A Review of: “Fairburn,C. G. (2008). Cognitive Behavior Therapy and Eating Disorders.”

Successful reports of behavioral treatment of encopresis describe interventions as unpleasant as the disorder: hospitalization, laxatives, prompted toileting, aversive consequences. The focus on soiling rather than on the constant constipation that precedes encopresis, on the reduction of soiling rather than on the acquisition of effective toilet use. Five normal chronically constipated children (four of whom were encopretic) were treated at home with combinations of: preparatory instructions, rewards for clean pants, reward for appropriate toileting (bowel movement in toilet). Once soiling was eliminated and appropriate bowel movements occured regularly, all families were taught to fade treatment contingencies. To determine the contribution of the toileting reward to treatment effectiveness, this reward was added to the other two treatment components in a multiple baseline across four cases; it provided a significant ingredient in short-term success. A fifth child achieved short-term success with only the instructions and the clean pants reward. Long-term results (11-20 months) revealed that the fifth child, who never received the toileting reward, was the only one who relapsed.     

大渐弥留的混沌之态：评《生死有时》一书

在人类命运共同体遭受一场前所未有的大疫威胁之际,上海教育出版社及时地推出了《生死有时》一书。尽管其副标题发问的要点是“美国医院如何型塑死亡”,但这个问题的尖锐性指向几乎是所有的重症医学实践。大疫将人之死的个体性纳入到一个疾病全球化的视野,《生死有时》并没有讨论重大公共卫生危机导致的世界性灾难,然而也能让我们联想到一个存在主义意义的危机问题。那就是大渐弥留的混沌之态。在此书中,涉及生命末端期的混沌问题包括：尊严死何以可能？旨在尊重患者主体性的生前预嘱是否可行？针对重症患者的医疗措施应该何时从常规治疗过渡到临终关怀？

     

Suicide survivors' mental health and grief reactions: a systematic review of controlled studies

There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified by searching the PsychINFO and MEDLINE databases. Forty-one studies met the eligibility criteria. A qualitative data analysis was performed. There were no significant differences between survivors of suicide and other bereaved groups regarding general mental health, depression, PTSD symptoms, anxiety, and suicidal behavior. The results regarding the overall level of grief are less clear, depending on whether general grief instruments or suicide-specific instruments are used. Considering specific grief variables, suicide survivors report higher levels of rejection, shame, stigma, need for concealing the cause of death, and blaming than all other survivor groups.     

Autobiographical Memory and Suicide Attempts in Schizophrenia

According to the cry of pain model of suicidal behavior, an over‐general autobiographical memory function is often found in suicide attempters. The model has received empirical support in several studies, mainly of depressed patients. The present study investigated whether deficits in autobiographical memory may be associated with an increased frequency of suicide attempts in patients with schizophrenia. We found support for our hypothesis that patients with schizophrenia and previous suicide attempts have an over‐generalized autobiographical memory compared to patients with schizophrenia without previous suicide attempts. Adjustment for sociodemographic and clinical variables did not change the results.