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[自闭症:探索历史上的精神病学和心理学概念]

[Autism: exploring historical psychiatric and psychological concepts].

作者信息

Kumbier E, Haack K, Herpertz S C

机构信息

AG Geschichte der Nervenheilkunde an der Klinik für Psychiatrie und Psychotherapie, Universität Rostock, Gehlsheimer Strasse 20, Rostock.

出版信息

Fortschr Neurol Psychiatr. 2008 Aug;76(8):484-90. doi: 10.1055/s-2008-1038229.

Abstract

Autism today is a widely used term, yet what is understood by autism has changed considerably since first being introduced in scientific discourse almost 100 years ago. Autism is one example for the influence of the psychoanalytic school of Sigmund Freud on scientific psychiatry at the beginning of the 20th century. In particular psychoanalysis had an impact on Eugen Bleuler's concept of schizophrenia. The Swiss psychiatrist did not only acknowledge and follow a biological, but also a psychological approach to psychiatry and thus opened up his subject to psychoanalytic thoughts. This paper provides insights into the term's conceptual history--or, more specifically and precisely--sheds light on the expansion of the term's scope, which has gotten to be used for more and more symptoms and phenomena. When Bleuler first presented the term autism, he used it to refer to a classical schizophrenic symptom. Since, however, Bleuler was not very specific and exclusive in his definition, the term was soon used for other phenomena as well, such as to describe a schizoid symptom in the sense of today's schizoid personality disorder (schizoid autism). The concepts of autistic hebephrenia and depressive autism are further examples how the term was used and give insight into how the contents behind the term changed, got less and less specific and widened its scope. Due to its growing vagueness its suitability and usability as a psychopathological term decreased. This process further was strengthened when the word autism got more and more widely used in colloquial language for different aspects of day-to-day routine and thinking. Thus in psychiatry today, autism is exclusively used in connection with the so-called autism spectrum disorders, but has, as other formerly exclusively technical terms, different and rather unspecific meanings in everyday communication.

摘要

如今,“自闭症”是一个被广泛使用的术语,然而自这个术语于近100年前首次引入科学论述以来,人们对自闭症的理解已经发生了相当大的变化。自闭症是西格蒙德·弗洛伊德精神分析学派在20世纪初对科学精神病学产生影响的一个例子。特别是精神分析对尤金·布洛伊勒的精神分裂症概念产生了影响。这位瑞士精神病学家不仅认可并遵循精神病学的生物学方法,还遵循心理学方法,从而使他的研究领域接纳了精神分析思想。本文深入探讨了该术语的概念历史,或者更具体、更精确地说,揭示了该术语范围的扩展情况,它已被用于越来越多的症状和现象。当布洛伊勒首次提出“自闭症”这个术语时,他用它来指代一种典型的精神分裂症症状。然而,由于布洛伊勒在定义上不是非常具体和排他,这个术语很快也被用于其他现象,比如用来描述当今分裂样人格障碍(分裂样自闭症)意义上的一种分裂样症状。“自闭性青春期痴呆”和“抑郁性自闭症”的概念是该术语如何被使用的进一步例子,也让我们了解到该术语背后的内容是如何变化的,变得越来越不具体且范围不断扩大。由于其日益模糊,它作为一个精神病理学术语的适用性和可用性降低了。当“自闭症”这个词在日常语言中越来越广泛地用于日常事务和思维的不同方面时,这一过程进一步加剧。因此在当今的精神病学中,“自闭症”仅与所谓的自闭症谱系障碍相关联使用,但与其他以前仅为专业术语一样,在日常交流中有不同且相当不明确的含义。

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