Rogler L H
Fordham University, Bronx, NY 10458.
Psychiatry. 1993 Nov;56(4):324-7.
The revised version of the third edition of the American Psychiatric Association's (1987) Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) gives scant attention to the significance of culture. Two paragraphs in the Introduction advising caution when using the Manual in different cultures (pp. xxvi-xxvii) are followed by more than 500 pages in which the relevance of culture remains basically unrecognized. This neglect is problematical: Ethnological research has repeatedly demonstrated the cultural plasticity of human behavior, so much so, in fact, as to controvert the unqualified attribution of psychiatric meaning to symptoms or sets of symptoms (Rogler, 1993). Yet, despite the scant attention given to culture, the DSM-III and its revised version are more widely used cross-nationally in teaching, research, and clinical practice than any other system for classifying mental illnesses (Maser et al. 1991).
美国精神病学协会1987年版《精神疾病诊断与统计手册》(第三版修订本,即DSM - III - R)几乎没有关注文化的重要性。引言中有两段文字(第xxvi - xxvii页)建议在不同文化中使用该手册时要谨慎,但随后的五百多页内容基本上没有认识到文化的相关性。这种忽视是有问题的:民族学研究反复证明了人类行为的文化可塑性,事实上,其程度足以反驳将精神病学意义不加限定地归因于症状或症状组(罗格勒,1993)。然而,尽管对文化关注甚少,但与任何其他精神疾病分类系统相比,DSM - III及其修订本在跨国教学、研究和临床实践中使用得更为广泛(马泽尔等人,1991)。