Anxiety Disorder IV: 焦慮症(四 ) :強迫症 Obsessive-Compulsive Disorder

A. Either obsessions or compulsions:難以擺脫或強迫

Obsessions as defined by (1), (2), (3), and (4):難以擺脫的定義如下:

(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.
患者有反複持續的思想,衝動,或想象,在某些時段,這些思想,衝動或想象是入侵性的不合理的,因而引起患者的焦慮和苦惱.

(2) the thoughts, impulses, or images are not simply excessive worries about real-life problems
這些思想,衝動或想象不是簡單的過分擔心生活中的事情

(3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
患者試圖去忽略,抑製這些思想,衝動或想象,或者用其他的思想或行為來中和他們.

(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)
患者意識到難以擺脫的思想,衝動,或想象是他或她自己意識裏的(不是從外界強加進來的)

Compulsions as defined by (1) and (2):強迫定義如下:

(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
重複的行為(如:洗手,整理排序,檢查),重複的思維動作(如:祈禱,數數,默默重複詞句),患者感到自己被難以擺脫的思想驅使去做,或是按照必須遵守的規則去做.

(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
重複的行為或思維動作是為了防止或減輕苦惱,或防止一些可怕的事件或情景發生;然而這些行為或思維動作在現實中並不能起到防止作用,或者明顯過分.

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.
在某些時候,患者也會意識到這些強迫行為和思維過分,或不合理. 注意:兒童這條不適用.

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.
這些難以擺脫或強迫的行為或思維引起顯著的苦惱,並消耗時間(每天至少消耗一個小時以上),或者顯著地幹擾了患者正常的生活,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).
如果患者還患有其他的精神疾病,那麽強迫症狀不止於那些疾病的症狀(如:厭食症患者在食物麵前;拔毛癖的拔頭發;藥物濫用者在毒品麵前;恐病症患者懷疑得了不治之症;性欲倒錯症的性衝動;嚴重憂鬱症的罪惡感)

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.
這種障礙不是某種藥物直接引起的身體上的反應,也不是某些身體疾病引起