Concurrent psychotherapy is used in various settings for patients of different diagnoses and ages. The concurrent group and individual psychotherapy of older adults with depressive disorders in a psychiatric day hospital is described, emphasizing phases of treatment and transference and countertransference themes uniquely relevant to working with depressed elderly patients in a day hospital. Case examples are offered to illustrate these issues. The special technical considerations that need to be utilized when multiple therapists and settings are present are described. The model employs the use of an integrative, interactive group therapy, along with various other group treatments and antidepressant medication, with individual therapy serving a subordinate but organizing role. 相似文献
The current research assesses relationships among coping skills, trait sport confidence, and trait anxiety. Two samples (n=47 and n=77) of international competitors from surf life saving (M=23.7 yr.) and touch rugby (M=26.2 yr.) completed the Athletic Coping Skills Inventory, Trait Sport Confidence Inventory, and Sport Anxiety Scale. Analysis yielded significant correlations amongst trait anxiety, sport confidence, and coping. Specifically confidence scores were positively associated with coping with adversity scores and anxiety scores were negatively associated. These findings support the inclusion of the personality characteristics of confidence and anxiety within the coping model presented by Hardy, Jones, and Gould, Researchers should be aware that confidence and anxiety may influence the coping processes of athletes. 相似文献
Multimorbidity, the presence of multiple health conditions that must be addressed, is a particularly difficult situation in patient management raising issues such as the use of multiple drugs and drug-disease interactions. Clinical Guidelines are evidence-based statements which provide recommendations for specific health conditions but are unfit for the management of multiple co-occurring health situations. To leverage these evidence-based documents, it becomes necessary to combine them. In this paper, using a case example, we explore the use of argumentation schemes to reason and combine evidence-based recommendations from clinical guidelines, expected effects, conflicts stemming from said recommendations, and preferences regarding treatment goals. We compare the results of reasoning using the schemes for practical reasoning and argument from negative consequences in the Carneades Argumentation System with those of ASPIC-G, an extension of the artificial intelligence system ASPIC+.
Journal of Religion and Health - Church-based stroke prevention programs for Hispanics are underutilized. The Stroke Health and Risk Education (SHARE) project, a multicomponent cluster-randomized... 相似文献
Healthy older adults typically perform worse than younger adults at rule-based category learning, but better than patients with Alzheimer’s or Parkinson’s disease. To further investigate aging’s effect on rule-based category learning, we monitored event-related potentials (ERPs) while younger and neuropsychologically typical older adults performed a visual category-learning task with a rule-based category structure and trial-by-trial feedback. Using these procedures, we previously identified ERPs sensitive to categorization strategy and accuracy in young participants. In addition, previous studies have demonstrated the importance of neural processing in the prefrontal cortex and the medial temporal lobe for this task. In this study, older adults showed lower accuracy and longer response times than younger adults, but there were two distinct subgroups of older adults. One subgroup showed near-chance performance throughout the procedure, never categorizing accurately. The other subgroup reached asymptotic accuracy that was equivalent to that in younger adults, although they categorized more slowly. These two subgroups were further distinguished via ERPs. Consistent with the compensation theory of cognitive aging, older adults who successfully learned showed larger frontal ERPs when compared with younger adults. Recruitment of prefrontal resources may have improved performance while slowing response times. Additionally, correlations of feedback-locked P300 amplitudes with category-learning accuracy differentiated successful younger and older adults. Overall, the results suggest that the ability to adapt one’s behavior in response to feedback during learning varies across older individuals, and that the failure of some to adapt their behavior may reflect inadequate engagement of prefrontal cortex. 相似文献
Objective: Haemodialysis patients are at risk of serious health complications; yet, treatment non-adherence remains high. Warnings about health risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory reduced resistance to health-risk information and improved fluid treatment adherence.
Design: In a cluster randomised controlled trial, 91 patients either self-affirmed or completed a matched control task before reading about the health-risks associated with inadequate fluid control.
Outcome measures: Patients’ perceptions of the health-risk information, intention and self-efficacy to control fluid were assessed immediately after presentation of health-risk information. Interdialytic weight gain (IDWG), excess fluid removed during haemodialysis, is a clinical measure of fluid treatment adherence. IDWG data were collected up to 12 months post-intervention.
Results: Self-affirmed patients had significantly reduced IDWG levels over 12 months. However, contrary to predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, intention to control fluid or self-efficacy.
Conclusion: A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce IDWG over a 12-month period, but the mechanism by which this apparent behaviour change occurred is uncertain. Further work is still required to identify mediators of the observed effects. 相似文献
Formalising deontic concepts, such as obligation, prohibition and permission, is normally carried out in a modal logic with a possible world semantics, in which some worlds are better than others. The main focus in these logics is on inferring logical consequences, for example inferring that the obligation Oq is a logical consequence of the obligations Op and O (p → q). In this paper we propose a non-modal approach in which obligations are preferred ways of satisfying goals expressed in first-order logic. To say that p is obligatory, but may be violated, resulting in a less than ideal situation s, means that the task is to satisfy the goal p ∨ s, and that models in which p is true are preferred to models in which s is true. Whereas, in modal logic, the preference relation between possible worlds is part of the semantics of the logic, in this non-modal approach, the preference relation between first-order models is external to the logic. Although our main focus is on satisfying goals, we also formulate a notion of logical consequence, which is comparable to the notion of logical consequence in modal deontic logic. In this formalisation, an obligation Op is a logical consequence of goals G, when p is true in all best models of G. We show how this non-modal approach to the treatment of deontic concepts deals with problems of contrary-to-duty obligations and normative conflicts, and argue that the approach is useful for many other applications, including abductive explanations, defeasible reasoning, combinatorial optimisation, and reactive systems of the production system variety. 相似文献
The authors show that verb aspect influences the activation of event knowledge with 4 novel results. First, common locations of events (e.g., arena) are primed following verbs with imperfective aspect (e.g., was skating) but not verbs with perfect aspect (e.g., had skated). Second, people generate more locative prepositional phrases as completions to sentence fragments with imperfective than those with perfect aspect. Third, the amplitude of the N400 component to location nouns varies as a function of aspect and typicality, being smallest for imperfective sentences with highly expected locations and largest for imperfective sentences with less expected locations. Fourth, the amplitude of a sustained frontal negativity spanning prepositional phrases is larger following perfect than following imperfective aspect. Taken together, these findings suggest a dynamic interplay between event knowledge and the linguistic stream. 相似文献
Users of pupil peer counselling for bullying services (n=50) rated their most helpful and their least helpful experiences of these services on five counselling process variables. The aim was to identify which, if any, of these variables differentiated between the two types of experience. Participants gave significantly higher ratings to 'core conditions', 'client openness' and 'maintain positive self-regard', but significantly lower ratings to 'counsellor directiveness', for their most helpful experience than for their least helpful experience. No significant differences emerged for ratings of 'counsellor self-disclosure'. None of these effects were qualified by gender. The implications of these findings for providers of peer counselling for bullying services are discussed. 相似文献