心理咨询和治疗的知情同意原则及其影响因素

随着心理咨询和治疗的发展,患者的知情同意成为临床心理学实践的一个基本伦理观念和原则.首先提出心理咨询和治疗实践中的知情同意问题,介绍心理咨询和治疗知情同意的要素、过程、内容、意义和影响因素,并附心理咨询和治疗提供给患者的知情同意问卷,旨在引起从业者的注意和重视,并在临床实践中自觉地遵守.     

降压达标在高血压治疗中的意义

随着高血压发病人数的增加,高血压所造成的心、脑、肾等重要靶器官损伤、功能衰竭日益受到重视.临床研究证明,为减少由高血压造成的重要器官损伤、提高患者的生活质量、降低病死率,通过各种方式尽快将血压控制在所要求的达标范围内是非常必要的.     

Social and emotional loneliness and self‐reported difficulty initiating and maintaining sleep (DIMS) in a sample of Norwegian university students

Social and emotional loneliness negatively impact several areas of health, including sleep. However, few comprehensive population‐based studies have evaluated this relationship. Over 12,000 students aged 21–35 years who participated in the student survey for higher education in Norway (the SHoT study) were assessed. Loneliness was assessed using the Social and Emotional Loneliness Scale. Difficulty initiating and maintaining sleep (DIMS) was assessed by a single‐item subjective response on the depression scale of the Hopkins Symptoms Checklist (HSCL‐25). Social loneliness was associated with more serious DIMS (unadjusted proportional odds‐ratio [OR] = 2.69, 95% CI = 2.46–2.95). This association was attenuated following adjustment for anxiety (adjusted OR = 1.92, 95% CI = 1.75–2.10) and depression (adjusted OR = 1.48, 95% CI = 1.34–1.63), however was not substantially altered when all demographics and psychological distress were accounted for (fully adjusted OR = 1.46, 95% CI = 1.30–1.63). Emotional loneliness was also associated with more serious DIMS (unadjusted proportional OR = 2.33, 95% CI = 2.12–2.57). Adjustment for anxiety (adjusted OR = 1.96, 95% CI = 1.78–2.15) and depression (adjusted OR = 1.64, 95% CI = 1.48–1.80) attenuated, but did not extinguish this relationship in the fully adjusted model (adjusted OR = 1.22, 95% CI = 1.09–1.31). Mediation analyses revealed that the social loneliness‐DIMS association was fully attributed to psychological distress, while the emotional loneliness‐DIMS association was only partially mediated, and a direct association was still observed. Associations between social and emotional loneliness and subjective DIMS were embedded in a larger pattern of psychological distress. Mitigating underlying feelings of loneliness may reduce potentially deleterious effects on sleep health and psychological wellbeing in young adults.     

MAOA基因T941G多态性与同伴侵害对男青少年早期抑郁的交互作用:COMT基因Val158Met多态性的调节效应

抑郁具有复杂的多基因遗传基础,然而既有研究大多采用单基因以及单基因-环境交互设计(G×E)考察抑郁的遗传机制。以757名男青少年为被试(初次测评时Mage=11.32岁,SD=0.49岁),采用多基因-环境交互(G×G×E)设计,本研究考察了MAOA(monoamine oxidase A,单胺氧化酶A)基因T941G多态性、COMT(catechol-O-methyltransferase,儿茶酚胺氧位甲基转移酶)基因Val158Met多态性与同伴侵害对青少年早期抑郁的影响。结果显示,MAOA基因T941G多态性与同伴侵害交互作用于青少年抑郁,同伴侵害仅显著正向预测G等位基因(而非T等位基因)青少年抑郁。而且,MAOA基因T941G多态性与同伴侵害的交互作用受到COMT基因Val158Met多态性的调节,上述交互作用仅存在于COMT Met等位基因而非Val/Val基因型携带者中。研究结果显示,抑郁的产生与个体差异存在多基因与环境间的复杂交互机制。     

发展级联:解释个体纵向发展的新视角

发展级联(developmental cascades)近年来已成为发展心理学追踪研究中一种重要的理论视角。其基本观点是:人的发展过程是一个诸多发展特征不断产生级联效应的过程,某个时间点上个体特征的发展状况会对该特征的后续发展产生影响,并影响其他领域的发展,进而影响到个体的整个发展进程。在发展级联的理论观点基础上形成的相关方法学模型,为探究发展系统中多个因素之间的纵向关联提供了方法学依据与指导。本文介绍了发展级联的相关概念、理论基础、主要观点以及相关的方法学问题,并对其在实证研究中的应用进行了展望。     

童年中晚期攻击的发展轨迹和性别差异：基于母亲报告的分析

采用母亲报告的方法, 对1618名儿童的攻击进行了4年(9岁~12岁)的追踪研究, 分析了童年中晚期攻击的一般发展轨迹、亚组发展轨迹以及性别差异。结果发现：(1)总体上, 童年中晚期儿童的攻击水平随年龄而下降。(2)基于亚组的准参数模型分析表明, 童年中晚期母亲报告的儿童攻击呈现三条不同的发展轨迹, 即无攻击轨迹、低攻击—下降轨迹以及持续高攻击轨迹, 各轨迹组人数比例分别约为68.7%、26.8%、4.5%。持续高攻击轨迹组以及低攻击—下降轨迹组的儿童在童年晚期均面临一定程度的人际适应困难。(3)多项Logit模型以及卡方检验表明, 男生更倾向于归属于攻击轨迹组(高或者低攻击轨迹组), 而女生更倾向于归属于无攻击轨迹组; 但这并不说明高攻击轨迹组中没有女生, 约2%的女生属于高攻击轨迹组。     

Applying artificial neural network models to clinical decision making

Because psychological assessment typically lacks biological gold standards, it traditionally has relied on clinicians' expert knowledge. A more empirically based approach frequently has applied linear models to data to derive meaningful constructs and appropriate measures. Statistical inferences are then used to assess the generality of the findings. This article introduces artificial neural networks (ANNs), flexible nonlinear modeling techniques that test a model's generality by applying its estimates against "future" data. ANNs have potential for overcoming some shortcomings of linear models. The basics of ANNs and their applications to psychological assessment are reviewed. Two examples of clinical decision making are described in which an ANN is compared with linear models, and the complexity of the network performance is examined. Issues salient to psychological assessment are addressed.     

中国人的时间知觉广度

时间知觉是社会结构和文化传统的映射,具有深刻的社会文化意涵。本文聚焦时间知觉广度这一概念,探讨中国人的时间知觉广度及其对自我连续性和社会变化观等心理过程的影响。通过综合讨论诸多实验发现提出,中国人具有较大的时间知觉广度,包括具有显著的过去取向和未来取向。较大的时间知觉广度提升了中国人跨时间的自我连续性,并且影响着中国人看待世事变化的变化观,这些特点又进一步影响到其它心理过程,例如对苦难和幸福的解读,在股票市场中的决策等。在一定程度上,这些特点可能是中国人在应对不确定性和重大危机时表现出更强的心理韧性和复原力的心理基础。本研究还指出中国人时间知觉广度具有独特的文化意义,包括整体性思维、过去现在未来互嵌互动和双向延展、与自我连续性和社会结构相关联以及具有道德属性等。基于此,本研究提出了时间知觉广度的文化心理比较模型,并分析了时间知觉广度对自我同一性和文化同一性的影响结果。希望本文能为进一步研究“中国人应对历史危机的心理特征与行为表现”提供科学依据。     

职业污名与离职倾向：牵连家人污名与家庭卷入的作用

职业污名对从业者的工作态度和工作行为有着重要影响。以往研究从个体职业身份的视角解释职业污名的作用, 忽略了从业者个体身份认同的多重属性。本研究基于身份边界理论, 提出职业污名会通过牵连家人污名这一机制影响从业者的离职倾向。另外, 这一机制的强弱取决于个体的家庭卷入程度。本研究通过对分属不同职业的384名从业者的3轮问卷调研发现, 家庭卷入调节了牵连家人污名在职业污名与离职倾向之间的中介作用。当个体的家庭卷入水平高时, 这一中介作用更强; 家庭卷入水平低时, 该中介作用更弱。本研究在理论上提出并检验了职业污名影响的新机制, 同时对实际管理工作提出了建议。