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[翻译癔症:创伤后应激障碍分离亚型]

[Translating Hysteria: PTSD dissociative subtype].

作者信息

Levy Yeyati Elena

出版信息

Vertex. 2016 Mar;XXVII(126):103-108.

Abstract

To address the symptoms of depersonalization and derealization a specific dissociative subtype of posttraumatic stress disorder has been included in DSM-5. Depersonalization and derealization have been defined as acute and chronic symptoms of dissociative disorders since DSM-III. Dissociative disorders with chronic features are often diagnosed in North America, Canada and other European countries, but this is not the case in Argentina. Dissociative disorders have clinical and historical features that are strongly connected with hysteria. The latter is included in ICD-10 within the guidelines for diagnoses of dissociative disorders. This would be one of the reasons for not using dissociative disorders with chronic presentations of symptoms like depersonalization and derealization in countries other than North America or Canada: instead hysteria keeps on been used. The relation between trauma, dissociation and hysteria has been explained in different ways depending on the underlying theory (i.e. Janet's or Freud's). Janet's conceptualizations have had decisive influence in DSM formulations in chronic forms of dissociative disorders. Janet's and Freud's theories lead to different consequences on psychotherapy: hypnosis or psychoanalysis. The aim of this article is to show that the authors of PTSD dissociative subtype are in search of a cross-cultural validity of the construct which might be able to exert a more global influence.

摘要

为解决人格解体和现实解体症状,创伤后应激障碍的一种特定解离亚型已被纳入《精神疾病诊断与统计手册》第5版(DSM - 5)。自《精神疾病诊断与统计手册》第3版(DSM - III)以来,人格解体和现实解体就被定义为解离障碍的急性和慢性症状。具有慢性特征的解离障碍在北美、加拿大和其他欧洲国家常被诊断出来,但在阿根廷并非如此。解离障碍具有与癔症密切相关的临床和历史特征。后者在国际疾病分类第10版(ICD - 10)中被纳入解离障碍的诊断指南。这可能是在北美或加拿大以外的国家不使用具有人格解体和现实解体等慢性症状表现的解离障碍的原因之一:相反,癔症仍在被使用。根据不同的基础理论(即让内或弗洛伊德的理论),创伤、解离和癔症之间的关系有不同的解释。让内的概念化对慢性形式解离障碍的DSM表述产生了决定性影响。让内和弗洛伊德的理论在心理治疗方面导致了不同的结果:催眠或精神分析。本文的目的是表明创伤后应激障碍解离亚型的作者正在寻求该结构的跨文化有效性,这可能能够产生更广泛的影响。

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