抑郁症起源的三类理论视角 *

doi:10.3724/SP.J.1042.2018.01041

摘要/Abstract

摘要：

生物医学取向下的抑郁症研究多着重探究具体的致病基因和神经病理机制,致力于对抑郁症的直接致病原因进行解释和干预。关于抑郁症起源的理论医学研究则以基于实证结果的理论推导为基本方式,力图从终极意义上探讨抑郁症的历史原因。这些理论视角基本可归为三类：进化适应视角认为抑郁症起源于应对进化压力的适应机制, 主要体现为社会性适应假说和个体性适应假说; 功能失调视角认为抑郁症起源于正常心境和情绪功能的失调, 主要体现为错配解释和基因分布解释; 社会文化视角则认为抑郁症起源于社会文化的建构, 主要体现为社会文化建构观点和知识发展观点。三种理论观点下的抑郁症在内涵和本质上存在本质主义和建构主义的不同倾向, 如何发展出更具综合性的解释框架还有待理论整合和实证依据。

关键词: 抑郁症, 精神疾病, 精神病学, 理论医学

Abstract:

Biomedical approaches to study depression focus on the explanation and intervention of the proximate cause of depression by exploring specific pathogenic genes and neuropathological mechanisms, while the theoretical medical studies of the origin of depression discuss the ultimate historical cause of depression, mainly through theoretical reasoning based on empirical results. Those theories can be classified into three perspectives. First is the evolutionary adaptation perspective, which suggested that depression originates from the adaptive mechanisms coping with evolutionary pressure, represented by the social adaptation hypothesis and the individual adaptation hypothesis. Second is the functional disorder perspective, which assumes that depression originates from the dysfunction of normal moods and emotions, represented by the mismatch explanation and gene distribution explanation. Third is the social culture perspective, which believed that depression originates from social-cultural constructed concepts, represented by the social-cultural construction viewpoint and knowledge development viewpoint. There are different tendencies of the meaning and essence of depression under three perspectives, either of essentialism or constructivism. Theoretical integration and evidence base are needed for developing more comprehensive interpretation frameworks.

Key words: depression, mental disorder, psychiatry, theoretical medicine

中图分类号:

R395

陈子晨, 张慧娟, 汪新建, 吕小康. (2018). 抑郁症起源的三类理论视角 ^*. 心理科学进展 , 26(6), 1041-1053.

CHEN Zichen, ZHANG Huijuan, WANG Xinjian, LV Xiaokang. (2018). Three theoretical perspectives on the origin of depression. Advances in Psychological Science, 26(6), 1041-1053.

图/表 1

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理论视角	如何认识抑郁症的?	抑郁症是否是一种客观存在的疾病实体?	“抑郁症”现象的本质是什么?
进化适应视角	本质主义	是一种不完全是疾病的实体	进化产物、适应
功能失调视角	本质主义	是一种疾病实体	功能失调、疾病
社会文化视角	建构主义	不是一种疾病实体	一系列由文化联系在一起的生理心理表现

理论视角	如何认识抑郁症的?	抑郁症是否是一种客观存在的疾病实体?	“抑郁症”现象的本质是什么?
进化适应视角	本质主义	是一种不完全是疾病的实体	进化产物、适应
功能失调视角	本质主义	是一种疾病实体	功能失调、疾病
社会文化视角	建构主义	不是一种疾病实体	一系列由文化联系在一起的生理心理表现