Proportionate responses to life events influence clinicians' judgments of psychological abnormality.
Proportionate responses to life events influence clinicians' judgments of psychological abnormality.
复制标题
对生活事件的相应反应影响临床医生对心理异常的判断。
DOI：
10.1037/a0026416
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发表时间：
2012
影响因子：
3.6
通讯作者：
Khalife,Danielle
中科院分区：
文献类型：
--
作者：
Kim,NancyS;Paulus,DanielJ;Gonzalez,JeffreyS;Khalife,Danielle
心理异常是《精神疾病诊断与统计手册》（DSM-IV-TR；美国精神病学协会，2000）和所有临床评估中的一个基本概念。临床心理学家如何利用生活事件的背景来判断一个人当前行为的异常？长期以来，生活事件背景在评估中的适当作用一直是临床理论家激烈争论和审查的主题，然而，对于临床医生在实践中自己的判断，人们知之甚少。作者提出了一个比例反应假说，即对异常的判断受到行为是否是对过去事件的不成比例反应的影响，使其难以理解或解释。有执照的临床心理学家（N= 77）被展示了一些小插图，这些插图描述了在创伤或轻度痛苦事件之前假设的人们的行为（紊乱、轻度痛苦或未受影响）。专家对异常的判断强烈而系统地受到过去事件与当前行为在强度和效价上的不匹配程度的影响，这种不匹配越大，这个人看起来就越不正常。另一组独立的临床心理学家（N= 20）进一步证实，不匹配程度越大，就越难以理解病人。这些发现适用于不同理论取向的临床医生，也适用于这些判断模式与DSM-IV-TR中的正式建议相反的疾病（美国精神病学协会，2000）。讨论了这些效应的合理性及其对临床决策科学的启示。（PsycINFO数据库记录(c) 2016 APA，版权所有）
Psychological abnormality is a fundamental concept in the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV–TR; American Psychiatric Association, 2000) and in all clinical evaluations. How do practicing clinical psychologists use the context of life events to judge the abnormality of a person's current behaviors? The appropriate role of life-event context in assessment has long been the subject of intense debate and scrutiny among clinical theorists, yet relatively little is known about clinicians' own judgments in practice. The authors propose a proportionate-response hypothesis, such that judgments of abnormality are influenced by whether the behaviors are a disproportionate response to past events, rendering them difficult to understand or explain. Licensed, practicing clinical psychologists (N= 77) were presented with vignettes describing hypothetical people's behaviors (disordered, mildly distressed, or unaffected) that had been preceded by either traumatic or mildly distressing events. Experts' judgments of abnormality were strongly and systematically influenced by the degree of mismatch between the past event and current behaviors in strength and valence, such that the greater the mismatch, the more abnormal the person seemed. A separate, additional group of clinical psychologists (N= 20) further confirmed that the greater the degree of mismatch, the greater the perceived difficulty in understanding the patient. These findings held true across clinicians of different theoretical orientations and in disorders for which these patterns of judgments ran contrary to formal recommendations in the DSM–IV–TR (American Psychiatric Association, 2000). The rationality of these effects and implications for clinical decision science are discussed.(PsycINFO Database Record (c) 2016 APA, all rights reserved)