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DSM-IV诊断手册(The Diagnostic and Statistical Manual of Mental Disorders, fourth edition)

潇碧
3/28/2008


DSM-IV診斷手冊
(The Diagnostic and Statistical Manual of Mental Disorders, fourth edition)
/瀟碧


(DSM -IV診斷手冊,為目前診斷「過動兒」普遍採用的一種方法。手冊中列出十八種行為表現,診斷者由孩童過去的行為,來核對在手冊中所佔的比例,以查驗是否為 注意力不足,或過動/衝動。這種診斷方式較適合孩童,至於成人,除非能清楚追查出小時候的情況,否則未必是恰當的診斷方式。)

(進行這種 檢視時,要特別小心,因為這種所謂的「病理檢視」,並不能讓人見到「過動兒」的全貌,若光以負面消極的態度來看待過動兒,就無法見到過動兒還有更「有趣」 的一面,例如豐富的創意、領導力、活潑、經力充沛、深具幽默感、絕頂聰明…。Edward Hallowell博士與John Ratey博士兩人就建議,任何診斷者在進行診斷時,都不要只診斷症狀,還必須同時測出孩子的特長與天賦才能所在,這將帶領孩子走向極為積極正面的一 生。)


DSM-IV診斷手冊
(The Diagnostic and Statistical Manual of Mental Disorders, fourth edition)



由符合以下(一)注意力不足,或(二)過動/衝動中特定的比例,來推斷。

(一):注意力不足:以下九項中,符合六項以上,有持續達六個月以上無法調適、發展的情形。
1.常常沒辦法注意細節,做學校功課或其它工作、活動時,常粗心犯錯。
2.做事、玩耍、活動時,沒辦法持續專心。
3.別人向他說話時,他好像沒聽到。
4.常常沒辦法照著告訴他該做的去做,也沒辦法完成功課、份內的工作(不是出於不情願,也不是聽不懂指示)
5.做事、活動時,常常雜亂沒有條理。
6.常常躲開、不喜歡、或不情願去面對需要花心思持續努力的工作。
7.工作或活動中需要的東西,常常丟三忘四。
8.很容易受到外界的刺激而分心。
9.常常忘記每天該做的事情。


(二):過動/衝動:以下九項中,符合六項以上,有持續達六個月以上無法調適、發展的情形。

過動:
1.常常手腳扭動,在座位上蠕動不安。2.在課堂上、或其它應該坐著的場合,經常離開座位。
3.在不恰當的時候亂跑亂爬。(對於青少年或成人過動兒來說,就是感覺沒辦法安心坐著)
4.在玩耍或參與休閒活動中,很難安靜。
5.好像上了發條似的停不下來。
6.不停的說話。

衝動:
7.常常問題還沒有問完,就搶著回答。
8.常常沒耐心排隊、等候。
9.常常打斷別人、或干擾別人。



DSM-IV


DSM-IV is a good screening tool for children. There are two clusters of symptoms, one describing symptoms of inattention, the other describing symptoms of hyperactivity and impulsivity. To qualify for the diagnosis, you need to meet the criteria set forth in cluster 1 or in cluster 2, as follows:

1.Six (or more) of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Inattention:
a. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
b. often has difficulty sustaining attention in tasks or play activities
c. often does not seem to listen when spoken to directlyd. often does not follow through on instructions and fails to finis: schoolwork, chores, or duties in the workplace (not due to op-positional behavior or failure to understand instructions)
e. often has difficulty organizing tasks and activities
f. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
g. often loses things necessary for tasks or activities
h. is often easily distracted by extraneous stimuli
i. is often forgetful in daily activities

2.Six (or more) of the following symptoms of hyperactivity and impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity
a. often fidgets with hands or feet or squirms in seat
b. often leaves seat in classroom or in other situations in which remaining seated is expected
c. often runs about or climbs excessively when it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
d. often has difficulty playing or engaging in leisure activities quietly
e. is often "on the go" or acts as if "driven by a motor"
f. often talks excessively

Impulsivity
g. often blurts out answers before questions have been completed
h. often has difficulty awaiting turn
i. often interrupts or intrudes on others

To receive a diagnosis of ADD you must have six out the nine symptoms on one or both of the clusters: inattention or impulsivity and hyperactivity. Your symptoms must date back to childhood. There is no such thing as adult-onset ADD; we call that modern life!

Furthermore, the symptoms must impair your life in some way for ADD to be diagnosed. And symptoms must occur in two or more areas of your life. Typically for children the areas include home, school, and social settings; and for adults they include home, work, and social settings.

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DSM-IV诊断手册(The Diagnostic and Statistical Manual of Mental Disorders, fourth edition) 
这是目前诊断过动儿(好动儿)最普遍采用的方法

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