晚期喉癌患者的个体化治疗和心理干预

晚期喉癌患者往往伴有严重的心理负担.这种负性心理状态因疾病的特殊性以及患者本身个体就医背景的差异而产生有别于其他癌症的个体特征.把握患者的个体负性心理状态,运用相应的心理干预措施,使患者的期望和医生的治疗目的趋向统一,将有助于晚期喉癌个体化治疗模式的有效实施.     

以患者为中心的现代医学模式与喉癌治疗

随着现代医学模式兴起,人们的健康观念有了新的内容,不再是单纯的躯体健康,还涉及好的心理状态和良好的社会适应。医疗服务也由单纯的技术服务转变为技术与心理和精神相结合。喉癌是头颈部常见的恶性肿瘤,喉癌治疗方式直接影响患者的生活质量,因此喉癌的治疗应与以患者为中心的现代医学模式相结合,以达到良好的治疗效果。     

以患者为中心的现代医学模式与喉癌治疗

随着现代医学模式兴起,人们的健康观念有了新的内容,不再是单纯的躯体健康,还涉及好的心理状态和良好的社会适应。医疗服务也由单纯的技术服务转变为技术与心理和精神相结合。喉癌是头颈部常见的恶性肿瘤,喉癌治疗方式直接影响患者的生活质量,因此喉癌的治疗应与以患者为中心的现代医学模式相结合,以达到良好的治疗效果。     

记忆抑制在正常人群与抑郁人群中的研究进展

抑郁症认知障碍的突出表现之一为患者的负性记忆偏向。已有研究常关注患者对负性信息自下而上的选择性注意,往往忽略了自上而下执行控制障碍对记忆的影响。近年研究提示,抑郁症患者和抑郁状态个体的记忆抑制缺陷在其负性记忆偏向的形成和维持中起到了重要作用,无法有效地主动抑制负性记忆可能是患者持续性负性反刍的主要原因。从抑郁症自上而下的执行控制缺陷入手,研究患者的记忆抑制障碍与其主要症状－负性反刍间的相关性,不仅能从理论上丰富Beck的抑郁症认知模型,还能指导临床建立更准确的预后评估指标,同时制定更有效的治疗方案。本文分别介绍了健康成人及抑郁症患者和抑郁状态个体的记忆抑制研究现状,并就当前在抑郁人群研究领域亟待解决的三个问题进行了探讨。     

心理弹性纵向预测因素的研究进展

虽然经历自然灾害、重大疾病等负性事件给个体的身心带来了严重的伤害,但仍有部分个体没被挫折打倒,这与心理弹性的作用密切相关。本文在回顾心理弹性纵向预测因素的基础上,探讨经历负性事件的个体心理弹性的变化轨迹和纵向预测因素,指出其是生物、心理、社会因素共同作用的结果,心理弹性的提升需要个人、家庭和社会的共同参与。未来的研究应注重构建心理弹性的纵向预测模型,针对这些初始预测因素制定干预措施,为经历负性事件的个体心理弹性的发展和心理社会适应能力的提高提供参考。     

高中生的社会适应

从上述求助的内容看，主要与社会适应问题密切相关。前来咨询的学生以高一年级的学生居多。社会适应是指个体为适应社会环境而改变自己行为习惯或态度的过程，个人与社会环境关系的一种状态，即人与社会环境之间的一种和谐协调、相宜相适的状态。当个体出现适应不良时，会有许多负性情绪表现，如彷徨、失望、忧虑、怀疑、悲伤、恐惧及绝望等，负性情绪过于持久强烈会导致心理异常。     

儿童期创伤与有留守经历大学生负性情绪：心理韧性的调节作用

本研究旨在考察有留守经历的大学生儿童期创伤与负性情绪关系,以及心理韧性在其间的调节作用。对391名有留守经历的大学生进行间隔3个月的两次问卷调查。结果:(1)相较于没有儿童期创伤的个体,有儿童期创伤的个体心理韧性更低,抑郁、焦虑、压力水平更高;(2)在控制性别、城乡来源、是否独生、年龄与T1时间点负性情绪的作用后,T1时间点的儿童期创伤、心理韧性均能显著预测T2时间点的负性情绪;(3)低心理韧性水平下,儿童期创伤显著预测留守经历大学生的负性情绪;高心理韧性水平下,预测作用不再显著。表明儿童期创伤是有留守经历的大学生负性情绪的风险因素,心理韧性可以调节儿童期创伤对有留守经历大学生的负性情绪的预测。     

精准的意义：负性情绪粒度的作用机制与干预

情绪粒度是指个体在相似情绪状态之间做出粒度化细微区分的能力,其中负性情绪粒度对个体的身心健康具有重要意义。在认知层面,负性情绪粒度可以通过情绪调节策略的选择性与有效性,人际情绪技能和充当个体内、外化问题的保护性因子发挥积极作用;在神经生理层面,负性情绪粒度可以通过调节自主和中枢神经系统活动来维持自身稳态。负性情绪粒度的干预技术主要包括情绪词汇训练和正念干预训练等。未来研究应进一步提高负性情绪粒度的测量精度,从个体中心视角探讨负性情绪粒度的动态变化过程,拓展其干预应用,并且关注正、负性情绪粒度作用机制的比较。     

1例晚期肿瘤患者宁养服务浅谈

通过提供居家宁养护理指导和心理疏导的方法,为晚期癌症患者提供身、心、灵全方位的照顾,从而提高晚期癌症患者的生活质量。通过对1例晚期肿瘤患者进行症状控制、护理指导、心理疏导、灵性沟通,该晚期肿瘤患者及家属的自身照顾能力提高,晚期肿瘤患者在生命末期的生活质量有所提高,最终达到善终。身心灵的照顾在宁养服务中起重要作用,有利于患者生活质量的提高,但仍要根据患者的个体特点并掌握一定技巧。     

情绪一致性对有意遗忘的影响

有意遗忘是强调遗忘的有意性和指向性。对负性情绪的有意遗忘有利于个体的身心健康。本研究采用单字范式,实验一以正性、负性和中性情绪词为材料,探讨了情绪材料对有意遗忘的影响。结果发现,三类词语均表现出了显著的有意遗忘效应;实验二在实验一的基础上加入了情绪状态,探讨了情绪状态和情绪材料对有意遗忘的影响,结果发现,在积极情绪状态下,被试更多地遗忘负性情绪词;在消极情绪状态下,被试更多地遗忘中性词。表明个体对情绪信息的有意遗忘既受信息的情绪性影响,又受个体情绪状态的影响。     

汉语确定性无界否定句模拟加工的时间进程

以往关于否定句理解的心理模拟过程是一步完成的还是两步完成的, 结果并不一致, 这与各个研究使用的实验材料类型有关。本研究以汉语确定性无界否定句为研究对象, 采用句-图匹配范式和2(句子类型：汉语确定性无界肯定句和汉语确定性无界否定句) × 2 (图片描绘事物状态与句子描述的事物状态的匹配类型：匹配与不匹配)被试内实验设计, 以对图片判断的反应时和正确率为指标, 探讨其理解的早期(250 ms)、中期(750 ms)和晚期(1500 ms)的心理模拟过程。研究结果表明：确定性无界否定句理解的心理模拟是分两步进行的, 首先模拟的是否定句的被否定状态, 随着加工时间的推进, 完成了对确定性无界否定句的第二步模拟即对实际状态的模拟。但是, 比其他类型否定句的模拟过程所用的时间要短, 即在阅读理解的中期就完成了心理模拟。     

Cognitive Behavioral Therapy Across the Stages of Psychosis: Prodromal, First Episode, and Chronic Schizophrenia

Since the early 1990s, cognitive behavioral therapy (CBT) has been increasingly used as an adjunctive treatment for psychotic disorders. This paper describes the CBT of three cases, each at a different stage of psychotic disorder: at-risk mental state, first-episode psychosis, and chronic psychotic disorder. For the at-risk mental state, treament focused on anxiety and social phobia, whereas the treatment of first-episode psychosis focused on the development of a shared formulation of the factors leading to and maintaining psychotic symptoms. For the chronic case, treatment emphasized the possibility of improving strategies to prevent symptoms from interfering with life goals. The potential contribution of CBT to improve outcomes in psychotic disorders beyond those obtained through traditional pharmacotherapy is discussed.     

老年人的消极交往与心理健康

积极交往和消极交往分别会对老年人的心理健康产生有利和不利影响, 然而, 探讨消极交往的负面作用及其机制的研究相对较少。目前研究主要涉及消极交往的类型(社会隔离、丧偶或离婚)、来源(配偶、子女或朋友)及强度, 并探讨感知评估、自尊的中介作用及性别、婚姻、受教育水平等变量的调节作用。社会情感选择理论、优劣势整合理论、社会交换理论及镜中我理论在一定范围内对消极交往的负面作用做出了合理解释。采取“原谅”或“认知疏远”的应对策略能有效缓解消极交往的负面影响。未来研究应进一步考察不同文化背景及社会网络背景下消极交往对老年人心理健康的影响, 同时加强对消极交往的理论研究和线上研究, 并关注相关的干预研究。     

慢性肾脏病患者心理状态研究进展

慢性肾脏病是一种很难治愈的一种疾病,绝大多数的患者需要中西医结合治疗。患有慢性肾脏病的患者最终需要肾脏替代疗法来缓解症状,如透析治疗或选择肾脏移植。巨大花费同疾病本身使患者身心均受到很大的压力,CKD患者抑郁、焦虑情况普遍存在,影响患者生存质量、营养状态和治疗配合性及疾病的预后,因此解决其心理问题至关重要。     

Meaning making in mothers' and children's narratives of emotional events

Narrative coherence and the inclusion of mental state language are critical aspects of meaning making, especially about stressful events. Mothers and their 8- to 12-year-old children with asthma independently narrated a time they were scared, frustrated, and happy. Although mothers' narratives were generally more coherent and more saturated with mental state language than children's narratives, for both mothers and children narratives of negative events were more coherent and contained more mental state language than narratives of positive events overall, and narratives of scary events contained more mental state language than narratives of frustrating events. Coherence appears to be multifaceted, in that the three dimensions of coherence coded, context, chronology, and theme were not strongly interrelated within narratives of the same event, but use of mental state language, including cognitive-processing and emotion words, appears to be more integrated. Moreover, while thematic coherence seems to be a consistent individual narrative style across valence of event being narrated, mental state language appears to be a consistent style only across the two stressful event narratives. Finally, and quite surprisingly, there were virtually no relations between mothers' and children's narrative meaning making.     

Meaning making in mothers’ and children's narratives of emotional events

Narrative coherence and the inclusion of mental state language are critical aspects of meaning making, especially about stressful events. Mothers and their 8- to 12-year-old children with asthma independently narrated a time they were scared, frustrated, and happy. Although mothers’ narratives were generally more coherent and more saturated with mental state language than children's narratives, for both mothers and children narratives of negative events were more coherent and contained more mental state language than narratives of positive events overall, and narratives of scary events contained more mental state language than narratives of frustrating events. Coherence appears to be multifaceted, in that the three dimensions of coherence coded, context, chronology, and theme were not strongly interrelated within narratives of the same event, but use of mental state language, including cognitive-processing and emotion words, appears to be more integrated. Moreover, while thematic coherence seems to be a consistent individual narrative style across valence of event being narrated, mental state language appears to be a consistent style only across the two stressful event narratives. Finally, and quite surprisingly, there were virtually no relations between mothers’ and children's narrative meaning making.     

Types of God Representations and Mental Health: A Person-Oriented Approach

As God representations are multi-facetted psychological processes regarding the personal meaning of God/the divine to the individual, this study examines how multiple aspects of God representations are configured within individuals belonging to a sample of psychiatric patients or a non-patient sample, and how these configurations are associated with mental health. By means of cluster analyses, three types of God representations were found: a Positive-Authoritative one, a Passive-Unemotional one, and, only among psychiatric patients, a Negative-Authoritarian one. Types of God representations were significantly related to affective state, as well as religious saliency and religious background. Patients with the negative type of God representation were more distressed and depressed, and Orthodox-Reformed patients reported significantly more negative types of God representations. This study demonstrates the value of a person-oriented approach, by showing that scale scores became especially meaningful in the context of the types, which enables more nuanced distinctions regarding subgroups.     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病。糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度。因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素。临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治。     

Leadership as a predictor of stigma and practical barriers toward receiving mental health treatment: a multilevel approach

The present research examined positive and negative leadership behaviors as predictors of stigma and practical barriers to mental health treatment. Soldiers completed measures of noncommissioned officer (NCO) and officer leadership, stigma, and practical barriers to getting mental health treatment at 2, 3, and 4 months following a 15-month deployment to Afghanistan. The results revealed that positive and negative NCO and officer leader behaviors were predictive of overall stigma and barriers to care (collapsed across the three time periods), with only NCO positive and negative behaviors being uniquely predictive of stigma when included in the same model with officer behaviors. In addition, negative and positive NCO leader behaviors were predictive of stigma within participants over the course of the three month time period, and positive NCO leader behaviors were inversely related to practical barriers to mental health treatment within participants across the same time period. The results are discussed in terms of how different leader behaviors may be linked to different factors influencing a soldier's decision to seek mental health treatment.