一例应用贝克疗法对服刑人员咨询报告

赵某,男,21岁,因"情绪低落、失眠多梦、感到对前途无望"主动要求心理援助。本案例诊断为严重心理问题。采用认知行为治疗,经过认知行为咨询,经过三个阶段的心理咨询,加强了对焦虑的认知,焦虑情绪基本缓解,消极行为和想法基本消失,工作、生活能力提高。     

健康行为改变中的社会认知因素：HAPA模型述评

HAPA是健康行为领域研究的新取向。认为改变健康行为需要两个分离的过程:动机和意志。首先,基于自我信念的基础上形成改变的意图;随意,行为改变才会被计划、引发并维持。HAPA认为,动机阶段引起行为意图,而意志阶段则产生实际行为。以自我效能为代表的社会认知因素在两个阶段起重要作用,对于健康行为的采纳、引发和维持的产生重要的预测作用。     

健康行为改变中的社会认知因素:HAPA模型述评

HAPA是健康行为领域研究的新取向.认为改变健康行为需要两个分离的过程:动机和意志.首先,基于自我信念的基础上形成改变的意图;随意,行为改变才会被计划、引发并维持.HAPA认为,动机阶段引起行为意图,而意志阶段则产生实际行为.以自我效能为代表的社会认知因素在两个阶段起重要作用,对于健康行为的采纳、引发和维持的产生重要的预测作用.     

跨理论模型在健康教育中的研究进展

跨理论模型通过评估分析行为改变者的意愿及需求,并为之提供有针对性的行为支持技术,从而帮助改变者建立健康行为。主要内容有变化阶段、变化过程、自我效能、决策平衡。变化阶段是跨理论模型的核心结构,反映出人们在行为改变过程中从意愿到行动的动态变化,为健康教育提供框架及评估方法。变化过程则为制定健康教育内容提供指南。自我效能及决策平衡贯穿于整个变化阶段及过程中,对行为改变有一定的预测作用。近年来,基于跨理论模型的健康教育已被广泛应用于个体及群体的生活方式健康教育中,但其效果仍需进一步论证。     

冲动还是习惯?成瘾不同阶段中冲动性的性质与机制

冲动性是一种缺乏充分思考、不顾后果的冒险行为或行为倾向, 它既表现在人格特质中, 也会表现为各类环境中的行为。成瘾者具有典型的冲动性特征, 但成瘾者的冲动性是如何影响和促进成瘾行为的发生、发展, 目前还并不明朗。从成瘾形成的不同阶段, 也许可以对此有更进一步的了解。在药物使用的开始阶段, 冲动性人格特质作为动机原因, 促进成瘾物质的首次使用; 接着操作性条件学习导致用药者进入“目标-导向”阶段, 呈现出选择冲动性。第三阶段, 经典条件学习又使相关线索和药物效应不断匹配, 形成条件反射性药物使用行为。成瘾者进入习惯性用药阶段, 表现出显著的停止冲动性。     

心理求助行为：研究现状及阶段－决策模型

回顾了国内外心理求助研究的进展和现状,指出了目前研究中存在的局限。在文献分析和前期研究基础上提出心理求助行为的阶段－决策模型,该模型将心理求助视为一个内部决策过程,包括连续的三个阶段,分别为问题知觉阶段、自助评估阶段、他助评估阶段。在不同的求助阶段,影响求助行为的因素及其影响力不同。文章简要介绍了基于这个理论模型所作的初步研究     

心率变异性是自我调节的生物指标

自我调节对人们的身体健康和心理健康都至关重要,最近越来越多的研究表明心率变异性是自我调节的生物指标,心率变异性越大,自我调节的能力越强。从这个意义上来说,未来人们可以通过提高心率变异性来改善自我调节能力,以期治疗某些自我调节能力缺乏的临床症状,如物质滥用、睡眠障碍、肥胖症等。     

奖惩对行为抑制能力和自主生理活动影响的时效性

将45名被试随机分配为奖励组、惩罚组和对照组, 实验进程按时间发展过程被分为五阶段, 采用停止信号任务探讨奖惩刺激对行为抑制能力和自主生理活动影响的时效性。结果显示：奖惩刺激对行为反应时和抑制失败率影响仅在第二、三阶段差异显著, 对心率影响的显著差异在第三阶段结束、而对皮电和指温影响的显著差异仍持续到第五阶段。结果表明：奖惩刺激对行为的抑制作用具有时效性, 有效时间内表现为仅奖励能提高行为抑制能力; 奖惩刺激对心率的影响具有时效性, 但对其它生理指标的影响则未显示出时效性。     

中国人人格特质结构对合作的影响机制

采用调整后的公共财物范式,将合作分为内部准备阶段（合作意识）和外部表现阶段（合作行为）,以中国人人格问卷（QZPS）为工具,研究人格特质结构对合作不同阶段的影响机制。结果表明,（1）在合作的不同阶段,产生影响作用的人格特质因素不同。中国人人格特质中的善良和情绪性直接影响合作意识,行事风格与人际关系因素直接影响合作行为,外向性通过调节合作意识与合作行为的关系影响合作行为。（2）在考虑合作意识与人格特质交互作用的模型能够更好的解释和预测合作行为。文中讨论了在研究合作过程时从个体内部因素、特质以及外部情境等多角     

亲社会行为产生机制的理论演进

亲社会行为是指人们在社会交往中表现出来的谦让、帮助、合作、分享,甚至为了他人利益而做出自我牺牲的一切有助于社会和谐的行为及趋向。亲社会行为的产生机制一直是社会心理学的研究热点,研究者们不断提出各种理论、模型解释亲社会行为。本文通过对亲社会行为理论的梳理,将其按照发展顺序概括为进化理论阶段（亲缘选择理论、群体选择理论、互惠理论）、认知理论阶段（损失-奖赏的激励模型、社会信息加工模型、捐赠的二阶模型）、生物基础理论阶段（生物情感理论、脑机制模型）。最后对这些理论进行总结和评论,并提出未来亲社会行为理论可以进一步关注的问题。     

Behavioral obesity research: Where have all the single subjects gone?

Many recent reviews of the literature concerning behavioral treatments of obesity have concluded that behavioral methods have not been as successful in treating this problem as might have been predicted in the early years of behavior modification. Among the many potential reasons for this lack of success is the growing trend to utilize group statistical designs rather than single subject designs to examine the problem of obesity, in spite of the fact that single case methodology has provided the foundation for applied behavior analysis and behavior therapy. Several behavioral journals were surveyed to determine more precisely the trends in types of research strategies utilized in obesity studies. The potential relationship between research methodology and the development of effective treatments is discussed.     

An Open Trial Examining Dialectical Behavior Therapy Skills and Behavioral Weight Loss for Adults With Emotional Eating and Overweight/Obesity

Third-wave cognitive behavioral interventions for weight loss have shown promise. However, sparse data exists on the use of dialectical behavior therapy for weight loss. Adapted dialectical behavior therapy skills programs may be especially well suited for adults who engage in emotional eating and are seeking weight loss. Dialectical behavior therapy is skills-based, shares theoretical links to emotional eating, and is effective in treating binge eating. The current study examined the feasibility, acceptability, and preliminary efficacy of Live FREE: FReedom from Emotional Eating, a 16-session group-based intervention. A total of 87 individuals expressed interest in the program, and 39 adults with overweight/obesity (BMI ≥25) and elevated self-reported emotional eating were enrolled. Live FREE targeted emotional eating in the initial sessions 1–9, and sessions 10–16 focused primarily on behavioral weight loss skills while continuing to reinforce emotion regulation training. Assessments were administered at baseline, posttreatment, and 6-month follow up. Enrolled participants were primarily female (97.4%) and Caucasian (91.7%). Treatment retention was strong with participants attending an average of 14.3 sessions and 89.7% of participants completing the intervention. On average, participants lost 3.00 kg at posttreatment, which was maintained at follow-up. Intent-to-treat analyses showed improvements in key outcome variables (self-reported emotional eating, BMI, emotion regulation) over the course of the intervention. Combining dialectical behavior therapy skills with conventional behavioral weight loss techniques may be an effective intervention for adults with overweight/obesity who report elevated emotional eating.     

浅谈认知行为治疗在肥胖治疗中的研究与应用

肥胖的治疗方法多种多样,各自具有不同的针对性和疗效特点,如何选择是一个最佳的治疗方案这是一个富有争议的话题。近年来,在肥胖心理学研究成果的基础上,发展了一系列的认知行为治疗方法,也开始应用于肥胖的治疗之中。不少追踪研究表明,该方法对于肥胖的长期疗效较佳,表现出广泛的应用前景。     

PCIT-Health: Preventing Childhood Obesity by Strengthening the Parent–Child Relationship

Childhood obesity is a costly, yet preventable, public health concern. Strengthening the parent–child relationship and teaching parents strategies to manage children’s general and health-related behaviors has the potential to reduce childhood obesity risk. Selective prevention interventions may help parents of young children establish positive parenting and feeding practices to actively reduce risk factors. We review the existing literature on childhood obesity interventions and describe an adaptation to a behavioral parent training program—parent–child interaction therapy (PCIT)—to address children’s behaviors in obesity-salient (e.g., mealtime, screen time, bedtime) contexts. In a case example, we describe how PCIT-Health can be effectively implemented.     

Food reinforcement and eating: a multilevel analysis

Eating represents a choice among many alternative behaviors. The purpose of this review is to provide an overview of how food reinforcement and behavioral choice theory are related to eating and to show how this theoretical approach may help organize research on eating from molecular genetics through treatment and prevention of obesity. Special emphasis is placed on how food reinforcement and behavioral choice theory are relevant to understanding excess energy intake and obesity and how they provide a framework for examining factors that may influence eating and are outside of those that may regulate energy homeostasis. Methods to measure food reinforcement are reviewed, along with factors that influence the reinforcing value of eating. Contributions of neuroscience and genetics to the study of food reinforcement are illustrated by using the example of dopamine. Implications of food reinforcement for obesity and positive energy balance are explored, with suggestions for novel approaches to obesity treatment based on the synthesis of behavioral and pharmacological approaches to food reinforcement.     

Charting as a Multipurpose Treatment Intervention for Family Therapy

This paper discusses the behavior modification technique of charting as a double-bind communication. Though the procedure was initially employed as a step in demonstrating operant conditioning ( 7 ) and later in diagnosis of the antecedents and consequences maintaining undesired behavior ( 8 ), it also proved one of the more powerful therapeutic interventions. Literature reviews on treatment programs for obesity ( 6 ) and behavioral approaches to marital therapy ( 2 ) support this contention. Its efficacy can be explained by integrating the viewpoints of behaviorist and family therapy approaches espoused by Haley ( 4 ) and Weakland et al . ( 9 ). Following are brief case reports in which charting resulted in quick and sometimes dramatic change.     

Reinforcer pathology,probabilistic choice,and medication adherence in patients with multiple sclerosis

The reinforcer pathology model posits that core behavioral economic mechanisms, including delay discounting and behavioral economic demand, underlie adverse health decisions and related clinical disorders. Extensions beyond substance use disorder and obesity, however, are limited. Using a reinforcer pathology framework, this study evaluates medical adherence decisions in patients with multiple sclerosis. Participants completed behavioral economic measures, including delay discounting, probability discounting, and a medication purchase task. A medical decision-making task was also used to evaluate how sensitivity to mild side effect risk and efficacy contributed to the likelihood of taking a hypothetical disease-modifying therapy. Less steep delay discounting and more intense (greater) medication demand were independently associated with greater adherence to the medication decision-making procedure. More generally, the pattern of interrelations between the medication-specific and general behavioral economic metrics was consistent with and contributes to the reinforcer pathology model. Additional research is warranted to expand these models to different populations and health behaviors, including those of a positive health orientation (i.e., medication adherence).     

Behavioral treatment of obesity: a two-year follow-up

Data obtained from a two-year follow-up of 10 obese women treated via behavioral methods is presented. Failure to obtain lasting results was noted, and reasons for this failure suggested. Implications of these data for investigators in the area of obesity were discussed.A review of the recent literature indicates a number of studies with encouraging results obtained via the behavioral treatment of obesity (Hall and Hall, unpublished). However, long-term follow-up data are generally lacking. This lack of long-term data is especially troublesome in the area of obesity. With regard to traditional treatment methods, such as drugs, psychotherapy, and nutritional counseling, it has generally been noted that those overweight individuals who complete a course of treatment, and who lose weight, regain the weight lost (Stunkard and McClaren-Hume, 1958) Within the literature on the behavioral treatment of obesity, only one study (Stuart, 1967) has provided weight data for as long as 1 year after initiation of treatment Stuart's data indicated a gradual loss of weight over the year. However, these data did not reflect S's ability to control weight following termination of treatment, for during the year, follow-up sessions were scheduled monthly, and thus, therapist contact was available.The present paper, in an attempt to fill the need for long-term follow-up data, presents data obtained 2 years after the termination of a behavioral treatment program. None of the Ss had been in contact with the therapist since the termination of the study 2 years earlier.     

CONTINGENT REINFORCEMENT OF ABSTINENCE WITH INDIVIDUALS ABUSING COCAINE AND MARIJUANA

Two males diagnosed with cocaine dependence received a behavioral intervention comprised of contingency management and the community reinforcement approach. During the initial phase of treatment, reinforcement was delivered contingent on submitting cocaine-free urine specimens. The community reinforcement approach involved two behavior therapy sessions each week. Almost complete cocaine abstinence was achieved, but regular marijuana use continued. During a second phase, reinforcement magnitude was reduced, but remained contingent on submitting cocaine-free specimens. Behavior therapy was reduced to once per week. Cocaine abstinence and regular marijuana use continued. Next, reinforcement was delivered contingent on submitting cocaine- and marijuana-free specimens. This modified contingency resulted in an abrupt increase in marijuana abstinence and maintenance of cocaine abstinence. One- and 5-month follow-ups indicated that cocaine abstinence continued, but marijuana smoking resumed. These results indicate that the behavioral intervention was efficacious in achieving abstinence from cocaine and marijuana; maintenance, however, was achieved for cocaine only.     

Behavioral treatment of adult obesity: Attentional controls and a 2-year follow-up

This research included controls for both amount of extra-therapy attention focused on target behaviors and for quality and duration of attention provided during therapy. Two pairs of therapists each conducted one group for each of four experimental conditions: nonspecific therapy, nonspecific therapy + attention prompting, behavior therapy, behavior therapy + positive induction (procedures designed to maximize favorableness of expectancies). Sixty-five obese adults ( OVERWEIGHT = 52%) attended 12 weekly group sessions and 3-month and 2-yr follow-ups. Ratings of expectancies, credibility and therapist characteristics were equivalent in all experimental conditions. Attrition was low (9.7%) and Ss averaged 1–2 lb weight losses per week during treatment, while improving concurrently in eating habits, cardiovascular fitness and adjustment. However, only participants who were in groups conducted by the therapist pair which was rated especially ‘democratic’ maintained average weight losses at the 2-yr follow-up. These results demonstrate the potentially vital role of several ‘nonspecific’ factors in long-term outcomes associated with behavioral treatments for adult obesity.