“自闭症”或“自闭症谱系障碍”:是否代表一种自然的心理障碍?

R. Hassall
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引用次数: 4

摘要

在DSM-5中,“自闭症谱系障碍”(ASD)是一个新的诊断类别,有效地取代了以前的“自闭症”类别。在本文中,我质疑两者是否有效地代表了一种具有重要科学和解释价值的心理自然类型。尽管有了新的分类,“ASD”和“自闭症”实际上是同义词,目前对ASD的理解很大程度上是基于以前专门针对自闭症的研究。然而,在过去的40年里,关于自闭症到底是什么并没有一个稳定的共识。目前还没有发现生物学上的解释,也没有单一的心理学理论可以解释自闭症症状的异质性。最近一项大规模的以人群为基础的研究未能确定自闭症各种症状的统一认知解释。在科学文献的哲学中,有一些被广泛接受的关于自然种类的描述,强调它们在科学解释和归纳中的作用。这些理论认为,自然种类通常可以通过一系列属性来识别,这些属性通过因果过程聚集在一起,并从解释和预测价值的角度反映了世界的因果结构。然而,自闭症谱系障碍的概念并没有给出任何因果解释,其判别和预测效度非常有限。因此,作为一种诊断,ASD不能被合理地视为一种心理上的自然类型,因为它在科学上似乎没有作为一个强大的解释性概念发挥作用。参与自闭症诊断服务的心理学家应该试着更清楚地解释他们认为自己诊断的是什么。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
‘Autism’ or ‘Autism Spectrum Disorder’: Does either represent a natural kind of psychological disorder?
In DSM-5, ‘autism spectrum disorder’ (ASD) is a new diagnostic category effectively replacing the previous category of ‘autism’. In this paper I question whether either effectively represents a psychological natural kind with significant scientific and explanatory value. Despite the new categorisation, ‘ASD’ and ‘autism’ are effectively synonymous, and current understandings of ASD are based largely on previous research focused specifically on autism. However, there has been no stable consensus over the past 40 years about what autism actually is. No biological explanation has been discovered, and no single psychological theory can account for the heterogeneity of autistic symptoms. A recent large-scale population-based study failed to identify a unifying cognitive account of the variety of symptoms of autism. In the philosophy of science literature, there are widely accepted accounts of natural kinds which emphasise their role in scientific explanations and induction. These claim that natural kinds can typically be identified by clusters of properties which are held together by causal processes and which reflect the causal structure of the world in terms of their explanatory and predictive value. However, the concept of ASD fails to indicate any causal explanation and has very limited discriminant and predictive validity. Consequently ASD, as a diagnosis, cannot plausibly be seen as a psychological natural kind, since it does not appear to function as a powerful explanatory concept in science. Psychologists involved in autism diagnostic services should try to explain more clearly what it is that they believe they are diagnosing.
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