Affective agnosia, an impairment in knowing how one feels emotionally, has been described as an extreme deficit in the experience and expression of emotion that may confer heightened risk for adverse medical outcomes. Alexithymia, by contrast, has been proposed as an over-arching construct that includes a spectrum of deficits of varying severity, including affective agnosia at the more severe end. This perspective has been challenged by Taylor and colleagues, who argue that the concept of affective agnosia is unnecessary. We compare these two perspectives by highlighting areas of agreement, reasons for asserting the importance of the affective agnosia concept, errors in Taylor and colleagues’ critique, and measurement issues. The need for performance-based measures of the ability to mentally represent emotional states in addition to metacognitive measures is emphasized. We then draw on a previously proposed three-process model of emotional awareness that distinguishes affective response generation, conceptualization and cognitive control processes which interact to produce a variety of emotional awareness and alexithymia phenotypes - including affective agnosia. The tools for measuring these three processes, their neural substrates, the mechanisms of brain-body interactions that confer heightened risk for adverse medical outcomes, and the differential treatment implications for different kinds of deficits are described. By conceptualizing alexithymia as a spectrum of deficits, the opportunity to match specific deficit mechanisms with personalized treatment for patients will be enhanced.

中文翻译：

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情感性失神症：情感障碍频谱中的核心情感加工缺陷

情感上的失知症（一种了解人的情感感受的障碍）已被描述为体验和情感表达的极端缺陷，可能会增加不良医疗后果的风险。相比之下，Alexithymia已被建议作为一种总体架构，其中包括一系列严重程度各不相同的缺陷，包括在较严重的一端的情感失认。泰勒及其同事对这种观点提出了挑战，他们认为情感无知的概念是不必要的。我们通过强调达成共识的领域，断言情感不可知论概念重要性的原因，泰勒及其同事的批评中的错误以及测量问题来比较这两种观点。强调除了元认知措施外，还需要基于表现的方法来在心理上表现情绪状态的能力。然后，我们基于先前提出的情绪意识的三过程模型，该模型区分了情感反应的产生，概念化和认知控制过程，这些过程相互作用以产生各种情绪意识和智力障碍表型-包括情感失认。描述了用于测量这三个过程的工具，它们的神经底物，赋予不良医学结果更高风险的脑机相互作用机制，以及对不同类型缺陷的不同治疗含义。通过将运动障碍概念化为一系列缺陷，