经济学人281:照本宣科

 　　Science and technology

　　科学技术

　　By the book

　　照本宣科

　　The American Psychiatric Association's latest diagnostic manual remains¹ a flawed attempt to categorise mental illness

　　美国精神医学会最新诊断手册在精神疾病分类上仍有欠缺

　　A BOOK with the title Diagnostic and Statistical² Manual of Mental Disorders⁴, Fifth Edition does not sound destined⁵ to be a bestseller, particularly at $199 a pop.

　　《精神疾病诊断与统计手册，第五版》这个书名听上去注定成不了畅销书，尤其一本竟要199美元。

　　But DSM-5, as it is known for short, is almost certain to become one.

　　但是DSM-5（书名的简称）几乎肯定会成为一本畅销书。

　　Its predecessor⁶, DSM-IV, which was published in 1994, has sold more than 1m copies. DSM-5, which will go on sale on May 22nd, is likely to do at least as well.

　　其上一版，1994年出版的DSM-4已售出超过一百万册。DSM-5将于5月22日开售，很可能至少也会卖到这个数。

　　The reason is that the DSM series, which is published by the American Psychiatric Association, has become the global standard for the description of mental illness.

　　美国精神医学会出版的DSM丛书如此大卖的原因是其已经成为精神疾病症状描述的全球标准。

　　Indeed, the DSM is treated by many people less as a medical handbook and more as holy writ⁷.

　　实际上，许多人把DSM更多是当成圣经，而非一本医学手册。

　　Insurers use it to decide whether or not to cover ailments⁸.

　　保险公司用其来确定是否涵盖一些病症。

　　And diagnoses based on it determine whether people get special services at school; whether they qualify for disability benefits; whether they are stigmatised in their careers; even whether they are able to adopt children.

　　据其做出的诊断会决定一个人是否会在学校受到特殊照顾；是否能得到伤残抚恤金；是否会在自己的职业生涯中蒙受污名；甚至是否能够领养小孩。

　　Doctors, patients, drug companies and insurers have all thus been waiting for the latest edition of what has become known as the psychiatric bible.

　　因此医生，患者，制药公司及保险公司都在翘首期盼这本被当作精神病学圣经的最新版。

　　The DSM's purpose is to set strict criteria⁹ for identifying mental disorders.

　　DSM的目的是设立鉴别精神疾病的严格标准。

　　This is supposed to make diagnoses more reliable: a laudable aim.

　　这应该会使诊断更为可靠，这一个值得称道的目标。

　　To that end, more than 1,500 experts have spent over a decade labouring.

　　为了这个目标，1500多名专家耗费了多年劳动。

　　In doing so, though, they have succeeded in adding to, rather than subtracting from, criticism that the DSM has become a monster.

　　然而这些辛劳让他们顺利地在DSM中增加了标准，而非减少，这使DSM成为了一个庞然大物。

　　In the eyes of many critics it is a vehicle for misdiagnosis, overdiagnosis, the medicalisation of normal behaviour and the prescription¹¹ of a large number of unnecessary drugs.

　　在许多批评家眼中，DSM是误诊，过度诊断，正常行为医疗化以及开出大量不必要药物处方的罪魁祸首。

　　Chapter and verse

　　引经据典

　　The DSM, the first version of which was published in 1952, has always attracted controversy¹².

　　DSM自1952年第一版出版起便一直引发争论。

　　That version, and the second edition, published in 1968, relied on the premise¹³ that mental illness was a neurotic¹⁴ response to a patient's experience and environment.

　　第一版及1968年出版的第二版有赖于精神疾病是对病人的经历及环境的神经质反应这一前提。

　　People with the same symptoms could therefore receive wildly different diagnoses.

　　然而具有相同症状的人会受到截然不同的诊断。

　　Different interpretations¹⁵ of experience and environment also meant that cultural differences affected¹⁶ diagnosis¹⁰.

　　经历及环境的不同解读也意味着文化差异会影响诊断。

　　In 1971 Robert Kendell demonstrated this by showing that, faced with the same patients, American psychiatrists¹⁷ were much more likely to diagnose them as schizophrenic than were British psychiatrists.

　　罗伯特·肯德尔于1971年证明了这点，他指出，面对同一个病人，美国的精神病医生比英国精神病医生更可能将其诊断为精神分裂患者。

　　The third DSM, published in 1980, introduced a new approach—also followed in the fourth in 1994.

　　DSM第三版于1980年出版，引入了一种新的方法，1994年出版的第四版也遵循了该方法。

　　DSM-III acknowledged that psychiatrists had a poor understanding of the physiological¹⁸ cause of mental illness.

　　DSM第三版承认精神病医生对于精神疾病的生理病因不甚了了。

　　Instead specific, observed symptoms became the diagnostic criteria, and clusters of them, known medically as syndromes²⁰, that appeared to coexist in individual patients were given labels.

　　观察到的症状而非具体病因被当成诊断标准，貌似存在于同一患者的症状集群-医学上称之为综合症-被冠以名称。

　　The hope was that biological markers of such syndromes would be discovered as physiological understanding increased.

　　希望是在于这些综合症的生物学标记会随着生理学知识的增加而得以发现。

　　This was a reasonable approach in principle.

　　这在原则上是一个合理的方法。

　　In practice, though, the lines dividing different disorders are blurry²¹.

　　但实际上，划分不同精神疾病的界限模糊不清。

　　The symptoms used to define them often do not cluster neatly²² in the way that those of true syndromes would, and the statistical evidence for their existence is sometimes sparse²³.

　　用来定义精神疾病的症状与综合症真正的症状时常并非一一对应，这些症状存在的统计证据有时也很匮乏。

　　Nor, in most cases, have the hoped-for biological markers turned up—and to the extent that they have, they have muddied the waters, rather than clarifying them.

　　在大多数情况下，期望的生物学标记并未被发现，从某种程度而言，已发现的生物学标记把水越搅越浑，而不是越搅越清。

　　The biggest muddyings have come from brain scanning and genetics.

　　最大的一趟浑水来自于脑部扫描术及遗传学。

　　Most psychiatrists, even those sceptical of the DSM's approach, would accept the idea that things like autism, major depression and schizophrenia are different from each other.

　　大多数精神病医生，甚至是那些对DSM的方法持怀疑态度的医生也会接受如自闭症、重度抑郁症及精神分裂症这些疾病互不相同这一概念。

　　However, a study published this year by a group called the Psychiatric Genomics Consortium, which has looked for links between genetic²⁴ variations and psychiatric disorders in tens of thousands of patients, has found that variations in four places were common to people diagnosed, using the DSM's criteria, with attention deficit²⁵ hyperactivity disorder³, autism, bipolar disorder, major depression and schizophrenia.

　　然而有一家叫做精神疾病基因体联盟的团体于今年发表了一份研究报告，在数以万计的患者中寻找了基因变异及精神疾病的联系，发现在按照DSM的标准确诊的患有注意力不足过动症、自闭症、躁郁症、重度抑郁症及精神分裂症的人中有四处变异很普遍。

　　Likewise, a series of papers over the past decade have shown similar abnormal activation²⁶ of part of the brain called the amygdala in people diagnosed with anxiety, major depression and post-traumatic stress disorder.

　　同样，过去十年中的一系列论文证实了确诊患有焦虑症，重度抑郁症及创伤后应激障碍的人的大脑中叫做杏仁核的部分有类似的异常活化。

　　Such results suggest that the DSM's approach of placing patients in diagnostic silos is questionable²⁷.

　　这样的结果表明DSM将患者按诊断症状分类的方法值得商榷。

　　As Dan Blazer of Duke University, who served on DSM-5's task-force, puts it, We're basically drawing artificial lines, and the body and the mind do not work like that.

　　正如DSM第五版的编写组成员，杜克大学的丹?布雷泽所说，我们正从大体上勾勒人为的分类界线，身体和精神都不会如此运作。

　　The new DSM aspires²⁸ to include objective criteria in its manual.It also seeks to scrap²⁹ nonsensical, strict lines between certain disorders.

　　新版的DSM渴望将客观标准也囊括在其手册中，也寻求将某些病症中荒谬的，严苛的条文去掉。

　　It has, for example, chunked together four previously³⁰ separate diagnoses, including autism and Asperger's syndrome¹⁹, into one disorder of varying severity, known as autism spectrum³¹ disorder.

　　例如，新版中将之前四种单独的病症，包括自闭症及阿斯伯格综合症合并成一种严重程度不一的神经疾病，叫做自闭症谱系障碍。

　　In this, it is following clinical practice, for the idea of an autistic spectrum has been around for a long time.

　　由于自闭症谱系的概念已经出现很久了，所以对该病症的诊断是遵循临床实践。

　　And the unfortunate truth is that it is still far too early to use biological markers as criteria for diagnosis.

　　但事实令人遗憾，使用生物学标记作为诊断标准仍然太早。

　　The human brain is the most impossibly complex thing in the universe, says Allen Frances, who led the development of DSM-IV.

　　人脑是宇宙中复杂到无可附加的事物，DSM第四版的编写组组长阿伦?弗朗西斯称，

　　It does not yield its secrets easily.

　　它不会轻易把自己的秘密交出来。

　　Worse, argues Dr Frances, DSM-5 has not stopped the rise in the number of allegedly recognisable and nameable mental conditions, many of which annex³² into psychiatry³³ things that the man in the street would think normal, if not always desirable, behaviour.

　　更糟的是，弗朗西斯博士提出，DSM第五版中所谓可以识别及命名的精神状况的数量还在增加，许多连路人都会认为属于正常，但不一定适当的行为被归为精神疾病。

　　Children may now, for example, be diagnosed with disruptive mood dysregulation disorder—what used to be known as temper tantrums.

　　例如，儿童现在可能会被诊断患有破坏性情绪失调症-曾被称为乱发脾气。

　　Past versions of the DSM stipulated³⁴ that those mourning a death should not be classified as depressed³⁵. DSM-5 scraps³⁶ this bereavement³⁷ exclusion³⁸.

　　之前版本的DSM规定那些哀痛逝者的行为不应该归为抑郁，但DSM第五版删掉了排除丧亲之痛这条。

　　It also includes a new binge-eating disorder, defined as eating to excess at least once a week over the previous three months.

　　第五版还加入了一种新的暴食症，将其定义为在过去三个月内至少每星期饮食过量一次。

　　Such a diagnosis covers millions of Americans, roping in people who would not remotely consider that they were mentally ill.

　　按此诊断的话会将数百万美国人涵盖其内，将那些从未想过自己患有精神病的人圈了进去。

　　DSM-5 does not, after some debate among those who put it together, make addiction³⁹ to internet gaming a formal disorder. But it recommends further research into the condition.

　　在经过其编写者的一些争论后，DSM第五版并未将网游成瘾归为正式的精神疾病，但其建议针对病情进一步研究。

　　Grief. Indulgence. Unhealthy habits.

　　悲痛、上瘾、不良习惯，

　　All, it seems, may be classified as mental derangement⁴⁰, and treated as such.

　　所有这些看来都会被归为精神错乱，并按此治疗。

　　And the sets of symptoms described by the DSM are often common.

　　DSM中描述的各类症状都非常常见。

　　More than one American child in ten has been diagnosed, using the DSM's definition, with ADHD—and about two-thirds of those so diagnosed are now prescribed drugs.

　　按照DSM的定义，每十名美国儿童中便至少会有一名被诊断患有ADHD-这些所谓患儿中有三分之二正在接受药物治疗。

　　It is this overdiagnosis and overtreatment that is the chief criticism of the DSM—or, rather, of the power it wields⁴¹ in the profession of psychiatry. That power, however, may be waning⁴².

　　这种过度诊断及过度治疗正是针对DSM的主要诟病-或者，更确切的讲，是针对DSM赋予精神病医生职业的权力的诟病。然而这种权力或许正在减弱。

　　Literary criticism

　　专业评论

　　DSM categories have long been used in research.

　　DSM的分类已经用于研究很久了。

　　That is changing.

　　但情况正在改变。

　　Other areas of medicine, cancer in particular, have been transformed by better understanding of the biological drivers of disease.

　　其它的医学领域，特别是癌症领域，已经通过对疾病的生物学驱动机制的更深入了解而发生了转变。

　　America's National Institute of Mental Health hopes that will transform psychiatry, too.

　　美国国家心理卫生研究所希望这也将使精神病学发生改变。

　　The NIMH seeks to use genetics, imaging and cognitive⁴³ science to create new diagnostic criteria.

　　NIMH寻求使用遗传学，成像及认知科学来建立新的诊断标准。

　　Thomas Insel, the NIMH's director, has specifically implored⁴⁴ researchers not to be confined by DSM-5's strict rules.

　　NIMH的主任托马斯·英索尔特别恳请研究人员不要被DSM第五版严苛的条文限制住。

　　Abiding⁴⁵ by DSM categories may prevent scientists from understanding the underlying⁴⁶ causes of sickness.

　　墨守DSM的分类可能会妨碍科学家了解疾病的根本原因。

　　Still, objective laboratory measures for mental illness are a long way off.

　　距离对精神疾病进行客观的实验室评估仍旧很远。

　　The APA says DSM-5 will be continuously updated to respond to new discoveries.

　　APA称DSM第五版将会不断更新以对新的发现做出反应。

　　For now, however, patients' treatment will be guided by the imperfect manual.

　　然而目前对病人的诊疗还要接受并不完美的手册指导。

　　The DSM is purely⁴⁷ a product of the state of our knowledge at this point in time, says Jeffrey Lieberman, the chairman of Columbia University's psychiatry department and president-elect of the APA.

　　DSM仅仅是我们在此时此刻的知识水平下的产物，哥伦比亚大学精神医学系主任，APA新当选的会长杰弗里·利伯曼说。

　　The state of our knowledge is not complete.

　　我们的知识水平还比较有限。

1 remains   

n.剩余物，残留物；遗体，遗迹

参考例句：

• He ate the remains of food hungrily.他狼吞虎咽地吃剩余的食物。
• The remains of the meal were fed to the dog.残羹剩饭喂狗了。

2 statistical   

adj.统计的，统计学的

参考例句：

• He showed the price fluctuations in a statistical table.他用统计表显示价格的波动。
• They're making detailed statistical analysis.他们正在做具体的统计分析。

3 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

4 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

5 destined   

adj.命中注定的；(for)以…为目的地的

参考例句：

• It was destined that they would marry.他们结婚是缘分。
• The shipment is destined for America.这批货物将运往美国。

6 predecessor   

n.前辈，前任

参考例句：

• It will share the fate of its predecessor.它将遭受与前者同样的命运。
• The new ambassador is more mature than his predecessor.新大使比他的前任更成熟一些。

7 writ   

n.命令状，书面命令

参考例句：

• This is a copy of a writ I received this morning.这是今早我收到的书面命令副本。
• You shouldn't treat the newspapers as if they were Holy Writ. 你不应该把报上说的话奉若神明。

8 ailments   

疾病（尤指慢性病），不适( ailment的名词复数 )

参考例句：

• His ailments include a mild heart attack and arthritis. 他患有轻度心脏病和关节炎。
• He hospitalizes patients for minor ailments. 他把只有小病的患者也送进医院。

9 criteria   

n.标准

参考例句：

• The main criterion is value for money.主要的标准是钱要用得划算。
• There are strict criteria for inclusion in the competition.参赛的标准很严格。

10 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

11 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

12 controversy   

n.争论，辩论，争吵

参考例句：

• That is a fact beyond controversy.那是一个无可争论的事实。
• We ran the risk of becoming the butt of every controversy.我们要冒使自己在所有的纷争中都成为众矢之的的风险。

13 premise   

n.前提；v.提论，预述

参考例句：

• Let me premise my argument with a bit of history.让我引述一些史实作为我立论的前提。
• We can deduce a conclusion from the premise.我们可以从这个前提推出结论。

14 neurotic   

adj.神经病的，神经过敏的；n.神经过敏者，神经病患者

参考例句：

• Nothing is more distracting than a neurotic boss. 没有什么比神经过敏的老板更恼人的了。
• There are also unpleasant brain effects such as anxiety and neurotic behaviour.也会对大脑产生不良影响，如焦虑和神经质的行为。

15 interpretations   

n.解释( interpretation的名词复数 )；表演；演绎；理解

参考例句：

• This passage is open to a variety of interpretations. 这篇文章可以有各种不同的解释。 来自《简明英汉词典》
• The involved and abstruse passage makes several interpretations possible. 这段艰涩的文字可以作出好几种解释。 来自《现代汉英综合大词典》

16 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

17 psychiatrists   

n.精神病专家，精神病医生( psychiatrist的名词复数 )

参考例句：

• They are psychiatrists in good standing. 他们是合格的精神病医生。 来自辞典例句
• Some psychiatrists have patients who grow almost alarmed at how congenial they suddenly feel. 有些精神分析学家发现，他们的某些病人在突然感到惬意的时候几乎会兴奋起来。 来自名作英译部分

18 physiological   

adj.生理学的，生理学上的

参考例句：

• He bought a physiological book.他买了一本生理学方面的书。
• Every individual has a physiological requirement for each nutrient.每个人对每种营养成分都有一种生理上的需要。

19 syndrome   

n.综合病症；并存特性

参考例句：

• The Institute says that an unidentified virus is to blame for the syndrome. 该研究所表示,引起这种综合症的是一种尚未确认的病毒。
• Results indicated that 11 fetuses had Down syndrome. 结果表明有11个胎儿患有唐氏综合征。

20 syndromes   

n.综合征( syndrome的名词复数 )；（某种条件下有共同特征的）一系列表现（事件、举动等）

参考例句：

• Other agents can cause similar syndromes. 其它病原也可引起相似的综合症。 来自辞典例句
• They have pointed out the similarities of the sprue syndromes in man and TGE. 他们强调了人的鹅口疮综合症和TGE的共同点。 来自辞典例句

21 blurry   

adj.模糊的；污脏的，污斑的

参考例句：

• My blurry vision makes it hard to drive. 我的视力有点模糊，使得开起车来相当吃力。 来自《简明英汉词典》
• The lines are pretty blurry at this point. 界线在这个时候是很模糊的。 来自《简明英汉词典》

22 neatly   

adv.整洁地，干净地，灵巧地，熟练地

参考例句：

• Sailors know how to wind up a long rope neatly.水手们知道怎样把一条大绳利落地缠好。
• The child's dress is neatly gathered at the neck.那孩子的衣服在领口处打着整齐的皱褶。

23 sparse   

adj.稀疏的，稀稀落落的，薄的

参考例句：

• The teacher's house is in the suburb where the houses are sparse.老师的家在郊区，那里稀稀拉拉有几处房子。
• The sparse vegetation will only feed a small population of animals.稀疏的植物只够喂养少量的动物。

24 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

25 deficit   

n.亏空，亏损；赤字，逆差

参考例句：

• The directors have reported a deficit of 2.5 million dollars.董事们报告赤字为250万美元。
• We have a great deficit this year.我们今年有很大亏损。

26 activation   

n. 激活，催化作用

参考例句：

• A computer controls the activation of an air bag.电脑控制着气囊的启动。

27 questionable   

adj.可疑的，有问题的

参考例句：

• There are still a few questionable points in the case.这个案件还有几个疑点。
• Your argument is based on a set of questionable assumptions.你的论证建立在一套有问题的假设上。

28 aspires   

v.渴望，追求( aspire的第三人称单数 )

参考例句：

• The fame to which he aspires was beyond his reach. 他追求的名誉乃是他所不能及的。 来自《简明英汉词典》
• An old steed in the stable still aspires to gallop a thousand li. 老骥伏枥，志在千里。 来自《简明英汉词典》

29 scrap   

n.碎片；废料；v.废弃，报废

参考例句：

• A man comes round regularly collecting scrap.有个男人定时来收废品。
• Sell that car for scrap.把那辆汽车当残品卖了吧。

30 previously   

adv.以前，先前（地）

参考例句：

• The bicycle tyre blew out at a previously damaged point.自行车胎在以前损坏过的地方又爆开了。
• Let me digress for a moment and explain what had happened previously.让我岔开一会儿，解释原先发生了什么。

31 spectrum   

n.谱，光谱，频谱；范围，幅度，系列

参考例句：

• This is a kind of atomic spectrum.这是一种原子光谱。
• We have known much of the constitution of the solar spectrum.关于太阳光谱的构成，我们已了解不少。

32 annex   

vt.兼并，吞并；n.附属建筑物

参考例句：

• It plans to annex an England company in order to enlarge the market.它计划兼并一家英国公司以扩大市场。
• The annex has been built on to the main building.主楼配建有附属的建筑物。

33 psychiatry   

n.精神病学，精神病疗法

参考例句：

• The study appeared in the Amercian science Journal of Psychiatry.这个研究发表在美国精神病学的杂志上。
• A physician is someone who specializes in psychiatry.精神病专家是专门从事精神病治疗的人。

34 stipulated   

vt.& vi.规定；约定adj.[法]合同规定的

参考例句：

• A delivery date is stipulated in the contract. 合同中规定了交货日期。
• Yes, I think that's what we stipulated. 对呀，我想那是我们所订定的。 来自辞典例句

35 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

36 scraps   

油渣

参考例句：

• Don't litter up the floor with scraps of paper. 不要在地板上乱扔纸屑。
• A patchwork quilt is a good way of using up scraps of material. 做杂拼花布棉被是利用零碎布料的好办法。

37 bereavement   

n.亲人丧亡，丧失亲人，丧亲之痛

参考例句：

• the pain of an emotional crisis such as divorce or bereavement 诸如离婚或痛失亲人等情感危机的痛苦
• I sympathize with you in your bereavement. 我对你痛失亲人表示同情。 来自《简明英汉词典》

38 exclusion   

n.拒绝，排除，排斥，远足，远途旅行

参考例句：

• Don't revise a few topics to the exclusion of all others.不要修改少数论题以致排除所有其他的。
• He plays golf to the exclusion of all other sports.他专打高尔夫球，其他运动一概不参加。

39 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

40 derangement   

n.精神错乱

参考例句：

• She began to think he was in mental derangement. 她开始想这个人一定是精神错乱了。
• Such a permutation is called a derangement. 这样的一个排列称为错位排列。

41 wields   

手持着使用（武器、工具等）( wield的第三人称单数 )； 具有； 运用（权力）； 施加（影响）

参考例句：

• She wields enormous power within the party. 她操纵着党内大权。
• He remains chairman, but wields little power at the company. 他还是主席，但在公司没有什么实权了。

42 waning   

adj.（月亮）渐亏的，逐渐减弱或变小的n.月亏v.衰落( wane的现在分词 )；（月）亏；变小；变暗淡

参考例句：

• Her enthusiasm for the whole idea was waning rapidly. 她对整个想法的热情迅速冷淡了下来。
• The day is waning and the road is ending. 日暮途穷。 来自《现代汉英综合大词典》

43 cognitive   

adj.认知的，认识的，有感知的

参考例句：

• As children grow older,their cognitive processes become sharper.孩子们越长越大，他们的认知过程变得更为敏锐。
• The cognitive psychologist is like the tinker who wants to know how a clock works.认知心理学者倒很像一个需要通晓钟表如何运转的钟表修理匠。

44 implored   

恳求或乞求（某人）( implore的过去式和过去分词 )

参考例句：

• She implored him to stay. 她恳求他留下。
• She implored him with tears in her eyes to forgive her. 她含泪哀求他原谅她。

45 abiding   

adj.永久的，持久的，不变的

参考例句：

• He had an abiding love of the English countryside.他永远热爱英国的乡村。
• He has a genuine and abiding love of the craft.他对这门手艺有着真挚持久的热爱。

46 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

47 purely   

adv.纯粹地，完全地

参考例句：

• I helped him purely and simply out of friendship.我帮他纯粹是出于友情。
• This disproves the theory that children are purely imitative.这证明认为儿童只会单纯地模仿的理论是站不住脚的。