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Mazenera atsopano ku thanzi la maganizo

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Kuzindikira ndi gawo lofunikira pazachipatala kwa opereka chithandizo chamankhwala. Pali mitundu iwiri ikuluikulu ya machitidwe owunikira: categorical ndi dimensional. Njira zamagulu zimaganiza kuti chikhalidwe chilichonse ndi gulu losiyana komanso losiyana. Mayendedwe a dimensional, mosiyana, amawona mikhalidwe motsatira gawo limodzi, kopitilira, kapena sipekitiramu.

Vuto

Kwa zaka zopitirira zana, kafukufuku wa psychopathology wakhala akuyang'ana pa kufufuza kwamagulu, cholowa chachipatala cha matenda a maganizo (maganizo). Zotsatira zake, machitidwe akuluakulu ndi amtundu: omwe ndi, Diagnostic and Statistical Manual of Mental Disorders (DSM), yopangidwa ndi American Psychiatric Association (APA); ndi International Classification of Diseases (ICD), yopangidwa ndi World Health Organization (WHO). Zitsanzo zoterezi zakhala zikulamulira masukulu, makampani azamisala, komanso anthu ambiri. Komabe, ngakhale zabwino ndi kutchuka kwawo, machitidwe amtundu ali ndi zofooka zazikulu.

Kupanda kulondola kwa matenda

Mavuto amisala ndizovuta kugawa, chifukwa amangokhalira kupitilira pakati pa matenda ndi zachilendo, monga kulemera kwa thupi ndi kuthamanga kwa magazi. Nkhaniyi ndi yofunika kwambiri pofufuza matenda a umunthu. Nazi zitsanzo zitatu:

  • Pali njira 227 zomwe zingatheke kukwaniritsa zofunikira za DSM za vuto lalikulu lachisokonezo (MDD).
  • Kuti muzindikire matenda a borderline personality (BPD), dongosolo la DSM-5 lili ndi njira zisanu ndi zinayi zodziwira matenda, zomwe osachepera asanu ayenera kukhalapo. Kuchita kuphatikiza kwa algorithmic kumatulutsa mawonedwe 256 osiyana a BPD.
  • Kuyesa kujambula zizindikiro zambiri za matenda a Post Traumatic Stress Disorder (PTSD), kutsatira DSM-5, kumabweretsa kuphatikiza kwakukulu kwa 636,120.
  • subjective, reductionist ndi atheoretical

    Dongosolo la DSM ndi dongosolo lokhazikika lomwe limagwiritsa ntchito njira ya phenomenological potengera kuvomerezana kwa akatswiri. Njira iyi, yochepetsera, komanso yosagwirizana ndi chiphunzitso (yopanda chiphunzitso cha psychological) imatenga kawonedwe kazachilengedwe m'malingaliro, motero imatsutsa kupita patsogolo kwaposachedwa kuchokera kumalingaliro a neurobiological ndi chikhalidwe cha anthu ndi zopereka zawo ku sayansi yamalingaliro.

    Zotsatira zake, dongosolo la DSM limabweretsa zovuta pakumvetsetsa zenizeni ndi magwero a psychopathology, kuphatikiza kutsika kwazizindikiro, kuchuluka kwa comorbidity (gulu likuphatikizana), kusiyanasiyana kodziwika bwino, komanso kudalirika kochepa. N'zosadabwitsa kuti "nthawi ya biomedical model yadziwika ndi kusowa kwatsopano kwachipatala komanso zotsatira za thanzi labwino" komanso kusowa kwa chithandizo chamankhwala.

    Pathologization of Normality ndi Kupanda Chikhalidwe Chachikhalidwe

    Kuchulukirachulukira ndi ma pathologies a chizolowezi ndizofala muzamisala komanso mu dongosolo la DSM. Kusintha kwa mkangano kophatikizidwa mu DSM-5 yokonzedwanso ikugwirizana ndi kuchotsedwa kwa "ndime yochotsera imfa" potsutsa mfundo yakuti zizindikiro za kuvutika maganizo zingakhale zachilendo panthawi yachisoni chaposachedwapa. Izi zikuperekanso chitsanzo cha chikhalidwe ndi chikhalidwe cha chikhalidwe cha kuvutika maganizo komanso kusowa kwa chikhalidwe cha chikhalidwe cha DSM-5. Izi zikuwonetsanso zolakwika zomwe zidabadwa komanso zoperewera zachipatala za njira ya gulu la DSM-5, zomwe zimapangitsa kuti kutsimikizika kwake kukhale kokayikitsa kwambiri.

    Kudzinyoza, kulemba ndi kukondera 'big pharma'

    Kutsutsa kwina kwa machitidwe a magulu ndi "kudzidzudzula kodabwitsa," komwe kumasonyeza zotsatira zoipa za kusalidwa ndi anthu, zomwe zimapangitsa kuti munthu asamachite bwino komanso azidzidalira pamene akukumana ndi malingaliro ambiri okhudzana ndi matenda a maganizo. . Allen Frances, yemwe kale anali wapampando wa gulu lomwe linapanga DSM-5, wakhala akutsutsa poyera DSM-5 yamakono, akuitcha kuti "Baibulo la psychiatry; malo oti mupiteko kuti mudziwe amene akudwala ndi amene sali” ndi kusewera “m’manja mwa Big Pharma, amene akukolola phindu la mabiliyoni ambiri”.

    Malinga ndi Frances, zosintha zomwe zachitika mu DSM-5 sizinakhudze matenda amisala, omwe akadali okhazikika pazigamulo zosokonekera m'malo moyesa mayeso, ndipo matenda amisala akukumana ndi vuto lokhazikika lachikhulupiliro chifukwa cha kukwera kwamitengo.

    Momwemonso, olemba ena amati zilembo zamatenda amisala zimakwaniritsa zofuna za asing'anga ena ndi mayanjano awo akatswiri komanso makampani opanga mankhwala. Ofufuza ena amalankhula za ziphuphu za epistemic ndikugwiritsa ntchito fanizo la dongosolo la DSM lomwe limayesa kukhazikika bwino komanso kusokonezeka kwamaganizidwe ngati zokopa za "McDonaldization" yazachuma ndi chikhalidwe cha anthu.

    N'zosadabwitsa kuti kuwonjezereka kwa chidwi kwayang'ana pa kuwonekera poyera ndi mikangano yomwe ingakhalepo mu sayansi ya zamankhwala ndi zachipatala, pamodzi ndi malingaliro oti mamembala a gulu la DSM aulule za zofuna zawo zachuma popanga mankhwala ochizira matenda a maganizo.

    Yankho: Hierarchical Taxonomy of Psychopathology (HiTOP)

    Hierarchical Taxonomy of Psychopathology (HiTOP) ndi njira yatsopano yosinthira magawo omwe amapangidwa kuti athe kuthana ndi malire amisonkho yachikhalidwe (mwachitsanzo, DSM-5) ndikuwonetsa umboni waposachedwa wasayansi. Umboni wofufuza (mosiyana ndi 'lingaliro la akatswiri') umasonyeza kuti zovuta zambiri zimakhala, 'zosasinthika motsatizana, zobwerezabwereza/zosatha ndipo zimakhalapo mosalekeza'.

    Chidule cha maubwino a HiTOP system

    The HITOP:

  • Lingalirani kuti muwone thanzi lamalingaliro mkati mwa sipekitiramu. Izi zimapangitsa kuti zikhale zotheka kufotokoza kuchuluka kwa zovuta za matenda amisala.
  • Zimathandizira kugawika kwa matenda amisala, kulola ofufuza ndi asing'anga kuyang'ana kwambiri pazizindikiro zabwino kwambiri kapena kuwunika momwe zingafunikire. Mwachitsanzo, pamene DSM-5 imayika matenda a chikhalidwe cha anthu m'gulu limodzi, chitsanzo cha HiTOP chimafotokoza kuti ndi gawo laling'ono, kuyambira kwa anthu omwe amakumana ndi vuto linalake (mwachitsanzo, kulankhula pagulu) kwa anthu omwe ali ndi nkhawa kwambiri. nthawi zambiri.
  • Imalongosola mwachidule zambiri zokhudzana ndi chiopsezo chogawana nawo ma genetic, zowopsa zachilengedwe, komanso zolakwika za neurobiological.
  • Zimalola kuti mlingo wopapatiza wa utsogoleri upereke zolinga zabwino za chithandizo cha zizindikiro zinazake. M'malo mwake, utsogoleri wapamwamba kwambiri umakhala wothandiza popanga phukusi lathunthu lamankhwala ndikukhazikitsa mfundo zaumoyo wa anthu.
  • Gwiritsani ntchito umboni wasayansi waposachedwa kwambiri m'malo modalira malingaliro a akatswiri (monga DSM-5 system).
  • Pomaliza

    Kwa zaka zopitirira zana, thanzi la maganizo lakhala likulamulidwa ndi matenda amtundu uliwonse. Dongosolo la DSM lawonedwa ngati chikalata chofunikira kwambiri pakuzindikira ndikuyika m'magulu azovuta zamaganizidwe. Umboni wokulirapo wa kafukufuku ukuwonetsa mwamphamvu kuti zizindikiro za kupsinjika kwamalingaliro zimayimiriridwa bwino kwambiri pogwiritsa ntchito miyeso yowoneka bwino m'malo mwa magawo osiyanasiyana.

    Izi zikuwonetsa kukwera kwa njira zofananira ndi sayansi ya matenda amisala. HiTOP yatsopano ndi njira yowoneka bwino yomwe imatha kufulumizitsa ndikuwongolera kafukufuku wamatenda amisala, komanso kuyesetsa kuyesa bwino, kupewa, ndikuchiza matenda amisala.

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