Hofmann Stefan G, Hayes Steven C
Boston University.
University of Nevada, Reno.
Clin Psychol Sci. 2019 Jan;7(1):37-50. doi: 10.1177/2167702618772296. Epub 2018 May 29.
Clinical science seems to have reached a tipping point. It appears that a new paradigm is beginning to emerge that is questioning the validity and utility of the medical illness model, which assumes that latent disease entities are targeted with specific therapy protocols. A new generation of evidence-based care has begun to move toward process-based therapies to target core mediators and moderators based on testable theories. This could represent a paradigm shift in clinical science with far-reaching implications. Clinical science might see a decline of named therapies defined by set technologies, a decline of broad schools, a rise of testable models, a rise of mediation and moderation studies, the emergence of new forms of diagnosis based on functional analysis, a move from nomothetic to idiographic approaches, and a move toward processes that specify modifiable elements. These changes could integrate or bridge different treatment orientations, settings, and even cultures.
临床科学似乎已达到一个临界点。一种新的范式似乎正在浮现，它对医学疾病模型的有效性和实用性提出了质疑，该模型假定潜在的疾病实体通过特定的治疗方案来靶向治疗。新一代基于证据的医疗已开始转向基于过程的疗法，以基于可检验的理论靶向核心调节因素和中介因素。这可能代表临床科学的范式转变，具有深远影响。临床科学可能会见证由既定技术定义的特定疗法的减少、广泛流派的减少、可检验模型的增加、中介和调节研究的增加、基于功能分析的新诊断形式的出现、从共性方法向个性方法的转变，以及朝着明确可改变要素的过程的转变。这些变化可能整合或弥合不同的治疗方向、环境，甚至文化。
