Isaac Mohan, Chand Prabhat K
Primary Care Mental Health Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Fremantle, Western Australia.
Curr Opin Psychiatry. 2006 Jan;19(1):61-6. doi: 10.1097/01.yco.0000194811.83720.69.
Although dissociative disorders have been described and diagnosed for some time, their aetiology, pathogenesis, phenomenology and management continues to arouse debate. It is only in recent times that researchers have made some progress by integrating trauma related theories with more contemporary cognitive theories and neurobiology.
Dissociation as a phenomenon is reported to occur in a variety of disorders. This widespread occurrence has contributed to a better understanding of dissociation. An expansion of this concept may have contributed to the loss of its original significance. Recent studies in the field of dissociation that pertain to its aetiology, pathophysiology, neurobiology and management are critically reviewed.
Dissociative disorder is conceptually a difficult disorder to study. Apart from exposure to trauma, certain primary personality attributes may contribute to the propensity to develop dissociative disorder. Recent advances in functional neuroimaging facilitated by enhanced knowledge in the neural representation of body state have helped to improve our understanding of dissociation. There is confusion over the use of various terms such as sexual abuse and physical abuse in explaining causality. Current classificatory systems have not been found suitable when applied across cultures. In spite of all of these limitations, there has been recent progress toward a better understanding of dissociative disorders.
尽管分离性障碍已经被描述和诊断了一段时间，但其病因、发病机制、现象学和治疗方法仍存在争议。直到最近，研究人员通过将创伤相关理论与更现代的认知理论和神经生物学相结合才取得了一些进展。
据报道，分离现象在多种疾病中都有发生。这种广泛存在有助于人们更好地理解分离。但这一概念的扩展可能导致其原本意义的丧失。本文对分离领域中关于其病因、病理生理学、神经生物学和治疗方法的最新研究进行了批判性综述。
从概念上讲，分离性障碍是一种难以研究的疾病。除了遭受创伤外，某些原发性人格特质可能会增加患分离性障碍的倾向。功能神经影像学的最新进展得益于对身体状态神经表征的深入了解，有助于增进我们对分离的理解。在解释因果关系时，诸如性虐待和身体虐待等各种术语的使用存在混淆。目前的分类系统在跨文化应用时并不适用。尽管存在所有这些局限性，但最近在更好地理解分离性障碍方面仍取得了进展。
