Csordas Thomas J, Storck Michael J, Strauss Milton
Department of Anthropology, University of California, San Diego, La Jolla, California 92093-0532, USA.
J Nerv Ment Dis. 2008 Aug;196(8):585-96. doi: 10.1097/NMD.0b013e3181812c68.
In contemporary Navajo society, traditional Navajo ceremonies, Native American Church prayer meetings, and Navajo Christian faith healing are all highly sought-after resources in the everyday pursuit of health and well-being. What is the nature of affliction among patients who turn to such forms of religious healing? Are these patients typically afflicted with psychiatric disorder? In this article we discuss 84 Navajo patients who participated in the Navajo Healing Project during a period in which they consulted one of these forms of healing. We present diagnostic results obtained from the Structured Clinical Interview for DSMIV (SCID) administered to these patients. We then present an ethnographically augmented analysis comparing the research diagnosis obtained via the SCID with a clinical diagnosis, with the diagnosis given by religious healers, and with the understanding of their own distress on the part of patients. These analyses demonstrate how a cultural approach contributes to the basic science and clinical understandings of affliction as well as to discussion of the advantages and limitations of DSM categories as descriptors of distress and disorder.
在当代纳瓦霍社会，传统的纳瓦霍仪式、美洲原住民教会祈祷会以及纳瓦霍基督教信仰疗法，都是人们在日常追求健康和幸福过程中极为追捧的资源。求助于此类宗教疗法的患者所患疾病的本质是什么？这些患者通常患有精神疾病吗？在本文中，我们讨论了84名参与纳瓦霍治疗项目的纳瓦霍患者，他们在一段时间内咨询了这些治疗形式中的一种。我们展示了对这些患者进行《精神疾病诊断与统计手册》第四版（DSM-IV）结构化临床访谈所获得的诊断结果。然后，我们进行了一项民族志增强分析，将通过结构化临床访谈获得的研究诊断结果与临床诊断结果、宗教治疗师给出的诊断结果以及患者自身对痛苦的理解进行比较。这些分析表明，文化方法如何有助于从基础科学和临床角度理解疾病，以及如何有助于讨论DSM类别作为痛苦和障碍描述符的优缺点。
