Mirowsky John, Ross Catherine E
Department of Sociology, Ohio State University, 300 Bricker Hall, 190 North Oval Mall, Columbus, Ohio 43210-1353, USA.
J Health Soc Behav. 2002 Jun;43(2):152-70.
This paper argues a number of points about measurement in the sociology of mental health: (1) measurement is critical, (2) measures should represent and assess elements of human experience, taking measure of life as people feel it, sense it, and understand it, and (3) social scientists should create a human science, producing information for the people it studies so that they can better understand and control their own lives. We argue that a human science is best achieved with the use of indexes, not diagnoses, to measure mental health. We present a brief history of diagnostic instruments and detail how a diagnosis is made. We show how use of diagnoses to measure mental health discounts much human suffering. They dichotomize the true range of feelings and emotions into crude either/or distinctions that do not reflect the reality of people's lives, and they often exclude suffering such as that due to loss or illness that does not meet medical model preconceptions about mental disorder. Using diagnoses to measure mental health presents a reified image of hidden disease knowable and manageable only by trained professionals--beyond the capacity of the suffering individuals to understand and control.
(1)测量至关重要;(2)测量应体现并评估人类体验的要素,考量人们所感受、所感知、所理解的生活;(3)社会科学家应创建一门人文科学,为其研究对象提供信息,以便他们能更好地理解和掌控自己的生活。我们认为,运用指标而非诊断来测量心理健康,最有利于实现人文科学的目标。我们简要介绍了诊断工具的历史,并详述了诊断是如何做出的。我们展示了使用诊断来测量心理健康是如何忽视了许多人类痛苦的。它们将真实的情感范围简单地一分为二,划分为粗略的“是/否”区分,这并不能反映人们生活的现实,而且它们常常排除诸如因不符合医学模式对精神障碍先入之见的丧失或疾病所导致的痛苦。使用诊断来测量心理健康呈现出一种固化的隐藏疾病形象,只有经过专业训练的人员才能知晓和处理,受苦的个体无法理解和控制。