边缘性人格障碍的认识不公正
1Honorary Senior Lecturer, Centre for Mental Health Research, City University, University of London, London, UK.
边界性人格障碍 (BPD) 诊断仍然存在争议,对患者产生负面影响. 这种标签导致了认识系统的不公正,使患者的叙述沉默,并阻碍了准确的解释.
科学领域:
- 精神病学是一个精神病学.
- 科学哲学的科学哲学
- 社会心理学 社会心理学
背景情况:
- 边界性人格障碍 (BPD) 已经面临诊断争议超过四十年.
- ICD对BPD的分类一直受到争议,最近的变化反映了游说活动的努力.
- 患者的经验表明,BPD标签会导致严重的痛苦,被描述为"侮辱伤害".
研究的目的:
- 分析BPD诊断对患者主观性和言语的影响.
- 运用米兰达·弗里克的认识不公正的概念来理解患有BPD的患者的经历.
- 探索BPD标签如何为证词窒息和安静做出贡献.
主要方法:
- 概念分析,将哲学概念应用于临床诊断.
- 用BPD标签对患者叙述和经验进行定性解释.
- 在ICD框架内检查BPD的诊断史和分类.
主要成果:
- 尽管存在争议,但BPD作为诊断的持续分类使理解陷入了局.
- 经验学上的不公正,通过解释学上的封闭,限制了患者真正表达自己的能力.
- 证词窒息和安静发生,患者改变或隐叙述,他们的证词能力被驳回.
结论:
- 保持BPD作为事实上的诊断破坏了患者的声音,并导致了认识系统的不公正.
- BPD标签可以在解释学上将患者封闭在非基于证据的思维方式中.
- 解决证词窒息和安静对于开发更肯定的解释和验证患者经验至关重要.
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