首页
外语
计算机
考研
公务员
职业资格
财经
工程
司法
医学
专升本
自考
实用职业技能
登录
外语
Why Depression Needs a New Definition A) Many psychiatrists believe that a new approach to diagnosing and treating depression—l
Why Depression Needs a New Definition A) Many psychiatrists believe that a new approach to diagnosing and treating depression—l
admin
2021-12-15
51
问题
Why Depression Needs a New Definition
A) Many psychiatrists believe that a new approach to diagnosing and treating depression—linking individual symptoms to their underlying mechanisms—is needed for research to move forward. In his Aphorisms, Hippocrates defined melancholia (忧郁症) , an early understanding of depression, as a state of "fears and losing courage, if they last a long time". It was caused, he believed, by an excess of bile (胆汁) in the body (the word "melancholia" is ancient Greek for "black bile").
B) Ever since then, doctors have struggled to create a more precise and accurate definition of the illness that still isn’t well understood. In the 1920s, the German psychiatrist Kurt Schneider argued that depression could be divided into two separate conditions, each requiring a different form of treatment: depression that resulted from changes in mood, which he called " endogenous depression" , and depression resulting from reactions to outside events, or " reactive depression". His theory was challenged in 1926, when the British psychologist Edward Mapother argued in the British Medical Journal that there was no evidence for two distinct types of depression, and that the apparent differences between depression patients were just differences in the severity of the condition.
C) Today, Schneider’s subtypes have largely fallen out of favor, but over the years, many more definitions were offered in their place. In 1969, the American psychologist Rollo May wrote in his book Love and Will that "depression is the inability to construct a future", while the cognitive psychologist Albert Ellis argued in 1987 that depression, unlike "appropriate sadness" , stemmed from "irrational beliefs" that left sufferers ill-equipped to deal with even mild setbacks.
D) In 1952, the American Psychiatric Association tried to standardize the definitions of mental illnesses, including depression, by creating a taxonomy (分类法) of mental illnesses. In the first edition of the Diagnostic and Statistical Manual, depression was listed under the broad category of "disorders without clearly defined physical cause". The DSM-II1, published in 1980, was the APA’s first attempt to clarify the definitions of specific disorders by listing their symptoms; the new edition included guidelines for differentiating depression from other disorders, and outlined eight symptoms of depression, included " poor appetite or significant weight loss" and " complaints or evidence of diminished ability to think or concentrate". If an adult met four of the eight symptoms, the manual counseled, he or she would meet the criteria for clinical depression. In the DSM-V, published in 2013, depressive disorders were finally allocated their own chapter. The diagnostic criteria were mostly unchanged, with the exception of one additional symptom: " Depressed mood most of the day, nearly every day, as indicated by either subjective report (e. g. feels sad or empty) or observation made by others (e. g. appears tearful). "
E) Some scientists believe that the DSM-V definition is still too vague. As the psychiatrist Daniel Goldberg noted in the journal World Psychiatry in 2011, many of the DSM symptoms are opposites, which can make it difficult for researchers working to develop a more precise understanding of the condition. "A patient who has psychomotor retardation (精神运动性阻滞) , hypersomnia (嗜睡) , and gaining weight is scored as having identical symptoms as another who is agitated, sleeping badly, and has weight loss," Goldberg wrote.
F) Many recent studies have verified Goldberg’s concerns. In 2000, for example, a group of researchers at Johns Hopkins University attempted to identify subtypes of depression by studying the symptoms of nearly 2,000 patients. However, die researchers were unable to find much of a pattern connecting gender, family history, symptoms, and the degree of the condition (mild to severe). "Depression is of different kind," they concluded, adding that " the severity of an episode appears to be more informative man the pattern of symptoms. " And in 2010, researchers in Germany testing the validity of the DSM-IV definition found that the criteria captured a huge population of patients with " widely varying associations with the pattern of co-morbidity (共病), personality traits, features of the depressive episode and demographic characteristics." The results, they argued, "challenge our understanding of major depression as a similar categorical entity. "
G) Part of the problem, said Scott Monroe, a professor of psychology at the University of Notre Dame, is that in medical term, depression is considered a syndrome rather than a disease. While a disease is a specific condition characterized by a common underlying cause and consistent physical traits, a syndrome is a collection of signs and symptoms known to frequently appear together, but without a single known cause. In a paper published in June in the journal Current Directions in Psychological Science, Monroe called for scientists to begin defining depression with more precision. "It is in mis vague and imprecise realm that problems can arise," he wrote, " and vague insights based on imperfect similarities and differences eventually may prove to be clear oversights. "
H) Part of the reason that scientists are still working in die "vague and imprecise realm" , as Monroe put it, is because they still don’t have a clear answer for what causes depression. In the 1960s, the dominant hypothesis was that it stemmed from a chemical imbalance in the brain, specifically from lower levels of the neurotransmitter serotonin (血清素). As a result, drug companies poured resources into developing "selective serotonin reuptake inhibitors" (SSRIs) , drugs that increased the amount of serotonin in the brain. SSRIs are still the most commonly prescribed type of antidepressant—despite die fact that research has shown that lower levels of serotonin do not necessarily cause depression for all individuals. And in 2010, a review of three decades’ worth of studies on antidepressants found that while SSRIs can be helpful for severely depressed people, their effectiveness " may be minimal or nonexistent" in those wild mild or moderate depression.
I) Bruce Cuthbert, the director of adult translational (转化的) research and treatment development at the National Institute of Mental Health (NIMH), thinks that part of the problem is that researchers have largely focused their attention on finding a one-size-fits-all treatment that doesn’t exist. "When you do a clinical trial, you’re getting a bunch of people who are ’depressed’ , but they’re actually very different," he said. "It’s like comparing apples, pears, and oranges. You’re not going to see a significant effect. You’re not going to be able to say, ’ This treatment works for fruits. ’" Trying to create a singular treatment for depression, Cuthbert said, is like trying to create one for cancer; too unspecific to actually be helpful. "While DSM has been described as a ’Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each," the NIMH director Tom Insel wrote in 2013.
J) In 2010, Insel invited Cuthbert, who was then working as a psychology professor at the University of Minnesota, to help the NIMH develop a new framework for defining mental illness. The result, unveiled in 2013, was die Research Domain Criteria (RDoC), a system created to flip the way researchers think about mental disorders. Unlike the DSM, RDoC isn’t organized by disorder; instead, it’s organized around specific symptoms, like fear, anhedonia (the inability to feel pleasure) , and willingness or unwillingness to work. The system also lists the genes, neural circuits, physical response, and self-reported behavior associated with each symptom.
K) The theory behind this RDoC system is that treating a specific symptom will produce better results than treating a broad category of illness. Many depression patients exhibit anhedonia, for example, but many others don’t. But if researchers took a group of patients who all displayed anhedonia, regardless of their diagnosis (it’s also a common symptom of schizophrenia) and tested treatments for that very specific symptom, they would get better results for treating anhedonia.
L) The current definition of depression, Cuthbert explains, has largely stemmed from scientists observing patients and then developing lists of symptoms based on what they saw. "The belief was that if you described the disorder well enough, you would be able to define it," he said. But it’s becoming increasingly clear, he said, that by relying on describing the disorder, scientists are only skimming the surface in terms of understanding it. Cuthbert hopes that the RDoC system will challenge researchers to look at the mechanics of each symptom more closely, and in the process, come up with more well-informed ideas around how to diagnose mental illness. "We’re starting over with how we think about mental disorders," Cuthbert said. "Our current diagnostic system is running out of steam for research. " " Our current concept of depression is left over from times when we didn’t really understand it very much," he added. " We know so much more about it now—physically, genetically, neurochemically—and we should be using that. "
Far from being the psychiatrists’ authoritative masterpiece, DSM is considered as a lexicon at best.
选项
答案
I
解析
由题干中的DSM和at best定位到原文I)段最后一句。同义转述题。I)段最后一句提到,NIMH的总监汤姆·因塞尔说,虽然《诊断与统计手册》被称为业界的“圣经”,但实际上它最多只是一本词典,它创编了一系列标签,还给它们下了定义。题干中的authoritative masterpiece对应原文中的Bible;lexicon对应原文中的dictionary。
转载请注明原文地址:https://kaotiyun.com/show/7Cx7777K
0
大学英语六级
相关试题推荐
Let’ssayyouloveroller-skating.Justthethoughtof【C1】______onyourroller-skatesbringsasmiletoyourface.Youalsoknow
A、Practicinginafriendlyenvironment.B、Writingarticlesonrelevantsubjects.C、Givingmembersthechancetopractice.D、Goin
A、MajorEuropeanairlineswillgobankrupt.B、Europeanswillpaymuchlessfortraveling.C、Travelingtimebytrainbetweenmajo
Whatifwecouldreadthemindofaterrorist?ResearchersatNorthwesternUniversityinChicagosaytheyhavetakenastepclos
会展业(exhibitionindustry)在中国被誉为朝阳产业。目前,中国的会展业已经成为新的经济增长点。北京奥运会和上海世博会的成功举办对中国的会展业发展意义深远。这两件国际盛事不仅让世界认识了中国,更为重要的是,为中国会展业引入了大量的外国资
Forthispart,youareallowed30minutestowriteashortessayentitledShouldSchoolSportsFacilitiesBeOpentothePublic?
A、Ithasthemostaggressivepolicies.B、Ithasthehappieststudents.C、Itisaveryexpensiveprivateschool.D、Itislocated
A、HeexploredthenightlifeofNewYork.B、Hecollectedusedboxesfromthestreets.C、Hejoinedmanyart-relatedactivities.D
A、Toliveamorecomfortablelife.B、Togiveperformances.C、Tobeapupilofafamousviolinist.D、Toenterafamousuniversity
A、Hisskillofmakingagoodresume.B、Hisattitudetohiscolleagues.C、Hisexpectingsalaryofthejob.D、Hisperformanceint
随机试题
内部提升的优点是()
A.温中与降逆并施,寓补益于温降之中B.温补并用,以温为主C.温阳与散寒并用,养血与通脉兼施D.温清消补并用,但以温清化瘀为主E.温补脾阳与攻下寒积并用当归四逆汤的配伍特点是
女性,71岁,结肠手术后深静脉留置导管并应用广谱抗生素,1个月后突然畏寒,高热,血压70/60mmHg,尿量16ml/小时,血象,白细胞总数18×109/L,中性0.92,BE-28mmol/L,CO2CP为15mmol/L。该病人目前的突出矛盾是
收到行政复议申请后,行政复议机关应当在()日内进行审查。
在工程费用监控过程中,明确费用控制人员的任务和职责分工,改善费用控制工作流程等措施,属于费用偏差纠正的()。
纳税人在办理完停业手续后,应当自行封存保管其税务登记证件及副本、发票领购簿、未使用完的发票和其他税务证件,防止丢失。()
上市公司信息披露的质量难以保证。下列选项中,不属于造成这一现象的主要原因的是()。
远东公司系中外合资经营企业,其注册资本为800万美元,合同约定分两次投入,合同汇率为1:6.8。中、外投资者分别于2012年1月1日和2012年5月1日投入500万美元和300万美元。假定2012年1月1日、1月31日、3月31日和5月1日美元对人民币的汇
[*]
请简要回答下列问题:(2017年西南财经大学801经济学一)如果政府采用宏观手段调节,则政府会采用什么措施?价格和产出会有什么变化?
最新回复
(
0
)