Causal and Conceptual Knowledge: Implications for Clinical Reasoning

因果和概念知识：对临床推理的影响

• 批准号: 7586276
• 负责人: WOO-KYOUNG AHN
• 金额: $ 37.24万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7586276
• 关键词: Adoption; American; Anorexia Nervosa; Basic Science; Belief; Categories; Cattle; Clinical; Cognitive; Cognitive Science; DSM-IV; Data; Decision Making; Diagnosis; Diagnostic and Statistical Manual; Diagnostic and Statistical Manual of Mental Disorders; Dimensions; Disease; Fatty acid glycerol esters; Fright; Future; Goals; Health Professional; Knowledge; Last Name; Life; Light; Memory; Mental Health; Mental disorders; Methods; Modeling; National Institute of Mental Health; Nature; Patients; Personality Disorders; Process; Public Health; Research; Sampling; Specific qualifier value; Sum; Symptoms; System; Taxonomy; Testing; Time; Translational Research; Weight; base; clinical practice; fascinate; improved; novel; theories; trait

DESCRIPTION (provided by applicant): Project Summary: This proposal aims to understand mental health professionals' concepts of mental disorders in light of (1) the current DSM and (2) a proposal for its revision. First, the DSM-IV purposely does not specify the causes of mental disorders because they are still controversial. Previous studies supported by NIMH, however, found that clinicians have rich causal theories about mental disorders and these theories determine which symptoms matter more in diagnoses. The proposed studies build on these studies and will further examine what moderates clinicians' use of their causal theories in diagnoses. In particular, Ahn, et al. (2006) found that clinicians only view some DSM mental disorders as kinds discovered in nature; others were thought of as culturally invented kinds. This proposal tests the hypothesis that the more clinicians believe that mental disorders are natural kinds, the more they will use their causal theories in categorization. These studies will use clinicians' categorization of mental disorders to illuminate a general cognitive mechanism by which causal knowledge influences categorization. Second, one prominent proposal for the next version of the DSM is to eliminate categories of personality disorders and to use only underlying traits. Existing cognitive theories of concepts and expertise predict that eliminating categories and imposing trait-based reasoning on clinicians would disrupt communicability of, memory for, and inferences about patients. However, dimensional systems might have great clinical utility if clinicians feel that the current taxonomy is incomplete or invalid. The proposed studies provide necessary in-depth tests of the clinical utility of the dimensional systems, which can inform decisions about their adoption. In sum, the proposal describes translational research: basic theories and methods developed in cognitive science are to be applied to understanding current clinical practices and the clinical utility of current and proposed taxonomy of mental disorders. Relevance to Public Health: Many Americans suffer from mental disorders and seek therapies from mental health practitioners. Yet clinicians' concepts of mental disorders are poorly understood, and the current taxonomy of mental disorders is controversial. The proposed studies will aid in understanding and improving clinical practices and in developing psychologically intuitive taxonomies of mental disorders in time for the next version of the DSM due in 2011.

描述（由申请人提供）：项目摘要：该提案旨在根据（1）当前的DSM和（2）修订的提案来了解精神卫生专业人员的精神障碍概念。首先，DSM-IV故意没有指定精神障碍的原因，因为它们仍然存在争议。然而，NIMH支持的先前研究发现，临床医生对精神障碍具有丰富的因果理论，这些理论决定了哪些症状在诊断中更重要。拟议的研究以这些研究为基础，并将进一步研究哪些临床医生在诊断中使用其因果理论的方法。特别是Ahn等。 （2006年）发现，临床医生仅将一些DSM精神障碍视为自然界中发现的种类。其他人被认为是文化发明的种类。该提案检验了以下假设：临床医生认为精神障碍是自然的，他们将在分类中使用其因果理论的越多。这些研究将使用临床医生对精神障碍的分类来阐明因果知识影响分类的一般认知机制。其次，针对DSM的下一个版本的一个突出建议是消除人格障碍类别并仅使用潜在的特征。现有的概念和专业知识的认知理论预测，消除类别并对临床医生施加基于特质的推理会破坏对患者的通讯，记忆和推断。但是，如果临床医生认为当前的分类法不完整或无效，则尺寸系统可能具有出色的临床用途。拟议的研究为维度系统的临床实用性提供了必要的深入测试，该测试可以为其采用的决定提供信息。总而言之，该提案描述了转化研究：认知科学中开发的基本理论和方法将用于了解当前的临床实践以及当前和拟议的精神疾病分类法的临床实用性。与公共卫生有关：许多美国人患有精神障碍并寻求精神健康从业者的疗法。然而，临床医生对精神障碍的概念知之甚少，目前的精神障碍分类法是有争议的。拟议的研究将有助于理解和改善临床实践，并在2011年届满的下一版DSM及时开发精神障碍的心理直觉分类法。