Bottom-Up and Top-Down Paradigms for Psychopathology: A Half-Century Odyssey
Bottom-Up and Top-Down Paradigms for Psychopathology: A Half-Century Odyssey
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DOI：
10.1146/annurev-clinpsy-071119-115831
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发表时间：
2020-01-01
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影响因子：
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通讯作者：
Achenbach, Thomas M.
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作者：
Achenbach, Thomas M.
自下而上的范式优先考虑经验数据，从中得出精神病理学的概念化。这些范例使用多变量统计数据来识别倾向于共同发生的问题的综合征，加上更高阶的分组，例如那些被指定为内化和外化的问题。自下而上的评估工具获得1 1/2 - 90岁以上的行为，情感，社会和思想问题和优势的自我评级和附带评级。人口样本的评级提供了规范的综合征和高阶尺度为每个性别，在不同的年龄，由不同的线人，在多元文化规范。规范的评估工具可操作的经验得出的综合征和高阶分组的应用，临床服务，研究和培训。由于跨受访者的一致性是适度的，没有一个受访者提供全面的评估数据，软件比较不同受访者的评级。自上而下的范式优先考虑精神病理学的性质和结构的概念表示，如心理动力学，DSM/ICD和HiTOP范式所示。虽然这些范式起源于观察，但它们倾向于优先考虑概念表征而不是经验数据。
Bottom-up paradigms prioritize empirical data from which to derive conceptualizations of psychopathology. These paradigms usemultivariate statistics to identify syndromes of problems that tend to co-occur plus higher-order groupings such as those designated as internalizing and externalizing. Bottom-up assessment instruments obtain self-ratings and collateral ratings of behavioral, emotional, social, and thought problems and strengths for ages 1 1/2 -90+. Ratings of population samples provide norms for syndrome and higher-order scales for each gender, at different ages, rated by different informants, in relation to multicultural norms. The normed assessment instruments operationalize the empirically derived syndromes and higher-order groupings for applications to clinical services, research, and training. Because cross-informant agreement is modest and no single informant provides comprehensive assessment data, software compares ratings by different informants. Top-down paradigms prioritize conceptual representations of the nature and structure of psychopathology, as exemplified by psychodynamic, DSM/ICD, and HiTOP paradigms. Although these paradigms originated with observations, they tend to prioritize conceptual representations over empirical data.