Treatment of Assaultiveness

Summary

Assaultiveness and abusiveness have a psychology that must be addressed in therapy; they are not merely the product of “bad attitudes” or social roles, nor can they be narrowly defined as the robotic imitation of action. Perceptions and feelings about the world of intimate relationships both sustain and are sustained by abusive actions. These provide points of intervention for cognitive behavioral therapy (CBT). Given the tendency to shame easily, abusive men must not be confronted too quickly or too strongly. On the other hand, given their well-established denial system and tendency to minimize the consequences of their abusiveness, some confrontation must occur. Hence a “Zen” line of least resistance must be found between the opposites of acceptance and confrontation. Treatment outcome studies indicate moderate success for cognitive behavioral treatment (CBT) for batterers. Treatment is less successful with men who have personality disorders, especially psychopathy.     

Treatment of PAT

It has been suggested that the dive reflex (elicited by face immersion in water with breath-hold) may be employed to induce vagally-mediated bradycardia in individuals with paroxysmal atrial tachycardia. However, in several cases the use of this reflex is reported to have led to exacerbation of the cardiac dysfunction. Examination of heartrate and EKG T-wave amplitude changes during the dive in healthy, college-aged individuals indicated that warming the water (10° through 20° C to 40° C) decreased the bradycardia, but did not alter theattenuation (approximately 100 μv) of the T-wave. The latter effect was taken to indicate that sympathetic activity, as indexed by T-wave amplitude, was not reduced by increases in water temperature. On the other hand, a 90° head-up to head-down body tilt produced a bradycardia response of some 30 bpm as well as a T-wave amplitudeincrease (sympathetic withdrawal) in the order of 100 μv. These data suggest that individuals who exhibit symptoms of ventricular sympathetic irritability may be adversely affected by the dive maneuver, regardless of water temperature. The body-tilt induced reflex in such individuals may thus be more appropriate given the large-magnitude bradycardia and absence of T-wave attenuation. At the present, however, the body-tilt preparation has been used only with healthy normal subjects, so this suggestion remains to be directly tested.     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病.糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度.因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素.临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治.     

Treatment of sexual dysfunction

Abstract

This study is based on a statistical analysis of 240 client records. The task of the study was to determine the variables inherent to women with diagnosed sexual problems. Data were secured for 93 variables in four classifications—sociological, sexological, psychological, and counseling. Frequency distributions revealed sociological characteristics which were representative of young, middle-class, well-educated women, except for a greater incidence of divorce and separation. Typical sexual experiences included extramarital relationships, oral and anal intercourse, masturbation, and childhood sexual contacts with adult males who were either a member or friend of the family. Compared to other reports of sexual experience, clients showed greater frequencies of intercourse, homosexual and extramarital experience, and childhood sexual contacts with adult males, but less frequency of orgasm. In addition, mean T-scores were moderately elevated (60–69) for eight of 13 MMPI scales.     

Narratives of Treatment Outcome

This article is based on the findings of an interview study that explored the discourses clinicians draw on in their narratives in relation to self-injury. More specifically, the study focused on the clinicians’ discourses of responsibility for treatment outcome, and how they construct concepts of success, failure, and partial failure. Eight mental health clinicians from various disciplines who employed a range of treatment modalities were selected using purposive sampling. An in-depth conversational-style interviewing approach was used. The findings of the study highlight the complexities and difficulties the clinicians encountered with regard to the evaluation of their clinical practice with self-injuring patients. It appears that clinicians have little or no systematic way of thinking or conceptualizing “progress” with regard to self-injury. In relation to who is responsible for treatment outcome, the clinicians occupied various discursive positions. These findings have implications for the education and training of clinicians in developing systematic indicators of progress with respect to self-injury and in creating spaces in which they can speak about and reflect on their clinical effectiveness and failures.     

心力衰竭的药物及非药物治疗

神经内分泌激活、心室重构是收缩性心力衰竭进展的关键机制,针对上述机制的生物学治疗包括血管紧张素转换酶抑制剂、β受体阻滞剂、盐皮质激素受体拮抗剂等可显著改善心力衰竭患者预后,利尿剂、洋地黄等常规药物治疗可改善心力衰竭症状、降低心力衰竭住院风险,为神经内分泌拮抗剂的应用奠定基础;近年来,从阻断心力衰竭发生机制方面研发了很多新药,但尚没有一种能对长期生存率有显著改善.器械治疗(植入型心脏复律除颤器、心室再同步和心室再同步心脏复律除颤器)可降低特定心力衰竭患者病死风险,预防猝死发生,显著改善预后;心室辅助装置及干细胞治疗则为心力衰竭治疗带来新的曙光.     

白血病需要综合治疗

通过分析目前白血病单一治疗方法学中的利与弊,可以得到一些重要的启示和思考,这些启示引导我们要用综合的手段去治疗白血病,并最终攻克白血病这一顽疾。     

Treatment of acute mania

Mood stabilizers have evolved considerably over the past decade. Lithium, divalproex, and olanzapine are currently Food and Drug Administration-approved for the treatment of acute mania. A number of new and traditional medications have also been tested and are commonly used in clinical practice. Several strategies for managing treatment-resistant mania have been suggested, but few have been rigorously tested. Emphases on rapid stabilization and fewer side effects have raised the bar for what is expected from mood stabilizers and the successful treatment of mania involves a delicate balance between swiftness, short-term tolerability, and long-term safety.     

In Treatment

This article deals with current representations of psychotherapy in movies and television and focuses on the recent TV series In Treatment. It is discussed if and how this and other TV series might contribute to a change in the public image of psychotherapy. This discussion is based on studies investigating the public image of psychotherapy and its image within the media as well as the potential to use movies and TV as a stage for psychotherapeutic processes. Among several TV series dealing with psychotherapy, In Treatment plays a special role because of its conception as an intimate play. The series is described and discussed in relation to the question how realistic psychotherapy is staged and whether the hero of the series ??Dr. Paul Weston?? can be used as a model in psychotherapeutic training.     

Treatment Acceptability

The present study assessed mothers' and fathers' acceptance of six interventions frequently used to alter children's problem behavior. This is the first study to assess fathers' perceptions of behavioral interventions for children. Positive reinforcement, response cost, medication, room timeout, chair timeout and spanking were rated by parents using the Treatment Evaluation Inventory (TEI). In addition, parents' perceptions of their children's behavior and own marital adjustment were measured using standardized checklists. Parents' acceptability ratings differed significantly across treatment conditions depending on parent gender, child behavior problems, and marital adjustment. Treatment preference order was equivalent for all groups.     

Mentalization-Based Treatment

The concept of mentalizing has captured the interest and imagination of an astonishing range of people—from psychoanalysts to neuroscientists, from child development researchers to geneticists, from existential philosophers to phenomenologists—all of whom seem to have found it useful. According to the Thompson Reuter maintained Web of Science, the use of the term in titles and abstracts of scientific papers increased from 10 to 2,750 between 1991 and 2011. Clinicians in particular have enthusiastically embraced the idea, and have put it to innovative use in their practices. Mentalization-based treatment (MBT)—making mentalizing a core focus of therapy—was initially developed for the treatment of borderline personality disorder (BPD) in routine clinical services delivered in group and individual modalities. Therapy with mentalizing as a central component is currently being developed for treatment of numerous groups, including people with antisocial personality disorder, substance abuse, eating disorders, and at-risk mothers with infants and children (A. Bateman & Fonagy, 2011). It is also being used with families and adolescents, in schools, and in managing social groups (Asen & Fonagy, 2011; Fonagy et al., 2009; Twemlow, Fonagy, & Sacco, 2005a Twemlow, S. W., Fonagy, P. and Sacco, F. C. 2005a. A developmental approach to mentalizing communities: I. A model for social change. Bull. Menninger Clin, 69(4): 265–281. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 2005b). In this article, we focus on MBT in the treatment of BPD.     

脑卒中的康复治疗

讨论和研究了遵循生物-心理-社会医学模式,从生物功能、心理功能、社会功能三个纬度综述脑卒中的康复治疗理论.一个以躯体生物功能损害为突出表现的脑卒中患者,要综合考虑他的受损的躯体功能、心理状态和社会功能,三者不宜偏废.     

白血病需要综合治疗

通过分析目前白血病单一治疗方法学中的利与弊,可以得到一些重要的启示和思考,这些启示引导我们要用综合的手段去治疗白血病,并最终攻克白血病这一顽疾.     

糖尿病防治的几点认识

根据世界卫生组织的健康定义,健康是人的生理、心理和社会的协调一致,反之产生疾病。糖尿病在影响人们生理、心理健康的同时,影响着人们的生活方式、社会关系、收入和社会期望度。因此糖尿病的诊断和治疗必须考虑到患者的心理社会因素。临床医生应学会使用现代的生物心理社会模式,倡导正确的行为生活方式、落实连续性医疗服务、提高卫生服务整体效能、提供多方位社会支持、选择个体化的糖尿病治疗方案,针对性地进行糖尿病的防治。     

肿瘤综合治疗中的系统观

进入 2 0世纪之后 ,医学渐渐进入理性阶段。随着对肿瘤本质认识的不断深入 ,更由于肿瘤局部治疗方法的停滞不前 ,恶性肿瘤逐渐地被看成为一种全身性疾病。由此而来 ,肿瘤治疗观念便发生了明显的转向 ,肿瘤综合治疗观应运而生。纵观恶性肿瘤治疗方法的历史发展与衍变 ,不难看出 ,肿瘤外科学、肿瘤放射治疗学、肿瘤化学治疗学构成了现代肿瘤治疗学的三大支柱。三种手段互有特点 ,互为补充。从治疗效应看 ,外科手术和放射治疗都为局部治疗的方法。因此 ,肿瘤外科学家和放射肿瘤学家对肿瘤概念结构认识极为相似 ,两者都认为恶性肿瘤发生在局部 ,…     

特应性皮炎的治疗

特应性皮炎（AD）是一种以瘙痒和湿疹为主要特征的慢性炎症疾病,严重影响患者的生活质量。由于病因和发病机制至今尚未完全明确,其治疗在临床上仍然是一个挑战。大多数患者可通过避免激发因素、基础皮肤护理和外用抗炎药得到较好的疗效,少部分患者皮损广泛且对常规治疗抵抗,需要系统药物治疗。由于患者的病情严重程度、合并的病变及发病年龄变异很大,在治疗上应遵循按照疾病严重程度进行个体化的阶梯治疗方案的原则。在选择系统治疗时,在考虑其治疗收益的同时应考虑其安全性和副反应。