心理弹性的心理社会及生物学机制

心理弹性是个体在经历急性压力、创伤或者更多不同形式的慢性压力时成功应对、积极适应的动态过程,对心理弹性机制的研究有心理社会及生物学两种研究取向.探索了心理弹性的个人、家庭、社会环境、神经生物、分子遗传学因素以及它们的作用机制过程,并对今后的研究进行了展望.     

慢性疼痛与心理障碍

疼痛是一种复杂的心理生物学过程。疼痛的感知和情绪活动密不可分,疼痛是一种包括感觉、情绪和认知的多维性体验,人与人之间差异很大,甚至同一个体也随疼痛的背景、意义以及心理状态而异。认知因素和情感因素对疼痛感知具有非常重要的影响。本文回顾疼痛认知和情感状态调节（身心治疗的重要组成部分）潜在的神经学机制。回顾慢性疼痛本身会改变大脑环路、包括参与内源性疼痛调节的循证证据,这些证据表明随着疼痛转为慢性,控制疼痛越来越困难。     

团队合作对4838例居家癌痛患者疼痛管理的效果与思考

通过对大连医科大学附属第一医院宁养院2001年3月～2013年11月收治的4838例癌痛患者进行调查,总结归纳居家癌痛患者的疼痛控制情况,探索癌痛患者的疼痛管理方法,结果提示依靠团队合作在居家条件下免费向癌痛患者及其家属提供身体、心理、社会和精神全方位的照顾和支持,即理想的疼痛管理是“整体性疼痛”与“整体性痛苦”的治疗,不仅针对临床疼痛症状,还必须处理相关因素。     

关于正念治疗疼痛的心理与脑机制研究

疼痛是临床常见的症状,它的产生与理化刺激、心理、社会因素密切相关,单纯的生物学治疗效果非常有限。在心理治疗领域,新近发展起来的正念治疗,能够有效缓解疼痛以及伴发的抑郁、焦虑症状,而且对于提高个体的情绪调节能力和生活质量也有重要作用。正念治疗简单有效,修习和运用是关键。疼痛患者容易学习,便于操作,患者可以通过长期的自我训练达到缓解疼痛,改善心理状况。本文从正念治疗疼痛的心理与脑机制出发,以期为正念治疗疼痛提供科学依据,同时也为疼痛的临床治疗提供新方法。     

抑制功能在疼痛中的作用

自生物心理社会模型提出以来, 利用心理因素预防和治疗疼痛备受关注, 越来越多的研究表明抑制功能在疼痛发展和恢复阶段起关键作用。疼痛诱发的自我防御机制通过争夺认知资源影响抑制功能, 反之低抑制功能个体在应对疼痛干扰中表现较差, 进而影响着疼痛的预期和学习。现有关于抑制功能影响疼痛的研究主要基于相关设计, 未来应进一步明确二者的因果关系。深入理解疼痛与抑制功能相互作用的认知机制有助于指导抑制功能对慢性疼痛的靶向干预。     

疼痛的心理学研究

心理学对疼痛的研究已经进行了几十年,成果颇丰。众多的研究已经证实了疼痛与基本心理过程之间的相互关系,包括注意、情绪、动机和记忆。除了基本心理过程外,社会因素也能够调节疼痛,如社会排斥、信仰、音乐、虚拟情境、金钱和权利等。已有疼痛研究中的疼痛测量方法过于主观,并且疼痛调节因素在临床中缺乏实践价值。当前疼痛研究呈现与具身思潮相结合的趋势,未来应更加重视发掘调节疼痛的社会因素。     

“非典”流行期民众常见的心理应激反应与心理干预

该文介绍了传染性非典型性肺炎（严重的急性呼吸综合征,SARS）急性流行期我国民众较常见的心理应激反应,包括焦虑和恐惧、愤怒和怨恨以及抑郁等情绪反应,认知反应,自我防御反应和生理反应,描述了人们面对SARS威胁时的应对策略;探讨了当前影响民众心理反应的诸种因素,包括刺激事件或刺激情境的性质与特点,对事物的态度和认识评价,应对挑战的能力与应对方式,以及心理社会环境和人格特征等;指出了心理干预应当遵循的四个原则和多种形式,说明了6种心理干预的具体措施和方法。     

危及生命的慢性疾病应对中的积极心理效应:证据、质疑与建议

危及生命的慢性疾病指病程长、治愈难、治疗周期长、严重情况下会危及生命且严重影响患者及其家属正常生活的疾病.研究发现,乐观、抗争勇气、心理一致感、受益发现和创伤后成长等积极心理因素在危及生命的慢性疾病应对过程中能产生积极效果,并证实积极心理通过生物加工、行为加工、社会加工三条路径促进患者对疾病的应对.对疾病态度或感知进行干预以及直接诱发积极心理等干预方法能对疾病康复产生良好的效果.对该领域研究的质疑主要包括研究方法的科学性以及积极心理和疾病应对间因果关系的明确程度两个方面.针对质疑,未来研究应以实验法为主导并结合其它方法,进一步探讨积极心理与疾病应对和康复之间的因果关系.     

心理痛苦研究述评 ——聚焦5·12汶川大地震受灾群众心理痛苦

心理痛苦是社会认知心理学和灾难心理学的重要概念之一,目前对心理痛苦的研究已经取得一定成果,主要包括心理痛苦的界定;心理痛苦的测量方法;心理痛苦客观存在的证据、心理痛苦与生理疼痛的关系、心理痛苦与自杀的关系。进一步的研究应注重研究方法趋向多元化、建立消除或缓解心理痛苦的干预机制及对心理痛苦的跨文化研究。关注心理痛苦的研究对个体的生存、适应和发展具有重大意义     

医学模式的转变与对腰痛患者实施认知行为治疗

随着医学模式从生物医学模式向生物-心理-社会医学模式的转变,心理社会因素对腰痛患者疼痛的影响亦日益引起社会的普遍关注.从心理社会因素对腰痛患者疼痛的影响探讨医学模式转变的必要性以及给腰痛患者实施认知行为治疗的可行性.     

The Role of Optimism,Social Constraints,Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors

The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.     

Effects of psychosocial and situational variables on substance abuse among homeless adults

Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing.     

The biopsychosocial approach to chronic pain: scientific advances and future directions

The prevalence and cost of chronic pain is a major physical and mental health care problem in the United States today. As a result, there has been a recent explosion of research on chronic pain, with significant advances in better understanding its etiology, assessment, and treatment. The purpose of the present article is to provide a review of the most noteworthy developments in the field. The biopsychosocial model is now widely accepted as the most heuristic approach to chronic pain. With this model in mind, a review of the basic neuroscience processes of pain (the bio part of biopsychosocial), as well as the psychosocial factors, is presented. This spans research on how psychological and social factors can interact with brain processes to influence health and illness as well as on the development of new technologies, such as brain imaging, that provide new insights into brain-pain mechanisms.     

Posttraumatic Growth in the Context of Heart Disease

The concept of positive consequences arising as a result of coping with traumatic experiences, such as life-threatening illness, represents an emerging area of empirical study in the stress and health literature. This study investigates three specific psychosocial variables (personality, social support, and coping) in relation to posttraumatic growth in a population of individuals coping with heart disease. The results indicate that Extraversion was the most significant predictor of growth, and there is evidence that Problem-Focused Coping partially mediated this relationship between Extraversion and posttraumatic growth. The role of Social Support Satisfaction in predicting growth remains unclear. Findings emphasize the importance of personal and environmental factors in psychological interventions aimed at improving the adjustment and posttraumatic growth of heart patients. Directions for future research are proposed.     

The Adaptation of Patients During the Hospitalization Period of Bone Marrow Transplantation

A longitudinally study was conducted among 42 bone marrow transplantation (BMT) patients to investigate the association between pretransplant psychosocial variables and psychophysiological outcomes during the immediate convalescence period. Family relationships (cohesion, expressiveness, and conflict) and coping resources (cognitive, social, emotional, spiritual/philosophical, and physical resources) were assessed on the admission day (Day –7 Time 1). Data on psychological distress and pain intensity were obtained on Day +7 (Time 2) and Day +14 (Time 3). The average scores at Times 2 and 3 were computed to indicate the overall adjustments of the patients during the hospitalization period after the day of actual transplant (Day 0). It was shown that higher expressiveness family relationships and higher resources to cope effectively with stressful situations were associated with less psychological distress during the above period. Both pretransplant psychosocial variables were not associated with pain intensity during hospitalization. Allogeneic transplant patients reported higher pain intensity than did autologous transplant patients. Psychological distress and pain intensity were positively correlated with each other. Our findings show that pretransplant family relationships and coping resources associate moderately with psychological distress during the immediate convalescent period of BMT. The present findings support the family-centered approach to BMT care and provide a scientific basis for pretransplant psychosocial interventions.     

Why does ADHD Confer Risk for Cigarette Smoking? A Review of Psychosocial Mechanisms

Research has documented that adolescents and young adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for cigarette smoking, but less attention has examined why this risk exists. The current paper reviews the literature on different psychosocial mechanisms [self-medication hypothesis, social factors (social modeling, social impairments), cognitive factors (attitudes, coping skills), and psychological variables (ADHD symptom dimensions, comorbidity)] that might explain this increased smoking risk. Results of the review suggest that, while the self-medication hypothesis has some theoretical merit, it has not been adequately examined among adolescents and young adults with ADHD. Further, cognitive and social factors may be important mechanisms that help to explain the association between ADHD and cigarette smoking, but research in these areas is sparse. Finally, a larger body of literature suggests that different psychological aspects of ADHD (e.g., comorbidity, symptom dimensions) are related to smoking. Interpretation of findings of many of these studies was hindered due to significant methodological problems and the lack of a guiding theoretical orientation. Potential theories that might facilitate future work in this area are discussed. Future research should continue to explore these important psychosocial mechanisms as well as gene–environment interactions in examining the link between ADHD and cigarette smoking.     

Older adults' recovery from surgery for osteoarthritis of the knee: psychosocial resources and constraints as predictors of outcomes.

The authors investigated psychosocial resources (positive support, active coping) and psychosocial constraints (negative support, avoidant coping) as predictors of improvement in the health of 63 older adults undergoing surgery for osteoarthritis of the knee. Following surgery, patients and social partners are motivated both to strive for the appetitive goal of recovery (approach), and to protect themselves from pain and impairment (avoidance). The authors assessed resources and constraints 6 weeks after surgery as predictors of outcomes (improvement in knee pain, knee functioning, and psychological well-being) 6 months after surgery. The constraints patients encountered early in recovery were strong predictors of poor recovery. Although resources were associated with some improvement, these effects were largely accounted for by constraints.     

Latent structure of strategies used to cope with nociceptive stimulation

A substantial number of recent investigations have focused upon the role of psychological factors (such as coping strategies) in mediating the experience of pain. One goal of this research has been to identify strategies that are particularly effective or ineffective in enabling persons to tolerate nociceptive stimulation. Although research in this direction appears promising, the field has lacked an adequate means for quantitatively comparing and contrasting strategies that persons actually use. The current studies were undertaken to describe empirically the latent dimensions along which subjects perceive coping strategies used by persons experiencing the cold pressor test to differ and to demonstrate a methodology using multidimensional scaling for developing empirically based classificatory schemes of strategies for coping with other forms of pain.     

The impact of a laryngectomy on the spouse: Who is better off?

Background: Diabetes self-care is a key element in the overall management of diabetes. However, the importance of psychosocial factors for successful disease management is under investigated. This study aimed at exploring the role of coping styles and social support in the relationship between self-care activities and glycated haemoglobin in patients with type 2 diabetes.

Methods: One hundred adults (60% female, aged 40–70 years) with type 2 diabetes completed questionnaires assessing self-care activities, coping styles and social support. In addition, a blood test was performed to obtain glycated haemoglobin levels.

Results: Result showed significant relationships of glycated haemoglobin with self-care activities, coping styles and social support. Regression analysis indicated that social support had a moderating role on the relationship between self-care activities and glycated haemoglobin, such that, at very high levels of social support the association, between Self-Care and HbA1c disappears.

Conclusions: Findings indicate that health care providers, within the context of the Iranian social and cultural situation, should pay more attention to psychosocial factors when addressing self-care activities. Delineation of the role of coping styles and social support might be useful for identifying patients in need of particular counselling and support for improving self-care activities and HbA1c levels.     

Psychosoziale Interventionen bei Patientinnen mit Brustkrebs

Breast cancer patients are subject not only to physical strain but also to substantial psychological and social stress as well as major threats and challenges.The paper presented gives an overview of the research status on psychosocial interventions to support patients in their coping endeavours.Psychosocial basic care of women with breast cancer is performed by the physicians treating oncologically and includes information fitting patients' information needs,and responding to their emotional stress.Evaluated training and educational programs are available for physicians to enhance their psychosocial competence.Psychosocial basic care is completed by psychoeducational interventions.In 20–30% of women with breast cancer, there is a need for a special psychotherapeutic treatment.Especially, supportive and cognitive-behavioral therapies in an individual or a group setting contribute to a reduction of anxiety and depression. Even anticipated side-effects of somatic treatments can be diminished by psychotherapy. Research in the field supports that there is a need for broad integration of psychosocial interventions into disease management programs for women suffering from breast cancer.