Hodiamont P
Department of Psychiatry, University of Nijmegen, The Netherlands.
Int J Soc Psychiatry. 1991 Spring;37(1):43-50. doi: 10.1177/002076409103700106.
In practice or in research, psychiatrists should confine their work to abnormal or pathological phenomena. To distinguish normality from abnormality, psychiatrists (often implicitly) test people's behaviour against the following criteria: suffering, loss of autonomy and unreality. The positive aspects of anxiety/fear will be discussed: in how far the phenomenon induces pleasure, enhances autonomy or is justified. This approach to the reality aspect is through an ethological focus on a specific form of fear--the fear of strangers in young children. The prevalence of abnormal fear and anxiety in similar populations is shown to be dependent on the way in which (ab)normality is operationalised. A qualitative individual-oriented approach yields considerably less anxiety than a quantitative group-oriented approach. In practice a careful assessment of (ab)normality will help the psychiatrist to treat normal anxiety in an efficient and abnormal anxiety in an effective manner.
在实践或研究中,精神科医生应将其工作局限于异常或病理现象。为了区分正常与异常,精神科医生(常常是隐性地)依据以下标准来检验人们的行为:痛苦、自主性丧失和失实性。焦虑/恐惧的积极方面将被讨论:该现象在多大程度上带来愉悦、增强自主性或具有合理性。这种对现实方面的探讨是通过从行为学角度关注一种特定形式的恐惧——幼儿对陌生人的恐惧。研究表明,类似人群中异常恐惧和焦虑的患病率取决于(非)正常状态的操作化方式。定性的个体导向方法产生的焦虑比定量的群体导向方法少得多。在实践中,对(非)正常状态进行仔细评估将有助于精神科医生以高效的方式治疗正常焦虑,并以有效的方式治疗异常焦虑。