Nosological Reflections
Nosological Reflections
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疾病学反思
DOI：
10.1177/2156869313519114
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发表时间：
2014
影响因子：
5.1
通讯作者：
Owen Whooley
中科院分区：
文献类型：
--
作者：
Owen Whooley
自从《精神障碍诊断与统计手册》（DSM）第三版中建立了基于社会背景的分类以来，社会学家对DSM在定义精神障碍时未能理解社会和背景因素提出了担忧。作者介绍了精神疾病分类学的最新发展-DSM-5修订过程和研究领域标准（RDoC）的出现-然后考虑其对解语境的影响。通过对参与DSM-5争议的精神病学家的深入访谈和对关键文件的内容分析，作者首先叙述了DSM-5雄心勃勃的修订，阐明了DSM-5工作组对维度化的拥抱，作为有效性问题的解决方案，以及精神病学家对这种“范式转变”的最终拒绝。工作组的失败促使国家精神卫生研究所将RDoC作为一种替代疾病分类框架，完全避开DSM类别。接下来，作者探讨了这些事件对去语境化的影响，DSM-5和RDoC都没有明确解决，展示了RDoC如何通过以大脑为中心的精神障碍概念化来升级去语境化。为了应对这些发展，社会学家应该继续推广强调其社会嵌入性的精神痛苦定义方法。
Since the establishment of the symptoms-based categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Third Edition, sociologists have raised concerns about the DSM’s failure to appreciate social, contextual factors when defining mental disorders. The author describes recent developments in psychiatric nosology—the DSM-5 revision process and the emergence of the Research Domain Criteria (RDoC)—and then considers their implications for decontextualization. Drawing on in-depth interviews with psychiatrists involved in the DSM-5 controversy and a content analysis of key documents, the author first recounts the ambitious DSM-5 revisions, illuminating the DSM-5 Task Force’s embrace of dimensionalization as a solution to the problem of validity and the ultimate rejection of this “paradigm shift” by psychiatrists. The Task Force’s failures prompted the National Institute of Mental Health to promote RDoC as an alternative nosological framework that eschews DSM categories altogether. Next, the author explores the ramifications of these events for decontextualization, which neither DSM-5 nor RDoC explicitly addresses, demonstrating how RDoC is poised to escalate decontextualization through its brain-centric conceptualization of mental disorders. To counteract these developments, sociologists should continue to promote ways of defining mental distress that underscore its social embeddedness.
精神病学诊断作为具体化的测量。
影响因子：
5
作者：
Mirowsky,J;Ross,CE
通讯作者：
Ross,CE
影响因子：
5
作者：
Bruce G. Link;J. Phelan
通讯作者：
Bruce G. Link;J. Phelan