Klein D F
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
J Abnorm Psychol. 1999 Aug;108(3):421-9. doi: 10.1037//0021-843x.108.3.421.
Can psychiatric disorders be conceptualized as "harmful dysfunctions" (J. C. Wakefield, 1992a, 1992b, 1999; S. O. Lilienfeld & L. Marino, 1995)? Wakefield's (1992a) central concept of disorder as "harmful dysfunction" is discussed by placing it in the context of a complementary discussion of disease, illness, the sick role, and evolution (D. F. Klein, 1978). S. O. Lilienfeld and L. Marino (1995) contended that proper biological function cannot be determined. This argument obscures the key significance of involuntary impairment of evolved functions. The claim that the Roschian concept has no counterpart in reality is incorrect and does not support the conclusion that dysfunctions are irreducibly evaluative and therefore arbitrary. J. C. Wakefield's (1999) views in this area are supplemented. The role of monothetic and polythetic categorization, extremal terms, and the concept of normality in nosology is considered. This analysis refutes the implication that deviance and illness are equivalent. The resolution of this debate is practically relevant to emphasizing areas of research investment, such as therapeutics.
精神障碍能否被概念化为“有害的功能失调”（J.C.韦克菲尔德，1992a，1992b，1999；S.O.利连菲尔德和L.马里诺，1995）？通过将韦克菲尔德（1992a）关于障碍的核心概念“有害的功能失调”置于对疾病、病症、患病角色和进化的补充讨论背景中（D.F.克莱因，1978）进行探讨。S.O.利连菲尔德和L.马里诺（1995）认为无法确定适当的生物学功能。这一论点掩盖了进化功能非自愿受损的关键意义。认为罗施概念在现实中没有对应物的说法是不正确的，也不支持功能失调本质上是评价性的因而具有任意性这一结论。对J.C.韦克菲尔德（1999）在这一领域的观点进行了补充。考虑了单一定义与多定义分类、极端术语以及疾病分类学中正常概念的作用。这一分析反驳了偏差与病症等同的观点。这场辩论的解决对于强调研究投资领域（如治疗学）具有实际意义。
