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  3. That evolving understanding can have implications for diagnoses. For example,

That evolving understanding can have implications for diagnoses. For example,

游客2025-01-09  23
问题    That evolving understanding can have implications for diagnoses. For example, in 1973, the American Psychiatric Association dropped homosexuality from its manual of mental disorders, amid a growing realization that no evidence linked homosexuality to any mental impairment. Overnight, an estimated four to five million "sick" people became well.
   More common, however, is for psychiatrists to add conditions and syndromes: The association’s first diagnostic manual, published in 1952, included some 60 disorders, while the current edition now has about 300, including every thing from sexual arousal disorders to kleptomania to hyposomnia and several shades of bipolar disorder.
   "The idea has been not to expand the number of people with mental conditions but to develop a more fine-grained understanding of those who do," said Dr. Ronald Kessler, a professor of health care policy at Harvard Medical School and lead author of the latest mental health survey.
   But if contemporary trends, whether scientific or commercial, can serve to expand the franchise of mental illness, the mores, biases and scientific ignorance of previous centuries did much to hide it.
   In the 18th and 19th centuries, doctors had far fewer words for mental impairment-madness, hysteria, melancholia and estimated its incidence at somewhere around 5 percent to 10 percent, as far as historians can determine.
   In some communities, the mentally ill were tolerated as holy fools or village idiots. The city of Geel, in Belgium, was particularly enlightened. There, in the 18th and 19th centuries, lunatics "could walk the streets, engage in commerce, they would deliver food, carry milk, they were incorporated into the society and respected," said Dr. Theodore Millon, director of the Institute for Advanced Studies in Personology and Psychopathology in Coral Gables, Fla., and author of a recent history of psychiatry and psychology, "Masters of the Mind." Skip to next paragraph
   But Geel was exceptional. More typical, Dr. Millon said, was for people considered mad or uncontrollable to be confined, sometimes in homemade chambers called lock boxes. They were captive, uncounted, beyond any hope of treatment, their stories lost to history.
   The behavior of millions of others who were merely troubled, rebellious or moody was often understood-and veiled in religious terms, said Dr. Nancy Tomes, a professor of medical history at the State University of New York in Stony Brook.
   Gamblers and drinkers, the excessively impulsive or rebellious, the sexually promiscuous (especially women) were considered sinners, deviants or possessed. Conversely, those who denied themselves food or comfort, or who prayed or performed ritual cleansing repeatedly, often struck others as especially pious, Dr. Tomes said.
   As science gradually displaced religion in the industrializing countries through the 19th century, such behavior was increasingly seen in secular, diagnostic terms, historians said. Excessive fasting became anorexia; ritualized behavior was understood as compulsive, or obsessive-compulsive.
   "In some ways this is the story of the past century, the medicalization of many behaviors that once were seen in an entirely religious context," Dr. Tomes said.
   Beyond that, some experts are convinced that modem life in the West-especially urban life-is more stressful than in earlier periods, and that the increased numbers of illnesses in the psychiatric association’s diagnostic manual is a reflection of that fact.
   Dr. Millon, who has served on panels to write and revise the manual, tells the story of borderline personality disorder. In the late 1970’s, he was among a small group of psychiatrists and psychoanalysts who settled on the term "borderline" to mean people who fell somewhere between neurotic and psychotic. [br] According to the text, which of the following is NOT TRUE
选项 A、People’s understanding is developing
B、People with mental diseases can be accepted by people sometimes
C、sexually promiscuous were regarded as innocent and ill
D、people living in today’s West have to face more pressure than before
答案 D
解析 倒数第二段讲到欧洲的现代生活同以前相比，压力更大。故D是错误的。
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