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发帖数: 132 | 1 nile连DSM-5的有关文献都看不懂，连bizarre delusions，nonbizarre delusions的定
义，什么叫逻辑混乱都没有弄明白，以及对逻辑混乱在妄想症和精神分裂症的诊断中的
意义也不清楚，还有什么能力争论妄想症诊断？
I,
nile对DSM-5定义的bizarre delusions，nonbizarre delusions的理解让人不知其所云。
nile对bizarre delusions，nonbizarre delusions的理解：
bizarre delusions就是nile所谓内在逻辑混乱：Delusions are deemed bizarre if
they are clearly implausible, not understandable, and not derived from
ordinary life experiences。注意这两个关键词：不合理implausible，不可理解not
understandable。
而non-bizarre delusions相当于nile所说的前提错误，如果接受前提为真，患者并没
有内在逻辑的混乱。 但是患者的前提经不起第三者查证。即使在反对证据面前，患者
也不会改变观念。Non-bizarre delusions typically are beliefs of something
occurring in a person’s life which is not out of the realm of possibility.
All of these situations could be true or possible, but the person suffering
from this disorder knows them not to be (e.g., through fact-checking, third
-person confirmation, etc.).
http://www.unknownspace.org/article_t/WaterWorld/2567355.html
II,
nile不懂什么叫逻辑混乱，以及逻辑混乱在DSM-5妄想症和精神分裂症的诊断中的意义：
http://www.unknownspace.org/article_t/WaterWorld/2567509.html
Nile的原话：
妄想症，有两个典型的特征。第一是荒谬性。或者内在逻辑混乱，或者前提错误。
http://www.unknownspace.org/article_t/WaterWorld/2562189.html
本人给nile的问话：
妄想症的妄想是怪诞性的？还是非怪诞性的？逻辑混乱不混乱？
http://www.unknownspace.org/article_t/WaterWorld/2566381.html
1），荒谬性，nile应该是指bizarre delusions。
2），妄想（delusion）是什么？
妄想是一种不理性、与现实不符且不可能实现但坚信的错误信念。
妄想不是逻辑。
再看看怪诞性妄想（bizarre delusions）是怎么定义的？
bizarre delusions are clearly implausible, not understandable, and not
derived from ordinary life experiences。这句话的意思是，怪诞性妄想是显然不可
信的，不可理解的，非源自平凡的人生经历的妄想。这句话根本就不是指逻辑混乱。
可是，到了Nile的嘴里就变成了：“bizarre delusions就是nile所谓内在逻辑混乱”。
http://www.unknownspace.org/article_t/WaterWorld/2567355.html
bizarre delusions是内在逻辑混乱吗？
3），什么是内在逻辑混乱？
逻辑是指什么？逻辑源自古典希腊语 (logos)，最初的意思是“词语”或“言语”，引
申意思是“思维（thinking）”、“推理（reasoning）”。逻辑混乱是指思维的杂乱
无章（Disorganized thinking）；通过交谈，这种思维的杂乱无章（Disorganized
thinking）表达出来（给医生）的是语言的杂乱无章（disorganized speech）。
再回头看看DSM-5妄想症的具体诊断标准。
DSM-5的妄想症具体诊断标准有一条，就是“不符合精神分裂症的诊断标准A”。
精神分裂症的诊断标准A包括有：
如果病人表现有bizarre delusions，再加上Disorganized thinking（each present
for a significant portion of time during a 1-month period (or less if
successfully treated)）就要诊断为精神分裂症。
这里，DSM-5强调了Disorganized thinking、disorganized speech是精神分裂症的诊
断标准之一和对妄想症诊断的排除。
显然， 当你nile说病人的症状有荒谬性（bizarre delusions），内在逻辑混乱（
Disorganized thinking）时，这就不是妄想症了，是精神分裂症。
妄想症病人的思维结构有层次，条理分明，逻辑性并不混乱。
III,
DSM-5的妄想症诊断标准：
Specific Diagnostic Criteria
1. Delusions lasting for at least 1 month’s duration.
2. Criterion A for Schizophrenia has never been met. Note: Tactile and
olfactory hallucinations may be present in Delusional Disorder if they are
related to the delusional theme.Criterion A of Schizophrenia requires two (
or more) of the following, each present for a significant portion of time
during a 1-month period (or less if successfully treated):
1. delusions
2. hallucinations
3. disorganized speech (e.g., frequent derailment or incoherence)
4. grossly disorganized or catatonic behavior
5. negative symptoms, i.e., affective flattening, alogia, or avolition
Note: Criteria A of Schizophrenia requires only one symptom if delusions are
bizarre or hallucinations consist of a voice keeping up a running
commentary on the person’s behavior or thoughts, or two or more voices
conversing with each other.
3. Apart from the impact of the delusion(s) or its ramifications,
functioning is not markedly impaired and behavior is not obviously odd or
bizarre.
4. If mood episodes have occurred concurrently with delusions, their
total duration has been brief relative to the duration of the delusional
periods.
5. The disturbance is not due to the direct physiological effects of a
substance (e.g., a drug of abuse, a medication) or a general medical
condition.
http://psychcentral.com/disorders/delusional-disorder-symptoms/
DSM-5的精神分裂症诊断标准：
Schizophrenia is a mental disorder that is characterized by at least 2 of
the following symptoms, for at least one month:
• Delusions
• Hallucinations
• Disorganized speech (e.g., frequent derailment or incoherence)
• Grossly disorganized or catatonic behavior
• A set of three negative symptoms (a “flattening” of one’s
emotions, alogia, avolition; see below)
Only one of the above symptoms is required to make the diagnosis of
schizophrenia if the person’s delusions are bizarre or if the
hallucinations consist of a voice keeping up a running commentary on the
person’s behavior or thoughts, or two or more voices conversing with each
other.
Positive Symptoms
• Delusions
• Hallucinations
• Disorganized thinking
• Agitation
Negative Symptoms
• Affective flattening- The person’s range of emotional expression
is clearly diminished; poor eye contract; reduced body language
• Alogia- A poverty of speech, such as brief, empty replies
• Avolition – Inability to initiate and persist in goal-directed
activities (such as school or work)
Although the above symptoms must be present for at least one (1) month,
there also needs to be continuous signs of the disturbance that persist for
at least six (6) months. During this period, the signs of the disorder may
be present in a milder form, for instance as just odd beliefs or unusual
perceptual experiences. During this 6 month period, at least two of the
above criteria must be met, or only the criteria of Negative Symptoms must
be present — if even just in milder form.
http://psychcentral.com/disorders/schizophrenia-symptoms/ |
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