原发性醛固酮增多症的临床实践与分析

探讨原发性醛固酮增多症(原醛)临床特点及诊治方面的经验,以早期诊断、根治,改善预后。对确诊的原醛53例临床资料(临床特征、实验室检查、影像学检查、病理类型、治疗情况)进行回顾性研究。男女比为1：1.65,30～49岁年龄段最多。50.9%高血压首发,15.1%低钾血症首发,并发高心痛9.4%,尿毒症1.9%,脑卒中13.2%。肾素-血管紧张素-醛固酮(RAA)系统激素检查,血浆醛固酮/血浆肾素活性比值(ARR)＞200者80.7%,ARR＞400者占半数,血浆醛固酮(PAC)＞140pg/ml者占84.6%。CT及MRI阳性率高。术后病理肾上腺皮质腺瘤占85%,结节性增生占15%(其中原发性肾上腺增生占12.5%)。手术后血压及血钾均较前改善,非手术者口服安体舒通有效。原醛是可治性内分泌性高血压之一,建议高血压和/或低血钾者应常规检查RAA系统激素,并争取行影像学检查,以使原醛得到早期诊治,改善预后。     

When prevention promotes creativity: the role of mood, regulatory focus, and regulatory closure

Promotion-focused states generally boost creativity because they associate with enhanced activation and cognitive flexibility. With regard to prevention-focused states, research evidence is less consistent, with some findings suggesting prevention-focused states promote creativity and other findings pointing to no or even negative effects. We proposed and tested the hypothesis that whether prevention-focused states boost creativity depends on regulatory closure (whether a goal is fulfilled or not). We predicted that prevention-focused states that activate the individual (unfulfilled prevention goals, fear) would lead to similar levels of creativity as promotion-focused states but that prevention-focused states that deactivate (closed prevention goals, relief) would lead to lower levels of creativity. Moreover, we predicted that this effect would be mediated by feelings of activation. Predictions were tested in 3 studies on creative insights and 1 on original ideation. Results supported predictions. Implications for self-regulation, motivation, mood, and creativity are discussed.     

“Yes,I Have Sometimes Stolen Bikes”: Blindness for Norm‐Violating Behaviors and Implications for Suspect Interrogations

Across two experiments, we studied a phenomenon akin to choice blindness in the context of participants' accounts of their own history of norm‐violating behaviors. In Experiment 1, N = 67 participants filled in an 18‐item questionnaire about their history of norm‐violating behaviors (QHNVB). Subsequently, they were questioned about four of their answers, two of which had covertly been manipulated by the experimenter. Of the 134 manipulations, 20 (14.9%) remained undetected concurrently and 13 were accepted in retrospect (9.7%). In Experiment 2 (N = 37), we inserted a one‐week interval between questionnaire and interview. Twenty‐seven (36.5%) of the 74 manipulations remained undetected concurrently and three were accepted in retrospect (8.1%). Data obtained in a four‐week follow‐up indicated that our manipulations may have long‐term effects on participants' perception of their own history of norm‐violating behaviors. Implications for the occurrence of false confessions during the course of an interrogation are discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Forms of Transformation in the Reflective Space: Clarifying “Mentalization” Theory Through a Clinical Application: Commentary on Paper by Stephen Seligman

In responding to discussions of my paper “Jonah: A Fantasy of Flight” by Fishman, Salberg, and Shulman, I focus on some of my critical assumptions in reading this or any other biblical text. Prominent among these is the need to relinquish the stance of “already knowing” the meaning of the text. This irreducibly enigmatic book demands close, informed, and literary reading. Within the context of a sustained reflection on the methodology and spirit of my enterprise, I discuss the main points of difference or disagreement that arise in the papers of my discussants, as well as celebrating the places of accord and enrichment.     

音乐与情绪诱发的机制模型

音乐与情绪关系的讨论正处于行为层面描述向认知及神经机制研究的初探阶段.线索一致性模型、音乐期待模型、协同化理论和多重机制模型分别从音乐线索、听者认知、音乐与听者互动关系及多重整合角度对音乐诱发情绪的过程做出了解释.当前分歧集中于三方面:(1)音乐诱发情绪是否必须以认知为中介;(2)诱发过程是一般领域还是特殊领域;(3)诱发情绪的机制是多元还是单一.文章提出确定概念同质、借助多指标测量和思考机制关系等解决思路,并阐明了此领域的研究趋势.     

Innovation in top management teams: Minority dissent,transformational leadership,and radical innovations

Research among lower level teams suggests that minority dissent stimulates team innovation. We consider the role of CEO transformational leadership in the dissent–innovation relation and study this in Top Management Teams (TMTs). We propose that transformational leaders create a psychologically safe team climate, in which dissenting opinions are used effectively to create radical innovations. Members of 36 TMTs (N = 196) completed a questionnaire to assess minority dissent, transformational leadership, and participative safety. CEOs provided data about the innovations implemented by the team. Results showed that minority dissent was positively related to the number of innovations implemented by TMTs. However, only under high levels of transformational leadership were these innovations radical. It was further found that transformational leadership had this effect because it was positively associated with participative safety. These results indicate that minorities stimulate innovativeness and that through transformational leadership CEOs can create a climate in which minority input is transformed into radical innovations. Implications for TMT performance and team innovation are discussed.     

Regulatory focus theory: Disentangling goals and strategies

The purpose of this research was to develop and test the Regulatory Goals and Strategies Questionnaire (RGSQ) to promote conceptual and empirical clarity in the literature on regulatory focus theory (RFT). According to RFT, construing an end-state as a maximal goal (ideal, gain, and advancement) elicits the adoption of an eager promotion-focused strategy, whereas construing an end-state as a minimal goal (ought, non-loss, and security) elicits the adoption of a vigilant prevention-focused strategy. This means that promotion-focused eagerness and prevention-focused vigilance can be elicited by various goals and that eager and vigilant strategies are in fact separate from goals. However, extant measurement instruments have not treated them as such. The RGSQ was developed to distinguish various maximal and minimal goals and to separate these goals from promotion- and prevention-focused strategies of eagerness and vigilance. Across three studies that combine six samples (total N = 1848), we examined the factor structure and nomological network of the RGSQ (Study 1: four samples of students and adults) and its predictive validity in a task context (Study 2) and working sample (Study 3). Overall, we found support for the RGSQ's validity and demonstrated that the RGSQ operationalizes regulatory focus in accordance with the theory's core assumptions.     

Perceptions of primary family therapy supervisory techniques: A critical incident analysis

This study surveyed a randomly selected group of Approved Supervisors of the American Association for Marriage and Family Therapy (n=275) and their supervisees (n=266) on their perceptions of the primary supervisory technique used in supervisory incidents that had a positive effect on supervisee development. Individual case consultation was the technique most often identified by both supervisors and supervisees.This study was funded in part by grants from the Research Committee of the American Association for Marriage and Family Therapy; the Agricultural Experiment Station, Purdue University; and the School of Liberal Arts and Sciences, Purdue University Calumet.     

Cyborgs, uploading and immortality — Some serious concerns

Transhumanism and Extropianism are two recent ‘movements’ which aspire to transcend the perceived limitations of human biological evolution. This paper takes a critical look at two of the most controversial aspects of Extropianism—Uploading and Immortality. Uploading is the process by which a human will be able to transfer the entire contents of their brain to a more suitable supercomputational medium. When the newentity exist as software, immortality is virtually assured. This should be possible, it is claimed, within the next fifty years! From both a pragmatic and philosophical perspective, I argue that these claims are at best misguided and at worst absurd.     

Empirical Support for an Evolutionary Model of Self‐Destructive Motivation

We tested predictions generated from an evolutionary account of self‐destructive motivation in two survey studies of 18–24‐year‐old university students. As hypothesized, hierarchical regressions showed that the positive relationship between perceived burden to family and suicide ideation was amplified for participants with low measured health and romantic relationship satisfaction, and for participants with relatively young mothers. The moderating effect of maternal age was also observed in logistic regressions of suicide attempts. These effects occurred independently of depression, hopelessness, and other relevant extraneous variables. Results have implications for understanding self‐destructive motivation, assessing suicide risk, and preventing suicidal thinking and behavior.