Pies Ronald
Dialogues Clin Neurosci. 2012 Jun;14(2):111-3. doi: 10.31887/DCNS.2012.14.2/rpies.
Recent controversies over the DSM-5 raise a foundational question for all diagnostic classifications: what is their underlying purpose? The author raises this question in the context of the proposed elimination of the "bereavement exclusion" from the DSM-5; and the possible addition of the category called "Complicated Grief." The author argues that our psychiatric diagnostic scheme should not be aimed primarily at establishing boundaries among putative "natural types." Rather, it ought to be guided by the principle of "instrumental validity, " which focuses on reducing the suffering and incapacity of those who seek our care. In so far as the category of "Complicated Grief" helps achieve this goal, it will foster the humane and ethical values that underlie medical practice.
近期围绕《精神疾病诊断与统计手册》第五版（DSM - 5）的争议引发了关于所有诊断分类的一个根本性问题：其根本目的是什么？作者在提议从DSM - 5中取消“丧亲排除条款”以及可能增加“复杂性哀伤”这一类别这一背景下提出了这个问题。作者认为，我们的精神科诊断体系不应主要旨在划定假定“自然类型”之间的界限。相反，它应以“工具效度”原则为指导，该原则侧重于减轻寻求我们治疗的人的痛苦和功能障碍。就“复杂性哀伤”这一类别有助于实现这一目标而言，它将促进作为医疗实践基础的人道和伦理价值观。
