Homosexuality 同性恋 There has been a shift away from a primarily libidinal interpretation toward an interpretation in broader terms to include the vicissitudes of hostility, as well as other more complex pregenital issues and developmental concerns. There has been less emphasis on intrapsychic conflicts as bearing the etiological burden, and increasing awareness of the role of interpersonal and psychosocial complexities and their interplay with intrapsychic factors. The role of homosexuality particularly has come under criticism and more rigorous evaluation. Gardner (1931) found evidence of repressed homosexuality in 45 percent of a sample of 40 unselected cases of paranoid schizophrenia and 80 conditions of paranoid condition. Miller(1941) on the other hand was able to find indications of homosexuality as the basis of paranoia in only 12 of 400 cases. Similarly Klein and Horwitz(1949) reported preoccupations of homosexuality in only 1 out of 5 of a group of 80 cases. More recently Klaf and Davis (1960) reported findings on a large group of paranoid patients and found that homosexual preoccupations, previous homosexual experiences, and same-sex persecutors were found in a significantly higher degree in the paranoid group as opposed to the control group. Planansky and Johnston (1962), however, were unable to establish any clear-cut relationship between paranoia and homosexual concerns and felt that their data would better support a view of these two factors as developmentally independent. They also felt that difficulties and concerns in heterosexual and homosexual areas appeared to be equally distributed among the types of schizophrenia. Likewise De Busscher (1963) finds latent or manifest homosexual desires present in both paranoid and nonparanoid schizophrenics, but has been more impressed with the incest theme in cases of paranoia, particularly in the form of delusions of marital jealousy. Aronson's(1964) study of Rorschach data in paranoia lends some support to the homosexual hypothesis, since it finds an overwhelmingly greater number of homosexual signs in paranoid patients than in either nonparanoid psychotics or normals. 目前已经从最初的力比多解释转向了更广泛的解释，包括敌意的变迁，以及其他更复杂的前性器问题和发育问题。较少强调精神内部冲突作为病因的负担，越来越多地认识到人际和心理社会复杂性的作用及其与精神内部因素的相互作用。同性恋的角色尤其受到批评和更严格的评估。Gardner(1931)在40例未被选择的偏执型精神分裂症和80例偏执状态下的样本中，发现了45%都有被压抑的同性恋的证据。另一方面，米勒(1941年)在400个病例中只有12个发现了同性恋迹象是偏执狂的基础。同样，Klein和Horwitz(1949)报告说，在一组80个病例中，只有五分之一的人关注同性恋。最近，Klaf和Davis(1960)报告了对一大批偏执型患者的调查结果，发现与对照组相比，偏执型患者的同性恋偏见、以前的同性恋经历和同性迫害的程度明显更高。然而，Planansky和Johnston(1962)无法在偏执和同性恋之间建立明确的关系，他们认为他们的数据更能支持这两个因素独立于发育的观点。他们还认为，异性恋和同性恋领域的困难和担忧在精神分裂症类型中似乎是均等分布的。同样地，德•布舍(1963)在偏执型和非偏执型精神分裂症患者身上发现了潜在的或明显的同性恋欲望，但在偏执的案例中，尤其是在婚姻嫉妒的妄想中，乱伦主题给人留下了更深刻的印象。Aronson(1964)对偏执患者罗夏测验数据的研究为同性恋假说提供了一些支持，因为它发现偏执患者中同性恋症状的数量远远多于非偏执精神病患者或正常人。 Thus the empirical studies that have attempted to assess the degree of homosexual content, either latent or manifest, in paranoid patients have proven neither to be so overwhelming nor so convincing that they can be accepted as directly supporting Freud's hypothesis. They point, however, to the role of homosexual content as a significant aspect of the symptomatology of paranoid states. Overall the evidence does not permit any conclusion as to the etiological role of homosexual conflicts, but suggests rather that homosexuality may be a significant aspect of the symptomatology in all states of schizophrenic regression, rather than specific to paranoia as such. 因此，在偏执症患者中，那些试图评估同性恋内容(不管是隐性的还是显性的)程度的实证研究，既没有被证明是压倒性的，也没有被证明是有说服力的，可以直接支持弗洛伊德的假设。然而，他们指出，同性恋内容的作用是偏执状态症状学的一个重要方面。总的来说，这些证据不允许对同性恋冲突的病因作用做出任何结论，而是表明同性恋可能是所有精神分裂症退行状态的症状学的一个重要方面，而不是偏执狂特有的。