégias de regulação emocional flexíveis e diversas que aumentam a complexidade do seu humor – a resposta de complexidade. Os indivíduos não-resilientes não são tão hábeis nesta resposta porque empregam estratégias rígidas e menos diversas, fazendo emergir perturbações do humor. Procurou-se evidência deste mecanismo tanto em séries temporais do humor reais, como em simulações de um novo modelo dinâmico do humor. Foram recrutados pacientes com perturbações do humor (N=17) e controlos (N=10) que auto-registaram diariamente o seu humor durante uma média de 233 dias, e foram calculadas a complexidade (sample entropy) e a carga de adversidade a partir das séries temporais. Os resultados mostraram que, tanto nos controlos como nos pacientes a complexidade aumentou com a adversidade, mas os pacientes mostraram disrupções substanciais e significativas dessa resposta, com perdas de até 29% da complexidade esperada nos controlos para a mesma carga de adversidade. Foi proposto um novo modelo dinâmico do humor baseado em equações diferenciais não lineares – o modelo SPLIT-CORE. Este modelo implementa mecanismos de regulação emocional como inércia emocional, ruminação depressiva, estratégias ativadoras e clivagem ou alternância entre modos dinâmicos do self. A afinação destes mecanismos permitiu simular diversas características dinâmicas do humor, entre as quais a resposta de complexidade e a sua disrupção em indivíduos que fazem uso rígido de estratégias de regulação emocional. Crucialmente, a alternância de modos dinâmicos do self foi essencial a uma resposta de complexidade saudável, indicando que esta resposta resiliente é o resultado de meta-flexibilidade do self. Esta investigação mostra, no caso concreto das perturbações do humor, como a afinação singular de um mesmo processo humano global não linear pode originar os padrões dinâmicos de sofrimento e incapacidade que compõem as doenças mentais. Isto permitirá dar conta de como as diferenças individuais interagem entre si e com o ambiente, e ser traduzido em monitorização de risco clínico, diagnóstico de mecanismos de doença e intervenções dirigidas e atempadas sobre indivíduos e circunstâncias concretas. Na dinâmica do humor, a resposta de complexidade individual perante a adversidade pode ser promovida pela diversificação de estratégias de regulação emocional. Resiliência requer humor complexo para vidas complicadas.
The human mind is a complex dynamical structure and its falling ill should be studied as are processes in other complex dynamical structures. The processes of change that act in the mind typically manifest as sudden and qualitative transitions, specific sensitivities to certain influences, and also as resilience in the face of adversity. All of these are manifestations of nonlinear dynamical systems. The purpose of this research was to understand the changes that act in the mind which lead to mental illness, and specifically to the emergence of mood disorders. Individuals with affective disorders show losses in the complexity of their mood variation, which appears more rigid, regular and predictable. The central hypothesis of this research is that, in the face of adversity, resilient individuals recruit flexible and diverse emotion regulation strategies that increase the complexity of their mood variation – the complexity response. Non-resilient individuals are not as skilled in this response because they employ rigid and less diverse strategies, giving rise to mood disorders. We searched evidence for this mechanism in both real time series of mood and in simulations of a newly developed dynamical model of mood. We recruited patients with mood disorders (N=17) and controls (N=10) who selfrecorded their daily mood over a mean duration of 233 days, and calculated the complexity (sample entropy) and the load of adversity from the time series. Results showed that, in both controls and patients, complexity increased with adversity but patients displayed significant and substantial disruptions in this response, with losses of up to 29% of the expected complexity of controls for the same load of adversity. We proposed a new dynamical model of mood based on nonlinear differential equations – the SPLIT-CORE model. This model implements emotion regulation mechanisms such as emotional inertia, depressive rumination, activating strategies and splitting or alternation of dynamical modes of the self. The tuning of these mechanisms allowed the simulation of several dynamical features of mood, including the complexity response and its disruption in individuals who rigidly use emotion regulation strategies. Crucially, the alternation of dynamical modes of the self was essential for a healthy complexity response, indicative that this resilient response is the outcome of meta-flexibility of the self. This research shows, in the particular case of mood disorders, how the unique tuning of a same global nonlinear human process may give rise to the dynamical patterns of suffering and disability that comprise mental illnesses. This will allow accounting for how individual differences interact with each other and the environment, and be translated into monitoring clinical risk, diagnosing mechanisms of illness and directing timely interventions to specific individuals and circumstances. Concerning the dynamics of mood, an individual’s complexity response in the face of adversity may be promoted through the diversification of emotion regulation strategies. Resilience requires complex mood for complicated lives.
The human mind is a complex dynamical structure and its falling ill should be studied as are processes in other complex dynamical structures. The processes of change that act in the mind typically manifest as sudden and qualitative transitions, specific sensitivities to certain influences, and also as resilience in the face of adversity. All of these are manifestations of nonlinear dynamical systems. The purpose of this research was to understand the changes that act in the mind which lead to mental illness, and specifically to the emergence of mood disorders. Individuals with affective disorders show losses in the complexity of their mood variation, which appears more rigid, regular and predictable. The central hypothesis of this research is that, in the face of adversity, resilient individuals recruit flexible and diverse emotion regulation strategies that increase the complexity of their mood variation – the complexity response. Non-resilient individuals are not as skilled in this response because they employ rigid and less diverse strategies, giving rise to mood disorders. We searched evidence for this mechanism in both real time series of mood and in simulations of a newly developed dynamical model of mood. We recruited patients with mood disorders (N=17) and controls (N=10) who selfrecorded their daily mood over a mean duration of 233 days, and calculated the complexity (sample entropy) and the load of adversity from the time series. Results showed that, in both controls and patients, complexity increased with adversity but patients displayed significant and substantial disruptions in this response, with losses of up to 29% of the expected complexity of controls for the same load of adversity. We proposed a new dynamical model of mood based on nonlinear differential equations – the SPLIT-CORE model. This model implements emotion regulation mechanisms such as emotional inertia, depressive rumination, activating strategies and splitting or alternation of dynamical modes of the self. The tuning of these mechanisms allowed the simulation of several dynamical features of mood, including the complexity response and its disruption in individuals who rigidly use emotion regulation strategies. Crucially, the alternation of dynamical modes of the self was essential for a healthy complexity response, indicative that this resilient response is the outcome of meta-flexibility of the self. This research shows, in the particular case of mood disorders, how the unique tuning of a same global nonlinear human process may give rise to the dynamical patterns of suffering and disability that comprise mental illnesses. This will allow accounting for how individual differences interact with each other and the environment, and be translated into monitoring clinical risk, diagnosing mechanisms of illness and directing timely interventions to specific individuals and circumstances. Concerning the dynamics of mood, an individual’s complexity response in the face of adversity may be promoted through the diversification of emotion regulation strategies. Resilience requires complex mood for complicated lives.
Descrição
Tese de doutoramento, Ciências Cognitivas, Universidade de Lisboa, Faculdades de Ciências, Faculdade de Letras, Faculdade de Medicina e Faculdade de Psicologia, 2016
Palavras-chave
Doença mental Ciências cognitivas Perturbação bipolar Depressão Resiliência Regulação emocional Teses de doutoramento - 2016