心理因素和慢性前列腺炎关系的思考

慢性前列腺炎患者大多伴有不同程度的心理障碍,应重视患者的心理状态和精神活动,改善患者的生存质量。对这些患者,单纯的药物治疗,效果往往不佳,辅以相应的心理认知疗法,可以明显提高治愈率。经过心理治疗的患者复发率低,并对其周围的慢性前列腺炎患者有良好的诱导和表率作用,具有一定的临床和社会意义。     

Structural Evaluation of the Contemporary Psychological Models of Chronic Pain: Does Fear of Pain Work for All?

The aim of the present study was to test Turk and Okifuji's (2002) model of chronic pain and in particular the moderating role of self-efficacy. We assessed 207 consecutive chronic pain patients (53.1% female) on a range of relevant measures and tested the model using structured equation modelling. The model was supported. These results support Turk and Okifuji's model of chronic pain and suggest that it can account for the relationships between variables in chronic pain patients. In particular, the results support the central role of fear-based avoidance and self-efficacy in chronic pain. Future research should be aimed at testing the alternative contemporary models of chronic pain at different stages of the development and maintenance of chronic pain and over time.     

The Self-in-Relation Theory and Women for Sobriety: Female-Specific Theory and Mutual Help Group for Chemically Dependent Women

This article discusses the self-in-relation theory as it applies to chemically dependent women. The theory provides an alternative way of understanding and viewing chemically dependent women. The self-in-relation model (or theory) states that relationships are extremely important in women's psychological development and functioning and that women's connection with others is fundamental to self-concept. Women for Sobriety, a mutual help group for chemically dependent women, offers an alternative way of supporting women in trying to achieve recovery, and this is also discussed in a relational context.     

The Traditional Explanation for Resistance Versus Attitude Accessibility

This investigation compared the traditional explanation for the way inoculation confers resistance to influence with an alternative rationale for resistance based on attitude accessibility. Four hundred forty‐three participants took part in the investigation in four phases spanning 54 days. The combined multiple regression and structural equation modeling results suggest that the traditional and alternative explanations for the way that inoculation confers resistance involve separate processes; counterarguing and accessibility appear to be distinct tracks en route to resistance, but the two explanations also are overlapping processes in which elicited threat plays an integral role.     

Community Living Skills

Persons with chronic mental health problems are frequently found living in the community at varying quality of life levels. Though rehabilitation programs are suitable for patients with acute exacerbations of mental health pathology, these programs are necessary but not sufficient to meet the needs of the chronic person. Long-term reliance on biomedically-based rehabilitation can produce dependence on the system and maintain reliance on the "sick role" which is counterproductive for current trends related to deinstitutionalization and "least restrictive environment." The intent of this article is to focus on an one alternative service delivery model- psychoeducation. The potentials for this mode to normalize or maximize independence is discussed and two community living skills programs for the chronically mentally ill are described to exemplify the application of psychoeducation.     

A critical assessment of Pereboom’s Frankfurt-style example

In this paper, I assess Derk Pereboom’s argument for the thesis that moral responsibility does not require the ability to do otherwise. I argue that the Frankfurt-style example Pereboom develops presupposes a prior act or omission which the agent was able to avoid. This undermines his argument. I propose a way for Pereboom to revise his example and thereby undercut this objection. Along the way, I also argue that Pereboom should supplement his account of what counts as a robust alternative—an alternative of the sort that should matter to those who argue for an ability-to-do-otherwise condition on moral responsibility.     

A comment on Fry's "The role of caring in a theory of nursing ethics

Our response to Sara Fry's paper focuses on the difficulty of understanding her insistence on the fundamental character of caring in a theory of nursing ethics. We discuss a number of problems her text throws in the way of making sense of this idea, and outline our own proposal for how caring's role may be reasonably understood: not as an alternative object of value, competing with autonomy or patient good, but rather as an alternative way of responding toward that which is of value.     

Quality of Life in Patients with Chronic Pain- A Study in Indian Population Using European Organization for Research and Treatment of Cancer(EORTC) Questionnaire

Quality of life in chronic pain Health-related quality of life was compared in patients of chronic pain with that of general population.We designed this study as a prospective, observational trial in a tertiary care centre. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The EORTC QLQ-C30 is a valid alternative to the SF-36 in the assessment of QOL in patients with chronic pain especially when a broader assessment of symptoms is desired. All participants completed a set of questionnaires on demographic variables, cause, pain intensity (VAS) and quality of life (EORTC qlq c30). A total of two hundred participants were enrolled including 100 patients with chronic pain. Chronic pain was defined as one which is persisting beyond 3 months. The study revealed significantly decreased quality of life in patients with chronic pain as compared to general population (p?<?0.001). Patients with chronic pain had significantly decreased score in Physical functioning, Role functioning, emotional and social functioning on functional scales and increased scores of pain, fatigue, sleep disturbances and financial difficulties on symptom scales. The study revealed sex-related differences on the QoL with females having a lower global QOL. It is thus concluded that patients with chronic pain especially females have decreased quality of life as compared to general population     

Applications cliniques en psychologie de la santé

The aim of the present article is to present recent and validated clinical applications in the field of health psychology, in particular regarding pain and chronic disease management. Techniques such as acceptance and engagement therapy, mindfulness meditation and positive emotions enhancement have proved to be successful. Mindfulness is an attribute of consciousness long believed to promote well-being. It is commonly defined as the state of being attentive to and aware of what is taking place in the present. By this way, mindfulness meditation learns to patients with chronic pain to reduce their pain sensation. Moreover, encourage patients to have positive emotions, such as gratitude, is efficient in long term well-being. Prospective studies reveal that optimism, coping strategies such as positive reframing and acceptance, and social support yield less distress for patients with chronic disease. Similarly, psychosocial interventions that foster optimistic appraisals, build coping strategies, and bolster social support are benefit for patients. Other methods such as Cognitive Behavioral Stress Management (CBSM), enable to significantly enhance quality of life, adaptation to illness and chronic disease patient compliance. This 10-week group CBSM intervention that includes anxiety reduction (relaxation training), cognitive restructuring, and coping skills training is tested among women with breast cancer and HIV patients. The intervention reduces reports of thought intrusion, anxiety and emotional distress. Furthermore, biofeedback through Heart Rate Variability appears to be an important component of the development of patient potential in terms of cognitive and emotional resources enabling better coping with stressful situations and hence maintaining optimal health conditions. Biofeedback treatment intervention on pain and quality of life is helpful in the rehabilitation of patients with chronic pain. Limits of these applications are discussed as well as future research directions.     

Chronic pain as a posture towards the world

This article discusses what chronic pain is “about”, what the intentional object is of pain, and what is the intentional relation like? My approach is based on Maurice Merleau‐Ponty’s phenomenology, with an aim is to understand a two‐way relationship: how the sufferers bestow meaning on chronic pain, and how pain, on the other hand, signifies peoples’ life. In contrast to biomedical and cognitive‐behavioral theories, chronic pain is not only meaningful, but as an intentional emotion as well; it does not simply “happen” in the nervous system. I analyzed meanings assigned to pain through the narratives of three patients with chronic pain. Pain is described as creating a discontinuity in the patient’s Lebenswelt at the narrative level. When attempting to find meaning to their pain, patients point both to everyday life and biomedical referents. The structure of bestowing meaning is, metaphorically, like a necklace with everyday world and biomedical interpretations strung like beads, one after the other. The intentional object of pain, on the contrary, is constituted of the patients’ world in its wholeness. My results don’t confirm Drew Leder’s idea of disrupted intentionality, but underline directness as the basic relation of human experience also in case of pain and disease. Pain in itself is an e‐movere, an intense passionate movement, an intentional relation with and a bodily posture taken towards the world.     

Stimulation through simulation? Motor imagery and functional reorganization in hemiplegic stroke patients

A key factor influencing reorganization of function in damaged neural networks of the adult brain is stimulation. How to stimulate motor areas of patients with paralyses is a formidable challenge. One possibility is to use internal movement simulations, or motor imagery, as an alternative to conventional therapeutic interventions that require voluntary limb movements. Before this alternative can be entertained, two preliminary issues must be resolved. First, do internal movement simulations involve the same neural circuits as comparable overt actions? Second, are motor-impaired populations capable of imagining movements they can no longer perform? Here, I show that under specific conditions, answers to these questions are affirmative. Further, I discuss preliminary evidence that internally simulating movements may induce functional reorganization of the contralesional hand representation of a chronic, densely hemiplegic, cerebral vascular accident (CVA) patient.     

Reply to Skow

We have argued against a standard way of defining Humean supervenience about laws, and in favor of an alternative definition. Skow says that our argument against the standard definition makes a big mistake. He is right about this. But that mistake is correctable. Skow also argues that our alternative definition is seriously flawed. We think he is wrong about this.     

The Disappearing (or Ghost) Mother Transference: In Search of the Available Mother Within

As analysts, we speak of maternal transference as if it were a unitary phenomenon. We are trained to expect intense, powerful transference reactions. Yet there is a group of female patients who have a specific type of transference that lacks intensity. These patients often present by not presenting. I term this phenomenon the disappearing (or ghost) mother transference. This transference is quiet and does not create much stress. Using a case example, I will define this particular type of object relationship and discuss an alternative technique in treating these patients. It is my premise that these women must discover for themselves, at their own time and in their own way, the caring, living, available mother in the analyst.     

Factor analytic investigation of the Illness Attitudes Scale in a chronic pain safmple

The Illness Attitudes Scale (IAS) is a self-report instrument comprising nine subscales designed to assess fears, beliefs and attitudes associated with hypochondriasis and abnormal illness behaviour [Kellner (1986). Somatization and hypochondriasis. New York: Praeger.]. The purpose of the present study was to explore the factor structure of the IAS in a chronic pain sample as a preliminary step toward determining the use of this measure in this sample. Hypochondriacal tendencies have been postulated to play a role in maintaining and exacerbating responses to chronic pain and, therefore, appropriate measurement in this sample is important. In the present study, consecutive chronic pain patients presenting to a pain treatment program (N=198) were administered the IAS. Principal component analysis with oblique (Oblimin) rotation identified that five factors best explain the measure in this population. These factors were (1) fear of illness, (2) effects of symptoms, (3) health habits, (4) disease phobia and conviction and (5) fear of death. The factor structure overlapped to some degree with the scoring of the IAS proposed by Kellner (1986), as well as with the factor structure identified in a non-clinical sample [Ferguson, E. & Daniel, E. (1995). The Illness Attitudes Scale (IAS): a psychometric evaluation on a non-clinical population. Personality and Individual Differences, 18, 463–469.]. There were enough discrepancies, however, to suggest an alternative method for scoring the IAS with chronic pain patients. Implications for the use of the measure with chronic pain patients, as well as future research directions for exploring the utility of this measure with chronic pain patients, are discussed.     

Group Therapy as an Ecological Bridge to New Community for Trauma Survivors

Abstract

Group therapy counteracts the isolating effects of interpersonal trauma and enables survivors to connect with sources of resilience within themselves and others. By providing an alternative relational experience in which the survivor and her safety are valued, groups empower members to establish self-affirming and supportive relationships in their outside lives. The current paper reviews the psychological impact of chronic interpersonal violence and the relevant literature regarding group therapy for trauma survivors. We describe an approach to group treatment for complexly traumatized patients developed at the Victims of Violence Program, and through a clinical vignette, illustrate some of the ways in which group therapy can expand the relational world of survivors.     

Influence of multiple categories on the prediction of unknown properties

Knowing an item's category helps us predict its unknown properties. Previous studies suggest that when asked to evaluate the probability of an unknown property, people tend to consider only an item's most likely category, ignoring alternative categories. In the present study, property prediction took the form of either a probability rating or a speeded binary-choice judgment. In keeping with past findings, the subjects ignored alternative categories in their probability ratings. However, their binary-choice judgments were influenced by alternative categories. This novel finding suggests that the way in which category knowledge is used in prediction depends critically on the form of the prediction.     

Playingwith fire: art therapy in a prison setting

Art therapy's distinctive approach mediates between verbal and non-verbal, acting and thinking. All behaviour has meaning. As the criminal act is non-verbal, the art therapist has a unique way of engaging patients to find alternative ways of processing difficult feelings and impulses. This paper will focus on work at Holloway Prison and in particular the dynamics of arson to case material.     

药物经济学在疾病管理中的应用

随着近年来慢性病患者的增多,慢性病防治成本的增加,各国政府急需一种方法来降低慢性病患者医疗保健费用,减少卫生资源的浪费;而疾病管理作为解决上述问题的一种有效模式,本文讲述了其定义以及其实施的动因。同时指出药物经济学作为疾病管理中有效的评价工具及其在改善卫生保健资源利用方面的重大作用,阐述了其定义和评价方法,及其在疾病管理中应用时的选取,然后描述了其应用过程中存在的问题及解决对策。     

Electro-aversion therapy of chronic alcoholism

Twenty-six male patients with severe chronic alcoholism were treated with electro-aversion therapy according to two different designs. At follow-up after 12 months, 24 per cent had not had any relapse requiring admissions to hospital, 12 per cent were lost during the follow-up period, and 64 per cent had relapses. Before treatment all the patients had been admitted to hospital several times a year.

Aversion therapy without supplementary treatment is indicated mainly for patients who have intact social relationships and regular work. Treatment of advanced states of alcoholism requires supplementary treatment in the form of anxiety-relieving methods, psychosocial support and teaching the patient new and alternative habits.