Anxiety Disorder IV: 焦虑症(四 ) :强迫症 Obsessive-Compulsive Disorder

A. Either obsessions or compulsions:难以摆脱或强迫

Obsessions as defined by (1), (2), (3), and (4):难以摆脱的定义如下:

(1) recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
患者有反复持续的思想,冲动,或想象,在某些时段,这些思想,冲动或想象是入侵性的不合理的,因而引起患者的焦虑和苦恼.

(2) the thoughts, impulses, or images are not simply excessive worries about real-life problems
这些思想,冲动或想象不是简单的过分担心生活中的事情

(3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
患者试图去忽略,抑制这些思想,冲动或想象,或者用其他的思想或行为来中和他们.

(4) the person recognizes that the obsessional thoughts, impulses, or image are a product of his or her own mind (not imposed from without as in thought insertion)
患者意识到难以摆脱的思想,冲动,或想象是他或她自己意识里的(不是从外界强加进来的)

Compulsions as defined by (1) and (2):强迫定义如下:

(1) repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
重复的行为(如:洗手,整理排序,检查),重复的思维动作(如:祈祷,数数,默默重复词句),患者感到自己被难以摆脱的思想驱使去做,或是按照必须遵守的规则去做.

(2) the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
重复的行为或思维动作是为了防止或减轻苦恼,或防止一些可怕的事件或情景发生;然而这些行为或思维动作在现实中并不能起到防止作用,或者明显过分.

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.
在某些时候,患者也会意识到这些强迫行为和思维过分,或不合理. 注意:儿童这条不适用.

C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.
这些难以摆脱或强迫的行为或思维引起显著的苦恼,并消耗时间(每天至少消耗一个小时以上),或者显著地干扰了患者正常的生活,工作,和社交.

D. If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).
如果患者还患有其他的精神疾病,那么强迫症状不止于那些疾病的症状(如:厌食症患者在食物面前;拔毛癖的拔头发;药物滥用者在毒品面前;恐病症患者怀疑得了不治之症;性欲倒错症的性冲动;严重忧郁症的罪恶感)

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
这种障碍不是某种药物直接引起的身体上的反应,也不是某些身体疾病引起