Silver School of Social Work and Department of Psychiatry, New York University, 1 Washington Square North, New York, NY, 10003, USA.
Theor Med Bioeth. 2010 Feb;31(1):5-17. doi: 10.1007/s11017-010-9132-2.
Current symptom-based DSM and ICD diagnostic criteria for mental disorders are prone to yielding false positives because they ignore the context of symptoms. This is often seen as a benign flaw because problems of living and emotional suffering, even if not true disorders, may benefit from support and treatment. However, diagnosis of a disorder in our society has many ramifications not only for treatment choice but for broader social reactions to the diagnosed individual. In particular, mental disorders impose a sick role on individuals and place a burden upon them to change; thus, disorders decrease the level of respect and acceptance generally accorded to those with even annoying normal variations in traits and features. Thus, minimizing false positives is important to a pluralistic society. The harmful dysfunction analysis of disorder is used to diagnose the sources of likely false positives, and propose potential remedies to the current weaknesses in the validity of diagnostic criteria.
当前基于症状的 DSM 和 ICD 精神障碍诊断标准容易产生假阳性,因为它们忽略了症状的背景。这通常被视为一个良性缺陷,因为生活问题和情感痛苦,即使不是真正的障碍,也可能受益于支持和治疗。然而,在我们的社会中,对一种障碍的诊断不仅对治疗选择有很多影响,而且对被诊断个体的更广泛的社会反应也有很多影响。特别是,精神障碍给个人带来了一种病态角色,并要求他们改变;因此,障碍降低了那些即使在特征和特点上有令人讨厌的正常变化的人通常得到的尊重和接受程度。因此,尽量减少假阳性对多元化社会很重要。障碍的有害功能障碍分析用于诊断可能的假阳性的来源,并为当前诊断标准有效性的弱点提出潜在的补救措施。