Kunzwisisa "bhaibheri rebhaibheri" kubva DSM-I kusvika DSM-5
Parizvino muhurukuro yayo yechishanu (DSM-5), Diagnostic and Statistical Manual (DSM) dzimwe nguva inonzi bhaibheri rerape. Muchikamu chayo pane zvikamu zvakananga zvekuongorora zvirwere zvepfungwa, pamwe nekuwanda kwemitemo inobvumira vanachiremba kuti vadzidze zvinyoronyoro zvinowanzomesa zvinetso zvemakambani einishuwarenzi uye mamwe maitiro ekutsvaga kutsvaga.
Iyi nzira inopa huwandu hwezvakanaka, zvakadai sekuenzanisa kwekuongororwa kune vakasiyana-siyana vanopa kurapa. Asi kuwedzera, vadzidzisi vehutano hwepfungwa vari kufunga nezvezvipingamupinyi, kusanganisira kukwanisa kuwedzeredza zvirwere. Nyaya ya2011 inotaura nezveSalon.com yakasimbiswa ichiti, "Vanachiremba vanopandukira bhaibheri chepfungwa." Kuti uchinzwisise nharo hurukuro, inotanga kudiwa kuti unzwisise kuti DSM chii uye haisi.
Nhoroondo yeDMM
Kunyange zvazvo midzi yaro iri kutevera kusvika pakupera kwezana remakore rechi19, maitiro ehutano hwepfungwa dzepfungwa akabatwa chaizvo mumakore achangotevera Hondo Yenyika II. Dhipatimendi reUnited States reVeterans Affairs (iyo yakabva yazivikanwa seVeterans Administration, kana VA) yaida nzira yekuongorora uye kubata zvekuita nhengo dzebasa dzinodzoka dzaive nehutano hwakawanda hwehutano hwepfungwa. Kushandisa zvizhinji zvezwi rakagadzirwa neAV, World Health Organisation yakabudisa hurongwa hwayo hwepasi rose hwezvirwere (ICD), shanduro yechitanhatu, iyo yekutanga yekubatanidza zvirwere zvepfungwa.
Kunyange zvazvo basa iri richimiririra mamwe emitambo yepakutanga yehutano hwehutano, hwakanga huri kure.
DSM-I uye DSM-II
Muna 1952, American Psychiatric Administration (APA) yakabudisa kushanduka kweCI-6 zvakanyatsorongedzerwa kushandiswa navanachiremba uye nevamwe vatapi venhau. I-DSM-Ndakanga ndiri wekutanga kune iyo, asi nyanzvi dzakabvuma kuti yakaramba ichida basa.
DSM-II, yakabudiswa muna 1968, yakagadzirisa zvimwe zvisiri izvo, kusanganisira kushandiswa kwemashoko ekuvhiringidza nekushayikwa kwezvinangwa zvakajeka zvekusiyanisa pakati pezvimwe zvinetso. I DSM-II yakawedzerawo basa racho.
DSM-III
Rakadhindwa muna 1980, DSM-III yakaratidza kuchinja kukuru muurongwa hweDMM. Yaiva yekutanga yekutaura zvinhu zvakadai zvino-zvinowanzoitwa se-multi-axis system, iyo inofunga nezvekwereti yese yepfungwa, nekujekesa kutsanangurira zvirongwa. Izvo zvakabvisawo zvakawanda zvepurogiramu yekare kushandura kwepfungwa ye psychodynamic, kana Freudian , kunyange zvazvo ichida kuratidza kusatenderera kune nzira.
Kunyange zvazvo DSM-III yakanga iri basa rokupayona, kushandiswa kwenyika-nyika munguva pfupi yakatevera kwakaratidza kukanganisa kwayo. Kuvhiringidza kuongororwa kwekuongorora uye kusawirirana kwakaunza APA kukudziridza kudzokorora. Zvimwe zvekuchinja uku zvaive zvichibva pakuchinja mitemo yevanhu. Semuenzaniso, mu DSM-III, ungochani hwakarongerwa se "kushungurudzwa kwepabonde." Pakazosvika makore makumi matatu, zvisinei, ungochani hwakange husisati hwaonekwa sechirwere, kunyange zvazvo kushushikana uye kushushikana pamusoro pekuita zvepabonde zvaive. Iyo DSM-III-R, yakabudiswa muna 1987, yakagadzirisa dzakawanda zvepfungwa dzomukati dzebasa rekare.
DSM-IV uye DSM-5
Rakadhindwa muna 1994, DSM-IV inoratidza kuchinja kwakawanda muku kunzwisisa kwehutano hwepfungwa.
Zvimwe zviongorori zvakawedzerwa, zvimwe zvinodzingwa kana kuiswazve. Mukuwedzera, chirongwa chekuongororwa chakanga chichigadziridzwa zvakare mukuedza kuita kuti zvive nyore-zvekushandisa.
I DSM-5, yakabudiswa munaMay 2013, inoratidza chimwe chinhu chakanyanya kuchinja mukufunga munharaunda yehutano hwepfungwa. Kuongorora kunove kwakashandurwa, kubviswa kana kuwedzerwa, uye sangano rehurongwa rakawana reworking huru. Kusiyana neshanduro dzakapfuura isati yasvika (iyo yakanga iine makumi emakore pakati pezvinyorwa), DSM-5 inotarisirwa kuongororwa nguva dzose ne mini zvinyorwa (zvakadai seDMM-5.1, DSM-5.2, nezvimwewo) mukuedza kuwedzera kuteerera tsvakurudzo.
Clinical Uses
Nyanzvi yose inoshandisa DSM nenzira yake. Vamwe vashandi vanoomerera zvakasimba kumabhuku acho, vachironga zvirongwa zvekurapa kune umwe neumwe muchengeti zvichienderana chete nezviratidzo zvebhuku racho. Vamwe vanoshandisa DSM semutungamiri - chidziro chinovabatsira kuona mazambuko asi vachiisa pfungwa pane imwechete yevabereki. Asi munyika yemazuva ano, zvese vese vadzidzisi vanozviwana ari kutaura nezvemashoko eDMM kuitira kuti vabhadhara mari kune makambani ehushuwarisi. Inishuwarenzi yehutano inzvimbo yakawandisa yakaoma, uye sarudzo yakagadziriswa inogadzirisa inishuwarenzi vanogadzirisa uye mahofisi ekubhadhara mahara kuti vataure mutauro mumwechete.
Batsirwa
Kunze kwekugadzirisa kwekubhadhara uye kukodha, DSM inopa huwandu hwezvakakosha kune vose murapi uye mutengi. Kuenzanisa kwekuongororwa kunobatsira kuvimbisa kuti vatengi vanogamuchira kurapa kwakakodzera, kunobatsira pasinei nenzvimbo, nzvimbo dzevanhu kana kukwanisa kubhadhara. Inopa kuongororwa kwakajeka kwezvinhu uye kunobatsira pakuvandudza zvinangwa zvehutachiona , pamwe chete nechiyero chekuyera pakuongorora kubudirira kwehutano. Mukuwedzera, DSM inobatsira kutsvaga kutsvakurudza munharaunda yehutano hwepfungwa. Zvinyorwa zvekuongorora zvinoshandiswa kubatsira kubatsira kuti mapoka akasiyana-siyana evatsvakurudzi vari kunyatsodzidza chirwere chimwechete - kunyange izvi zvingave zvinyorwa zvinopfuura zvinoshanda, sezvo zvinetso zvakawanda zvakadaro zvine zviratidzo zvakasiyana-siyana zvakasiyana.
Kune chiremba, DSM inopedza zvakawanda zvekufungidzira. Kuongororwa kwakakodzera uye kurapwa kwechirwere chepfungwa kunoramba uri unyanzvi, asi chirongwa cheDMM chekuongorora chinoshanda semhando yemarata anotungamirira. Muzera remishonga pfupi , chiremba anogona kuona muchengeti chaiwo zvishoma chete zvenguva, izvo zvingave zvisiri nguva yakakwana kuti zviongorore zvakakwana mumamiriro ekutenda nematambudziko. Kushandisa nzira yekuongororwa inowanikwa muDMM, murapi anogona kukura nekukurumidza kurongedza, iyo inonatswa panguva dzezvikamu zvega.
Drawbacks
Ive pfupi yekupedzisira yekutsoropodzwa inoratidzika kunge inofanidza kukanganisa kwenguva refu pamusoro pemamiriro ehutano hwepfungwa. Vanotsoropodza vakawanda veDMM vanozviona sekuwedzeredza kwekuwedzera kwekuita kwevanhu. Vamwe vanonetseka kuti nokuderedza zvinetso zvakaoma kune mazita uye nhamba, sangano rezvesayenzi rinogona kukanganisa kukanganisa kwezvinhu zvakasiyana-siyana zvevanhu. Zvimwe zvinokonzera njodzi dzinosanganisira kusazivikanwa kana kunyanya kuongororwa-siyana, mumapoka makuru emapoka evanhu anorondedzerwa seane chirwere chega nekuda kwekuti mufambiro wavo hausi nguva dzose unowirirana nezvino "zvakanaka." Kuve nehanya nevana uye kusagadzikana kwehutano ( ADHD ) kunowanzoridzirwa semuenzaniso. Kushandura mumagumo ezwi uye kutsanangurira zviratidzo pakati pe DSM-II ne DSM-IV zvakabatana nekukwira kukuru kwechizvarwa chevana paRitalin kana mamwe mishonga inokurudzira.
Dzimwe njodzi dzinosanganisira kukanganisa kwekushorwa. Kunyange zvazvo matambudziko ehutano hwepfungwa asingatarisirwi nemaitiro asina kunaka ayo aimbove aripo, zvinetso zvakananga zvinogona kuonekwa semakanyorwa. Vamwe vanachiremba vanonyanya kuchenjerera kudzivisa kuvhara mavara kumakambani avo, kunyange zvazvo kune zvikonzero zveinishuwarenzi, chirwere chinonyanya kuonekwa chinogona kudiwa.
Zvaunogona Kuita
Pasinei nekunetseka kwekuwedzera kwezvikamu zvehutano hwehutano hwepfungwa, DSM inoramba iine hutano hwekuongororwa kwehutano hwepfungwa. Kungofanana nedzipi zvinyorwa zvedzidzo, kunyange zvakadaro, DSM yakagadzirirwa kushandiswa seimwe yezvigadzirwa zvakawanda zvekunyatsoongorora uye kurapa. Hapana kune chinotsiviwa nekutonga kweunyanzvi pane rutivi rwechiremba. Zvakakosha kubvunzurudza vashandi vechiremba sezvamungaita chero mumwe mupi webasa. Bvunza mibvunzo pamusoro pemamiriro ekurapa uye nzira yekurapa, uye sarudza uyo ane chimiro chakanakisisa neunhu hwako nezvinangwa zverapi.
Mumakore achangobva kupfuura, mamwe masangano ehutano hwepfungwa akabudisa mabhuku ezvokuwedzerwa anoedza kutarisa zvimwe zvezvido zveDMM nezvimwe zvakanyanya zvinoratidzirwa zvinotarisirwa kuchikoro chekufungidzira. Semuenzaniso, sangano shanu dzakabatana kuti dzigadzire Psychodynamic Diagnostic Manual, kana PDM, muna 2006. Bhuku rino rakagadzirirwa kuvarapi vanoita maitiro epfungwa , asi vamwe vanotarisa pane pfungwa dzakasiyana dzepfungwa. Chinangwa chemazana mabhuku ndechekuongorora zvimwe zvakadzika mukusiyana kwakasiyana-siyana kunogona kukanganisa vatengi vane dambudziko rese. Kana usina chokwadi pamusoro peDMM, bvunza mushandi wako kana iye achishandisa chero zvipi zvese zvinowedzera kuongorora.
Kana uchinetseka pamusoro pehutano hwako, bvunza chiremba wako kuti uwane mamwe mashoko. Kuwana murapi akakodzera kunogona kunge wakaoma, asi mibayiro inofanirwa nekutambudzika.
Sources:
> DSM: History. American Psychiatric Association. http://www.psych.org/MainMenu/Research/DSMIV/History_1.aspx.
DSM-V Kuvandudza. American Psychiatric Association. > https://www.psychiatry.org/psychiatrists/practice/dsm.
> Mvura, Rob. "Vanachiremba vanopandukira bhaibheri chepfungwa." Salon . December 27, 2011. http://www.salon.com/2011/12/27/therapists_revolt_against_psychiatrys_bible/.