Walsh B Timothy
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
Int J Eat Disord. 2007 Nov;40 Suppl:S3-7. doi: 10.1002/eat.20397.
This article provides a brief overview of the development of the diagnostic criteria for eating disorders in DSM-IV.
The process by which DSM-IV was developed is reviewed, including perspectives on what constitutes diagnostic validity and clinical utility, and their importance in assessing proposed changes in diagnostic criteria.
The question of whether alterations in diagnostic criteria would clearly improve clinical utility was a major consideration in the DSM-IV process. Because of concerns that changes in diagnostic criteria would be disruptive and might entail loss of established knowledge, the DSM-IV Task Force assumed a generally conservative stance vis-à-vis change.
The process of developing DSM-V is just beginning, and it is far from clear what alterations in diagnostic criteria for eating disorders will occur. However, the evolution of DSM-IV may provide a useful perspective on the development of DSM-V.
本文简要概述了《精神疾病诊断与统计手册》第四版(DSM-IV)中饮食失调诊断标准的发展情况。
回顾了DSM-IV的制定过程,包括对构成诊断效度和临床实用性的观点,以及它们在评估诊断标准提议变化中的重要性。
诊断标准的改变是否会明显提高临床实用性这一问题是DSM-IV制定过程中的主要考虑因素。由于担心诊断标准的改变会造成混乱并可能导致既定知识的丧失,DSM-IV特别工作组在面对变化时采取了总体保守的立场。
DSM-Ⅴ的制定过程刚刚开始,饮食失调诊断标准会发生哪些改变还远不清楚。然而,DSM-IV的演变可能为DSM-Ⅴ的发展提供有益的视角。