臺灣博碩士論文加值系統

本篇論文我討論「失智症病人是否失去自我」這個問題。我從簡述何謂失智症開始，轉而分析關於失智症病人失去自我的理論。我先論證這些理論背後皆預設了敘事自我的概念，亦即自我作為一種敘事結構的概念。我接著指出這個預設使得失智症敘事自我理論不足以解釋失智症病人的核心症狀。為了避免以上所述之問題，我引用Karen Yan的主體性與自我理論提出一個失智症自我模式理論。這是一個有別於以敘事自我來解釋失智症病人自我的主張。在此理論下，我主張將「失智症病人是否失去自我」這個問題轉為「失智症病人能否產生自我模式」。在重新理解這個問題之後，我論證初期與中期失智症病人產生異常的自我模式，而晚期失智症病人可能無法產生自我模式。最後，我將引入認知神經科學家Georg Northoff的研究，以進一步證明我的理論確有經驗科學證據的支持。

This thesis focuses on the question concerning whether demented patients lose their selves. I start by reviewing the symptoms of demented patients and neurological facts about them. I then examine two arguments according to which demented patients lose their selves. I aim to show that these two arguments presuppose the concept of narrative self, i.e. that self is a kind of narrative structure. I argue that this presupposition leads to some problems. I then propose an alternative to compete with the above two arguments. This alternative makes use of Karen Yan’s theory of subjectivity and self according to which the self/selves are specific patterns of subjectivity. Under my view, the original question is thus transformed into the question concerning whether demented patients produce any self-pattern. I then argue that mildly and moderately demented patients do produce self-patterns, albeit abnormal ones. On the other hand, severely demented patients may not produce any self-pattern. I then employ Georg Northoff’s work in order to provide further empirical support for my view.

致謝 i
摘要 ii
Abstract iii
目錄 iv
圖目錄 vi
表目錄 vii
緒論 1
第一章 失智症概述 4
第一節 成因、症狀與疾病分期 4
第二節 記憶的受損 7
第二章　關於失智症病人的自我理論 13
第一節 關於失智症病人的自我理論 13
第二節　敘事自我 18
第三節　失智症病人自我理論中的預設 23
第四節 關於失智症病人自我理論的問題 27
第三章　失智症自我模式理論 30
第一節 歷程形上學與自我模式 31
第二節 重新理解「失智症病人是否失去自我」這個問題 36
第三節 初期與中期失智症病人能否產生自我模式 38
第四節 晚期失智症病人能否產生自我模式 42
第五節　不同失智症理論的比較 45
第四章 失智症自我模式理論的神經基礎 49
第一節 差異編碼與靜息活動的時空結構 49
第二節 意識產生的預設傾向 55
第三節 外來刺激與大腦自身相關程度的決定 59
第四節 靜息活動作為主體歷程的神經基礎 66
第五節　失智症病人的靜息狀態 69
結論 73
參考文獻 81

圖目錄
圖 1 自傳式記憶受損之時間性梯度 ............. 10
圖 2 主體歷程與自我模式 ..................... 33
圖 3 初期與中期失智症病人的主體歷程與自我模式 ..... 40
圖 4 差異編碼與刺激編碼示意圖 ............ 51
圖 5 意識的產生與神經編碼 ................ 54
圖 6 預設傾向 ............................... 56
圖 7 外來刺激與靜息活動兩者時空結構比對示意圖 ..... 63
圖 8 健康受試者與失智症病人的靜息活動功能連結 ..... 70
圖 9 健康受試者與失智症病人的靜息活動功能連結 ..... 71

表目錄
表 1 不同失智症自我理論與失智症自我模式理論的比較 ..47
表 2 外來刺激在大腦神經活動、意識經驗與認知判斷三層次之對應表 ... 61
表 3 外來刺激在大腦神經活動、意識經驗與認知判斷三層次之對應表 .. 64
表 4 主體歷程與靜息活動的對照表 ....... 68

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