Room R, Janca A, Bennett L A, Schmidt L, Sartorius N
Addiction Research Foundation, Toronto, Ontario, Canada.
Addiction. 1996 Feb;91(2):199-220, discussion 221-30. doi: 10.1046/j.1360-0443.1996.9121993.x.
The cross-cultural applicability of criteria for the diagnosis of substance use disorders and of instruments used for their assessment were studied in nine cultures. The qualitative and quantitative methods used in the study are described. Equivalents for English terms and concepts were found for all instrument items, diagnostic criteria, diagnoses and concepts, although often there was no single term equivalent to the English in the languages studied. Items assuming self-consciousness about feelings, and imputing causal relations, posed difficulties in several cultures. Single equivalent terms were lacking for some diagnostic criteria, and criteria were sometimes not readily differentiated from one another. Several criteria--narrowing of the drinking repertoire, time spent obtaining and using the drug, and tolerance for the drug--were less easy to use in cultures other than the United States. Thresholds for diagnosis used by clinicians often differed. In most cultures, clinicians were more likely to make a diagnosis of drug dependence than of alcohol dependence although behavioural signs were equivalent. The attitudes of societies to alcohol and drug use affects the use of criteria and the making of diagnoses.
在九种文化中研究了物质使用障碍诊断标准及其评估工具的跨文化适用性。描述了该研究中使用的定性和定量方法。尽管在所研究的语言中通常没有与英语完全对等的单一术语，但为所有工具项目、诊断标准、诊断和概念都找到了英语术语和概念的对应词。在几种文化中，涉及对情感的自我意识以及归因因果关系的项目存在困难。一些诊断标准缺乏单一的对应词，而且标准之间有时难以区分。在美国以外的文化中，诸如饮酒种类变窄、获取和使用药物所花费的时间以及对药物的耐受性等几个标准不太容易应用。临床医生使用的诊断阈值往往不同。在大多数文化中，尽管行为体征相同，但临床医生更倾向于诊断为药物依赖而非酒精依赖。社会对酒精和药物使用的态度会影响标准的使用和诊断的做出。
