Всемирная психиатрия. №1 2021

Иерархические модели психопатологии: эмпирическая поддержка, последствия и нерешенные вопросы

Benjamin B. Lahey1 , Tyler M. Moore2 , Antonia N. Kaczkurkin3 , David H. Zald3

Department of Public Health Sciences, University of Chicago, Chicago, IL, USA; 2 Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3 Departments of Psychology and Psychiatry, Vanderbilt University, Nashville, TN, USA

Стр. 57-63

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Опубликовано: 1 февраля 2021

Аннотация / Abstract

Хотя на данный момент в психиатрии и психологии доминирует взгляд на психопатологию как сумму дискретных диагностических категорий психических расстройств, некоторые ученые, по крайней мере, начиная с 1960-х годов, утверждали, что психопатология лучше концептуализируется как состоящая из непрерывных измерений дезадаптивного поведения, эмоций и когнитивных функций 1-4 . Совсем недавно междисциплинарное движение решительно выступило за отказ от категориальных диагнозов и замену их пространственной классификацией психопатологии 5-8 . Это международное движение ставит три ключевых проблемы. Во-первых, преимуществами пространственного измерения психопатологии являются его надежность и обоснованность 9–11 . Во-вторых, важным принципом движения является то, что все измерения психопатологии положительно коррелированы в той или иной степени и что паттерны корреляций так же важны, как и сами измерения 12–14 . В-третьих, нет эмпирического обоснования для того, чтобы не включать все симптомы как ранее выделенных клинических, так и личностных расстройств в одну и ту же пространственную систематизацию 6,15 . Предлагаемая иерархическая классификация фенотипических измерений психопатологии получила значительную эмпирическую поддержку, но наше понимание этих измерений в настоящее время требует экстраполяции из ограниченных данных. В частности, нет общепринятого диагностического инструмента, который учитывал бы все симптомы. Разработка такого инструмента представляется первоочередной задачей; мы не можем всесторонне определить измерения психопатологии, пока не будут изучены все симптомы, которые определяют совокупность психопатологии одновременно и одним и тем же способом. РАЗЛИЧИЯ МЕЖДУ СТАТИСТИЧЕСКИМИ МОДЕЛЯМИ ИЕРАРХИИ ИЗМЕРЕНИЙ ПСИХОПАТОЛОГИИ Некоторые теоретики утверждают, что модели корреляций между измерениями психопатологии первого порядка (например, генерализованное тревожное расстройство, депрессия) могут быт...

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Иерархические модели психопатологии: эмпирическая поддержка, последствия и нерешенные вопросы

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Иерархические модели психопатологии: эмпирическая поддержка, последствия и нерешенные вопросы

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