【作者】 李贤；

【导师】 余嘉元；

【作者基本信息】 南京师范大学 ， 应用心理学， 2006， 硕士

【摘要】 在精神科医疗领域，由于病因不明，缺乏可靠的实验室检查指标作为多数精神障碍诊断的参考依据，精神科的诊断更多地依赖于医生的临床经验。这种经验不断作用于医生的知识结构和推理策略，形成所谓的专长。专长是指专家在某一领域任务中表现出胜人一筹的能力，已成为心理学研究的一个重要课题。 本文回顾了专长研究的发展历程，从专家和新手对比的视角研究精神科医疗诊断专长。本研究选取了30名医生和30名学生作为被试，采用Q分类法、多维量表分析和口语报告分析等方法研究了精神科专家和新手在对精神分裂症的诊断过程中的知识结构和推理机制的差异。结果发现： 1．专家和新手的诊断知识结构存在差异。专家的知识模型分化程度高，结构性强，维度含义清晰，且呈现多样性和独特性。新手的知识模型则趋向单一，结构化程度不好。 2．专家和新手的推理机制存在差异。专家善于进行深层的推理，具有系统性，全面性。且对问题情境有良好的适应性。而新手的推理流于表面，往往孤立地对待信息，提出的诊断假设具有刻板性。 3．专家在推理的精确性、诊断时间、信息搜索质量、提出诊断假设的数量等指标上与新手有显著差异。 4．诊断过程实际上就是一个心理模型不断扩展的过程，知识结构和推理机制存在交互作用，领域知识是推理过程顺利进行的基础。而推理的结果又丰富了原有的知识结构。更多还原

【Abstract】 Owing to lack of knowing the cause and reliable laboratory examination evidence, psychiatrists’ protracted clinical experience plays a more important role in clinical diagnosis on psychopathy. Expertise forms as psychiatrists’ clinical experience interact with their knowledge structures and reasoning strategies. Expertise indicates the competence of experts whose performances are more excellent than others. And now, expertise is an important issue in psychology.In this thesis, the trajectory of research on expertise has been retrospected, and the expertise in the field of mental disorder diagnosis has been researched by expert-novice study. In this research we examined 30 psychiatrists and 30 students to find the differences of knowledge structures and reasoning mechanism between experts and novices when they diagnose the illness as schizophrenia. The main methods adopted are Q sorting method, multi-dimensional scale method and verbal protocol analysis. The results show that:’1. The knowledge structures that experts and novices possess differ from each other. The experts’ knowledge structures revealed high differentiation and clear structure and dimension meaning, while the novices’ knowledge structures are lack of clear differentiation and structure.2. The reasoning mechanism of experts contrast with that of novices. Experts are apt at deep, comprehensive and systematical reasoning, and have good adaptability to problem situation, while novices are apt at superficial reasoning, treating information solitarily, and their diagnostic hypotheses are more stereotypical.3. There are significant differences between experts and novices in the accuracy and time of diagnosis, the quality of the searched information and the number of diagnostic hypotheses, etc.4. The process of clinical diagnosis is a process of mental model expanding continuously. Knowledge structure and reasoning mechanism act on each other. The in-domain knowledge is the basis of the smooth reasoning, while the results of reasoning can improve the original knowledge structure.更多还原