综合性医院中抑郁症患者述情障碍与躯体化症状的研究

1　前言　　综合性医院就诊者中心理障碍患者占 2 4 % ,其中抑郁症为 1 0 4 %。一部分抑郁症患者具有明显的躯体化症状 ,多以躯体病就诊 ;一部分抑郁症患者不具有明显的躯体化症状 ,以情绪障碍症状为主诉。国内已对心身疾病、神经症、物质依赖的抑郁症患者述情障碍进行研究 ,我们进一步研究抑郁症患者述情障碍与躯体化症状之间的关系。述情障碍 (ａｌｅｘｉｔｈｙｍｉａ)主要表现为对情绪状态描述困难 ,少幻想和实用性思维方法 ,人际关系僵化。述情障碍者难以区别情绪状态和躯体感觉 ,描述躯体不适较多 ,因为他们常过分关注自己的躯体感受 …     

躯体形式障碍的社会心理学分析

本研究对躯体形式障碍患者的社会心理特点进行调查分析.按照中国精神障碍分类与诊断标准第3版（CCMD-3）,试验组躯体形式障碍患者51例,在社区分层抽样51人作为对照组,用防御方式问卷、多伦多述情障碍量表进行测量.试验组不成熟型防御方式明显高于对照组,成熟型防御方式低于对照组,差异有统计学意义;述情障碍总分高于对照组,差异有统计学意义.情绪表达障碍、不成熟心理防御方式和社会文化因素共同作用形成了躯体形式障碍发病机制中的社会心理原因.在预防与治疗中需加强心理干预,以有效预防疾病的发生和提高治疗效果.     

高述情障碍者的情绪图式特征

采用混合实验设计,以情绪词和情绪图片为实验材料,选取不同述情障碍得分的大学生为被试,通过三个实验考察了高述情障碍者的情绪图式特征。研究结果发现：（1）高述情障碍组被试对情绪词的效价判断反应时显著长于低述情障碍组,述情障碍各维度得分均与情绪词的效价判断反应时呈显著正相关;（2）高述情障碍组被试对情绪图片的效价判断反应时与低述情障碍组相比差异不显著;（3）高述情障碍组被试情绪图式联结所需反应时显著长于低述情障碍组,情感描述困难与情绪图式联结所需反应时之间相关显著。研究结论如下：高述情障碍者存在情绪语言图式和参考性链接上的缺陷,而在情绪意象上并不存在积极/消极区分能力方面的缺陷     

高述情障碍者的信息选择特征

目的:探讨高述情障碍者在信息选择中表现出的注意偏向。方法:以各类颜色词为实验材料,由40名大学生(高述情障碍组被试20名,低述情障碍组被试20名)完成情绪Stroop任务。结果:低述情障碍组被试对情绪词的颜色判断反应时显著长于中性词和疾病关联词,高述情障碍组被试对疾病关联词的颜色判断反应时显著长于情绪词和中性词;述情障碍各维度得分均与情绪词的颜色判断反应时呈显著负相关,与疾病关联词的颜色判断反应时呈显著正相关。结论:高述情障碍者存在信息选择上的注意偏向,具体表现为注重生理信息而忽略情绪信息。     

心理咨询的述情障碍及相关对策

心理咨询过程中述情障碍的存在,不仅引起主客双方信息交流渠道的堵塞,而且直接影响咨询服务的效果。从心理方面分析发现,心怀敌意、情绪不稳定和心理定势及意志疲竭是产生述情障碍的重要因素,并相应提出消除障碍的心理对策。     

中学生述情障碍与心理健康的关系

目的调查中学生述情障碍状况,探讨中学生述情障碍与心理健康的关系。方法采用多伦多述情障碍量表(TAS-20)和抑郁-焦虑-压力量表(DASS-42)对666名中学生进行测查分析。结果 1当前中学生述情障碍状况处于中等偏下水平;2学生述情障碍总体水平在是否独生子女、家庭关系感知、年级上存在显著差异,但在性别上差异不显著;3中学生述情障碍与心理健康状况存在极其显著的相关,述情障碍对心理健康状况存在预测效应。结论述情障碍在一定程度上可预测中学生负性情绪的多少,并进一步影响其心理健康状况。     

临床共情与护理技术结合:人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

临床共情与护理技术结合：人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

述情障碍成因的认知及社会机制

对述情障碍本质和形成原因的解释主要包括认知机制和社会机制两种, 认知机制认为, 述情障碍体现了在情绪认知加工上的缺陷, 主要涉及到情绪图式、心理理论和执行功能等方面; 社会机制认为, 述情障碍的产生与儿童早年的一些经历有关, 并在社会文化和社会关系中得到不断的强化, 主要涉及到社会文化、社会经济地位和家庭功能及环境等方面。未来研究要把研究视角进一步扩展到热执行功能、整合研究、提出系统的社会机制理论等方面, 在研究方法上, 注意测量工具和研究技术的进一步改进。     

父母述情困难与儿童行为问题:父母心境的中介作用

采用整群抽样法选取438名学前儿童及其家长为被试, 通过量表考察父母述情困难、心境与儿童问题行为之间的关系。结果发现:(1)父亲述情困难与儿童焦虑害羞行为显著正相关, 父亲情绪愉悦在其述情困难与儿童焦虑害羞行为之间具有完全中介作用;(2)母亲述情困难与儿童愤怒攻击、焦虑害羞行为显著正相关, 同时母亲的情绪波动在其述情困难与儿童愤怒攻击行为之间起着部分中介作用。研究结果说明述情困难风险较高的父亲, 其情绪愉悦水平也相对较低, 进而导致儿童表现出更多焦虑害羞行为;述情困难风险较高的母亲, 一方面会直接导致儿童表现出较多愤怒攻击与焦虑害羞行为, 另一方面又会通过其情绪波动增加儿童出现愤怒攻击行为的风险。     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

The Possibility of Meaning in Human Evolution

Science undermines the certitude of non-naturalistic answers to the question of whether human life has meaning. I explore whether evolution can provide a naturalistic basis for existential meaning. Using the work of philosopher Daniel Dennett and scientist Ursula Goodenough, I argue that evolution is the locus of the possibility of meaning because it has produced intentionality, the matrix of consciousness. I conclude that the question of the meaning of human life is an existentialist one: existential meaning is a product of the individual and collective tasks human beings undertake.     

Phenotypic plasticity and archetype: a response to common objections to the biological theory of archetype and instinct

Since Jung’s death in 1961, scholars have attempted to integrate growing biological science data into Jungian concepts such as the collective unconscious, instincts and the archetypes. This enterprise has been challenging due to persistent false dichotomies of gene and environment occasionally arising. Recent works by Roesler (2022a, 2022b) for example, have raised objections to the biological theory of archetypes, but the objections are plagued by such dichotomies. The concept of phenotypic plasticity, however, helps to both avoid this problem as well as bridge the gap between competing theories into a more integrated model with solid biological foundations.     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

Kann Es Ein Argument Für Den Skeptizismus Geben? Das Epistemische Problem Der Irrtumsmöglichkeit

Summary  Is there any argument for scepticism? The epistemic problem of the possibility of error. Arguments for scepticism rest on the assumption that knowledge claims are fallible. For this reason the concept of knowledge appears to be questionable. Since it is necessary to distinguish doubts from possible doubts, the arguments for scepticism appear to be unconvincing. If we take it into account that we know something that is immune to doubt, we should draw the conclusion that, contrary to scepticism, knowledge claims have to be compatible with being fallible. Thus any knowledge claim is capable of being doubted.     

The transcendent function in Spitteler’s Prometheus and Epimetheus

In August 2020, John Beebe and Steve Myers met via Zoom to discuss their differing interpretations of psychological typology and the different sources within Jung’s writings that influenced their books: Integrity in Depth: Energies and Patterns in Psychological Type (Beebe), and Myers-Briggs Typology vs Jungian Individuation (Myers). The discussion centred on Spitteler’s epic poem Prometheus und Epimetheus, which forms the basis of chapter V of Psychological Types. This is both the largest chapter and one of two chapters that Jung highlighted in the Argentine foreword as containing the essence of the book. Jung’s book is primarily about the transformation of personality rather than the categorization of people. Although it contains a critical psychology that deconstructs the nature of consciousness, that is only one half of the book and a stepping-stone to the other half, which is the reconciliation of opposites with particular emphasis on the relation of consciousness and the unconscious. Jung assumed that readers were already familiar with Prometheus und Epimetheus, an understanding of which sheds light on the nature of the transformation that Jung described – the development of a new attitude towards attitude itself.     

Chapter 6: Biblical Foundations for a Practical Theology of Aging

SUMMARY

This article reviews Biblical sources pertaining to the elderly, particularly the frail elderly. Founded on these sources, implications for elderly with Alzheimer's Disease and other forms of dementia are addressed through a personal perspective informed by writings of Christian mystics.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.