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《精神疾病诊断与统计手册》第五版及以后版本中精神障碍的维度分类与类别分类:对特别章节的评论

Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and beyond: comment on the special section.

作者信息

Brown Timothy A, Barlow David H

机构信息

Center for Anxiety and Related Disorders, Boston University, Boston, MA 02215-2013, USA.

出版信息

J Abnorm Psychol. 2005 Nov;114(4):551-6. doi: 10.1037/0021-843X.114.4.551.

Abstract

The value of including dimensional elements in the Diagnostic and Statistical Manual of Mental Disorders (DSM) has been recognized for decades. Nevertheless, no proposals have been made for introducing dimensional classification in the diagnostic system in a valid and feasible manner. As an initial step in this endeavor, the authors suggest introducing dimensional severity ratings to the extant diagnostic categories and criteria sets. Although not without difficulties, this would begin to determine the feasibility of dimensional classification and would address some limitations of the purely categorical approach (e.g., failure to capture individual differences in disorder severity, and clinically significant features subsumed by other disorders or falling below conventional DSM thresholds). The utility of incorporating broader dimensions of temperament and personality in diagnostic systems beyond the fifth edition of the DSM is also discussed.

摘要

几十年来,人们已经认识到在《精神疾病诊断与统计手册》(DSM)中纳入维度元素的价值。然而,尚未有人提出以有效且可行的方式在诊断系统中引入维度分类的建议。作为这一努力的第一步,作者建议对现有的诊断类别和标准集引入维度严重程度评级。尽管并非没有困难,但这将开始确定维度分类的可行性,并将解决纯粹分类方法的一些局限性(例如,未能捕捉到疾病严重程度的个体差异,以及被其他疾病涵盖或低于传统DSM阈值的具有临床意义的特征)。本文还讨论了在DSM第五版之外的诊断系统中纳入更广泛的气质和人格维度的效用。

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