【作者】 刘勇； 陈健芷；

【Author】 Liu Yong,Chen Jian-zhi Department of Psychology,College of Education,Harbin Normal University,Harbin,150025,

【机构】 哈尔滨师范大学教育科学学院心理学系；

【摘要】 囤积障碍(hoarding disorder,HD)是在美国精神疾病诊断与统计手册第五版(DSM-5)中新独立出来的一种精神疾病,指个体因知觉到储藏物品的需要而难于丢弃或难与物品分离并由此导致一系列的心理和行为障碍。HD的现象学特点涉及流行率、发病与病程、共病性以及具有的危害性:HD的流行率约为2～5%,在个体中比较普遍;HD多发于童年期或青少年早期,是一种毕生发展的疾病,其病因可能与儿童早期的创伤经历及脑区功能(如腹内侧前额叶皮层、扣带回皮层和内侧颞叶区域等)异常有关;大多数HD患者往往具有额外的轴I(焦虑障碍谱系)或轴II障碍(C族人格障碍);此外,HD可能对个体、他人和社会产生巨大的危害,影响个体的认知功能及人际关系,同时物品堆积给社会带来巨大的火灾隐患。HD的诊断和评估主要是根据DSM-5、囤积量表修订版(the savinginventory-revised,SI-R),并结合过往病史和伴随症状。三类治疗方法(认知行为疗法、药物疗法和综合疗法)在理论与操作层面各有倚重,均可收到一定治疗效果。特别是认知行为疗法已经建构了针对HD的认知行为模型,相对来说是一种较好且安全的疗法。针对这三种疗法,还存在不足之处,如各疗法的维持效果及副作用均不清楚等。未来的研究应了解不同文化下HD的流行病学特点和年龄发展模式,提高HD危害性的认识,完善诊断标准和评估工具,而HD的病因及治疗将是该领域中比较有价值的研究方向。更多还原

【Abstract】 Hoarding disorder(HD) is a new independent mental disorder in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders.It refers to persistent difficulty discarding or parting with possessions,this difficulty is because of etrong urges to save items and/or distress accociated with discarding.The symptoms result in the a series of psychological and behavior problems.Systematically,this article reviews the phenomenological characteristic and the diagnosis and assenssment of HD,with an introducation of three commonly-used therapeutic methods for HD(i.e.,the cognitive-behavioral therapy,pharmacotherapy,and the multi-modal treatment),and a discussion of comparison of three therapeutic methods.The phenomenological characteristic of HD mainly consist of conception,prevalence,onset and course,comorbidities, and detriments.The diagnosis of HD mainly depends on the Diagnostic and Statistical Manual of Mental Disorders(DSM-5),the saving inventory-revised(SI-R) and clients’ medical history and concomitant symptoms.Each of the three therapies places emphasis on different parts in theory and in practice,and has ite own advantages and disadvantages.The key concept of the cognitive-behavior therapy is to change the false conviction and unhealthy harding behavious;the pharmacotherapy is to use drugs for the treatment of obsessive-compulsive disorder;while the multi-modal treatment is the combination of the above two methods.In the future,the epidemiology and the age development model within different cultures requied mo reserch. Research should also pay attention to the detriments of HD and the improvement of diagnosis and assessment.The etiology and treatment would be an important and valuable researching domain in the future.更多还原