Psychiatr Serv. 1995 Sep;46(9):926-31. doi: 10.1176/ps.46.9.926.
Important and common relational conditions, such as severe couple dysfunction and family violence involving child or elder abuse, have been omitted from DSM-IV, the authors believe. They argue that such conditions can exist independently of severe individual psychopathology and that these conditions should be described in relational terms, with specific diagnostic criteria. They outline a classification of relational disorders and propose its addition to axis I of DSM-IV. This classification scheme focuses on severe family dysfunction; problems of living usually treated by couple and family therapists are intentionally omitted. Descriptions of two relational disorders, written in DSM style, are provided. The authors discuss implications for the treatment and rehabilitation of patients, the future training of psychiatrists, and the direction of research.
作者认为,一些重要且常见的关系状况,如严重的夫妻功能障碍以及涉及虐待儿童或老人的家庭暴力,已被排除在《精神疾病诊断与统计手册》第四版(DSM-IV)之外。他们指出,这些状况能够独立于严重的个体精神病理学存在,并且应以关系术语来描述,同时具备特定的诊断标准。他们概述了关系障碍的分类,并提议将其添加到DSM-IV的第一轴。该分类方案聚焦于严重的家庭功能障碍;通常由夫妻和家庭治疗师处理的生活问题被有意排除。文中提供了两种按照DSM风格撰写的关系障碍描述。作者探讨了对患者治疗与康复、精神科医生未来培训以及研究方向的影响。