Norton Peter J
Department of Psychology, University of Houston, Houston, TX 77204-5022, USA.
Cogn Behav Ther. 2006;35(2):88-105. doi: 10.1080/16506070500441561.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) model of psychopathology has generally been the accepted standard in North America for understanding and diagnosing psychological disorders for over half a century. This classification model, particularly since DSM-III, has been formulated around the goals of aiding diagnosis, enhancing communication among professionals, fostering psychopathology research and informing treatment. However, all classification systems are inherently dependent on the purpose for the classification. In this paper, an argument is made for a clinically-relevant diagnostic system of mental disorders to support a primary goal of informing treatment. Several lines of research are examined, including studies on diagnostic reliability, dimensional vs categorical nature of anxiety disorders, co-morbidity, and psychotherapeutic and pharmacological treatment outcome as they relate to current and proposed diagnostic models of anxiety disorders. Based on the evidence, suggestions are made for revising diagnostic models of anxiety, and key lines of future research are proposed.
半个多世纪以来，《精神疾病诊断与统计手册》（DSM）的精神病理学模型一直是北美理解和诊断心理障碍的公认标准。这种分类模型，尤其是自《精神疾病诊断与统计手册》第三版以来，是围绕辅助诊断、加强专业人员之间的沟通、促进精神病理学研究以及为治疗提供依据等目标制定的。然而，所有分类系统本质上都依赖于分类的目的。本文主张建立一个与临床相关的精神障碍诊断系统，以支持为治疗提供依据这一主要目标。研究了多个研究方向，包括关于诊断可靠性、焦虑症的维度与分类性质、共病以及心理治疗和药物治疗结果等方面的研究，这些研究与当前和提议的焦虑症诊断模型相关。基于这些证据，对焦虑症诊断模型的修订提出了建议，并提出了未来研究的关键方向。
