Hudziak James J, Achenbach Thomas M, Althoff Robert R, Pine Daniel S
University of Vermont, Burlington, VT 05401, USA.
Int J Methods Psychiatr Res. 2007;16 Suppl 1(Suppl 1):S16-23. doi: 10.1002/mpr.217.
The expression psychopathology in general and child psychopathology in particular, is affected by multiple sources of variance. Some of these sources include gender differences, informant differences, and age-related differences. In this paper, we discuss how these sources of variance complicate both research and clinical management. We argue that the current diagnostic system would be aided by the inclusion of a quantitative axis that can take these sources of variance into account. We reason that the fields of genomics and neuroscience are prepared to move the field of developmental psychopathology forward, but need a diagnostic system that allows for these sources of variance to be controlled. We demonstrate how in Conduct Disorder, inclusion of dimensional information would allow the clinician or researcher to demonstrate not only the presence or absence of pathology, but also the degree to which the disorder is manifested in a particular individual. Because dimensional approaches are already used widely as an alternative measure of psychopathology, we argue that there is reason to consider dimensionalizing some aspects of the DSM.
一般而言，精神病理学尤其是儿童精神病理学，受到多种变异来源的影响。其中一些来源包括性别差异、信息提供者差异以及与年龄相关的差异。在本文中，我们讨论了这些变异来源如何使研究和临床管理变得复杂。我们认为，当前的诊断系统若纳入一个能够考虑这些变异来源的定量轴将会得到改进。我们推断，基因组学和神经科学领域已准备好推动发展性精神病理学领域向前发展，但需要一个能够控制这些变异来源的诊断系统。我们展示了在品行障碍中，纳入维度信息将使临床医生或研究人员不仅能够证明病理状态的存在与否，还能证明该障碍在特定个体中的表现程度。由于维度方法已被广泛用作精神病理学的替代测量方法，我们认为有理由考虑对《精神疾病诊断与统计手册》的某些方面进行维度化。
