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To fully leverage fine-grained clinical phenomena, we have to think beyond DSM-based concepts and the presumption of diagnostic kinds.
Journal of Psychopathology and Clinical Science ( IF 3.1 ) Pub Date : 2023-10-01 , DOI: 10.1037/abn0000876
Holly Frances Levin-Aspenson 1
Affiliation  

In light of the limitations of dominant psychiatric classification systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), this special section positions fine-grained clinical phenomena as key to the future of psychopathology research. This shift is necessary given the constraints DSM-based diagnoses place on (a) the specificity of theories and models of psychopathology and (b) efforts to develop alternative paradigms. Fine-grained clinical phenomena offer comparative advantages, but transitioning to their study involves significant challenges. Chief among these challenges is the need to move beyond DSM as a source of concepts. Implicit assumptions that DSM-based disorders provide valid, circumscribed, and explanatory definitions of clinical phenomena perpetuate existing reification of diagnostic categories rather than reimagining psychopathology nosology beyond DSM, thus needlessly restricting and even undermining research efforts. Moving forward requires careful attention to consensual operationalization. Otherwise, we will continue to struggle to develop valid compositional explanations of clinical phenomena and to organize them into explanatory conceptual taxonomies. Scientific progress here depends on coordinated pluralism that incorporates different lenses into psychopathology and different approaches to data collection and analysis, with a firm grounding in construct validity and a corresponding commitment to continually reimagine rather than reify our concepts and objects of study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译:

为了充分利用细粒度的临床现象,我们必须超越基于 DSM 的概念和诊断类型的假设。

鉴于《精神疾病诊断与统计手册》(DSM)等主流精神病学分类系统的局限性,本特殊部分将细粒度的临床现象定位为精神病理学研究未来的关键。鉴于基于 DSM 的诊断对(a)精神病理学理论和模型的特殊性以及(b)开发替代范式的努力的限制,这种转变是必要的。细粒度的临床现象提供了比较优势,但过渡到他们的研究涉及重大挑战。这些挑战中最主要的是需要超越 DSM 作为概念来源。基于 DSM 的疾病提供了有效的、有限制的和解释性的临床现象定义的隐含假设使现有的诊断类别具体化,而不是重新想象 DSM 之外的精神病理学分类学,从而不必要地限制甚至破坏研究工作。向前迈进需要认真关注协商一致的运作。否则,我们将继续努力开发临床现象的有效组成解释,并将它们组织成解释性概念分类法。这里的科学进步取决于协调的多元化,将不同的视角纳入精神病理学以及不同的数据收集和分析方法,并以建构有效性为坚实的基础,并相应地致力于不断重新想象而不是具体化我们的概念和研究对象。(PsycInfo 数据库记录 (c) 2023 APA,保留所有权利)。
更新日期:2023-10-01
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