Singy Patrick
Union College, Schenectady, NY, 12308, USA,
Arch Sex Behav. 2015 Jul;44(5):1109-16. doi: 10.1007/s10508-015-0542-0.
In 2008, the concept of hebephilia, which denotes an erotic preference for "pubescent children," was suggested by Blanchard and his team for inclusion in the DSM-5 (Blanchard et al., 2009). Four years later, the APA's Board of Trustees opted for the status quo and rejected that proposal. This essay sheds light on the reason for this rejection. I consider three important questions related to hebephilia: Does hebephilia exist? Is it a disease? And what would have been the social consequences of including it in the DSM? I argue that if Blanchard failed to convince others that hebephilia should be included in the DSM-5, it is not because he focused too much on the first question and was unable to offer a convincing answer to the second one, but because he made the mistake of dismissing the third one as extraneous. The DSM is not intended to be a pure research manual, and a category like hebephilia cannot be evaluated without taking into account its potential forensic impact. In part or in whole, the decision to include a new diagnostic category in the DSM is, and always should be, a political decision.
2008年,布兰查德及其团队提议将恋童癖(指对“青春期儿童”的性偏好)这一概念纳入《精神疾病诊断与统计手册》第五版(DSM - 5)(布兰查德等人,2009年)。四年后,美国心理学会理事会维持现状,否决了该提议。本文揭示了此次否决的原因。我思考了与恋童癖相关的三个重要问题:恋童癖是否存在?它是一种疾病吗?将其纳入《精神疾病诊断与统计手册》会产生哪些社会后果?我认为,如果布兰查德未能说服他人将恋童癖纳入DSM - 5,并非因为他过于关注第一个问题且无法对第二个问题给出令人信服的答案,而是因为他错误地将第三个问题视为无关紧要而不予考虑。《精神疾病诊断与统计手册》并非旨在成为一本纯粹的研究手册,像恋童癖这样的类别如果不考虑其潜在的法医影响就无法进行评估。在《精神疾病诊断与统计手册》中纳入一个新的诊断类别的决定部分或全部而言,过去是、而且始终应该是一个政治决定。