初级卫生保健立法的探讨

我国在初级卫生保健方面所作的努力及取得的成就就是有目共睹的。但是,由于立法滞后,在初级卫生保健工作的落实与推广中存在不少问题。论证初级卫生保健立法的必要性和可行性,并对初级卫生保健立法框架提出设想,将促进初级卫生保健立法工作,推动初级卫生保健工作的发展。     

Observing behavior: effects of rate and magnitude of primary reinforcement

Four experiments examined the free-operant observing behavior of rats. In Experiment 1, observing was a bitonic function of random-ratio schedule requirements for the primary reinforcer. In Experiment 2, decreases in the magnitude of the primary reinforcer decreased observing. Experiment 3 examined observing when a random-ratio schedule or a yoked random-time schedule of primary reinforcement was in effect across conditions. Removing the response requirement for the primary reinforcer increased observing, suggesting that the effects of the random-ratio schedule in Experiment 1 likely were due to an interaction between observing and responding for the primary reinforcer. In Experiment 4, decreasing the rate of primary reinforcement by increasing the duration of a random-time schedule decreased observing monotonically. Overall, these results suggest that observing decreases with decreases in the rate or magnitude of the primary reinforcer, but that behavior related to the primary reinforcer can affect observing and potentially affect measurement of conditioned reinforcing value.     

Practical Guidance for Targeting Insomnia in Primary Care Settings

Insomnia is among the most prevalent conditions in primary care. Despite the development of well-established, evidence-based cognitive and behavioral interventions for insomnia, they are not typically applied in primary care environments. One method for improving primary care delivery of these interventions is to integrate behavioral health providers as a service delivery team member in this environment. The population health focus and time-limited appointments of primary care require that these well-established interventions are adapted for effective implementation in primary care. Using a case example, we describe practical methods of delivering these interventions in the primary care setting.     

The Current State of Intervention Research for Posttraumatic Stress Disorder Within the Primary Care Setting

Posttraumatic Stress Disorder (PTSD) is common among primary care patients and is associated with significant functional impairment, physical health concerns, and mental health comorbidities. Significant barriers to receiving adequate treatment often exist for primary care patients with PTSD. Mental health professionals operating as part of the primary care team have the potential to provide effective brief intervention services. While good PTSD screening and assessment measures are available for the primary care setting, there are currently no empirically supported primary care-based brief interventions for PTSD. This article reviews early research on the development and testing of primary care-based PTSD treatments and also reviews other brief PTSD interventions (i.e., telehealth and early intervention) that could be adapted to the primary care setting. Cognitive and behavioral therapies currently have the strongest evidence base for establishing an empirically supported brief intervention for PTSD in primary care. Recommendations are made for future research and clinical practice.     

Counselling the community: The contribution of counselling psychologists to the development of primary care

The primary care groups (PCGs) newly introduced to the National Health Service require general practitioners and primary care teams to improve the health of their communities by addressing the health needs of their population, promoting the health of that population and working with other organizations to deliver effective and appropriate care. Community-oriented primary care (COPC) is an internationally tested model for primary health care development which is now being employed within the UK. This paper outlines the COPC model, and demonstrates how the skills and knowledge base of counselling psychologists and primary care counselling can contribute to a community-oriented primary care approach.     

小学二、四年级学生注意瞬脱特征的比较研究

为测查注意瞬脱的发展特征,该研究对36名小学二年级和40名小学四年级学生的注意瞬脱特征进行全面测查。结果发现：小学二年级学生与小学四年级学生在其注意瞬脱程度、注意瞬脱持续时间、注意瞬脱的最低点上都存在非常显著的群体差异,其中又以女性小学生之间的群体差异更为显著。由此推测,小学二年级到四年级学段是注意瞬脱发展的敏感期,其中女性小学生注意瞬脱发展更为明显。     

情绪智力对农村小学校长职业倦怠的影响：领导效能和工作满意度的链式中介作用

为考察领导效能、工作满意度在情绪智力与农村小学校长职业倦怠关系中的链式中介效应,采用情绪智力量表、领导效能量表、工作满意度量表和职业倦怠量表对258名农村小学校长进行调查。结果表明：（1）情绪智力会负向预测农村小学校长职业倦怠;（2）领导效能是情绪智力与农村小学校长职业倦怠之间的中介变量;（3）工作满意度是领导效能与农村小学校长职业倦怠之间的中介变量。因此,领导效能和工作满意度在情绪智力与农村小学校长职业倦怠之间起链式中介作用,这些结果对于农村小学校长职业倦怠的预防与干预具有重要的价值。     

小学教师对学生注意问题的知觉准确性研究

本研究以24名小学教师和98名小学生为研究对象,采用访谈法与测验法探讨了小学教师对学生注意问题的知觉准确性及其影响因素。结果表明:(1)从总体上看,小学教师对学生注意问题的知觉有着较高的准确性;(2)小学教师对学生注意问题的知觉准确性水平随教龄和职称的增高而呈下降趋势;(3)小学教师对学生注意问题的知觉准确性水平与其条件性知识掌握情况表现正相关;(4)小学教师对学生注意问题的知觉准确性与其所教年级无关。     

中小学生生活满意度的调查与分析*

为了解中小学生的生活满意度状况,课题组用中小学生的愉快心境来定义生活满意度,对我国10249名中小学生进行了调查。结果表明:85%的中小学生生活得很愉快或比较愉快,72.3%的中小学生有烦恼,经检验存在明显的年级、性别及城乡差异;中小学生最烦恼问题排在前三位的分别是学习紧张、父母期望值高、同学中没友谊;中小学生最烦恼问题与愉快心境相关的排序依次是:父母期望值高、学习紧张、家庭气氛紧张和同学中没友谊。     

职业压力对西部山区中小学教师主观幸福感的影响：有调节的中介模型

为了探讨西部山区中小学教师职业压力与主观幸福感的影响,采用问卷调查法对2568名西部山区中小学教师进行调查,结果显示：（1）西部山区中小学教师主观幸福感在性别、是否担任班主任、月收入、教龄等人口学变量上存在显著性差异;（2）职业压力显著负向预测西部山区中小学教师主观幸福感;（3）职业倦怠中介了职业压力对西部山区中小学教师主观幸福感的影响;（4）职业认同调节了职业压力→职业倦怠→西部山区中小学教师主观幸福感这个中介过程的前半段。     

“Feeling Good in Your Own Skin” Part I: Primary Levels of Mental Organization

This two-part article (the first part published here and the second part will be published in the March 2011 Issue of the AJP), deals with the relation between a certain type of idiomatic expression, which we call somatic idioms, and what we recognize as the primary levels of mental organization. The article raises the following questions: What do we actually know about the primary levels of mental organization? What is the language's way to connect with the primary levels of mental organization? The first part of the article addresses the issue of how to describe and conceptualize the individual's earliest experiences, and how they continue to exist throughout one's adult life. The second part of the article focuses on the accessibility of the primary levels to language. Whereas most of the theories identify the primary levels as being outside of the linguistic realm, we suggest that some idiomatic expressions are the language's way to get in touch or connect with the primary levels. Therefore, the goals of the present article are to (1) characterize the primary levels of mental organization differently from the ways in which other psychoanalytic schools have done up until now; (2) reveal how language manages to find a way to connect with these primary levels, which are not outside of the linguistic realm, as has been previously suggested; and (3) exemplify the frequency and wide range of mental states—not only those which are pathological or extreme—in which the primary levels can be identified.     

The Evolutionary Significance of the Primary Process—The Freudian Concept and Its Revision

Freud’s Lamarckian beliefs contributed to his theory of instincts, as well as his concepts regarding the unconscious primary process. Freud’s theory of the primary and secondary process is fundamentally biological, as he placed it within an evolutionary context and hypothesized that the two systems were distinguished by free and bound psychic energy. Freud’s distinction between the primary and secondary process is one of the few psychoanalytic theories that has been confirmed by science. We believe that Freud was correct in maintaining that the primary process is of earlier evolutionary origin than the secondary process. But Freud failed to recognize the distinction between primary-process thinking that occurs in dreams and that which occurs in the waking state. In the waking state, the primary process is not wish fulfilling, as Freud believed, but functions as an inference making tool utilizing metaphor and metonymy. As such, rapid, unconscious primary process thinking is at the heart of our survival.     

Primary process thinking and anxiety in children

The relationship between primary process thinking and two measures of anxiety was investigated in fourth- and fifth-grade children. Holt's Scoring System for Primary Process Responses on the Rorschach was the measure of primary process thinking. The major hypotheses were supported for boys in that frequency of expression of primary process material was positively related to behavioral manifestations of anxiety as measured by the Teacher's Rating Scale. Also, controlled access to and integration of primary process was negatively related to teacher's ratings of anxiety. There were no significant results for girls. Primary process measures were not related to the State-Trait Anxiety Inventory for Children. Possible reasons for the different relationships between the primary process measures and the anxiety measures are discussed.     

Training Primary Care Psychologists

Primary care psychology is a new area that provides exciting opportunities for the field. This paper discusses the definition of primary care and the role of psychologists in primary health care. Educational programs developed by the author for pre- and postdoctoral training in primary care psychology are described.     

老年人乐观、领悟社会支持与主观幸福感的关系—控制策略的中介作用

基于毕生控制理论，方便选取杭州市60~95岁的老年人320名，采用问卷法考察了老年人控制策略使用的现状和特点，并在控制了年龄、健康状况、日常活动数量后，探讨了老年人的乐观、领悟社会支持与主观幸福感的关系，以及控制策略的中介作用。结果发现：低龄的老年男性和女性更偏好选择初级和补偿初级策略，而高龄老年女性更偏好补偿初级策略；乐观和领悟社会支持不仅可以直接影响老年人的主观幸福感，还可以通过选择初级策略间接影响主观幸福感。初级控制在老年人中依然具有首要性地位，老年人的资源越丰富，越有可能采用积极的控制策略（选择初级），进而提高主观幸福感，实现成功老龄化。