The application of “chaos theory” to the physical and chemical sciences has resolved some long-standing problems, such as how to calculate a turbulent event in fluid dynamics or how to quantify the pathway of a molecule during Brownian motion. Biology and medicine also have unresolved problems, such as how to predict the occurrence of lethal arrhythmias or epileptic seizures. The quantification of a chaotic system, such as the nervous system, can occur by calculating the correlation dimension (D2) of a sample of the data that the system generates. For biological systems, the point correlation dimension (PD2) has an advantage in that it does not presume stationarity of the data, as the D2 algorithm must, and thus can track the transient non-stationarities that occur when the systems changes state. Such non-stationarities arise during normal functioning (e.g., during an event-related potential) or in pathology (e.g., in epilepsy or cardiac arrhythmogenesis). When stochastic analyses, such as the standard deviation or power spectrum, are performed on the same data they often have a reduced sensitivity and specifity compared to the dimensional measures. For example, a reduced standard deviation of heartbeat intervals can predict increased mortality in a group of cardiac subjects, each of which has a reduced standard deviation, but it cannot specify which individuals will or will not manifest lethal arrhythmogenesis; in contrast, the PD2 of the very same data can specify which patients will manifest sudden death. The explanation for the greater sensitivity and specificity of the dimensional measures is that they aredeterministic, and thus are moreaccurate in quantifying the time-series. This accuracy appears to be significant in detecting pathology in biological systems, and thus the use of deterministic measures may lead to breakthroughs in the diagnosis and treatment of some medical disorders. 相似文献
Children with selective mutism (SM) experience significant challenges in a variety of social situations, leading to difficulties with academics, peers, and family functioning. Despite the extensive evidence base for cognitive-behavioral interventions for youth anxiety, the literature has seen relatively limited advancement in specialized treatment methods for SM. In addition, geographic disparities in SM treatment expertise and the roughly 6-month duration of some of the supported SM treatment protocols can further restrict the accessibility and acceptability of quality SM care. Intensive group behavioral treatment (IGBT) for SM was developed to expand the portfolio of evidence-based SM treatment options by offering brief, but high-dose, expert SM intervention in a group format for youth ages 3–10 years that can be completed in 1 week. In this article, we outline IGBT for SM program, which has already received initial support in a waitlist-controlled trial. Our presentation is organized around the five main components of the treatment model: (1) individual “lead-in” sessions, (2) camp (i.e., all-day group sessions for children held in a simulated classroom setting, with an emphasis on graduated exposures and structured reinforcement), (3) parent training, (4) school outreach, and (5) booster treatment, as needed. We conclude with a discussion of clinical considerations and future directions for further IGBT refinement and evaluation. 相似文献
Communication during a combat deployment has changed significantly in current times. Couples can now communicate with each other frequently and through multiple modes. Despite this greater availability of communication options, there remain unanswered questions related to how healthy deployment communication is best achieved between couples, particularly regarding navigating the uncertainty of deployment. In this qualitative study, we report on the experiences of 31 National Guard couples who endured a combat deployment in support of Operation Enduring Freedom. Couples were interviewed three months after the soldier returned from deployment. Through the lens of relational turbulence theory, we provide a conceptual framework related to effective and non-effective deployment communication, along with structural communication barriers in the military that may negatively affect the mental well-being of partners. Finally, we provide recommendations to guide couples through these difficult deployments.
While our field has made positive strides in adapting psychotherapeutic interventions for diverse groups of people, considerable work is still needed in this area. We present our formal adaptation procedure for parent–child interaction therapy (PCIT) with Deaf persons. This includes a review of the cultural adaptation process for psychological interventions, including PCIT, as well as an introduction to Deaf culture. Details regarding the specific adaptation of PCIT for Deaf persons are outlined. We found that the utilization of a clear framework to guide the cultural adaptation process facilitated careful consideration of the numerous linguistic and cultural variables involved, while maintaining integrity of the treatment model. While the current focus was on adapting PCIT for Deaf families who communicate via American Sign Language, this framework can also be applied to other populations and/or interventions. 相似文献
Gerald Caplan's Theory and Practice of Mental Health Consultation (1970), considered to be a classic seminal work in the field of consultation, is reviewed. First, the author presents Caplan's general definition of consultation along with what may be considered the general principles or procedures of consultation. Then the author presents Caplan's procedures and principles as relevant to each type of consultation. Next, each of Caplan's four models of consultation is described. Last, these four models are compared in terms of the professional role of the consultee, the primary goal of consultation, and the target of consultation intervention. 相似文献
Neurocognitive impairment can predict functional capacity in individuals with bipolar disorder, though little research has examined whether different neurocognitive domains impact specific types of tasks. This study examined the relationship between several neurocognitive variables and the UCSD Performance‐Based Skills Assessment (UPSA; Patterson et al., 2011) to identify the domains and tests that best predict the performance across the subscales. Forty‐seven euthymic participants who were diagnosed with either Bipolar I or Bipolar II were recruited and assessed on a battery of neuropsychological measures and the UPSA. Correlational and regression analyses were run to identify neurocognitive predictors of UPSA subscales. Per the literature, verbal learning and memory and executive function composites were first examined. Verbal learning and memory predicted the Communication subscale and Total score variables above and beyond the estimated FSIQ and symptom rating scales. In a secondary exploratory analysis, the Benton Judgment of Line Orientation subtest predicted the Finance subscale while the California Verbal Learning Test predicted the UPSA total score. Verbal learning and memory emerged as the strongest predictor of functional capacity, suggesting that this domain should be investigated in future mediational and longitudinal studies with the UPSA. 相似文献
South Africa has one of the highest HIV infection rates in the world, with young people particularly affected. Condoms are an effective preventative method against HIV among sexually active adults. This study assessed the level of condom usage among university students in South Africa and their attitudes towards condom usage, negotiation efficacy and confidence in condom usage. It was a cross-sectional study conducted amongst South African university students living at the university residences. Students were randomly selected and required to complete a self-administered questionnaire. The mean age of participants (n?=?441) was 22.7?±?4.3 years. The mean age of sexual debut was 17.7?±?3.0 years with 1.4?±?1.47 (range 0–13) current partners. Less than half of the students used a condom at sexual debut and only 28.5% used condoms during recent sexual activity. Those students who used a condom at first sexual intercourse had marginally more positive attitudes about condom usage than those who did not do so (p?=?0.056). Students with a single current partner had more positive attitudes about condom usage than those with multiple current partners (p?=?0.021). Only 32.5% (n?=?127) of the students were very confident in using condoms. Similarly, only 33.0% (n?=?130) of the participants felt that they could definitely negotiate condom use with their partners. We conclude that condom use among South African students is low and that they lack the confidence to use condoms. We recommend that programmes to step up condom use must also incorporate educational interventions on usage. 相似文献