Moving Target The Developing Social Brain Psychopathology运动目标的社会脑与精神病理学的发展.pptVIP

Moving Target: The Developing Social Brain Psychopathology Research Committee Group for the Advancement of Psychiatry (GAP) Jacob Kerbeshian Co-author: Larry Burd Other committee members: Russell Gardner, Beverly Sutton, John Beahrs, Fred Wamboldt, Alan Swann, Johan Verhulst, Michael Schwartz, Morton Sosland, Carlo Carandang, Doug Kramer, John Looney Copyright SLACK Incorporated Used with Permission Reprint web site Http:///reprints/ Jacob Kerbeshian and Larry Burd, Moving Target: The Developing Social Brain and Psychopathology, Psychiatric Annals, 35(10), pp 839-852, 2005. Decade of the brain Presidential fiat: 1990 Investigative technology ? Knowledge boom Organizing framework remains lacking (research ≈ blind men elephant) Theory requisite for proper study Psychodynamics appropriately no longer guides psychiatry now But therefore few bridges between domain of personal knowledge neurobiology data Requirements of overarching theory Comprehensible to the psychiatrist Intuitively acceptable to the public Scientifically sound Can overcome the crude reductionism of “biochemical imbalance” DSM III precursors Menu-like seeming specificity Earlier editions used narrative Like introductions of present editions Documents ok but these presently used more specifically than intended Disorders not valid clinical diagnoses nor illnesses Rather spectra from symptom complex to disease Considered categories even when clearly dimensional “Co-morbidities” Term used because manual omits dimensions Original intent of DSM-III Focused on clinical decision-making Not on defining “caseness” Impairment need for treatment not indicated in dx categories Requirements for diagnostic validity Differentiation of pathology from normality Pathological states represent statistical variations from physiological norms Pathognomic symptom expression Syndromal patterns Design Use of DSM Designed for diagnostic gatekeeper purposes or screening But present use involves rigid criteria