抑郁和焦虑与心血管疾病

抑郁焦虑与心血管疾病的关系最能体现身与心两者相互影响、不可分割的特点。但临床上,心血管疾病患者抑郁焦虑的诊疗率不足1％。这说明现有的诊疗理念和方式没有将心血管疾病和精神障碍联系起来,给患者全面全程的干预和管理。这样的缺陷不仅增加患者的痛苦和功能障碍,也增加心血管疾病的发病率和病死率,还增加患者及社会的医疗负担。本文结合临床经验,从心身一体的诊疗理念,谈谈抑郁焦虑与心血管疾病。     

对保乳手术及预防性乳腺切除术的思考

鉴于对乳腺癌是全身性疾病的认识,为提高术后生存质量,目前乳腺癌治疗中保乳手术日益受到重视.而为了阻断高危险性的乳腺向乳腺癌发展,预防性乳房切除术也正在被患者接受.保留乳腺与预防性切除乳腺的医学实践反映了目前人们对乳腺癌的深层认识,值得深入思考.     

面孔识别的自我群体偏向

面孔认知研究表明, 人们识别和再认自己所属群体(如种族、性别、年龄)面孔的成绩显著好于识别其他群体面孔的成绩。近年来围绕面孔识别的这种自我群体偏向进行了实验研究, 研究者提出了知觉经验说和社会认知论两种理论来解释其认知加工机制, 而类别化-个性化模型和双路径模型则是将两种理论分别加以整合提出的新解释。研究者还对面孔识别自我群体偏向的神经机制进行了研究, 探讨了评价者、评价对象和评价任务等因素对自我群体偏向的影响。提升面孔识别自我群体偏向研究的生态效度, 构建整合性理论模型以及加强跨文化和本土研究是未来研究的重要方向。     

大学生核心自我评价、学业倦怠对厌学现象的影响

采用问卷法对362名大学生进行问卷调查, 探讨核心自我评价、学业倦怠对厌学现象的影响。结果发现:(1)核心自我评价、学业倦怠各维度与厌学现象有不同程度的相关关系;(2)结构方程模型结果显示:a.核心自我评价对厌学情绪、厌学行为存在直接和间接效应;b.厌学情绪-厌学行为存在分离现象;c.核心自我评价对厌学情绪的直接效应和间接效应相当, 对厌学行为的直接效应明显大于间接效应;d.学业倦怠在核心自我评价对厌学情绪和厌学行为的影响中存在中介作用。     

Suicidal Ideation and Behavior in Adolescents Aged 12–16 Years: A 17‐Year Follow‐Up

The prevalence of suicidal ideation/behavior in 1983 or 1987 and its association with future mental health in 2001 were evaluated in a provincially representative sample of Canadian adolescents (n = 1,248) aged 12 to 16 years. Approximately 13.3% (95% CI = 11.5–15.3) of adolescents self‐reported suicidal ideation/behavior. Adolescent agreement with parent (κ = .07) and teacher (κ = .05) reports at baseline was low because adults identified so few subjects. In adulthood, the associations between adolescent self‐reports of suicidal behavior/ideation and major depression and other mental health indicators were explained by respondent sex and adolescent emotional problems reported in 1983/1987. Adolescents with suicidal behavior/ideation often are not recognized by their parents and teachers and may be at risk for persistent psychiatric problems attributable to coexisting mental health problems early‐on.     

A Trait‐Interpersonal Analysis of Suicide Proneness Among Lesbian,Gay, and Bisexual Community Members

Suicide remains a concerning issue for lesbian, gay, and bisexual (LGB) persons. The integrated effects of five‐factor model personality traits and interpersonal‐psychological theory of suicide (IPTS) constructs on suicide proneness in a community sample of 336 LGB adults were examined. Results supported a model inclusive of all five‐factor model domains predicting IPTS constructs leading to suicide proneness. Effects of neuroticism and extraversion were both mediated by perceived burdensomeness and thwarted belongingness. Thwarted belongingness mediated the effect of agreeableness on suicide proneness. Identified mediation pathways build on existing trait‐interpersonal theory and may inform clinical services for sexual minority persons.     

I Can Stomach That! Fearlessness About Death Predicts Attenuated Facial Electromyography Activity in Response to Death‐Related Images

Objective measures of suicide risk can convey life‐saving information to clinicians, but few such measures exist. This study examined an objective measure of fearlessness about death (FAD), testing whether FAD relates to self‐reported and physiological aversion to death. Females (n = 87) reported FAD and disgust sensitivity, and facial electromyography was used to measure physiological facial responses consistent with disgust while viewing death‐related images. FAD predicted attenuated expression of physiological death aversion, even when controlling for self‐reported death‐related disgust sensitivity. Diminished physiological aversion to death‐related stimuli holds promise as an objective measure of FAD and suicide risk.     

Impact of Firearm Availability and Gun Regulation on State Suicide Rates

Past studies on suicide have investigated the association of firearm ownership and suicide risk in the United States. The aim of the present study was to build on previous work by examining the impact of firearm storage practices and the strictness of firearm regulation on suicide rates at the state level. Data were compiled from primarily three sources. Suicide and firearm ownership information was obtained from the Centers for Disease Control and Prevention. Strictness of handgun regulation was derived from figures available at the Law Center to Prevent Violence, and controls were taken from the US Bureau of the Census. Mixed models were fitted to the data. Household firearm ownership was strongly associated with both suicide by all mechanisms, and firearm suicide. Storage practices had especially elevated consequences on suicide rates. Percent with loaded guns and gun readiness increased suicide rates, and strictness of gun regulation reduced suicide rates. Ready access to firearms can make a difference between life and death. Loaded and unlocked firearms within reach become risk factors for fatal outcomes from suicidal behavior. Future research might want to examine ways of obtaining more recent data on individual firearm ownership. This study proposes several policy recommendations for suicide prevention.     

多元企业认同的身份构建及其张力调和机理

基于认同驱动的营销关系视角, 系统地探讨了基于多元企业认同的企业身份构建及其张力调和机理。具体地, 通过定性和定量相结合的方法, 首先基于社会认同理论和身份理论, 探索多元企业认同的结构; 其次, 从社会心理学和文化创新的视角, 描绘多元企业认同形成及演化过程; 最后, 探究多元企业认同的身份构建以及身份张力调和机制。在理论上将消费者-企业认同扩展到多个利益相关者与企业的认同, 探索多元企业认同的身份构建及调和过程, 揭示其背后深层作用机理。实践上为企业与客户保持长期、和谐、多赢关系提供重要依据。     

Posttraumatic Stress Disorder Symptom Clusters and Acquired Capability for Suicide: A Reexamination Using DSM-5 Criteria

This study used the interpersonal–psychological theory of suicide to explore the relationships among DSM-5 posttraumatic stress disorder (PTSD) symptom clusters derived from the six-factor anhedonia model and facets of acquired capability for suicide (ACS). In a sample of 373 trauma-exposed undergraduates, most PTSD symptom clusters were negatively associated with facets of ACS in bivariate correlations, but the anhedonia cluster was positively associated with ACS in regression models. Structure coefficients and commonality analysis indicated that anhedonia served as a suppressor variable for the other symptom clusters. Our findings further elucidate the complex relationship between specific PTSD symptom clusters and ACS.