Centre for Emotional Health, Macquarie University, Sydney, Australia University of Amsterdam, The Netherlands.
J Child Psychol Psychiatry. 2012 May;53(5):454-68. doi: 10.1111/j.1469-7610.2011.02479.x. Epub 2011 Nov 8.
Functional impairment is a key factor in the clinical importance of mental health problems in children. Yet, the nature of impairment and criteria for defining and assessing impairment in childhood disorders has been surprisingly overlooked in much of the literature. The current article examines the extant literature on the conceptualisation, nature and assessment of impairment in childhood disorders. Relations between diagnostic symptoms and functional impairment are discussed together with the influence of impairment on diagnostic decisions and prevalence rates. Several factors influencing impairment in childhood such as culture, development and gender are considered. This article concludes with a discussion of the utility of separating judgements of impairment from specific diagnoses, which is proposed for consideration in the forthcoming DSM-5.
功能障碍是儿童心理健康问题临床重要性的关键因素。然而，在很大一部分文献中，儿童障碍的损害性质以及定义和评估损害的标准却被令人惊讶地忽视了。本文考察了有关儿童障碍概念化、性质和损害评估的现有文献。本文讨论了诊断症状与功能损害之间的关系，以及损害对诊断决策和患病率的影响。还考虑了影响儿童损害的几个因素，如文化、发育和性别。本文最后讨论了将损害判断与特定诊断分开的效用，这在即将出台的 DSM-5 中被提议考虑。
