Ouss Lisa
Child and Adolescent Psychiatry Department, Necker-Enfants Malades Hospital, APHP, Paris, France.
Front Psychol. 2024 Jan 24;14:1225108. doi: 10.3389/fpsyg.2023.1225108. eCollection 2023.
Current psychopathology models have evolved toward dimensional models, in which symptoms and diseases are at the extremes of dimensions. Despite these new dimensional proposals, classifications and third-person approach have shown limitations. Their extraordinary evolution nevertheless underlines the contributions of developmental and psychodynamic frameworks. Developmental contributions have made it possible to evolve from disorders centered on a first-person perspective. Complementarily to the first-person/third-person perspectives, we advocate a second-person perspective, based on intersubjectivity. This perspective reverses the intuitive trend to focus our interventions on the most specific symptoms and syndromes, and advocates instead interventions on a "p" general factor that are both generalized and highly targeted. The implications are (1) to intervene as early as possible, (2) to base the definition of our therapeutic targets on an intersubjective perspective, (3) to identify and enhance children's and parents' strengths. These empirically informed directions are not in the current mainstream of psychopathology frameworks, and need to be developed.
当前的精神病理学模型已朝着维度模型发展,在该模型中,症状和疾病处于维度的两端。尽管有这些新的维度提议,但分类法和第三人称方法已显示出局限性。然而,它们的非凡发展凸显了发展心理学和心理动力学框架的贡献。发展心理学的贡献使从以第一人称视角为中心的障碍发展成为可能。作为对第一人称/第三人称视角的补充,我们倡导基于主体间性的第二人称视角。这种视角扭转了将干预重点放在最具体症状和综合征上的直观趋势,而是主张对一个既具有普遍性又具有高度针对性的“p”一般因素进行干预。其影响包括:(1)尽早进行干预;(2)基于主体间性视角来定义我们的治疗目标;(3)识别并增强儿童和家长的优势。这些基于实证的方向并不在当前精神病理学框架的主流范围内,需要进一步发展。