Early Versus Late Onset of Spinal Cord Injury Among the Elderly

The objective of this study is to compare elderly individuals with late (60 years old) versus early (<60 years old) onset spinal cord injury (SCI) across quality of life (QOL) domains for which cross-sectional design was used. The outcome measures selected were secondary medical complications (e.g., pneumonia, autonomic dysreflexia, number of days hospitalized), Functional Independence Measure (FIM), Satisfaction With Life Scale (SWLS), and the Craig Handicap Assessment and Reporting Technique (CHART). Analyses between groups showed that individuals with SCI onset 60 years of age or older were significantly older, had a greater proportion of incomplete lesions, were more likely to have SCI resulting from medical complication, and were less likely to be working. After controlling for differences in demographic and lesion characteristics, the majority of QOL domains were similar between groups. However, overall self-reported handicap (CHART-total score) was significantly greater among elderly with late onset SCI, particularly in the areas of physical independence and social integration. Differences in QOL between elderly with late versus early onset SCI were most prominent in the area of physical independence and social integration. The importance of appropriate statistical control, theoretical implications, and future directions are discussed.     

从耗散理论解读肿瘤的发病及治疗

肿瘤的综合治疗方案,即药物-社会-心理治疗已广泛地应用于临床,虽效果显著,但其机制尚缺乏确切的实验依据。笔者从耗散结构理论来解读这种综合疗法,认为药物、社会及心理治疗均是通过增加机体的负熵,使肿瘤患者的内环境处于有序平衡状态而改善其病情。从耗散理论出发可以将肿瘤的综合疗法更好地应用于临床。     

从耗散理论解读肿瘤的发病及治疗

肿瘤的综合治疗方案,即药物-社会-心理治疗已广泛地应用于临床,虽效果显著,但其机制尚缺乏确切的实验依据.笔者从耗散结构理论来解读这种综合疗法,认为药物、社会及心理治疗均是通过增加机体的负熵,使肿瘤患者的内环境处于有序平衡状态而改善其病情.从耗散理论出发可以将肿瘤的综合疗法更好地应用于临床.     

Body Image and Depression in Women With Early and Late Onset Obesity

Three groups of women (N = 27 in each group) were compared: women of normal weight and asymptomatic for eating disorders (M = 125.5 lb); women with early onset obesity—before 13 years (M = 182.4 lb); and women with adult onset obesity—17 years or over (M = 172.4 lb). Subjects (M age = 40.7 years) were obtained through church and business groups. Body image and depression were assessed, respectively, by three scales of the Body-Self Relations Questionnaire (Winstead & Cash, 1983) and by the Beck Depression Inventory (Beck, 1967). The combined group of obese subjects rated their bodies as less fit than normal weight subjects (p<.01). However, there were no other significant differences between obese and normal weight subjects. Also, no significant differences were found between the early and late onset groups. Results showed that (a) there is a subpopulation of obese women who are relatively satisfied with their bodies and whose psychological adjustment is no different from that of other women, and that (b) an early onset of obesity does not necessarily have more serious psychological consequences than late onset.     

Family Structure and Stress

This report presents an evolving theoretical model of the relationship between normative and severe stresses and a family's organizational structure. It is useful for understanding these processes and for planning treatment intervention for families at several levels of function: competent, dominant-submissive, chronically conflicted, and severely disturbed.     

Alcoholism,Aging, and Cognition: A Review of Evidence for Shared or Independent Impairments

Little is known about the combined effects of aging and alcoholism on cognitive function, in spite of the potential importance of this knowledge. Studies reported to date have focused on whether aging and alcoholism have shared mechanisms (i.e., the premature aging hypothesis) or independent mechanisms. Most have concluded that the effects of aging and alcoholism on cognition operate through independent mechanisms. However, there are reasons to doubt this conclusion. Many of the studies were not optimally designed to discover shared mechanisms because they used a limited range of ages, included several different groups in their analyses, or had low statistical power. Furthermore, interpretation of the patterns of main effects and interactions between aging and alcoholism is not straightforward. Assumptions must be made about the nature of the impairments in order to interpret the data. This review uses several theories of cognitive aging as an organizing heuristic for interpreting the extant data on aging, cognition, and alcoholism. Some potential shared mechanisms for cognitive deficits in aging and alcoholism are identified, such as information processing speed and proactive interference in working memory. In contrast, some potential independent mechanisms are also identified, such as decay from working and long-term memory. These mechanisms should be used as a base to guide necessary further research.     

Alcoholism: A conflict of models

Adherents to the traditional model of alcoholism explain alcoholic behavior as a consequence of alcoholism. Alcoholism is identified as an unseen, unmeasured entity inherent in alcoholics. This concept parallels the thinking of Copernicus, Kepler, Galileo, and Newton, who believed in an unseen, unmeasurable creator behind the physical world. These traditional approaches contrast with the emergent model of alcoholism and twentieth-century scientific thought. Emergent scientific model adherents explain alcoholic behavior without resort to unseen factors. Since the traditional and emergent scientific models begin with different assumptions, model adherents experience communication difficulties. Future developments with determine which model will dominate the field of alcohol studies and treatment.     

Recurrence of Posttraumatic Stress Disorder in Late Life: A Cognitive Aging Perspective

Clinical experience with older adults shows that many will experience PTSD symptoms in older adulthood because of trauma exposure early in life. Some of these patients struggled with PTSD in the distant past and remained symptomfree for decades only to have a recurrence of PTSD in late life. This paper outlines a cognitive aging explanation for the recurrence of PTSD. It is proposed that the age-related decreases in attention make the intrusion of trauma-related memories more likely. The increase in intrusive memories, combined with age-related decreases in working memory, explicit memory, and prospective memory, increases the subjective distress associated with the memories and results in a recurrence of PTSD.     

Alcoholism and incest: Improving diagnostic comprehensiveness

This article is designed to underscore the similarities in characteristics between alcoholic and incestuous family operations. Hopefully, readers will develop a more acute appreciation and understanding of the frequency of occurrence of both of these behaviors in the same family. The author contends that too often alcoholism will be diagnosed, while the incest is diagnostically missed or vice versa. To best insure that recidivism of either the alcohol or incest can be avoided, the author believes it is important to comprehensively diagnose and then treat appropriately.     

语言哲学的基本问题:结构还是生成?——卡西尔与海德格尔对洪堡思想的不同解读

威廉·洪堡对语言的思考,既包括结构方面,也包括生成方面,由此为卡西尔、海德格尔的不同解释提供了依据.     

Experimental and Behavioral Approaches to Alcoholism: Kongressrapport

Hypochondriasis is highly prevalent in medical settings, has detrimental effects for affected individuals, and is associated with high societal costs. Although cognitive behavior therapy (CBT) has been shown to be effective in the treatment of hypochondriasis, it is not widely available because of a lack of properly trained therapists. Therefore, it is essential to evaluate therapy forms that require less therapist time. The authors investigated the effect and economic impact of group CBT delivered in a psychiatric setting among 24 people with hypochondriasis. A within-group design with prolonged baseline was used, and all participants received 10 weeks of group-based treatment. The primary outcome measures were the Health Anxiety Inventory and the Illness Attitude Scales. Results indicate significant improvement on both measures at posttreatment and 6-month follow-up (Cohen's d = 1.03–1.72). Medical and nonmedical costs were substantially lowered. The authors conclude that group-based CBT delivered in a psychiatric setting is an effective and potentially highly cost-effective treatment for hypochondriasis.     

Contemporary Perspectives on Stress Management: Medication,Meditation or Mitigation

Stressful life events can increase the risk for developing a variety of physical disorders and emotional problems. A biopsychosocial approach can help mental health professions to better understand and more effectively treat disorders that are related to severe negative life events. Biological approaches focus on suppressing emotional reactions, usually through a reliance on psychopharmacological interventions. Psychological approaches usually focus on the cognitive processes that translate stress into distress. Psychological interventions focus on changing the negative attitudes and maladaptive behaviors that aggravate most stressful situations. Social interventions focus on improving social support and involvement with agencies to confront limited finances, unemployment, and housing problems. In these times of economic crisis and severe financial hardship, psychological and social intervention strategies appear more useful than biological treatments.     

Neuropsychology: Implications for the Treatment of Alcoholism

The author describes cognitive deficits that are attributable to alcoholism and discusses the prospect for recovery of these impaired skills. Rather than viewing neuropsychological testing simply as a diagnostic exercise, the author considers the potential treatment role of this psychological subspecialty and its implication for alcoholism counselors.     

Alcoholism: etiologies proposed and therapeutic approaches tried

Alcohol, probably the most popular mood-altering drug, has frightening consequences when abused. Genetic factors and sociocultural influences contribute to alcoholic behavior. Study of endocrines, neurotransmitters, and neuropeptides may reveal biological markers to help identify those at risk for alcoholism. Drinking patterns are often based on the expectation of alcohol's mood-altering quality. The focus of treatment has expanded to include not only drinking behavior but also emotional, social, and vocational adjustment. Controlled drinking has proved effective for some, so that complete abstinence is no longer the sole goal of therapy. Behavioral, martial, group and individual, outpatient and inpatient therapy, and drugs as adjuncts, all help some alcoholics, but none is a cure for all. Answers still lag behind questions but researchers have registered some advances that challenge therapists to enlarge therapeutic approaches to fit the multifaceted picture of alcoholism.