心理预防概念的更新及其对实践的指导意义

继Caplan的“公共卫生预防模型”之后,Gordon提出另一个综合性预防模型;美国国家科学院医学研究所绘制了“心理健康干预光谱”; 美国国家研究所和国家科学院医学院则进一步将“心理健康促进”正式纳入心理预防概念。“心理健康促进”是针对消极被动的传统预防而提出的积极主动的预防。心理预防概念的发展与更新,特别是将“心理健康促进”纳入心理预防体系,要求树立预防的全局观念,提高预防的针对性,将消极心理预防与积极心理健康促进结合起来。     

A model for the description and interpretation of suicide prevention.

Views about suicide prevention are based on underlying beliefs about the origins of problems and basic concepts about humankind. These implicit theories have an effect on prevention practices. Making these views explicit is one of the keys for the further development of suicide prevention. In this study a paradigm for analyzing suicide prevention of means of a coding frame and interpreting findings by means of theoretical models of prevention was elaborated. The analysis was based on empirical data consisting of definitions of prevention given by psychologists (N = 34) participating in the national suicide prevention project in Finland. The study demonstrates that suicide prevention can be differentiated at the operational level by means of the analysis method generated. Moreover, the findings can be interpreted according to theoretical criteria. Views expressed by the psychologists seemed to correspond largely to central features of current prevention models. Furthermore, the data can be seen to serve as an empirical validation of these models. Suicide prevention proved to be a multifactorial concept manifesting mainly process theory and interactional explanations of suicidality, and prevention practices fell into a simple typology of four categories.     

Suicide across the Life Span: Pathways to Prevention

As reflected in a recent series of highly visible suicide awareness and prevention activities, the call for a comprehensive suicide prevention strategy has never been stronger, nor more unified. Using the framework provided by the transactional model of human development, the author illustrates the central implications that a developmental perspective has for suicide prevention, emphasizing the need to consider multiple pathways to prevention, to place renewed emphasis on prevention strategies that have their impact earlier in the life course and earlier in the course of mental disorder, and to collaborate with prevention specialists and advocates in related fields.     

Optimism, promotion pride, and prevention pride as predictors of quality of life

The relationship between optimism and two potential sources of optimistic beliefs--promotion pride (based on a history of success in promotion regulation) and prevention pride (based on a history of success in prevention regulation)--was explored. Optimism was more strongly related to promotion pride than prevention pride (controlling for neuroticism), consistent with past work showing that anticipating success increases eagerness motivation but decreases vigilance motivation. This suggests that the psychology of prevention regulators is not captured well by the existing literature on optimism. Although prevention pride does not predict self-reports of well-being, it does predict adaptive functioning independent of optimism, neuroticism, and promotion pride. Promotion pride uniquely predicted a sense of purpose in life or goal directedness. Both promotion and prevention pride predicted active coping. It is argued that promotion and prevention pride tell us something unique and important about the role of successful self-regulation in determining quality of life.     

Prévention du suicide de la personne âgée : la place des interventions communautaires

Although elders’ social isolation has been a topic of interest for public policies in the recent years, its prevention, specifically in relation to suicide prevention, has not stimulated the interest of researchers, yet. This paper present the results from a literature review aiming to identify the actions in elders’ suicide prevention. From the 425 initial papers identified on elders’ suicide prevention, only 57 describe “actions” in suicide prevention, 47 of which are actions targeting individuals, with psychological, psychiatric or psychotherapeutic interventions. Only eight researches integrate the social environment as a facilitator for suicide prevention. We discuss the particularity of this field, the limits of an individual-centred approach, and the interests of community, integrative interventions.     

Community-Based Prevention Support: Using the Interactive Systems Framework to Facilitate Grassroots Evidenced-Based Substance Abuse Prevention

The community plays an important role in the success of substance abuse prevention efforts. However, current funding structures and a focus on limited approaches to prevention delivery have created a large gap between what substance abuse prevention professionals practice and what the community at large knows about prevention. The concept of “community” has not always been well‐defined in the field of prevention, and there are few mechanisms to engage grassroots community members in evidence‐based substance abuse prevention. This article explains how Wandersman et al.'s (Am J Community Psychol 41:171–181, 2008) Interactive Systems Framework can be applied to grassroots prevention efforts. The authors describe a Community Prevention Support System that collaborates with the Professional Prevention Support System to promote the adoption of evidence‐based substance abuse prevention practices at the grassroots, community level. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Flooding as a function of shock level and length of confinement

In a one-way avoidance learning situation with rats, response prevention trials facilitated extinction as an increasing function of the duration of the prevention interval for shock levels below 1.8 mA. For 1.8 mA, extinction was a nonmonotonic function of the response prevention interval, with 15- and 210-sec durations showing the most facilitation of extinction. For all response prevention intervals except 15 sec, trials to extinction was a direct function of shock level. For 15 sec, it was an inverse function of shock level. The unexpected interaction of shock level with prevention interval was explained by invoking the concept of relief.     

Moving From Efficacy to Effectiveness in Eating Disorders Prevention: The Sorority Body Image Program

Although eating disorders prevention research has begun to produce programs with demonstrated efficacy, many such programs simply target individuals as opposed to engaging broader social systems (e.g., schools, sororities, athletic teams) as participant collaborators in eating disorders prevention. Yet, social systems ultimately will be responsible for the real-world delivery of eating disorder prevention programs, suggesting that an important issue has yet to be addressed. Namely, it is unclear to what degree efficacious individual-focused eating disorder prevention programs remain effective when incorporated into critical social systems under real-world conditions. Over the past 5 years, we have collaborated with the campus sororities in the development of a sustainable eating disorders prevention program that is based on the prevention efficacy literature. This paper describes both challenges and helpful strategies that we encountered in tailoring an evidence-based eating disorders prevention program to the needs of a relevant social system.     

Preferences for suicide prevention strategies among university students in Japan: a cross-sectional study using full-profile conjoint analysis

In Japan, implementation of suicide prevention policies is mainly supported by public funds. However, it is unclear what kinds of suicide prevention strategies people prefer. We conducted a survey to clarify people’s preferences regarding suicide prevention strategies adopted in Japan. This was a cross-sectional self-administered questionnaire survey. Participants were recruited through a lecture held by the first author at their university. We distributed questionnaires to 324 people present at the lecture; 249 completed questionnaires were included in the final analysis. We estimated suicide prevention strategy preferences using full profile conjoint analysis. For all six prevention strategies, the inclusion of each strategy in the policy profile was statistically significantly related to the positive evaluation of the overall policy profile. Marginal Willingness to Pay (MWTP) for restriction of access to means showed the highest value of the six suicide prevention strategies. MWTP was the lowest for public awareness activities. Preferred suicide prevention strategies in Japan are restriction of access to means and enhancement of psychiatric services. The results of this study indicate the strategies that are preferred have a high level of evidence of suicide prevention and do not directly intervene in a person’s free will to die by suicide.     

Multinational efforts in substance abuse prevention

This article is a review of the world-wide efforts of clinicians and researchers in the area of diagnosis, treatment, and prevention of multiple substance abuse. Represented are studies in cross-cultural prevention research and substance abuse which address the new and burgeoning area of clinical prevention research from a multidisciplinary perspective. The article also discusses the theory and methods in prevention in New York City, Israel, Italy, Spain, and in Cali, Columbia. The authors hope that this information will result in greater recognition for the need to understand effective measures of drug prevention, and to develop new research directions which shall enrich and enhance our present state of knowledge in substance abuse prevention programming.     

Embedding prevention services within systems of care: Strengthening the nexus for children

System-of-care models that offer a continuum of integrated mental health services for children are being widely implemented in local communities. Preventive services, arising from the theoretically grounded prevention sciences, are an important but neglected component of this model. Studies of the use of mental health services by children are reviewed, and an integrative model is proposed to incorporate prevention services as a component of the child mental health service system. Construction of the prevention sciences has followed a linear phase model that has advantages and disadvantages for bridging prevention sciences and services research. As prevention science progresses into broader field tests of its effectiveness, studies of child services can be informative, especially in advancing the applicability and dissemination of research findings. Future directions are outlined to strengthen the nexus between services research and prevention science, and to construct a new genre of prevention services research.     

Two pathways to prevention

Health promotion and disease prevention programs are becoming important components of contemporary health care. There are at least 2 pathways to the enhancement of population health status through disease prevention. The first pathway requires the early diagnosis and treatment of disease. The second pathway promotes healthy lifestyles and disregards the requirement that a condition must be diagnosed before intervention is recommended. Data from several evaluations suggest that prevention efforts that rely on diagnosis have produced somewhat limited benefits, whereas primary prevention efforts may have substantial benefits. Current health policy places greater emphasis on secondary prevention. The objectives of improved population health might be better achieved by devoting relatively more resources to primary prevention through the promotion of healthy behaviors.     

哮喘教育和管理工作中的一些新的启示与思考

简要叙述了目前哮喘防治中存在的问题,提出必须彻底转变哮喘防控模式,简单介绍了我们自己的哮喘教育和管理的具体做法及其效果,最后就哮喘的防控和管理提出一些值得思考的问题,包括建立和谐医患关系,减轻医疗经济负担,建立新型疾病防控模式和医疗服务体系等。     

Practicing school psychologists' perceived role in prevention of school violence

School psychologists have been called upon to take a leadership role in school-violence prevention, but little is known about their involvement in this issue, especially in states where school shootings have occurred. The current study surveyed 258 Michigan school psychologists about their role in prevention of school violence. Analysis suggested respondents felt prepared to address violence prevention but do not have a leadership role and are not sought for advice about prevention. The number of annual special education evaluations was significantly associated with frequency of being sought for advice on violence prevention but was not related to perceptions of leadership or preparedness. Modest relationships were noted between feeling prepared, knowledge of risk factors, and self-perceptions of a leadership role. Suggestions for research are included.     

Promoting Science-based Approaches to Teen Pregnancy Prevention: Proactively Engaging the Three Systems of the Interactive Systems Framework

In the field of teen pregnancy prevention many efficacious prevention programs are available but adoption of these programs is slow at the community level. In this article, we present a multi-site, capacity-building effort called the Promoting Science-based Approaches to Teen Pregnancy Prevention project (PSBA) as a case example of a proactive application of the Interactive System Framework (ISF) for dissemination and implementation. The ISF is a multi-system model leading to dissemination and implementation of science-based prevention programming through the work of three interactive systems: The "Prevention Delivery," "Prevention Support," and "Prevention Synthesis & Translation" Systems. This article describes the proactive use of the ISF to conceptualize and bolster the PSBA program's goal of assisting local prevention partners in the use of science-based approaches (SBA) to prevent teen pregnancy. PSBA uses all three systems of the ISF to facilitate practice improvements and offers valuable research opportunities to investigate factors related to dissemination and implementation processes across these systems. Describing our application of this framework highlights the feasibility of actively using the ISF to build prevention infrastructure and to guide large-scale prevention promotion strategies in the area of teen pregnancy prevention. The program's ongoing evaluation is presented as an example of early efforts to develop an evidence base around the ISF. Research implications are discussed.     

The role of prevention focus under stereotype threat: Initial cognitive mobilization is followed by depletion

Previous research has demonstrated that stereotype threat induces a prevention focus and impairs central executive functions. The present research examines how these 2 consequences of stereotype threat are related. The authors argue that the prevention focus is responsible for the effects of stereotype threat on executive functions and cognitive performance. However, because the prevention focus is adapted to deal with threatening situations, the authors propose that it also leads to some beneficial responses to stereotype threat. Specifically, because stereotype threat signals a high risk of failure, a prevention focus initiates immediate recruitment of cognitive control resources. The authors further argue that this response initially facilitates cognitive performance but that the additional cognitive demands associated with working under threat lead to cognitive depletion over time. Study 1 demonstrates that stereotype threat (vs. control) facilitates immediate cognitive control capacity during a stereotype-relevant task. Study 2 experimentally demonstrates the process by showing that stereotype threat (vs. control) facilitates cognitive control as a default, as well as when a prevention focus has been experimentally induced, but not when a promotion focus has been induced. Study 3 shows that stereotype threat facilitates initial math performance under a prevention focus, whereas no effect is found under a promotion focus. Consistent with previous research, however, stereotype threat impaired math performance over time under a prevention focus, but not under a promotion focus.     

Multilevel Analysis of a Measure of Community Prevention Collaboration

This study assesses a measure of community-wide collaboration on prevention-specific activities (i.e., prevention collaboration) in context of the theory of community change used in the Communities That Care prevention system. Using data from a sample of 599 community leaders across 41 communities, we examined the measure with regard to its factor structure, associations with other concurrent community-level measures, and prediction by individual- and community-level characteristics. Results of multilevel confirmatory factor analysis provide evidence for the construct validity of the measure and indicate significant (p < .05) associations with concurrent validity criteria. Female community leaders reported significantly higher levels of prevention collaboration and community leaders sampled from religious organizations reported lower levels of prevention collaboration than did their respective counterparts. Although no community-level characteristics were associated significantly with prevention collaboration, community clustering accounted for 20-28% of the total variation in the measure. Findings support the use of this measure in assessing the importance of collaboration in community-based prevention initiatives.     

Eating disorder prevention on college campuses: Recruitment challenges

IntroductionUniversities are believed to present rich opportunities for eating disorder prevention research. However, the widespread recruitment from psychology subject pools and the attractive compensation offered widens the gap between efficacy trials and effectiveness studies, and raises concerns about the possibility of wide-scale dissemination.ObjectiveTo encourage thinking about how to disseminate prevention programs broadly.MethodWe provide a real-world example of the implementation of two prevention programs.ResultsThis paper illustrates the difficulties of recruiting for a disordered eating prevention intervention when offering minimal compensation despite the use of comprehensive and creative advertising.ConclusionsThese difficulties speak to the challenges in conducting widespread eating disorder prevention in university settings and highlight the need to develop strategies to help overcome challenges in prevention research and dissemination.     

Preventing Adolescent Cigarette Smoking

Recent studies have supported the efficacy of approaches to smoking prevention that focus primary attention on social and psychological factors implicated in initiation of adolescent cigarette smoking. This article reports first year data from a large-scale smoking prevention study conducted within three geographic regions of New York State. The sample consists of 5,954 seventh graders from 56 middle/junior high schools. Schools were randomly assigned to (1) receive the Life Skills Training (LST) prevention program with a one-day teacher training workshop; (2) receive the LST prevention program with teacher training provided by video tape; or (3) serve as a comparison group. This study was designed to further test the efficacy of this type of smoking prevention program and to compare the relative effectiveness of two different types of provider training in an effort to learn more about the potential effectiveness of this prevention strategy when implemented under "real world" conditions. Pretest and posttest data were collected by questionnaire concerning self-reported tobacco use and several hypothesized mediating variables. Results indicate that the prevention program significantly impacted on several hypothesized mediating variables in a direction consistent with non-smoking. Within one region, the students in both experimental conditions reported significantly less current cigarette smoking and reported themselves less likely to smoke in the future than the students in the control condition.     

Relating Coalition Capacity to the Adoption of Science-Based Prevention in Communities: Evidence from a Randomized Trial of Communities That Care

Coalition‐based efforts that use a science‐based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science‐based approach to prevention in communities. Using data from 12 coalitions participating in a community‐randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community‐wide adoption of a science‐based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta‐regression analyses found that CTC had a greater impact on the adoption of a science‐based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages).