唇腭裂序列治疗中的人文关怀

唇腭裂是面部最常见的先天畸形,1996年以来我国出生缺陷监测显示唇腭裂的发生率始终排在前三位.唇腭裂不仅存在面部形态异常,还导致语音、听力、吮吸、心理和社会行为等方面的缺陷,患者自出生起需要接受涉及多个学科的序列治疗.序列治疗显著提高了唇腭裂患者的治疗效果,但我国唇腭裂治疗总体水平与国际先进水平存在较大差距,相关学科的介入也很少,患者及家庭在序列治疗过程中对人文关怀的需求问题日益突出.     

综合医院精神卫生实践方法之UPSCALE查房模型

综合医院精神卫生服务需求非常之高,门诊常见有躯体疾病合并精神心理问题或以躯体症状就诊的心理生理障碍患者。医学分科导致的医学学科割裂正使得各学科在独立处理这些患者时都面临困难。北京协和医院心理医学科魏镜医生探索建立的多学科的、生物心理社会医学模式为理念的、基于以患者为中心的医患关系和访谈模式的UPSCALE查房模型设计用于从形式到内容上都整合地去面对患者这个人和患者的症状,以有效地建立医患关系、实现对患者的有效治疗。其已在临床上显示有效性和可操作性。     

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.     

Alief——影响心血管康复的潜在心理状态

心血管康复是涉及医学评价、处方运动、心血管危险因素矫正、教育、咨询和行为干预等的长期综合治疗程序,以改善心血管病的生理和心理状态,减少再次心肌梗死和猝死的危险,控制心血管症状,稳定或逆转动脉硬化过程和改善患者的心理和职业状态。心血管康复干预具体包括药物治疗、行为干预和心理介入等治疗。其中涉及一系列的心理-行为现象及概念。最近,心理医学领域提出了介于信念和想象的状态——Alief,这一具象派状态可以很好地解释与心血管康复相关的一些心理-行为现象,本文就此作一论述。     

我国医学人文学科建设的现状调查及建议

为了解我国当前医学人文学科的建设状况,自行设计问卷调查了48所独立设制的医药本科院校和设置有医药类专业的综合性高校,41.7%的院校设有医学人文硕士学位授权点、22.9%的院校设有医学人文博士学位授权点,主要研究方向为医学伦理、医学心理、医学哲学等。当前医学人文学科建设存在的突出问题是专业人才队伍薄弱、缺乏高水平的学科平台、学科门类归属不统一等。调查显示,医学人文硕士生、博士生教育开设的医学人文方向杂多、授予的学位门类不统一,大多院校尚未形成自己的医学人文学科特色和优势。建议在医学门类下设立医学人文一级学科,并进一步规范其二级学科的名称及设置,打造高水平的学科平台,提升学科的影响力。     

发展行为遗传学简介

发展行为遗传学是发展心理学与行为遗传学的交叉学科, 旨在探明遗传与环境对人类心理与行为发展是否存在影响, 如何产生影响, 以及该影响及其作用机制是否随年龄增长而发展变化的问题。该学科与行为遗传学在研究对象、设计和内容等方面存在不同; 开展发展行为遗传学研究需要综合运用心理测量法和行为遗传学研究方法; 未来研究应拓宽和深化候选基因与行为关联性的考察, 并着力探析基因与环境的相互作用机制。     

论人文医学学科化:研究对象和基本问题

目前我国人文医学学科化已经完成了外在社会建制的建构,但内在观念建制的建构尚未受到重视。从人文医学的学科使命是引领医务工作者的价值观和医学时代精神的角度看,人文医学的研究对象应该是医务工作者在职业行为过程中实际持有的价值观的生成条件、变化机制和规律以及由医务工作者的职业性社会互动形成的医学时代精神的变化条件、机制和规律。人文医学研究的基本问题应该是怎样改变和引领医务工作者在职业行为过程中实际持有的价值观以及医学的时代精神。     

ADHD儿童的病因、诊断及心理干预

ADHD是儿童常见的心理障碍,临床表现为以多动为主的行为问题,其病因包括各种生理因素和社会心理因素,参照SDM-Ⅳ提出具体的儿童多动症诊断标准,对儿童多动症的心理干预提出了支持性心理治疗、行为治疗、运动和游戏治疗以及认知——行为治疗等具体的策略。现在的发展趋势是系统的和整合的心理干预。     

心理干预在化疗患者中的应用

本研究针对化疗患者常见的恶心呕吐、烦躁不安等副作用．运用心理行为技术．采用病例对照研究方法,对129名化疗患者进行了比较研究。结果为：各项情绪指标和总的情绪状况以及恶心呕吐反应。干预组患者比对照组改善明显;生活质量各指标在组问和组内比较中,有不同程度的改善,角色、社会、认知功能和疼痛症状在两组比较中改善不明显。由此认为,对化疗患者实施恰当的心理行为技术．干预效果是明显的     

综合医院精神医学问题的认识

综合医院精神医学问题涉及面较广,主要是指除精神病外的各种心理障碍与心理应激相关疾病。患者就诊主诉多样化,就诊医院或专科繁多。提高对综合医院精神医学问题的识别能力对临床各科医务人员非常重要。本文对综合医院常见器质性和功能性精神疾病的临床特点、识别处理作一概述。     

The Effects of Emotion Regulation Treatment on Disruptive Behavior Problems in Children: A Randomized Controlled Trial

Research on Child and Adolescent Psychopathology - Disruptive behavior problems are a frequent reason for children’s referrals to psychological services and can have negative effects on...     

Dementia and suicidal behavior

Behavioral and psychological symptoms of dementia, including depression, might complicate the course of the disorder additionally. Dementia is more frequent in older people and suicide rates are higher in later life than in any other age group. To explore the phenomenology of suicidal behavior in patients with dementia, we searched electronic databases and key journals for original research and review articles on suicide in demented patients using the search terms “suicide, suicidal behavior, dementia, Alzheimer disease, and old age”. Although cognitive impairment could result in a diminishing ability to think flexibly and to solve problems or to cope with conflict, in the early stage of dementia such impairments are absent or mild, and suicidal behavior might be expected, especially following diagnosis. In addition, personality changes based on declining cognitive capacity and the neurochemical imbalances described in late-life depression and in dementia may predispose patients to aggressive or impulsive acts, such as suicide attempt. The literature on suicidal behavior and dementia highlights the need for further research in this area.     

Relational Aggression in Mothers and Children: Links with Psychological Control and Child Adjustment

This study assesses associations between mothers’ use of relational aggression with their peers and psychological control with their children, and child adjustment in a sample of fifty U.S. mothers of elementary and middle school children. Mothers completed surveys assessing their relational aggression and psychological control. Teachers completed surveys assessing children’s externalizing behavior, internalizing symptoms, and relational aggression. Results suggest that mothers who are relationally aggressive with their peers are more likely to be psychologically controlling with their children. Results also showed that relational aggression predicted adjustment problems in youth. Relational aggression was associated with externalizing problems among boys and girls, and with internalizing problems among boys. Few gender differences in mean levels of maternal or child behaviors emerged.     

Neighborhood and Housing Disorder,Parenting, and Youth Adjustment in Low-Income Urban Families

Using two waves of data, this study examined relations among neighborhood and housing disorder, parents’ psychological distress, parenting behaviors, and subsequent youth adjustment in a low‐income, multiethnic sample of families with children aged 6–16. Results supported the hypothesized indirect relation between disorder and youth outcomes via parenting processes. Higher levels of neighborhood and housing disorder were associated with higher levels of parents’ psychological distress, which was in turn related to more frequent use of harsh and inconsistent discipline strategies and lower parental warmth. More frequent use of harsh and inconsistent discipline was associated with higher levels of youth internalizing and externalizing behaviors 3 years later. Housing disorder contributed more strongly to parents’ psychological distress than neighborhood disorder, whereas neighborhood disorder contributed more strongly to youth externalizing behaviors compared to housing disorder. Multiple‐group analyses showed that the patterns of relations were similar for younger and older children, and for girls and boys.     

Impact of Social Networking Sites on Children in Military Families

Youth in military families experience a relatively unique set of stressors that can put them at risk for numerous psychological and behavior problems. Thus, there is a need to identify potential mechanisms by which children can gain resiliency against these stressors. One potential mechanism that has yet to be empirically studied with military youth is social networking sites (SNSs). SNSs have gained significant popularity among society, especially youth. Given the significance of these communication tools in youths’ lives, it is important to analyze how SNS use may affect military youth and their ability to cope with common military life stressors. The current review examines the potential positive and negative consequences associated with SNS use in coping with three common stressors of youth in military families: parent deployment, frequent relocation, and having a family member with a psychological or physical disability. By drawing from SNS and military literature, we predict that SNS use can be a positive tool for helping children in military families to cope with stressors. However, certain SNS behaviors can potentially result in more negative outcomes. Recommendations for future research are also discussed.     

攻击性初中生的类别转变：潜在转变分析

研究采用潜在转变分析探讨了攻击性初中生的类别转变。276名初中参加了为期一年的短期纵向追踪研究,在一年中分两次报告了自己的攻击行为。用潜在转变模型分析了初二到初三时青少年的攻击类别转变,结果表明初中生有三种攻击模式。研究以潜在转变模型进一步探究了这三种攻击模式的变化,结果发现两种模式具有很强的稳定性,不同模式之间也有一定程度的转变。最后,研究探讨了攻击类别转变的影响因素,结果表明性别与友谊质量可以起到显著作用。针对实际意义,文章最后进行了讨论和总结。     

The Peer Informant: Characteristics Related to the Perceptions of Peer Behavior Problems

Victimization and rejection by peers leads to and exacerbates behavior problems in children and adolescents. Given the implications of problematic peer relations for adolescents who experience behavior problems, the present study examined factors that may be related to how adolescents perceive peers who exhibit such problems. Specifically, the present study examined the relationship of adolescent informants’ socioeconomic status, their prior exposure to psychological symptoms, their perceived social acceptance, and their own behavior problems to their perceptions of peers’ internalizing and externalizing behavior problems, their liking and disliking of peers who exhibit such problems, and their attributions for the etiology of such problems when portrayed by fictitious peers of the same age. In particular, adolescents were asked to rate a set of vignettes portraying internalizing and externalizing behavior problems that are seen commonly in peers and to complete a set of brief questionnaires. Results revealed that adolescents were able to perceive the presence of both internalizing and externalizing behavior problems in vignette characters. Additionally, vignette characters who did not exhibit behavior problems were most likely to be approached and liked, whereas those vignette characters who displayed externalizing behavior problems were more likely to be disliked and ignored. Finally, although adolescents endorsed both internal and external etiological factors, ratings were related to the sex of the depicted vignette character and the nature of the portrayed behavior problems. Overall, this study provided additional evidence that, although adolescents can serve as valuable informants, they also tended to be rejecting of peers who display behavior problems.     

Behavioral and Emotional Problems on the Teacher’s Report Form: A Cross-National,Cross-Clinic Comparative Analysis of Gender Dysphoric Children and Adolescents

For gender dysphoric children and adolescents, the school environment may be challenging due to peer social ostracism and rejection. To date, information on the psychological functioning and the quality of peer relations in gender dysphoric children and adolescents has been studied via parental report, peer sociometric methods, and social interactions in laboratory play groups. The present study was the first cross-national investigation that assessed behavior and emotional problems and the quality of peer relations, both measured by the Teacher’s Report Form (TRF), in a sample of 728 gender dysphoric patients (554 children, 174 adolescents), who were referred to specialized gender identity clinics in the Netherlands and Canada. The gender dysphoric adolescents had significantly more teacher-reported emotional and behavioral problems than the gender dysphoric children. In both countries, gender dysphoric natal boys had poorer peer relations and more internalizing than externalizing problems compared to the gender dysphoric natal girls. Furthermore, there were significant between-clinic differences: both the children and the adolescents from Canada had more emotional and behavioral problems and a poorer quality of peer relations than the children and adolescents from the Netherlands. In conclusion, gender dysphoric children and adolescents showed the same pattern of emotional and behavioral problems in both countries. The extent of behavior and emotional problems was, however, higher in Canada than in the Netherlands, which appeared, in part, an effect of a poorer quality of peer relations. Per Bronfenbrenner’s (American Psychologist, 32, 513–531, 1977) ecological model of human development and well-being, we consider various interpretations of the cross-national, cross-clinic differences on TRF behavior problems at the level of the family, the peer group, and the culture at large.     

Improved Parental Emotional Functioning After Circle of Security 20-Week Parent–Child Relationship Intervention

This study examined the effectiveness of the attachment-based Circle of Security 20-week intervention (COS) in improving parent emotional functioning in 83 families referred to a community clinical service with concerns about their young children’s behavior. Parenting stress and parent psychological symptoms were assessed pre and post intervention and mixed design repeated measures ANOVAs were used to assess change. Severity of presenting problems was considered as a moderator. Results showed clinically significant improvements in both aspects of parent emotional functioning, with changes accounted for by for those with more severe problems at the outset. Improvements for parents were associated with improved child behavior and more positive parent representations of the child and of parenting capacity. Findings suggest the intensive COS intervention is effective in reducing parenting stress and psychological symptoms in parents of children from aged 1–7 years. Questions remain about the mechanisms of change and the direction of effects.     

父母心理攻击与小学中高年级儿童问题行为的关系：儿童愤怒和悲伤管理的中介作用

以660名小学中高年级儿童及其父母为被试,采用问卷调查法探讨父母心理攻击与学龄中期儿童内外化问题行为之间潜在情绪机制的差异。结果发现：（1）父亲心理攻击显著正向预测儿童外化问题行为,母亲心理攻击显著正向预测儿童内化问题行为;（2）儿童愤怒失调在父亲和母亲心理攻击和儿童外化问题行为之间起中介作用,儿童悲伤失调在母亲心理攻击与儿童内化问题行为之间起中介作用,儿童愤怒应对在母亲心理攻击和儿童内外化问题行为之间存在中介作用。结果表明,父母心理攻击影响儿童内外化问题行为的情绪机制因儿童自身情绪类型与管理策略的不同而表现出差异性。