社会焦虑与精神疾病--社会焦虑致抑郁性自杀现象透视

社会焦虑是指在社会成员中普遍存在着的一种心理紧张状态.社会焦虑现象容易导致社会成员的关系紧张,不利于社会人群的心理健康并促使社会问题的产生和恶化.因此,遏制社会焦虑利于有效防止精神疾病的发生和社会的安全运转.     

心内科处理心理障碍患者治疗方案的可行性分析

为了探讨在心内科治疗心理障碍患者的可行性,我们应用汉密尔顿量表评估400例到心内科就诊的患者,对诊断为焦虑或抑郁状态的患者分为两组（心内科干预组,心理科治疗组）,随访半年,观察焦虑或抑郁状态的缓解情况。结果显示,本研究共入选符合心理障碍诊断者71例,占就诊人数的17．75％。到心理科治疗患者30例,在心内科门诊治疗患者41例,半年随访评估,治疗有效率分别为16．7％和79．4％（16．7％vs79．4％,P〈0．05）。因此,在心内科门诊对就诊的心理障碍患者进行治疗,是一种可行的方案。     

慢性疼痛与心理障碍

疼痛是一种复杂的心理生物学过程。疼痛的感知和情绪活动密不可分,疼痛是一种包括感觉、情绪和认知的多维性体验,人与人之间差异很大,甚至同一个体也随疼痛的背景、意义以及心理状态而异。认知因素和情感因素对疼痛感知具有非常重要的影响。本文回顾疼痛认知和情感状态调节（身心治疗的重要组成部分）潜在的神经学机制。回顾慢性疼痛本身会改变大脑环路、包括参与内源性疼痛调节的循证证据,这些证据表明随着疼痛转为慢性,控制疼痛越来越困难。     

Lived Experiences of Men With Dissociative Identity Disorder

Dissociative disorders affect 29% of the clinical population, with women diagnosed 9 times more often than men. For this study, the authors used a phenomenological approach to uncover experiences of 5 men with dissociative identity disorder. Findings revealed 5 themes: history, alters, male gender expectations and identity, challenges, and strengths and support. Implications for practitioners are discussed.     

青少年精神障碍者日常生活实践的失序与重塑

以日常生活世界为分析视角,通过半结构式访谈的方法收集资料,深描曾患精神障碍青少年的日常生活实践,发现他们要面对生活的失序,包括带病生活日常化、家庭系统受损和社会失能与污名等生物性与社会性的困境叠加,揭示了对精神障碍群体的排斥从制度文化延伸到了日常生活。同时,精神障碍青少年通过个体的韧性坚持、家庭关怀保护、社会链接赋能等策略“正常化”生命历程,实现主体性重塑。最后提出利用自我决定、社会关系协调等优势视角帮助青少年精神障碍者重整日常生活实践。

     

大一新生网络心理问题调查研究

采用自编网络心理问卷研究了669名大一新生在情绪反应、动机冲突、现实疏离、躯体症状四个维度上的性别、家庭来源、家庭气氛、父母教养方式上的差异。结果表明．大一新生网络使用的负性心理总体上不严重;在情绪反应和现实疏离上存在极其显著的家庭气氛主效应;在动机冲突和躯体症状上存在极显著的家庭气氛与父母教养方式交互作用。     

延长哀伤障碍的概念、流行病学和病理机制

延长哀伤障碍是一种由亲近的人去世引发的病理性哀伤反应, 即死亡发生6个月后, 个体对死者的想念影响到了生活各方面, 且社会功能受损, 其最近20年才开始受到临床心理学研究者关注和探讨。本文首先回顾了概念提出及后续发展, 并讨论了其与持续性复杂哀伤相关障碍的区别与联系。随后, 本文综述了其独立的诊断标准、评估工具和流行病学调查、以及与正常哀伤、抑郁症和创伤后应激障碍的区别。接下来, 本文对其病理机制的理论思考和实证研究进行了讨论。最后, 本文指出未来可考察诊断标准的跨文化适用性、丰富病理机制的理论与研究。     

关于大学生心理障碍干预模式的理论建构

本文在已有研究的基础上,根据大学生心理发展与心理素质的特点和不同心理学派的理论观点建构了大学生心理障碍干预模式,该模式由多维系统的干预途径、多样渗透的干预方法、丰富全面的干预工作内容和完善化人性化的干预机制组成,它们之间的关系既是独立的,又是相互协调和影响的。体现了大学生心理障碍干预模式的系统完整性及实施干预的灵活多样性和明确针对性。     

网络游戏成瘾研究的争议及趋势

网络游戏成瘾(Internet Gaming Disorder, IGD)是否能被确认为独立的精神障碍?目前的争议来自三个方面:概念上难以明确IGD与正常游戏行为,其他精神障碍之间的差异, 且上瘾对象仅为网络游戏或包含线下游戏并不明确; 鉴定标准上DSM-5总结的9条标准没能刻画IGD的本质特征, 现行的18种诊断工具在内容,诊断阈限等方面参差不齐; 研究方法上缺乏理论支撑, 过分依赖问卷数据, 忽视电子游戏的积极作用.争议内容体现出研究者对网络游戏行为本身缺乏理解, 因此难以判断正常与异常的游戏行为.未来研究应考虑回退到对网络游戏行为的研究, 对网络游戏类型特点,影响网络游戏行为的各因素以及电子游戏的积极贡献做深入探讨, 以达到从本质上明确网络游戏成瘾的特质.     

青少年网络成瘾人格特征研究

本研究采用问卷调查法,对某初级中学363名初中生的网络成瘾状况与人格特征进行研究。结论表明:初中生网络成瘾检出率为5.79%;初中生在网络成瘾存在性别差异,男生比女生更易成瘾。网络成瘾学生与非成瘾学生在《卡特尔十四种人格因素问题》中的忧虑性、自律性、适应性与焦虑性、孤独倾向、身体症状和冲动倾向等因子上差异显著。与非成瘾学生相比,成瘾学生的自制能力较差,成瘾学生可能更经常体验到孤独、焦虑和不满,并且在生活中较容易出现适应不良现象。     

Exploring the Psychological Foundations of Ideological and Social Sorting

Americans are sorting ideologically: Liberals and conservatives are more likely to respectively identify as Democrats and Republicans. They are sorting socially as well: Partisans like and trust copartisans more than opposing partisans. Existing explanations for these phenomena rely on exogenous factors, such as elite polarization. But exogenous explanations cannot fully explain variation in sorting. We argue that psychological characteristics can help explain the tendency to sort ideologically or socially. Specifically, we investigate an individual’s responsiveness to internal values versus normative social pressures as a determinant of sorting. We test this theory with several nationally representative surveys, as well as one survey experiment, and find strong support that an individual’s own tendency to respond to social cues, as opposed to ideological values, has important consequences for this process. Our work allows for a better understanding of the psychological factors that promote partisan sorting and for interpreting variation in the degree to which citizens sort into partisan groups.     

Perinatal Posttraumatic Stress Disorder: Implications for Occupational Therapy in Early Intervention Practice

The purpose of this article is to present literature regarding perinatal posttraumatic stress disorder and to describe the implications of research findings for occupational therapy screening and treatment in early intervention practice. Changes in legislation regarding early intervention practice and family centered care are presented as a rationale for including maternal mental health screening as a standard practice in the field of early intervention. A case study illustrates symptoms of perinatal posttraumatic stress disorder and the effect on maternal-infant co-occupational engagement. The Model of Human Occupation is used to guide clinical reasoning about potential occupational therapy interventions.     

Test of Alternative Hypotheses Explaining the Comorbidity Between Attention-Deficit/Hyperactivity Disorder and Conduct Disorder

There is significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). The conclusions of studies that examined the causes of comorbidity between ADHD and CD conflict, with some researchers finding support for the three independent disorders model and others finding support for the correlated risk factors model. We tested these models and eleven alternative hypotheses using the same analytical approach. The participants were 110 monozygotic twin pairs and 181 dizygotic twin pairs recruited from the Colorado Learning Disabilities Research Center Twin Study. The three independent disorders model did not fit the data, whereas the correlated risk factors model fit the data well. Several other comorbidity models fit the data as well as or better than the correlated risk factors model. The results suggest that correlated risk factors are a better explanation for the comorbidity between ADHD and CD than a third, independent ADHD+CD subtype.     

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.     

R．D．莱因对传统精神疾病诊疗观的变革

传统的精神疾病诊断以一种经验式的分类手册来诊断精神疾病,而莱因主张从存在主义——现象学的视角来理解精神疾病,认为家庭或社会才是精神疾病的真正来源。在精神疾病的治疗方面,莱因主张通过改变患者的生存环境来促使其进行自我恢复。莱因的思想推动了当代精神病学的变革与发展,具有重要的现实意义。     

Treatment Adherence Among War Veterans with Posttraumatic Stress Disorder: A Concept Analysis

Aim: This study was made to analyze the concept of treatment adherence among war veterans who suffer posttraumatic stress disorder.

Methods: This concept analysis was done using Walker and Avant’s concept analysis model. Online English and Persian databases were searched using keywords such as “posttraumatic stress disorder,” “mental disorder,” “compliance,” and “adherence.” Finally, 11 eligible documents were included in the analysis. The retrieved articles were perused word-by-word, line-by-line, and paragraph-by-paragraph in order to arrive at an in-depth understanding about their contents. Then, the obtained excerpts from the articles, which were relevant to the study subject matter, were coded. The codes were then grouped into the antecedents, consequences, and attributes of the concept.

Findings: In total, 122 primary codes, 19 subcategories, 8 main categories, and 4 main themes were extracted. The main antecedents of the treatment adherence concept are patients’ personal health background and the attributes of posttraumatic stress disorder and its treatments while its main outcome is the changes in the quality of life. Moreover, the main attribute of adherent veterans is that they take responsibility for their own health and subsequently attempt to plan for health promotion.

Conclusion: The concept of treatment adherence among war veterans who suffer from PTSD is a complex and relative concept which depends on patients’ personal health background as well as the attributes of the afflicting disorder and its treatments. The concept is manifested by patient’s attempts to plan for receiving or parting with treatments and can result in changes in health-related quality of life.     

Understanding the Covariation Among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder,Attention Deficit Hyperactivity Disorder,and Oppositional Defiant Disorder Symptoms

Conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) are common childhood externalizing disorders that frequently co-occur. However, the causes of their comorbidity are not well understood. To address that question, we analyzed data from > 600 Finnish twin pairs, who completed standardized interviews at age 14. Behavior genetic methods were used to examine how genetic/environmental factors contribute to each disorders symptoms and to their covariation. We found significant genetic effects on each disorder with only modest evidence of shared environmental influences. Our data suggest the comorbidity among CD, ADHD, and ODD is primarily explained by shared genetic influences; however, each disorder was also under unique genetic influence, supporting the distinction of each disorder.     

Daily Occupations and Adaptation to Daily Life Described by Women Suffering from Borderline Personality Disorder

Clients suffering from Borderline Personality Disorder have significant impairments in relation to health. Despite this, their occupational status is rarely described. The aim of this study was to examine how women with Borderline Personality Disorder describe their daily occupations and adaptation to daily life. The study included nine participants. The data were collected using a semi-structured interview and were analyzed using content analysis.

Theme: Having few organized daily activities and poor personal causation prevent changes in adaptation to daily life. Two categories: performance and self-image, and four subcategories: competent or incompetent to perform, positive self-image, and lack of self-image were identified.     

Mental Contamination in Obsessive-Compulsive Disorder: Associations With Contamination Symptoms and Treatment Response

The most common symptom of obsessive-compulsive disorder (OCD) is contamination fear. Feelings of contamination can be provoked through contact with a physical contaminant, referred to as contact contamination (CC), as well as in the absence of one, referred to as mental contamination (MC). Prior research indicates that CC and MC are distinct, and MC may interfere with treatment for CC. However, no study to date has examined how MC may be associated with responses to physical contaminants and treatment response for CC. This study examined the relationships between CC and MC in a sample of individuals with elevated contamination symptoms (N = 88), half of whom met diagnostic criteria for OCD. Participants engaged in three sessions of exposure and response prevention (ERP) for CC and completed self-report measures and behavioral tasks assessing CC and MC at pretreatment, posttreatment, and follow-up. As hypothesized, at pretreatment, MC was positively associated with reactivity to physical contaminants, even after participants washed their hands. ERP for CC was associated with unique changes in CC and MC across self-report and behavioral measures, and greater pretreatment MC predicted greater posttreatment CC, though this effect was evident in only one of two CC measures. Additionally, specificity analyses indicated changes in MC were independent of changes in disgust propensity, a related construct. Pretreatment disgust propensity also predicted treatment outcome, though the addition of pretreatment disgust propensity as a covariate reduced the relationship between pretreatment MC and posttreatment CC to nonsignificance. Results suggest MC plays an important role in the manifestation and treatment of CC symptoms and may represent a manifestation of disgust proneness. Theoretical and clinical implications are discussed.