VOA慢速英语2013 AS IT IS 2013-06-21 Debating the ＂Bible＂ of American Psychiatry

 

AS IT IS 2013-06-21 Debating the ＂Bible＂ of American Psychiatry¹

From VOA Learning English this is As It Is.

Welcome to the show. I’m Caty Weaver². The Diagnostic and Statistical³ Manual of Mental Disorders⁵ is a guide to help doctors identify mental health problems in patients. The guide was first published in 1952. It has recently been updated for the fourth time. The DSM-5 has caused debate among psychiatric professionals, patients and others.

Our first subject on today’s show: The DSM-5.

Here’s Christopher Cruise.

DSM-5 Debate

The Diagnostic and Statistical Manual of Mental Disorders is often called the bible of psychiatrists⁶ and psychologists. The book is also used by others, including insurance companies to help decide what health care services to pay for. The last version came out in 1994.

The DSM is published by the American Psychiatric Association. It is put together with the help of experts around the world.

David Kupfer is a professor of psychiatry at the University of Pittsburgh. He led the international team that reworked the guide. It took ten years to complete.

“We’re quite excited about putting out the DSM-5 as a revision.”

But not everyone likes the changes. For example, the new DSM has removed Asperger’s syndrome⁷ as an individual disorder⁴. This developmental disorder has been absorbed into a larger group called autism spectrum⁸ disorder. People with autism have problems with social and communication skills. Asperger’s was considered a mild form of autism.

Dr. Kupfer considers the change in Asperger’s identification in the DSM to be minor⁹. But Alycia Halladay does not. She is a director of Autism Speaks, an advocacy group for people with autism. Ms. Halladay says her group is worried that the change may keep people from receiving treatment or other services.

“We’re concerned about individuals that may have shown symptoms of Asperger’s not meeting the criteria¹⁰ for what is now called autism, and therefore not receiving services.”

Another change in the DSM-5 that critics have targeted is its new definition of depression. The old diagnosis¹¹ called for a patient to show signs of unhappiness or lack of pleasure for a long time.

Now the manual suggests as little as two weeks of sadness could qualify as depression. Critics say simple grief can cause this.

“To diagnose major depression after bereavement¹² is medicalizing a normal human reaction – that is, the grief of losing a loved one.”

That is Bruce Cuthbert from the Research Domain¹³ Criteria Project, or RDoC, at the National Institute of Mental Health. RDoC is collecting the latest research to identify the biological causes of mental disorders like depression.

Bruce Cuthbert says another problem is that mental health research generally follows definitions provided by the DSM.

“That’s what we need to change, because we now know that these categories are very complicated. There are many different mechanisms¹⁴ of brain functioning and behavior that are involved with any one of these disorders.”

Some new disorders to the manual are also raising questions. Disruptive Mood Disregulation Disorder is an example. The DSM-5 says signs of the disorder include explosions of anger at least three times a week that do not seem in balance with the cause. The manual says to receive this diagnosis, the patient would have to be at least six years of age and the signs would have to show before ten years of age.

But critics say such behavior does not necessarily mean a mental disorder. They argue that angry outbursts are normal behavior in young kids.

Allen Frances is the former chairman of the Department of Psychiatry at Duke University. He also led the team that produced the fourth version of the DSM. Dr. Frances has been extremely critical of the new manual. In a blog on the Huffington Post website, he said the DSM-5 could, for example, “turn temper tantrums into a mental disorder.”

I'm Christopher Cruise.

Gratitude¹⁵ Ceremony

And now we go to New York City for an unusual ceremony. It was held to honor the dead who had  donated their bodies for medical purposes. Kelly Jean Kelly has details.

A cadaver¹⁶ is the body of someone who has died. Since the 16th century, medical students have studied cadavers¹⁷ to learn about the biology of humans. In the past 40 years, New York’s Columbia University College of Physicians and Surgeons have honored donors¹⁸ of cadavers with what they call a "gratitude ceremony." Medical and dental students, professors and families of the donors attend. 

This spring, the ceremony was held at Colombia University's Medical Center theater.  Zachary Feldman attended the ceremony. He is one of many medical and dental students who have trained with cadavers.

“It’s nice to have a ceremony to acknowledge the larger context and to see the real story and the human story outside the physical body, to sort of corroborate¹⁹ your data from the lab with real relatives and real people who loved that individual. It puts you in touch with your own humanity.”

Children, friends, husbands and wives of the dead had the chance to give a small goodbye speech. 

One daughter spoke²⁰ of her mother’s desire to give to research.

“My mom felt that the greatest gift was to contribute to the education of others and always expressed that she wanted her body donated for research. By being here today, we know that her greatest gift and wish has been fulfilled.”

Paulette Bernd designed and supervises Columbia’s Clinical Gross Anatomy²¹ course. She says no other source of medical training can compare to study using human bodies.

“There’s manual dexterity²² in terms of learning to use dissection²³ equipment that they will eventually be using in surgery as well. And they need to interpret what they see.”        

Still for many, making that first cut into a human body can be hard. Elizabeth Shy, a medical student, says she was unsure.

“So even if you have a scalpel in your hand, you know that your job is to cut into the body, it’s hard to really put enough pressure to make that happen. I found myself throughout many, many labs, I would just be holding the cadaver’s hand, and I would find myself sort of rubbing the arm or the shoulder. Because I think it's still my human reaction to try to be comforting the patient.”

Zachary Feldman who plans to specialize in psychiatry says medical students often report a similar dream. He says they will dream of cutting into a cadaver who suddenly comes alive. And its face is the same face as the dreamer’s.

“I interpret that as in, when you start medical school, your boundary between physician and patient is really blurred…when you see someone hurting or ill it’s not hard to see your own mortality and your own vulnerability.”

Gratitude ceremonies were once rare, but now can be found across the country. Medical student David Hankins says it’s impossible to overstate the value of the body donor’s gift.

“Because if you think about…how many people we are going to see every single day of our careers, we have millions of chances to make a difference in someone’s life. And that really only is possible because of the donors.

I’m Kelly Jean Kelly.

And that’s As It Is for today. I’m Caty Weaver. Thanks for joining us.

1 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。

2 weaver   

n.织布工；编织者

参考例句：

• She was a fast weaver and the cloth was very good.她织布织得很快，而且布的质量很好。
• The eager weaver did not notice my confusion.热心的纺织工人没有注意到我的狼狈相。

3 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。

4 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。

5 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》

6 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

7 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。

8 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。

9 minor   

adj.较小(少)的，较次要的；n.辅修学科；vi.辅修

参考例句：

• The young actor was given a minor part in the new play.年轻的男演员在这出新戏里被分派担任一个小角色。
• I gave him a minor share of my wealth.我把小部分财产给了他。

10 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。

11 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。

12 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》

13 domain   

n.(活动等)领域，范围；领地，势力范围

参考例句：

• This information should be in the public domain.这一消息应该为公众所知。
• This question comes into the domain of philosophy.这一问题属于哲学范畴。

14 mechanisms   

n.机械( mechanism的名词复数 )；机械装置；[生物学] 机制；机械作用

参考例句：

• The research will provide direct insight into molecular mechanisms. 这项研究将使人能够直接地了解分子的机理。 来自《简明英汉词典》
• He explained how the two mechanisms worked. 他解释这两台机械装置是如何工作的。 来自《简明英汉词典》

15 gratitude   

adj.感激，感谢

参考例句：

• I have expressed the depth of my gratitude to him.我向他表示了深切的谢意。
• She could not help her tears of gratitude rolling down her face.她感激的泪珠禁不住沿着面颊流了下来。

16 cadaver   

n.尸体

参考例句：

• Examination of a cadaver is to determine the cause of death.尸体解剖是为了确认死亡原因。
• He looked down again at the gaping mouth of the cadaver.他的眼光不由自主地又落到了死人张大的嘴上。

17 cadavers   

n.尸体( cadaver的名词复数 )

参考例句：

• Human cadavers were the only known source of hGH, and demand was intense. 人类尸体是hGH已知的惟一来源，而且需求广泛。 来自英汉非文学 - 生命科学 - 口蹄疫疯牛病
• Will there be enough cadavers for each group this term? 这个学期每一个组都有足够的尸体吗？ 来自电影对白

18 donors   

n.捐赠者( donor的名词复数 )；献血者；捐血者；器官捐献者

参考例句：

• Please email us to be removed from our active list of blood donors. 假如你想把自己的名字从献血联系人名单中删去，请给我们发电子邮件。
• About half this amount comes from individual donors and bequests. 这笔钱大约有一半来自个人捐赠及遗赠。 来自《简明英汉词典》

19 corroborate   

v.支持，证实，确定

参考例句：

• He looked at me anxiously,as if he hoped I'd corroborate this.他神色不安地看着我，仿佛他希望我证实地的话。
• It appeared that what he said went to corroborate my account.看来他所说的和我叙述的相符。

20 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

21 anatomy   

n.解剖学，解剖；功能，结构，组织

参考例句：

• He found out a great deal about the anatomy of animals.在动物解剖学方面，他有过许多发现。
• The hurricane's anatomy was powerful and complex.对飓风的剖析是一项庞大而复杂的工作。

22 dexterity   

n.(手的)灵巧，灵活

参考例句：

• You need manual dexterity to be good at video games.玩好电子游戏手要灵巧。
• I'm your inferior in manual dexterity.论手巧，我不如你。

23 dissection   

n.分析；解剖

参考例句：

• A dissection of your argument shows several inconsistencies.对你论点作仔细分析后发现一些前后矛盾之处。
• Researchers need a growing supply of corpses for dissection.研究人员需要更多的供解剖用的尸体。