Bayer R, Spitzer R L
Arch Gen Psychiatry. 1985 Feb;42(2):187-96. doi: 10.1001/archpsyc.1985.01790250081011.
The adoption of DSM-III by the American Psychiatric Association has been viewed as representing a major advance for psychiatry and as an indication of the emergence of a broad professional consensus on diagnostic issues. The process of drafting the new manual was not, however, free of conflict. This article presents a narrative account of the controversies over the role of psychodynamic formulations in DSM-III and the more focused, though sharply contested, symbolic dispute over the inclusion of neurosis in the nomenclature. It traces the evolution of these disputes and focuses on the interplay of scientific and political considerations as psychiatrists committed to differing professional and therapeutic paradigms confronted each other for more than two years as the profession sought to develop a new manual that would improve the level of reliability of psychiatric diagnosis.
美国精神病学协会采用《精神疾病诊断与统计手册》第三版（DSM - III）被视为精神病学的一项重大进展，也表明在诊断问题上达成了广泛的专业共识。然而，新手册的起草过程并非没有冲突。本文叙述了关于精神动力学表述在DSM - III中的作用的争议，以及关于在术语表中纳入神经症的更具针对性但争议激烈的象征性争论。它追溯了这些争议的演变，并聚焦于科学和政治考量的相互作用，因为致力于不同专业和治疗范式的精神病学家在两年多的时间里相互对峙，而该专业试图编写一本能够提高精神病诊断可靠性水平的新手册。
