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创伤后应激障碍的重生:精神病学新范式的兴起。

The rebirth of PTSD: the rise of a new paradigm in psychiatry.

作者信息

Rechtman Richard

机构信息

Cesames (Inserm, CNRS,Université Paris 5), Paris, France.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2004 Nov;39(11):913-5. doi: 10.1007/s00127-004-0874-x.

Abstract

The new conception of psychological trauma that arose in the 1980s with the definition of PTSD in the DSM-III was a major change compared to the previous traumatic neurosis. While the clinical features were in some way similar, the political and sociological meanings of trauma were absolutely different. At that time, the invention of PTSD was much more the consequence of a broad mutation in mentality that introduced a new moral perspective in trauma studies than of a scientific discovery. In this paper, the author underlines from an anthropological point of view the second turning point that occurred in trauma studies in the mid 1990s when large epidemiological surveys did not confirm the first hypothesis. Readdressing the issues of vulnerability and risk factors that the previous version of PTSD had withdrawn, this second conception raises new epistemological questions that stay unsolved.

摘要

20世纪80年代随着《精神疾病诊断与统计手册》第三版中创伤后应激障碍(PTSD)的定义而出现的心理创伤新概念,与之前的创伤性神经症相比是一个重大变化。虽然临床特征在某些方面相似,但创伤的政治和社会学意义却截然不同。当时,PTSD的发明更多是心态广泛转变的结果,这种转变在创伤研究中引入了新的道德视角,而非科学发现。在本文中,作者从人类学角度强调了20世纪90年代中期创伤研究中出现的第二个转折点,当时大规模流行病学调查并未证实第一个假设。第二个概念重新审视了前一版PTSD所摒弃的易感性和风险因素问题,引发了一些尚未解决的新认识论问题。

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