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科学哲学与《精神疾病诊断与统计手册》第三版。关于诊断的哲学、观念史及社会学视角。

Philosophy of science and DSM-III. Philosophical, idea-historical and sociological perspectives on diagnoses.

作者信息

Malt U F

出版信息

Acta Psychiatr Scand Suppl. 1986;328:10-7. doi: 10.1111/j.1600-0447.1986.tb10518.x.

DOI:10.1111/j.1600-0447.1986.tb10518.x
PMID:3463133
Abstract

The validity of a classification system is primarily a question of philosophical premise. DSM-III is from this point of view a theoretical classification system based on hypotheses currently considered reliable and interesting and which--as presupposed--could not be rejected by empirical methods. The relevance or validity of this empirical approach depends on the aim of the DSM-III. An empirical approach may facilitate communication but can only have limited success as a help for planning treatment of psychiatric disorders where motives and meaning are important factors. The choice of hypotheses and the empirically derived concepts used to construct the classification system neglects other important ways of comprehension. Although aspects of rational philosophy may be found in the DSM-III system too, important ways of comprehension like the metaphysical approach is lacking. It is showed how this fact reflects a philosophical trend in the Western world following the Renaissance. By considering the Myth of Faust it is demonstrated how a metaphysical comprehension of life would lead to a different understanding of states of mind currently assumed to be a reflection of individual psychopathology according to empirical or rational comprehension. Thus in the end the validity of a classification system depends on the basic philosophical assumptions chosen. A choice which may be determined more by irrational and cultural forces than conscious contemplation. The content of DSM-III or ICD is also influenced by professional interests; the needs of the society and international political factors.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

分类系统的有效性主要是一个哲学前提的问题。从这个角度来看,《精神疾病诊断与统计手册》第三版(DSM - III)是一个基于当前被认为可靠且有趣的假设的理论分类系统,并且——如预先假定的那样——不能通过实证方法被否定。这种实证方法的相关性或有效性取决于DSM - III的目标。实证方法可能有助于交流,但作为规划精神疾病治疗的辅助手段,其成功程度有限,因为动机和意义是重要因素。用于构建分类系统的假设选择和从实证中得出的概念忽略了其他重要的理解方式。尽管在DSM - III系统中也可能发现理性哲学的方面,但缺乏像形而上学方法这样重要的理解方式。文中展示了这一事实如何反映了文艺复兴后西方世界的一种哲学趋势。通过思考《浮士德》的神话,证明了对生命的形而上学理解会如何导致对目前根据实证或理性理解被认为是个体精神病理学反映的心理状态有不同的理解。因此,最终分类系统的有效性取决于所选择的基本哲学假设。这种选择可能更多地由非理性和文化力量而非有意识的思考所决定。DSM - III或国际疾病分类(ICD)的内容也受到专业利益、社会需求和国际政治因素的影响。(摘要截选至250字)

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