国外自我表露研究述评

自我表露是社会心理学、临床咨询和治疗的重要概念之一。主要介绍了自我表露的概念,静态的现象或动态的过程;描述性与评价性自我表露或正向与负向自我表露类型;自我表露的功能;社会渗透理论、压抑理论、沟通隐私管理理论等相关理论及主要测量方法。早期研究主要集中在主题、目标人、性别差异及自我表露与孤独感、亲密友谊的关系等方面,AIDS/HIV表露、儿童性侵犯表露、情绪表露和创伤表露等现实社会问题的表露成为近几年研究的焦点。扩展自我表露的概念,进一步深入研究青少年自我表露以及完善和发展自我表露的研究工具是未来的研究趋向     

Keeping the Spirit of Community Partnerships Alive in the Scale Up of HIV/AIDS Prevention: Critical Reflections on the Roll Out of DEBI (Diffusion of Effective Behavioral Interventions)

DEBI, or the Diffusion of Effective Behavioral Interventions is the largest centralized effort to diffuse evidence-based prevention science to fight HIV/AIDS in the United States. DEBI seeks to ensure that the most effective science-based prevention interventions are widely implemented across the country in community-based organizations. Thus, this is a particularly timely juncture in which to critically reflect on the extent to which known principles of community collaboration have guided key processes associated with the DEBI rollout. We review the available evidence on how the dissemination of packaged interventions is necessary but not sufficient for ensuring the success of technology transfer. We consider additional principles that are vital for successful technology transfer, which were not central considerations in the rollout of the DEBI initiative. These issues are: (1) community perceptions of a top-down mode of dissemination; (2) the extent to which local innovations are being embraced, bolstered, or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Consideration of these additional factors is necessary in order to effectively document, manage, and advance the science of dissemination and technology transfer in centralized prevention efforts within and outside of HIV/AIDS.     

Elaborative processing in the Korsakoff syndrome: context versus habit

Using a procedure of Hay and Jacoby [Hay, J. F., & Jacoby, L. L. (1999). Separating habit and recollection in young and older adults: Effects of elaborative processing and distinctiveness. Psychology and Aging, 14, 122–134], Korsakoff patients’ capacity to encode and retrieve elaborative, semantic information was investigated. Habits were created during initial training, whereupon cued-recall memory performance was examined, with habit opposing as well as facilitating recollection of earlier studied words. A first group of patients was instructed and tested in the same way as healthy controls and showed poor test performance. Nevertheless, when given more processing and response time, additional explanation, and explicit encouragement, a second group of patients performed similarly to healthy controls. The results suggest that, when given adequate support, Korsakoff patients are able to encode and make use of semantic, contextual, and sequential information. Word distinctiveness, however, only influenced performance of controls.     

Cognitive-Behavioral Therapy for Offender Hopelessness: Lessons from Treatment of Forensic Inpatients

Patients remanded to forensic hospitals often experience a marked situational depression once initial psychotic symptoms subside and the reality of their legal situation becomes evident. Individual psychotherapy is not often used with this population due to a generally high level of impairment. It is suggested, that with modifications, the cognitive-behavioral therapy manual by Michael Thase (in: VanHasselt, Hersen (eds) Sourcebook of psychological treatment manuals for adult disorders, 1996) designed to treat depression in psychiatric inpatients can be used to treat situational depression in forensic inpatients. Modifications include the use of increased behavioral techniques, the addition of a group component, and lengthening of time limits for each treatment phase. Case examples from a first attempt to implement the new treatment program are presented.     

A family history of psychopathology modifies the decrement in cognitive control among patients with HIV/AIDS

The present study was designed to evaluate the effect of HIV/AIDS on cognitive control and to determine if the effect is modified by familial risk for either alcohol or mood disorders. Sixty HIV-1 seropositive and 75 seronegative volunteers were assigned to four subgroups defined by the crossing of a diagnosis of alcohol dependence in the biological father with diagnoses of either major depressive disorder or bipolar disorder in the biological mother. Cognitive control was evaluated during a task in which subjects were asked, on occasion, to inhibit the impulse to respond in the same physical direction as the stimulus and instead respond in the opposite direction. Event related brain potentials and measures of task performance were recorded. The task evoked a negative shift in a late slow potential (SP) as well as an increment in reaction time when cognitive control was challenged. An important finding was an interaction between trial type, HIV/AIDS, and family history: HIV/AIDS and family history each attenuated the negative shift in the SP to such a degree that no further attenuation could be accomplished by the other. The effects of familial risk for alcohol versus mood disorders were equivalent. In conclusion, the absence of change in a late slow potential following a challenge to cognitive control may represent a marker of familial risk for both externalizing and internalizing disorders. The effects of familial risk on this slow potential are sufficiently robust as to attenuate the effects of HIV/AIDS on the probable generators of the response: the anterior cingulate and prefrontal cortex.     

Bewitchment, biology, or both: the co-existence of natural and supernatural explanatory frameworks across development

Three studies examined the co-existence of natural and supernatural explanations for illness and disease transmission, from a developmental perspective. The participants (5-, 7-, 11-, and 15-year-olds and adults; N = 366) were drawn from 2 Sesotho-speaking South African communities, where Western biomedical and traditional healing frameworks were both available. Results indicated that, although biological explanations for illness were endorsed at high levels, witchcraft was also often endorsed. More important, bewitchment explanations were neither the result of ignorance nor replaced by biological explanations. Instead, both natural and supernatural explanations were used to explain the same phenomena, and bewitchment explanations were highest among adults. Taken together, these data provide insight into how diverse, culturally constructed belief systems about illness co-exist across development.     

Child Psychosocial Adjustment and Parenting in Families Affected by Maternal HIV/AIDS

Child adjustment and parenting were examined in twenty-three 9–16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of programs targeting parenting skills to prevent or ameliorate child difficulties.     

Ethical aspects of HIV/AIDS prevention strategies and control in Malawi

HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In principle, all schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies.

Infant feeding and HIV in Sub-Saharan Africa: what lies beneath the dilemma?

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more generally in other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities.

HIV/AIDS reduces the relevance of the principle of individual medical confidentiality among the Bantu people of Southern Africa

The principle of individual medical confidentiality is one of the moral principles that Africa inherited unquestioningly from the West as part of Western medicine. The HIV/AIDS pandemic in Southern Africa has reduced the relevance of the principle of individual medical confidentiality. Individual medical confidentiality has especially presented challenges for practitioners among the Bantu communities that are well known for their social inter-connectedness and the way they value their extended family relations. Individual confidentiality has raised several unforeseen problems for persons living with HIV/AIDS, ranging from stigma and isolation to feelings of dejection as it drives them away from their families as a way of trying to keep information about their conditions confidential. The involvement of family members in treatment decisions is in line with the philosophy of Ubuntu and serves to respect patients’ and families’ autonomy while at the same time benefiting the individual patient.