Target domain categories and distribution of MEs.

This study identified and analyzed metaphors related to the lived experience of young-onset dementia that were used in nine illness narratives written by people with the condition. A final set of 1111 MEs sorted into 30 source domain categories were grouped according to six target domain categories reflecting the biologic (the person with dementia’s body/brain), psychologic (suffering with dementia, coping with dementia, dementia itself, the person with dementia), and social (the social experience of dementia) aspects of having dementia. Notably, many of the metaphors were similar to previously reported metaphors of illness, such as fight and journey, and other metaphors of embodiment, as well as disease as enemy, body as container, and body as machine. In addition, although negative conceptualizations were in the majority, almost one-third of the metaphoric expressions, belonging to the fight and journey source domain categories, reflected mainly positive images. The commonality of metaphor types with those of other illness experiences supports the notion of shared metaphors across illness contexts. Moreover, in contrast to the dehumanizing and stigmatizing terms that have previously been used to socially construct dementia, the positivity of metaphoric images identified here indicates the authors’ proactive and affirming conceptualizations of their experience of dementia. Health care professionals can draw on this study’s findings to help their own patients make sense of and cope with dementia.本研究识别并分析了9篇由早发性痴呆（young-onset dementia）患者撰写的疾病叙事文本中，与该病症生活体验相关的隐喻。最终纳入分析的1111个隐喻表达（Metaphorical Expressions，以下简称MEs）被划分为30个源域类别，并根据6个目标域类别进行分组，这6个目标域类别分别反映了罹患痴呆的生物学层面（痴呆患者的身体/大脑）、心理学层面（罹患痴呆的痛苦、应对痴呆、痴呆本身、患者自身）以及社会层面（痴呆的社会体验）。值得注意的是，多数隐喻与既往报道的疾病隐喻高度相似，例如“战斗”与“旅程”类隐喻，以及其他具身化隐喻，还包括“疾病即敌人”“身体即容器”“身体即机器”等隐喻模式。此外，尽管负面概念化表达占多数，但归属于“战斗”与“旅程”源域类别的近三分之一的隐喻表达，主要传递出积极意象。此类隐喻类型与其他疾病体验的隐喻类型存在共通性，这印证了“不同疾病语境下共享通用隐喻”的观点。进一步而言，与既往用于社会建构痴呆的去人性化、污名化表述不同，本研究识别出的隐喻意象所传递的积极倾向，表明这些叙事作者对自身的痴呆体验持有主动且肯定的概念化认知。医疗从业者可参考本研究的发现，助力其患者理解并应对痴呆病症。