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This article provides an overview of cognitive-behavioral therapy (CBT) for panic disorder. CBT is currently considered a first-line treatment for panic disorder. It offers benefit after short-term intervention, typically consisting of 12-15 sessions conducted in either an individual or a group format. The treatment focuses on the elimination of the patterns that underlie and perpetuate the disorder. Through CBT, patients learn about the nature of the disorder and acquire a set of strategies that counter the fears of panic attacks themselves, and break the recurring cycle of anticipatory anxiety, panic, and agoraphobic avoidance. The collaborative format of treatment, and a focus on elimination of core fears may be factors in enhancing longer-term outcome. In this article, we review the efficacy of CBT as a first-line treatment, a strategy for medication nonresponders, a replacement strategy for patients who wish to discontinue pharmacotherapy, and a potential preventive strategy for at-risk individuals. We also discuss some of the complex issues involved with combination-treatment strategies. 相似文献
83.
We examined figural aftereffects in images of human faces, for which changes in configuration are highly discriminable. Observers
either matched or rated faces before or after viewing distorted images of faces. Prior adaptation strongly biases face perception
by causing the original face to appear distorted in a direction opposite to the adapting distortion. Aftereffects transferred
across different faces and were similar for upright or inverted faces, but were weaker when the adapting and test faces had
different orientations (e.g., adapt inverted and test upright). Thus the aftereffects depend on which images are distorted,
and not simply on the type of distortion introduced. We further show that the aftereffects are asymmetric, for adapting to
the original face has little effect on the perception of a distorted face. This asymmetry suggests that adaptation may play
an important normalizing role in face perception. Our results suggest that in normal viewing, figural aftereffects may strongly
influence form perception and could provide a novel method for probing properties of human face perception. 相似文献
84.
The last decade has brought exciting advances to the treatment of panic disorder and agoraphobia, and a variety of cognitive-behavioral and pharmacologic treatment strategies offer clear benefit to patients. Nonetheless, treatment nonresponse continues to be a chronic problem, and additional strategies are needed to aid patients who do not respond fully to initial interventions. In the present study, we use 'services' research to document the clinical response of pharmacotherapy nonresponders to a standard program of brief, group cognitive-behavioral therapy. Patients responded well, regardless of whether they had received a full, adequate trial of pharmacotherapy. In addition to its application as an initial treatment for panic disorder, routine application of cognitive-behavioral therapy in pharmacologic treatment algorithms is encouraged, with attention to referral of pharmacotherapy nonresponders to cognitive-behavioral therapy. 相似文献
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Equity theory (Adams, 1965) suggests that when persons are asked to divide a given amount of reward between two other persons, one relatively more disadvantaged than the other at performing a task, they will make allocations that are disproportionate to the two persons' performance levels, giving the disadvantaged person a disproportionately larger share and the advantaged person a disproportionately smaller share of the reward. The theory attributes this effect to the allocator's perception that the disadvantaged individual expended a disproportionately greater amount of effort. A group of third- and fourth-graders and a group of seventh-graders were asked to divide rewards between pairs of children that were described to vary in age (“younger” vs. older) or ability (“unskilled” vs. skilled) or that were the “same” in age and ability and that were described to vary (5 vs. 15, or 0 vs. 20 baskets) or to be equal (10 vs. 10 baskets) in performance on a basketball-shooting task. Unlike the group of third- and fourth-graders, the seventh-graders generally made significantly larger allocations to the disadvantaged individuals (“younger” and “unskilled”) than to the “same” individuals, making the largest allocations under the most discrepant performance condition (0 vs. 20). Overall, the results suggested that the equity principle becomes more salient in children as age increases. 相似文献
88.
The U.S. House of Representatives Armed Services Committee (HASC) review of the US. Navy's investigation of the U.S.S. IOWA incident provides a case study of the problems with reconstructive psychological evaluations. The US. Navy attributed the explosion on board the U.S.S. IOWA to the intentional suicidal acts of Gunner's Mate Clayton Hartwig, a conclusion supported primarily by an Equivocal Death Analysis (EDA) conducted by the FBI. Systematic analysis of the reports of the expert panelists who consulted to the NASC reveals that 11 of the 14 panelists were critical of the conclusions reached by the Navy/FBI. There was considerable variability among the judgments of the panelists, who reached consensus only for broad categories. Because the reliability and validity of postmortem psychological reconstructions such as EDA and psychological autopsy have not been established, clinicians are urged to exercise caution in the use of such procedures and to be sensitive to ethical obligations to consumers when using such techniques. 相似文献
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The aims of this study were to explore the validity of a set of computerized tests, and to explore the validity of reaction time variability as an index of sustained attention. In Phase 1, 105 children 7–10 years old were presented with five tests from the Neurobehavioral Evaluation System (NES). The children were able to complete four of the tests: the Continuous Performance, Simple Reaction Time, Symbol-Digit Substitution, and Digit Span tests. In Phase 2, a follow-up of 88 children, performance on these tests was significantly associated with teachers' ratings of attention and with standardized academic achievement measures. Moreover, variability on the Simple Reaction Time and performance on the Digit Span and Symbol-Digit tests significantly predicted reading achievement. Similarly, performance on the Digit Span and Symbol-Digit tests significantly predicted mathematics achievement. In addition, variability on the Simple Reaction Time and Digit Span test performance were significant predictors of reading achievement above and beyond the prediction provided by teachers' ratings. 相似文献
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