LSD LSD[一种致幻剂] The upsurge in the interest in, and use of, LSD in recent years needs little commentary. The patterns of use vary all the way from relatively innocuous and infrequent experimentation to heavy and frequent usage characteristic of the so-called "acid heads." For the latter types of individual, the use of acid becomes a motif around which the entire patterning of their lives is structured. The use of the drug becomes woven into a counterculture associated with the rebellion against society among middle-class and usually white youths. 近年来，人们对LSD的兴趣和使用激增，这一点无需多加评论。使用模式各不相同，从相对无害和不经常的试验到所谓"酸头"的大量和频繁使用。对于后一种类型的人来说，使用酸性物质成为他们整个生活模式的主题。吸毒已成为中产阶级通常是白人青年反叛社会的一种反文化。 LSD generally produces vegetative autonomic alterations which are followed by anxiety and even paranoid, depressive, or euphoric states (Hoch,1959). With increasing doses, illusions can develop—and even delusions, which are often grandiose. The individual may feel omnipotent or may feel omniscient. Such feelings may lead to attempts to take exceedingly risky chances under dangerous circumstances, such as walking close to the edge of high cliffs, or putting oneself in needless danger. When anxiety feelings become exacerbated, apprehension can be a prominent feature, at which point paranoid delusions may take on a distinct persecutory character. LSD通常会产生植物性自主神经改变，随后出现焦虑甚至偏执、抑郁或兴奋状态（Hoch，1959年）。随着剂量的增加，会产生幻觉——甚至是妄想，这种妄想往往是宏大的。个体可能会觉得自己无所不能，或者觉得自己无所不知。这种感觉可能会导致在危险的情况下试图冒极大的风险，如走近高崖的边缘，或将自己置于不必要的危险之中。当焦虑感加重时，忧虑会成为一个突出的特征，此时偏执妄想可能会带有明显的迫害性特征。 Prolonged delusional states with definite paranoid characteristics have been described by a number of investigators—and frequently are seen in a significant percentage of cases. Most of the studies of LSD effects indicate that, in patients in whom psychotic effects were produced by the drug, a fairly high percentage showed no manifestations of psychotic or schizoid personality structure prior to the taking of the drug. This would seem to indicate a direct pharmacological effect; however the same reservation that applies to the evaluation of amphetamine takers applies here as well—namely, that the evaluation of latent or hidden paranoid trends is difficult to accomplish and remains a possible contributing factor to the observed pathology. 一些调查者描述了具有明确偏执特征的长期妄想状态，而且经常在相当比例的病例中出现。大多数关于LSD效应的研究表明，在药物产生精神病性效应的患者中，相当高比例的患者在服药前没有表现出精神病性或分裂型人格结构。这似乎表明了一种直接的药理作用；然而，适用于评估安非他明服用者的同样的保留意见也适用于这里，即对潜在的或隐藏的偏执趋势的评估很难完成，而且仍然是观察到的病理的一个可能的促成因素。 Particularly disturbing is the so-called "flashback" phenomenon in which recurrent symptoms of depersonalization, delusional episodes, and often terrifying outright delusions can occur spontaneously, considerably after drug intake has ceased. These delusional flashback experiences can occur weeks to months after ingestion of LSD. The mechanism of the flashback is poorly understood, but it usually occurs more frequently in individuals who have taken the drug more frequently, and in whom the flashback experience occurred in relationship to situations of significant stress. Attention has also been called to the incidents of suicide and homicide in connection with LSD usage. The connection of these forms of violence with paranoid states of mind has already been discussed. 特别令人不安的是所谓的"闪回"现象，在这种现象中，反复出现的人格解体症状、妄想情节，以及常常是可怕的完全妄想，可以在停止吸食毒品后相当长的时间内自发地发生。这些妄想性的闪回经历可在摄入LSD后数周至数月内发生。闪回的机制还不太清楚，但通常在更频繁地服用这种药物的人身上发生得更多，而且闪回的经历是在有重大压力的情况下发生的。人们还提请注意与使用LSD有关的自杀和杀人事件。这些形式的暴力与精神偏执状态之间的联系已经讨论过了。 In a previous study of the functioning of the hippocampus and related limbic structures in cognitive processing, I discussed the disruptive effects of LSD on these structures. These effects may have to do with interruption of the internal circuitry of the hippocampus, or they may also relate to the production of seizure episodes in hippocampus and limbic structures. Hallucinogenic effects would thus correspond to seizurelike discharges which disrupt hippocampal function and integration of cognitive and affective experience (Meissner,1966). It can be suggested that the paranoid manifestations of both amphetamine psychosis and the LSD psychosis may be related to disruptive effects of these agents on limbic system functioning which either directly produce paranoid distortions, usually of a delusional nature, or trigger a compensatory paranoid protective response. This formulation is speculative, but allows us to link the observations related to drug-induced paranoid states to the more psychological formulations that relate to the clinical observations which form the substance of the present study. It must be kept in mind, however, in evaluating the relationship between such drug effects and the occurrence of paranoid symptomatology, that, by and large, in uncontrolled and social usages, such drugs are frequently implemented within a counterculture which has been described popularly as the "drug culture." The thesis that I would advance is that the development of such a counterculture involves the implementation and expression of paranoid mechanisms which in part motivate, in part intensify, and enter into, complex interaction with drug effects. 在以前的一项关于海马体和相关边缘结构在认知加工中的功能的研究中，我讨论了LSD对这些结构的破坏性影响。这些影响可能与海马体内部电路的中断有关，也可能与海马体和边缘结构产生癫痫发作有关。因此，致幻作用将对应于破坏海马功能和认知与情感经验整合的 癫痫样放电（Meissner,1966）。可以认为，安非他明精神病和LSD精神病的偏执表现都可能与这些药物对边缘系统功能的破坏性作用有关，这些作用要么直接产生偏执性扭曲，通常是妄想性的，要么引发补偿性的偏执性保护反应。这种表述是推测性的，但允许我们将 与药物诱导的偏执状态有关的观察 与 更心理学的表述联系起来，这些表述与构成本研究实质的临床观察有关。然而，在评估这种药物作用与偏执症状发生之间的关系时，必须牢记，大体上，在不受控制的和社会性的使用中，这种药物经常是在一种反文化中实施的，这种反文化被流行地描述为 "药物文化"。我要提出的论点是，这种反文化的发展涉及到偏执机制的实施和表达，这种机制部分地促使、部分地强化并进入与毒品效应的复杂互动。