过去十年中学生SCL-90调查结果的元分析

选取31篇有关中学生心理问题的研究报告,这些报告都用了90项症状自评量表（简称SCL-90）。用元分析方法对报告的数据进行了重新处理和分析。结果发现（1）平均效果量在-0．44到-0．15之间,即是以中学生常模为标准,以往的研究结果显示中学生心理并非不健康。（2）报告质量效应和出版年代效应显著,分别能解释效果量变异的26．6％和19．7％。显示原始报告的出版年代、发表刊物的等级等特征对其报告的SCL-90得分有系统影响。（3）出版年代效应显著显示以往研究报告SCL-90得分可能有随年代的推进而上升的趋势,但上升的原因尚不清楚。     

Long-term efficacy of exercise across diagnostically heterogenous mental disorders and the mediating role of affect regulation skills

BackgroundExercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects.MethodsPhysically inactive outpatients, with depressive disorders, anxiety disorders, insomnia or attention deficit hyperactivity disorder were randomized to a standardized 12-week exercise intervention, combining moderate exercise with behavior change techniques (BCTs) (n = 38), or a passive control group (n = 36). Primary outcome was global symptom severity (Symptom Checklist-90, SCL-90-R) and secondary outcomes were self-reported exercise (Physical Activity, Exercise, and Sport Questionnaire), exercise-specific affect regulation (Physical Activity-related Health Competence Questionnaire) and depression (SCL-90-R) assessed at baseline (T1), post-treatment (T2) and one year after post-treatment (T3). Intention-to-treat analyses were conducted using linear mixed models and structural equations modeling.ResultsFrom T1 to T3, the intervention group significantly improved on global symptom severity (d = −0.43, p = .031), depression among a depressed subsample (d = −0.62, p = .014), exercise (d = 0.45, p = .011) and exercise-specific affect regulation (d = 0.44, p = .028) relative to the control group. The intervention group was more likely to reveal clinically significant changes from T1 to T3 (p = .033). Increases in exercise-specific affect regulation mediated intervention effects on global symptom severity (ß = −0.28, p = .037) and clinically significant changes (ß = −0.24, p = .042).ConclusionsThe exercise intervention showed long-term efficacy among a diagnostically heterogeneous outpatient sample and led to long-lasting exercise behavior change. Long-term increases in exercise-specific affect regulation within exercise interventions seem to be essential for long-lasting symptom reduction.     

Psychological assessment of quality of life following liver transplantation

Administered measures of functional status, psychological distress, and quality of life to a consecutive series of 48 liver transplant recipients in follow-up clinic. Results showed that nearly total functional recovery was the norm. Thirty-six patients (75%) had a Karnofsky Performance Status (KPS) score of 80–100. Twelve transplant recipients had KPS scores below 80; none were employed, and most had been transplanted within 1 year. In spite of their impaired financial status, eight of these 12 reported being mostly satisfied on the self-report Quality-of-Life Scale (QLS). For the posttransplant sample as a whole, 83% were mostly satisfied with their quality of life. Pre- and posttransplant patient samples were not significantly different in reporting mild emotional distress. Results for the small subgroup with significant objective or subjective problems in achieving acceptable quality of life following liver transplantation were reviewed. Higher than normal emotional distress on the Symptom Checklist (SCL-90-R) was consistently reported by these patients. Prospective studies are needed to identify predictor variables of quality-of-life problems and to develop prevention and rehabilitation interventions.     

Short‐term psychodynamic infant–parent interventions at Child health centers: Outcomes on parental depression and infant social–emotional functioning

Randomized controlled trials (RCTs) demonstrate efficacy of parent–infant psychotherapy, but its applicability and effectiveness in public health care are less known. The method followed is Naturalistic study evaluating Short‐term Psychodynamic Infant–Parent Interventions at Child Health Centers (SPIPIC) in Stockholm, Sweden. One hundred distressed mothers with infants were recruited by supervised nurses. Six therapists provided 4.3 therapy sessions on average (SD = 3.3). Sessions typically included the mothers, often with the baby present, while fathers rarely attended sessions. The Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stages Questionnaire: Social–Emotional (ASQ: SE) were distributed at baseline and at 3 and 9 months later. Data from a nonclinical group were collected simultaneously to provide norm data. Multilevel growth models on the mothers’ questionnaire scores showed significant decreases over time on both measures. Nine months after baseline, 50% achieved a reliable change on the EPDS and 14% on the ASQ: SE. Prepost effect‐sizes (d) were 0.70 and 0.40 for EPDS and ASQ: SE, figures that are comparable to results of other controlled studies. Psychotherapists integrated with public health care seem to achieve good results when supporting distressed mothers with brief interventions in the postnatal period. SPIPIC needs to be compared with other modalities and organizational frameworks.     

The association between retrospective outcome evaluations and pre-post-treatment changes in psychodynamic group-psychotherapy

In the present study of 203 patients in psychodynamic group psychotherapy, we explore associations between patient and therapist global retrospective outcome evaluations (ROE), and pre-post-treatment changes on the Symptom Check List 90 Revised (SCL-90-R) and non-symptomatic focus of therapy. There were no significant associations between ROE, diagnoses and demographic variables, and pre-treatment SCL-90-R associations were negligible (less than 4% of overlapping variance). SCL-90-R subscale improvement expressed as residual gain score explained the overall largest percent of variance in both patients and therapists (44% and 25%, respectively) when compared with raw difference scores (32% and 18%), and percent reduction from baseline (34% and 23%). Moreover, ROE/end-state adjustment associations were substantial (42% and 24%). Therapists' evaluation of change showed the strongest association with improvement in non-symptomatic focus of therapy, while patients' evaluation had the strongest association with improvement in SCL-Depression. It is concluded that retrospective evaluations reflect changes related to treatment. However, unexplained variance may be independent of symptomatic state, and associated with personality factors or domains not captured by standard questionnaires.     

中国军人心理健康状况的横断历史研究：1990~2007

使用1990~2007年18年间的142组数据, 以横断历史研究的元分析方法, 研究了108736位中国军人的心理健康状况随年代的变化趋势。这些数据来自94篇相关研究报告, 这些研究都使用了90项症状自评量表(SCL-90)作为心理健康的测评工具。结果发现：(1)世纪之交的18年间, 中国军人的心理健康越来越好; (2)18年间, 中国军人在“人际敏感”方面变化最大, 而在“躯体化”方面变化最小; (3)18年间, 中国军人在“恐怖”方面最没问题, 而在“强迫症状”和“人际敏感”方面所表现出的问题一直突出; (4)中国独生子女军人(N = 1944)的心理健康状况低于非独生子女军人(N = 2649); (5)中国城市籍军人(N = 7808)的心理健康状况低于农村籍军人(N = 11459); (6)中国高中学历军人(N = 10189)的心理健康状况低于初中(N = 8407)和大学学历(N = 863)的军人。     

MMCS的心理测量学性能及中国大学生心理控制源的特点

以某民族大学的2006级学生为被试探讨了MMCS量表的心理测量学性能。结果表明MMCS的信度与国外基本相同,验证性因素分析发现在分解出正向和反向陈述效应后MMCS呈现出较好的模型拟合度。对MMCS的8个分量表总分所做的因素分析发现了清晰的因素结构,与理论假设非常符合。这些结果说明中国人也存在内外控的心理结构。但不同的是中国被试中内控和外控并不是相互独立的,也不是对立的两极,而是相关的,且表现出内控强于外控的倾向。通过与症状自评量表SCL-90的相关分析发现外控是不利于心理健康的,过强的内控也不好,而既不过分外控也不过分内控的适度控制方式可能是中国文化背景下最理想的心理控制方式。     

1992年以来中学生心理健康的变迁：一项横断历史研究

我国中学生的心理健康状况是否真的在逐渐下降呢？为回答这个问题,研究采用“横断历史研究”这种特殊的元分析方法,选取1992年至2005年间107篇采用90项症状自评量表（SCL–90）的研究报告,分析了111925名中学生在该量表9个因子上得分随年代的变化情况。研究结果表明：(1)SCL–90的7个因子均值与年代正相关显著（0.22~0.35）,7个因子均值的增加量为0.09~0.22（效果量d为0.06~0.35）,这说明1992至2005年间中学生的心理问题在缓慢增加,即中学生健康水平缓慢下降。(2)SCL–90的7个因子的标准差与年代间正相关显著(0.19~0.38),这说明中学生的心理健康水平不再像以前那样趋同,而是逐年变得更为分化。(3)中学生SCL–90得分与社会威胁、教育状况、经济状况三方面的10项社会指标相关显著,这说明社会变迁是预测中学生心理健康水平的重要因素     

A Longitudinal Study of Parental Depressive Symptoms and Coparenting in the First 18 Months

Although the negative impact of postpartum depression on parenting behaviors has been well established—albeit separately—for mothers and fathers, the respective and joint impact of both parents' mood on family‐group interactive behaviors, such as coparenting support and conflict behaviors between the parents, have not yet been investigated. The aim of this study was to examine the association between parental depressive symptoms and coparenting behaviors in a low‐risk sample of families with infants, exploring reciprocity between the variables, as well as gender differences between mothers and fathers regarding these links. At 3 (T1), 9 (T2), and 18 months postpartum (T3), we assessed both parents' depressive symptoms with a self‐report questionnaire and observed coparenting support and conflict during triadic mother–father–child interactions. The results revealed that higher maternal depressive symptoms at T1 were associated with lower support at T1 and T2. Conflict at T3 was associated with higher maternal depressive symptoms at T3 and, more surprisingly, with less depressive symptoms in mothers at T2 and fathers at T3. Cross‐lagged associations suggested that parental depressive symptoms were more likely to influence coparenting than the reverse. Moreover, maternal depressive symptoms were more likely to be linked to coparenting behaviors than were paternal depressive symptoms. These results confirm that parental—mostly maternal—depressive symptoms, even of mild intensity, may jeopardize the development of healthy family‐level relations, which previous research has shown to be crucial for child development.