Medical student dreams about medical school: The unconscious developmental process of becoming a physician

This paper is a report on a collection of almost four hundred dreams of medical students and postgraduate trainees with the manifest content about medical training. It is a unique dream collection from a defined population that experiences a developmental sequence of observable, reality events. The reality events appear in the manifest content of the dreams along with their symbolic alterations. The dreams are used as a psychodynamic database. The data may illustrate which reality experiences seem psychologically formative, their emotional developmental sequences and their specific emotional content. This is a pilot project exploring whether dream material collected from a discrete task group might give information about a group's emotional adaptation. The dreams seem to show an unconscious developmental process in response to medical training and becoming a physician that unfolds in overlapping stages as trainees learn to master skills and tolerate care-giving responsibility for human life. A progressive, unconscious hero-healer fantasy seems to form. It becomes elaborated in masochistic and then sadistic fantasies. These fantasies are evoked by, and used as a defense against, inevitable but painful anxieties of emotional adaptation to medical education experiences.     

Ritual in Western Medicine and Its Role in Placebo Healing

Ritual has long been thought to play an important role in the healing processes used by ancient and non-Western healers. In this paper, I suggest that practitioners of Western medicine also interact with patients in a highly ritualized manner. Medical rituals, like religious rituals, serve to alter the meaning of an experience by naming and circumscribing unknown elements of that experience and by enabling patients' belief in a treatment and their expectancy of healing from that treatment. These are all critical elements necessary to mobilize the potent placebo effects reported elsewhere to result from doctor-patient interactions.     

猝死、医疗纠纷与尸体剖检

貌似“健康”的人突然死亡(即猝死),由于事先无任何预兆,出乎人们意料往往使人们对死因产生怀疑,若死者是在因病就医过程中突然死亡,特别是在刚注射或服药后死亡,很容易被认为是医护人员的医疗活动及其相关活动有问题而引发医疗纠纷,每位医务人员应高度重视,若死因不明,尸检则是解决这一棘手问题的关键。     

医疗信息的风险感知

从信息加工视角探究个体对医疗信息的风险感知过程, 通过医疗信息来源、医疗信息内容与呈现形式和信息加工主体三个方面归纳其影响因素, 并基于经验-分析式加工理论和字面-要义加工理论探讨医疗信息风险感知的认知机制。今后研究可更注重医疗信息风险感知的通用研究与特殊主题研究的平衡、风险感知测量工具的规范性与特异性的结合, 并立足于中国医疗体系建立具有循证依据的预防措施和配套政策。     

新型农村合作医疗制度进一步发展的瓶颈分析

提出制约新农合制度发展的瓶颈有：筹资方式及筹资成本问题、筹资水平、补偿内容的设计问题、过多照搬了城镇职工基本医疗保险的资金管理方式、管理能力与管理手段、位于卫生局内的合管办、无法实现“解决因病致贫、因病返贫”的政策目标。     

Towards a unified model of aesthetic pleasure in design

In this study we test the Unified Model of Aesthetics (Hekkert, 2014), which posits that the aesthetic sense has evolved to identify and value prospects for safety and accomplishment. The principles of unity-in-variety, most-advanced-yet-acceptable and autonomous-yet-connected are considered manifestations of these conflicting urges at separate levels of stimulus processing. We empirically integrate these principles to gauge their unique contribution to the aesthetic experience, using two distinct surveys (study 1–300 respondents and 20 stimuli, study 2–60 respondents and 24 stimuli). Both surveys confirm the three principles constituting the Unified Model of Aesthetics. The principles are found to operate independently and jointly, although unity-in-variety has the strongest impact on aesthetic pleasure.     

Attention-Deficit Hyperactivity Disorder: The Medicalization of Misbehavior

During the past decade, there has been an increase in the diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD). This syndrome, typically diagnosed in childhood, is characterized by inattention, hyperactive motor behavior, and distractibility. Current prevalence rates obtained in various countries generally exceed the 3–5% reported by DSM-IV. Reasons for increased ADHD prevalence include changes in diagnostic standards, overlap between ADHD and other externalizing disorders, nonspecific behavioral criteria, and the rapid effects of stimulant medication on cognitive functioning. However, social, cultural, and economic factors may also contribute to increased diagnosis. ADHD has become a common topic in the lay media. Popular discussions of ADHD may serve as a metaphoric expression of social anxieties, particularly with respect to children. At the same time, ADHD has rapidly become incorporated into a medical model, with emphasis on pharmacological treatment. Reductions in mental health and educational services, as well as economic pressures of managed care, may also contribute to medicalization of behavioral problems. Collaboration between psychologists and primary care physicians can lead to more accurate diagnosis and appropriate treatment of ADHD and related disorders.     

Medical semiotics in the 18th century: A theory of practice?

Medical semiotics in the 18th century was more than a premodern form of diagnosis. Its structure allowed for the combination of empirically proven rules of instruction with the theoretical knowledge of the new sciences, employing the relation between the sign and the signified.     

Prescriptions: Autonomy,Humanism and the Purpose of Health Technology

My purpose is to examine two of the foundations of medical ethics: the principle of autonomy and the concept of the human. I also investigate the extent to which health technology makes autonomy and humanness possible. I begin by underlining Illich's point that the same health technology designed to promote health and autonomy also is pathogenic. I proceed to analyse the Kantian concept of autonomy, a concept which is closely associated with health and which continues to determine current ethical thinking. In so doing, I uncover an unexpected ontological function of health technology, a function described in Heidegger's work on technology. Based on this discovery, I suggest that calls for Kantian autonomy may often be self-defeating or even sometimes harmful. I conclude by calling for continued ethical vigilance, but also for a questioning of the hitherto virtually unquestionable concepts of ethics and humanness which may themselves play a role in our era's greatest problems.     

Report of the Working Group on Research

Prepared by the Working Group on Research from the November 1995 Georgetown conference sponsored by the Association of Medical School Psychologists, this paper focuses upon the challenges for psychologists who wish to maintain active research programs in academic medical settings. Six specific strategies are offered that, if followed, would increase opportunities and visibility of psychological research programs both within academic medical settings and within society at large.