Cooper Rachel
Lancaster University.
Hist Psychiatry. 2018 Mar;29(1):49-65. doi: 10.1177/0957154X17741783. Epub 2017 Nov 29.
This paper aims to understand the DSM-5 through situating it within the context of the historical development of the DSM series. When one looks at the sets of diagnostic criteria, the DSM-5 is strikingly similar to the DSM-IV. I argue that at this level the DSM has become 'locked-in' and difficult to change. At the same time, at the structural, or conceptual, level there have been radical changes, for example in the definition of 'mental disorder', in the role of theory and of values, and in the abandonment of the multiaxial approach to diagnosis. The way that the DSM-5 was constructed means that the overall conceptual framework of the classification only barely constrains the sets of diagnostic criteria it contains.
本文旨在通过将《精神疾病诊断与统计手册》第五版（DSM-5）置于DSM系列的历史发展背景中来理解它。当人们审视诊断标准集时，DSM-5与DSM-IV惊人地相似。我认为在这个层面上，DSM已经变得“固化”且难以改变。与此同时，在结构或概念层面上已经发生了根本性的变化，例如在“精神障碍”的定义、理论和价值观的作用以及放弃多轴诊断方法等方面。DSM-5的构建方式意味着该分类的整体概念框架对其所含诊断标准集的约束微乎其微。
