Umqulu weNgcaciso kunye neSatisatisti yeengxaki zeengqondo unyatheliswa nguMbutho wezeMpilo waseMelika kwaye usetyenziswa ngabagula ngengqondo kunye neengcali zengqondo ukuze zibone ukukhathazeka kwengqondo. Upapasho lokuqala lwe-DSM lwapapashwa ngo-1952. Nangona liye lagqithiswa inani leenguqulelo malunga neminyaka edlulayo, lihlala lichazwe ngokucacileyo kwiingxaki zengqondo.
Inguqu yanamhlanje yencwadana yokuxilonga, i-DSM-5, yapapashwa ngoMeyi ka-2013 kwaye ichaza iziphazamiso ezininzi ezahlukahlukeneyo eziquka ukukhathazeka kwemizwelo, i-bipolar kunye neengxaki ezinxulumene nazo, ukukhathazeka kokukhathazeka, ukutya kunye nokukhathazeka kokutya, kunye nokuphazamiseka kwezidakamizwa.
Nangona inani leengxaki ezibandakanywe kwinguqulelo yangoku ye-DSM, kusekho ezinye izinto ongeke uzifumane kule ncwadi. Iimeko ezithile, ngelixa zifunyanwe ngabagqirha nabagula ngengqondo, aziqatshelwa ngokwasemthethweni njengeengxaki ezihlukileyo kwi-DSM-5.
Ziziphi iimeko ezingabhalwanga kwi-DSM-5?
Ngoxa i-DSM iqulethe iinjongo ezininzi, ayikho uluhlu olupheleleyo lwemiqathango ekhoyo. Ezinye zeemeko ezingabonakaliyo kwi-DSM-5 zibandakanya:
- I-Orthorexia
- Ukuxhatshazwa ngokwesondo
- Isifo se-Asperger
- Isifo sokuhlukanisa abazali
- Ukukhutshwa kwemfuno yokugula
- Umlutha we-Intanethi
- Ingxaki yokucwangcisa
- IMisophonia
Kutheni iimeko ezithile zibhalwe kwi-DSM ngelixa ezinye zingekho? Kwiimeko ezininzi, kuhla kumlinganiselo wophando okhoyo kwi-disorder.
Ngokomzekelo, ngelixa utywala lwe-intanethi yi-diagnostic ecetywayo, kusekho ukuphikisana okukhulu malunga nokuba ngaba kufuneka kuthathwa njengesimo esicacileyo okanye ukuba kungabonakaliswa kwesinye isifo.
Ezinye iingcali zithi ukugqithiswa kwe-intanethi kubonisa ezininzi iimpawu ezihambelana nezinye iziphazamiso ezibonakaliswa yi-DSM, kuquka nokusetyenziswa ngokugqithisileyo, iimiphumo ezimbi ezinxulumene nokusetyenziswa, ukuhoxiswa kunye nokunyamezela.
Abanye bacetyisa ukuba kungekudala ukuqwalasela ukuxilongwa ngokucacileyo kunye nokuba igama elithi 'umlutha' liye lagqithiswa. "Ukuba yonke inqwenela yokuthanda i-heroin ukuya kwiingxowa zesikhwama isimboli 'somlutha,' ke igama lichaza yonke into kwaye akukho nto," kuchaza omnye umchazi.
Ngamafutshane, iimeko ezichazwe kwi-DSM zinexesha elide lophando olunolwazi oluninzi lweempawu, ukusabalalisa, kunye nezokwelapha ukuxhasa ukufakwa kwazo. Ngenxa yeziphazamiso ezininzi ezichasiweyo kwi-DSM, olu phando alukho nje-ubuncinane alukho.
I-Orthorexia njengomzekelo
Cinga imeko ye- orthorexia . I-orthorexia yekota yenziwa kuqala ngo-1996 kwaye idla ngokubhekiselele njengento yokutya ngokutya okunempilo. Ngokwezicwangco ezicetywayo zokuxilongwa ezinikezelwa ngugqirha oye waqaphela kuqala imeko, iimpawu ze-orthorexia zibandakanya ukukhathazeka ngokutya okuthintela ukulungiselela ukufikelela kwimpilo efanelekileyo. Ezi zithintelo zokutya zisoloko ziquka ukupheliswa okanye ukuthintela amaqela okutya.
Xa le miyalelo yokuzibophelela iphulwa, umntu unokushiywa ngeemvakalelo ezixhalabileyo, ukuhlazeka, kunye nokwesaba izifo. Iimpawu ezinjalo zingakhokelela ekulahlekeleni ubunzima obunzima, ukungondleki, uxinzelelo kunye nemiba yomzimba.
Kodwa awuyi kufumana le miqondiso ichazwe kwi-DSM-5. Kungenxa yokuba i-orthorexia ayibonakali njengengxaki esemthethweni kwi-DSM.
Kutheni oku? I-Orthorexia yileyibhile entsha esetyenziswe kwimeko engazange ifumane umlinganiselo omkhulu wophando. UDkt. Stephen Bratman, ugqirha oye waqulunqa le meko, akazange acinge nje ngoxilongo olunzulu waze wafumanisa ukuba abantu abaqhelwanga kuphela ngoxilongo olusicetywayo, kodwa ukuba abanye banokufa.
Nangona kukho ukungabikho kwezifundo zobuqhetseba kwiimpawu kunye nokusabalalisa kwe-orthorexia, uDkt. Bratman nabanye bacetyisa ukuba kukho ubungqina obaneleyo bokukhuthaza uphando olongezelelweyo kunye nokuqwalaselwa okubonakalayo njengemeko ehlukileyo.
Iintlupheko ezintsha zenza njani kwi-DSM?
Ngoko yintoni ikomiti ye-DSM ejongayo xa ichonga ukuba zeziphi iingxaki ezifunekayo ezifakwe kwi-manual manual?
Ukuhlaziywa kwinqununu kwathonywe ngophando olutshanje kwi-neuroscience, iingxaki ezazifunyenwe kwinguqu yangaphambili yencwadana, kunye nomnqweno wokulungelelanisa le ncwadana kunye neenguqu zakutsha zoHlelo lwaMazwe ngamazwe.
Ekuqaleni kwenkqubo yokuhlaziywa, iingcali ezingaphezu kwe-400 ezivela kwimimandla eyahlukeneyo kuquka ukugula ngengqondo, ingqondo, i-epidemiology, ukunakekelwa kweprayimari, i-neurology, isifo sezingane kunye nophando ethathe inxaxheba kwiinkomfa zamazwe ngamazwe ezibangele ukuveliswa kwee-monographs ezenzelwe ukuzisa i-DSM -5 Umsebenzi we-Task Force njengoko bezakhele iziphakamiso zokutshintshwa kwikhowudi yokuxilonga.
Emva kokuba i-disorder iphakanyisiwe ukuphetha, ikomiti iphinda ihlolisise uphando olukhoyo kwimeko kwaye inokumisela iiphononongo ukuqhubela phambili ukuhlola ingxaki ephakanyisiweyo. Isigqibo sigcina sihlala kunye neqela le-DSM.
Inkqubo yokongeza iinkathazo ezintsha ayinakuphikisana. Ngokomnye uphando, ngaphezu kwesigamu seengcali ezijongene nokuqulunqwa kwe-DSM-IV zazinxulumene nezezimali kwi-shishini lezobisi. Ezi zinto zidibana nabaxhamli beengxaki, abavakalelwa kukuba ukubandakanywa kweengxaki ezithile kunokunxulumene nokukwazi ukuvelisa amabhaksi amakhulu kwiinkampani zonyango. Iziphazamiso ezinjengeenkxalabo zokukhathazeka jikelele kunye nokukhathazeka kweentlalo, abo bahlalutyi, bangabakho ubuncinci kwinqanaba kuba bakhuthaza ukunyanzelisa izidakamizwa ezikhuselekileyo ezixhasayo.
Kuthiwani Ukuba Unemiqathango Engekho kwi-DSM-5?
Ngoko kuthetha ntoni kwizigulane ezineempawu zengxaki engazange zibonwe ngumbhalo wokuxilonga olusemthethweni? Kwabanye abantu, kusenokuthi umahluko phakathi kokufumana unyango lwempilo yengqondo kwaye ungenakho ukufumana uncedo. I-DSM inceda ukunika iiklinikhi, oogqirha kunye nabagula ngengqondo ngolwimi olulwana ngalo ukuxubusha iingxaki zengqondo , kodwa lidlala indima ebalulekileyo ekubuyiselweni kwe-inshurensi. Ukuxilongwa ngokuqhelekileyo kuyimfuneko ukuze ufumane inkokhelo ye-inshurensi kwiinkonzo zempilo yengqondo. Kwezinye iimeko, izigulane ziyakwazi kuphela ukuhlawula unyango ukuba zifumene i-diagnostic echazwe yi-DSM-5.
Kwabanye abantu, bengaboni imeko yabo kwi-DSM-5 bangongeza kwiimvakalelo zokuhlukana. Nangona abanye abantu befumana ukubhaliswa kweemeko zengqondo nokunciphisa ngokweqile, abanye bakuthola kuncedo kwaye banomuvo wokuthi ukufakwa kwi-DSM kubonisa ukuba iimpawu zabo ziyaqatshelwa luluntu lwezonyango. Ukuxilongwa ngokusemthethweni kunika ithemba kulezi zi gulane, ngubani ekugqibeleni unokuziva ukuba akafumananga nje inkcazo ezenza iimpawu zabo, kodwa nokuba nazo zinokuthi zingaphumelele ukuhlangabezana nazo okanye zibuyiselwe kwisifo.
Iinguqu kwiNguqulelo yeNtsha ye-DSM
Kwinkqantosi yakutshanje yesicatshulwa sokuxilonga, ezinye iziphazamiso ezaziwayo ngaphambili zazisuswa. Ngokomzekelo, i-Asperger's syndrome, ithathwa njengesicatshulwa esisodwa kwi-DSM-IV, kodwa ixutywe phantsi kwe-ambulula ye-Autism Spectrum Disorders kwi-DSM-5. Esi sigqibo sakha imbambano eninzi njengoko abaninzi besabayo kunokuthi bathe balahlekelwa ukuxilongwa kwabo kwaye ekugqibeleni baholele ekulahlekelweni kweentlobo ezahlukeneyo zeenkonzo.
Olunye utshintsho lwalukhutshwa "ngaphandle kokuchazwa" ukuxilongwa kwi-DSM-5. Olu xilongo lwalugubungela izigulane ezinezinye iimpawu zengxaki kodwa azizange zihlangabezane neempawu ezipheleleyo. Kwi-DSM-5, inketho 'engacacisiwe ngenye indlela' ingasuswa kwiintlobo ezininzi zeengxaki, okanye ithatyathelwe 'ngenye ingxaki echaziweyo' okanye 'ingxaki engaxeliweyo.'
Iimpawu ezingaphumeleli ukuhlangabezana neendlela zokuxilonga zengxaki yokugula kwengqondo zingase zibe phantsi kweqela elibanzi "nezinye iingxaki zengqondo." I-DSM-5 ibona iziphazamiso ezine kuloluhlu:
- Ezinye izifo zengqondo ngenxa yengxaki yonyango
- Isifo sengqondo esingacaciswanga ngenxa yengxaki yonyango
- Enye ingxaki yengqondo
- Ingxaki engacaciswanga yengqondo
I-catch-all category of "ingxaki engacaciswanga yengqondo" nayo yabangela ukugxekwa kwabanye abagula ngengqondo kunye neengqondo zengqondo kwizinto abazivelayo ukungabikho ngokuchanekileyo. Umqathango kuphela wokufumana ukuxilongwa kukuba isigulane "ayinakuhlangabezana nemigaqo epheleleyo yeengxaki zeengqondo." Oku, bathetha, kusenokuthi abantu abahluleki ukufumana ukuchonga okuchanekileyo nokuchanekileyo okuya kubakhokelela ekugqibeleni ukuba bangafumani unyango olufanelekileyo kwimeko yabo.
Nangona ezininzi iingxaki zokusetyenziswa kweziyobisi ziyabonwa kwi-DSM, ezo zibandakanya ukutya, ubulili, i-caffeine kunye ne-intanethi azizange zinqunywe kulo nyaka. Nangona kunjalo, ukusetyenziswa kwe-caffeine kunye nokudlala kwe-intanethi kubhalwe njengeemeko ezifuna uphando olongezelelweyo kwaye zinokuqwalaselwa kwizibuyekezo ezizayo kwincwadi.
Imiqathango yokuFundisisa kwakhona
Ngaba zikhona ezinye iimeko ezinokufanelwa ukufakwa kwexesha elizayo kwi-DSM? Le ncwadana iquka ibakala "kwiimeko zokuqhubela phambili ukufunda." Nangona le miqathango ingamkelekanga njengengxaki ehlukileyo kwinguqulelo yangoku ye-DSM, le ncwadana iyaqaphela ukuba iyavuma ukuba iphinde iqhutywe uphando kwaye ingabandakanywa kwiingxelo ezizayo kwincwadi ngokuxhomekeke kubungqina obuboniswe.
Eli candelo le-DSM-5 linokucingwa ngathi phantse into eluhlu lokulinda. Uphando malunga nale miqathango ithathwa njengonqongophe ngexesha langoku, kodwa ukuqhubela phambili ukufunda kwizinto ezifana nokuxhaphaka, imilinganiselo yokuxilonga, kunye nemingcipheko ekhuthazwayo.
Ziziphi iziphazamiso okwangoku zidweliswe kweli candelo le-DSM-5? Kukho iimeko ezikhethiweyo ezikhethiweyo ezichongiweyo njengoko zifuna ukufunda okuqhubekayo:
- I-Attenuated Psychosis Syndrome
- Iimpawu ezixakekayo nge-Hypomania efutshane
- Iingxaki eziqhubekayo zokunxilwa koBhuselo
- Iingxaki ze-Neurobehavior Associated With Extenatal Alcohol Exposure
- Ingxaki yokuzibulala
- Nonsuicidal Self-Injury
- I-Caffeine Use Disorder
- I-Intanethi yeMidlalo yokuDlala
Nangona le miqathango ingabonakali njengengxaki edibeneyo ngeli xesha, ingaba iphela ibe yi-diagnosti epheleleyo kwiinguqulelo ze-DSM.
Yintoni elandelayo? Ukuhlaziywa kwangoku-Time kwi-DSM
Omnye ukugxekwa kwe-DSM kukuba le ncwadana ngokwayo ayisoloko ihamba kunye nophando olukhoyo kwiingxaki ezahlukeneyo. Nangona ipapasho olutsha lwale ncwadi lwakusasazwa ngo-2013, i-DSM-IV eyayihamba phambili, yayineminyaka engama-20 ubudala ngelixesha lokukhutshwa kwesihlanu.
Ukubhalwa kwe-STAT, isifo sengqondo sikaMichael B. Okokuqala ichaza ukuba injongo ye-APA kukukwenza kube lula ukuhlaziya umgaqo-nkqubo ukuze kubonakaliswe uphando olutsha kunye nezinye utshintsho kwintsimi yesifo sengqondo. Okokuqala ilungu leKomiti yeCarm entsha ye-DSA, elithemba ukusetyenziswa ngokukhawuleza kokushicilelwa kwedijithali ukugcina i-DSM ingaphezulu. Injongo kukuhlakulela imodeli evumela ukuba incwadana yokuxilonga ihlaziywe rhoqo kunye nokuhlaziywa kwesiseko kwiinkcukacha eziqinileyo kunye nobungqina obunobungqina.
Ngokwenza njalo, banethemba lokuba ikusasa le-DSM liza kubonisa ngokuthe gqolo intuthuko yezenzululwazi ngokukhawuleza kunokuba kuhlaziywe iiprogram zokuhlaziywa komdala, ekugqibeleni ekuncedeni ukuncedisa izifo zengqondo, iingcali zeengqondo kunye nezinye iinkonzo zokunakekelwa kwempilo yengqondo kunceda izigulane zabo.
ILizwi
Ngoxa i-DSM-5 ingabandakanyi yonke imimandla enokuthi ikhona, isisitye esibalulekileyo sokuxilonga ngokuchanekileyo nokuphatha isifo sengqondo. Ezinye iimeko zingabonakali okwangoku kwi-manual, kodwa oko kungatshintshwa kwimiqulu ezayo ukuba uphando lubandakanya ukufakwa kwabo.
Ukuba unomuvo wokuba unempawu zengxaki ekwazi okanye ezingabhaliswa kwi-DSM, qhagamshelana nomboneleli wakho wezempilo ukuze uphonononge ngakumbi ukuze ufumane unyango kunye nokunyangwa.
> Imithombo:
> I-American Psychiatric Association. Imbali yeDSM.
> I-American Psychiatric Association. (2013). Incwadana yokuxilonga kunye neenkcukacha zeengxaki zeengqondo (5th ed.). Washington, DC: Umbhali.
> Dunn, T & Bratman, S. Kwi-orthorexia nervosa: Ukuhlaziywa kweencwadi kunye neempendulo zokuxilonga. Ukutya. 2016; 21: 11-7
> Iipi, R. Ngaba i-DSM-V ibonisa ukuba "intengiso ye-intanethi" isifo sengqondo? Psychiatry. 2009; 6 (2): 31-37.
> I-Regier, i-DA, i-Kuhl, i-EA, ne-Kupfer, i-DJ. I-DSM-5: Uhlobo kunye neendlela zokutshintsha. Ihlabathi leengqondo. 2013; 12 (2): 92-98.