自传体记忆功能对失独者延长哀伤的影响:家族主义情感的调节作用

为厘清自传体记忆功能对失独者延长哀伤的影响,以及家族主义情感在其中的调节作用,本研究采用生活经历回想问卷、家族主义情感量表和延长哀伤问卷对372名失独者进行调查。结果发现：（1）失独者自传体记忆的自我功能、社会功能和指导功能均能负向预测其延长哀伤水平;（2）家族主义情感在自传体记忆的自我功能和指导功能对失独者延长哀伤的影响中起调节作用,对家族主义情感水平高的失独者来说,自传体记忆的自我功能和指导功能能负向预测其延长哀伤水平,但对家族主义情感水平低的失独者来说,自传体记忆的自我功能和指导功能对其延长哀伤水平没有预测作用;（3）对罹患延长哀伤障碍的失独者来说,自传体记忆功能对延长哀伤水平的预测作用和家族主义情感的调节作用均不显著。     

自闭症谱系障碍的症状、诊断与干预

自闭症谱系障碍(autism spectrum disorders, ASD)是一种广泛发展障碍, 以社会交往障碍、言语和非言语交流缺陷、兴趣狭窄和行为刻板等为主要临床特征。对ASD的准确诊断是早期干预的关键, 也对患者的康复及其家庭幸福产生积极作用。日渐增长的发病率促进了对早期识别、诊断评估、以事实为基础干预的重视。在探索药物治疗ASD的基础上, 中国传统医学方法, 尤其是“靳三针”治疗ASD获得越来越多的实证支持。可以根据Simpson等人(2005)提出的指标体系对各种干预和治疗方法的疗效进行评价。今后研究将从认知神经科学的视角, 尤其是将眼动技术与ERP、fMRI相结合, 探索ASD的核心症状表征以及各亚类的特异性。     

自闭症谱系障碍的生物基础

自闭症谱系障碍是一组发病于生命早期, 由一系列生理、心理因素引起的神经发育障碍。遗传、脑神经结构、营养素等是自闭症谱系障碍的生物基础的重要来源。个体在孕育早期形成的大脑和机体异常可能是导致自闭症谱系障碍的关键。这种异常在出生后的发育中具体作用于神经活动、脑发育、免疫系统等生理途径。研究者们今后可以尝试横跨不同自闭症谱系障碍亚型、年龄和发育阶段, 开展横向与纵向相结合的大范围研究, 以进一步明确自闭症谱系障碍的生物基础。     

躯体疾病和抑郁障碍共病的诊断、评估及治疗原则

躯体疾病和抑郁障碍共病已经成为一个越来越严重的临床和全球公共健康问题.共病的躯体疾病与抑郁障碍之间存在着双向的联系,即一种疾病对另一种疾病的发生、发展、预后以及治疗有消极的作用.本文就躯体疾病和抑郁障碍共病的流行病学、临床评估、诊断及治疗原则作一综述.     

自闭症谱系障碍个体的焦虑：发生机制、评估与治疗

自闭症谱系障碍是一种神经发育性障碍, 主要表现为社会交往互动障碍和重复刻板性行为。焦虑或焦虑障碍常被认为是自闭症个体最普遍的共病之一。焦虑与自闭症之间的关系尚不明确, 自闭症个体的焦虑与无法忍受不确定性、杏仁核功能和体积、情绪调节策略、消极思维存在一定关联; 目前已经开发出专门用于自闭症个体焦虑的评估工具; 修订版认知行为疗法对自闭症个体焦虑的治疗取得了良好效果。未来的研究应着重探索自闭症个体焦虑的认知与神经机制, 检验专用评估工具的有效性, 继续关注现代技术(如虚拟现实技术)对自闭症个体焦虑的治疗效果。     

胰腺癌的流行病学和病因学机制

胰腺癌常指起源于胰腺外分泌系统导管上皮的导管腺癌,这是因为它占全部胰腺恶性肿瘤病例90％以上,它是人类致死第4位的常见癌。在致病因素中,吸烟是致使环境污染的重要原因,此外,体质指数、慢性胰腺炎、摄入高动物脂肪也是重要的危险致病因素。糖尿病和糖耐量损害也占到诊断胰腺癌病例的80％以上。但最为重要的危险因素是基因素质,胰腺...     

孤独症儿童动作发展障碍的神经机制

动作发展障碍(Developmental motor disorders)是孤独症谱系障碍的常见特征。通过系统回顾孤独症儿童动作发展障碍的神经科学研究, 发现γ-氨基丁酸和5-羟色胺浓度的改变及γ-氨基丁酸相关蛋白和Shank蛋白的表达异常不仅会损害中枢神经系统的发育, 而且还能导致突触兴奋性与抑制性失衡, 进而改变孤独症儿童小脑和大脑皮层运动区的功能连接。孤独症儿童小脑、基底神经节和胼胝体结构的改变对全脑的连通性产生了负面影响。神经生化机制和脑结构的异常共同导致了脑功能的异常, 最终造成孤独症儿童的动作发展障碍。此外, 动作发展障碍与孤独症核心症状共同的神经基础主要包括镜像神经元系统紊乱, 丘脑、基底神经节和小脑异常以及SLC7A5和PTEN 基因突变。未来研究需要关注与运动密切相关的其他神经递质, 如乙酰胆碱和多巴胺; 探索动作发展障碍神经网络的动态机制及其形成; 剖析该障碍的神经机制和自闭症核心症状神经机制的相互作用。     

虚无主义的现代性病理机制

虚无主义是现代性的副产品,是现代性与传统脱域的必然产物。当前,应当深入剖析虚无主义形成的现代性病理机制,揭示动态的现代性何以导致精神价值的瓦解与定向,进而催生了现代虚无主义。     

异常心理病理机制的哲学思考

通过现代心理学、异常心理学、心理哲学及分子生物学的研究成果对异常心理病理机制的哲学分析,探讨异常心理病理机制的哲学本质.异常心理同正常心理一样不仅有自然物质世界的各种特性,还有许多自然物质世界不具有的高级和复杂特性.异常心理病理机制的哲学本质是它的意义世界和价值世界.     

社交焦虑障碍：自我认知偏倚与疾病的发展

社交焦虑障碍患者具有特征性的自我认知模式。消极自我评价、以自我为焦点的注意是使疾病持久难以自愈的重要因素,妨碍了人格的健康发展。探索社交焦虑障碍患者的自我认知特点、寻找规律创建符合本土文化背景的认知模型,将有利于深入了解疾病形成与发展的易患性因素和病理心理学机制。     

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

Factors Associated With Treatment Response in an Internet-Based Intervention for Prolonged Grief Disorder After Cancer Bereavement

Internet-based psychological interventions have proven effective in the treatment of prolonged grief disorder (PGD). Yet, some patients do not benefit from treatment in a clinically significant way. We aimed to examine predictors of symptom reduction in an Internet-based intervention for PGD after cancer bereavement, in order to identify possible treatment mechanisms and discern directions for future intervention design. A secondary analysis of data from a randomized wait-list controlled trial on an Internet-based intervention for PGD after cancer bereavement was conducted. Multiple regression models were used (1) to test for the influence of pretreatment PGD, working alliance, avoidance and gender on PGD symptom reduction; and (2) to explore further predictors of treatment success with a best subset selection protocol. The regression models explained 18% (Model 1) and 34% (Model 2) of variance in symptom reduction. Participants with more favorable symptom change had more severe pretreatment PGD scores and better working alliance. Those with lower social support and less posttraumatic growth experienced more PGD symptom change. In conclusion, therapeutic alliance is an important factor that should be monitored and fostered. Findings regarding social support and posttraumatic growth need further replication and clarification.     

The Traumatic Grief Inventory Self-Report Version (TGI-SR): Introduction and Preliminary Psychometric Evaluation

Persistent Complex Bereavement Disorder (PCBD) is a disorder of grief newly included in the “Emerging Measures and Models” section of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. [Google Scholar]). Prolonged Grief Disorder (PGD) is a disorder with similar symptoms, likely to be included in the forthcoming 11th edition of the International Classification of Diseases (ICD-11; World Health Organization, 1992 World Health Organization. (1992). International classification of diseases and related health problems (10th revision). Geneva, Switzerland: World Health Organization. [Google Scholar]). We developed the Traumatic Grief Inventory Self-Report version (TGI-SR), an 18-item measure, for the assessment of symptoms of PCBD and PGD in clinical and research settings. This study was an initial attempt to evaluate psychometric properties of the TGI-SR. To this end, the measure was administered to 327 patients of a mental health institute specialized in the treatment of psychopathology associated with loss and trauma. We found evidence that items of the TGI-SR (all 18 items, as well as the selection of 17 items representing PCBD criteria, and 11 items representing PGD criteria) loaded on one dimension. The TGI-SR demonstrated strong internal consistency. Elevated scores on the TGI-SR were significantly correlated with elevated scores on indices of psychopathology and lower quality of life, attesting to the concurrent validity. Receiver operation characteristic (ROC) analyses of the TGI-SR total score against provisional diagnoses of PCBD and PGD yielded a high area under the curve index suggesting that the TGI-SR total score can be used as an indicator for probable diagnoses of both PCBD and PGD. Results of this study provide initial evidence that PCBD and PGD symptoms may be readily and reliably measured using the TGI-SR.     

The Underlying Structure of Grief: A Taxometric Investigation of Prolonged and Normal Reactions to Loss

Recent studies have supported the distinctiveness of complicated and prolonged forms of grief as a cluster of symptoms that is separate from other psychiatric disorders. The distinction between prolonged and normal reactions to loss remains unclear, however, with some believing that prolonged grief represents a qualitatively distinct clinical entity and others conceptualizing it as the extreme end of a continuum. Thus, in this study a taxometric methodology was used to examine the underlying structure of grief. Participants included 1,069 bereaved individuals who had lost a first-degree relative. Each participant completed the Dutch version of the Inventory of Complicated Grief–Revised, which was used to create indicators of prolonged grief. The mean above and mean below a cut (MAMBAC) and maximum eigenvalue (MAXEIG) tests supported a dimensional conceptualization, indicating that pathological reactions might be best defined by the severity of grief symptoms rather than the presence or absence of specific symptoms.

ICD-11 prolonged grief disorder: Prevalence,predictors, and co-occurrence in a large representative sample

The International Classification of Diseases has recently defined Prolonged Grief Disorder (PGD) with symptoms such as longing, worry, and intense emotional pain that exceed sociocultural norms more than 6 months after the loss. This study aims to (a) estimate the prevalence of this new diagnostic category, (b) identify its sociodemographic and loss-related predictors, and (c) assess the co-occurrence of PGD with other psychological disorders and substance abuse. A large representative sample of Spanish adults (N = 1498) participated. Several multivariate binary logistic regression and multivariate logistic regression models were used. Results showed a 9.95% prevalence in the total sample. Catholic beliefs were a positive predictor, while higher income and more time since loss significantly decreased the odds of PGD. PGD significantly increased the likelihood of anxiety, depression, somatisation, post-traumatic stress disorder, loneliness and substance use. Our study contributes to assessing the multicultural PGD validity, as our results from a large representative sample are comparable to those in other countries with the PGDS. Our findings have direct implications for the assessment and treatment of bereavement, identifying for practitioners variables that make individuals more vulnerable to PGD. Results highlighted the high co-occurrence of PGD with other psychological illnesses and increased drug use.     

Cognitive behavioral variables mediate the associations of neuroticism and attachment insecurity with Prolonged Grief Disorder severity

Abstract

Prolonged Grief Disorder (PGD) is a debilitating syndrome of grief. A recent cognitive behavioral model asserts that three processes are critical to this condition: (1) insufficient integration of the loss with autobiographical knowledge about the self and the lost person; (2) negative cognitions; and (3) anxious and depressive avoidance behaviors. These processes are assumed to contribute to PGD symptoms and to mediate the influence of personality-related vulnerabilities on the development and maintenance of these symptoms. The present study examined the mediational role of these three processes in the linkage between neuroticism, attachment anxiety, and attachment avoidance on the one hand and PGD symptom severity on the other hand. Self-reported data from 348 bereaved people were used. The results showed that the three personality variables were significantly associated with PGD symptom severity. Moreover, the results provided support for the mediating effects of indices of insufficient integration, negative cognitions, as well as avoidance behaviors – even after controlling for the shared variance between mediators. Theoretical and clinical implications are discussed.     

Hoarding Disorder: Diagnosis,Assessment, and Treatment

Hoarding disorder (HD) is a newly added mental disorder in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). In this article, the symptoms, characteristics, and features of HD are described, along with diagnosis and assessment strategies. The most efficacious treatments for counseling clients diagnosed with HD are also discussed.     

Grief Counseling: An Investigation of Counselors' Training,Experience, and Competencies

Grief is prevalent in counseling, but little is known about the current status of counselors’ preparation and competencies to provide effective care. This exploratory study surveyed counselors (N= 369) on grief training, personal and professional experiences with grief, and grief counseling competence. Multiple regression analyses found training and experience were statistically significant predictors of competence. The strong relationship between variables suggests these concepts may be understood as synonymous. Implications for training, practice, and research are discussed.     

Information Processing and Decision-Making in Pathological Worriers and their Potential Role in Mechanisms of Generalized Anxiety Disorder

Systematic information processing and decision-making under uncertainty are key constructs of new conceptions explaining the severity of pathological worry. The current study attempted to analyze their usefulness in subclinical and clinical groups. In the first phase of the study (N = 251) participants were examined with the Penn State Worry Questionnaire (PSWQ), a GP consultationrelated survey, and a screening survey for generalized anxiety disorder (GAD). In the second phase (N = 220), the State-Trait Anxiety Inventory, the PSWQ, and tasks measuring systematic information processing (SIP) versus heuristic reasoning (HR) were applied. In the third phase (N = 60), GAD (n = 30) and healthy control (n = 30) groups were examined with the above methods and the Iowa Gambling Task (IGT). In the low risk group, a relationship between mood and the representativeness heuristic (ρ = 0.50), as well as anchoring and adjustment heuristic (anxiety-related stimuli) was found (ρ = −0.53). In the GAD group, significant correlations between the PSWQ score, the IGT loss avoidance score (ρ = 0.40), and total IGT score (ρ = 0.48) were found. The results did not confirm a particular usefulness of the systematic/heuristic information processing construct in subclinical and clinical groups. Theory-consistent results were rather found in the nonclinical groups. Nevertheless, the data revealed some interesting findings supporting potential explanatory power of some theoretical models.