医疗界与法律界的关系问题——中国医疗秩序重构中的重要课题

医疗秩序是指各医疗要素的合理配置、医疗关系中各主体的有规则的有序互动所形成的整齐规则状态。当今中国医疗失序的本质是医疗正义的缺失。医疗秩序重构和恢复的实质在于医疗正义的彰显。在彰显医疗正义的过程中,需要研究解决的重要课题之一是如何处理作为医疗实践者的医疗界与作为正义实践者的法律界之间的关系。     

网络成瘾的潜在结构:连续的还是分类的?

变量的潜在结构是连续的还是分类的不应被随意指定,错误的设定可能导致不正确的结论。本研究的目的在于从实证的角度探索网络成瘾的潜在结构。研究采用了来自中国杭州的2511名初中生对Young网络成瘾量表的有效作答数据,比较了Rasch模型、潜在类别模型和混合Rasch模型与数据的拟合情况。结果表明:2个潜在类别的混合Rasch模型可以最好地反映网络成瘾的潜在结构,说明网络成瘾包含两个存在着质的差异的群体,并且每个群体内的个体间存在量的差异。研究进一步比较了基于混合Rasch模型的分类与传统划界分数分类的区别,结果表明:Young的网络成瘾标准可能具有很小的误判率和较高的漏判率;基于Young网络成瘾测验的修订需要考虑有针对性地增加部分题目。     

创伤后应激障碍患者情绪记忆优势研究述评

创伤后应激障碍(PTSD)是由高情绪刺激引起延迟出现和长期持续的精神障碍。闯入、闪回、病理性重复体验、持续性警觉性增高和回避等症状严重损害其认知功能。PTSD患者记忆形成了情绪网络。情绪记忆具有强烈、持久的特点, 在记忆中具有优势地位。回顾PTSD患者情绪记忆优势的行为及脑成像研究发现, PTSD患者情绪记忆优势研究结果并不完全一致, 受到诸多因素的影响, 这些影响因素需进一步探讨。     

WISC-III Cognitive Profiles in Children with ADHD: Specific Cognitive Impairments and Diagnostic Utility

This study aimed to investigate the presence of specific cognitive impairments and the diagnostic utility of the WISC-III in children with ADHD. Ninety-eight children with ADHD and 81 children without ADHD matched by age and gender (control group), between the ages of 6 and 12?years, participated in the study. Children with ADHD revealed the most pronounced deficits in the subtests tapping working memory and processing speed. Freedom from Distractibility was the cognitive profile most impaired and that showed the highest diagnostic accuracy to discriminate children with ADHD. The optimal cutoff scores of the most common WISC-III cognitive profiles revealed greater diagnostic accuracy than the traditional approach of full or partial profiles. Taken together, these results suggested that in the context of a comprehensive psychological assessment, the WISC may provide knowledge about the specific cognitive strengths and weaknesses that characterize this disorder and may be useful in the decision-making process relative to ADHD diagnosis.     

Attachment Representation and Sensitivity: The Moderating Role of Posttraumatic Stress Disorder in a Refugee Sample

It has been hypothesized that adult attachment representations guide caregiving behavior and influence parental sensitivity, and thus affect the child's socio‐emotional development. Several studies have shown a link between posttraumatic stress disorder (PTSD) and reduced parental sensitivity, so it is possible that PTSD moderates the relationship between insecure attachment representations and insensitivity. In this study symptoms of PTSD (Harvard Trauma Questionnaire), parental sensitivity (Emotional Availability Scales), and attachment representations (Attachment Script Assessment) were assessed in 53 parents who were asylum seekers or refugees. Results showed that when parents were less able to draw on secure attachment representations, symptoms of PTSD increased the risk of insensitive parenting. These findings suggest that parental sensitivity is affected not just by attachment representations, but by a conjunction of risk factors including symptoms of PTSD and insecure attachment representations. These parents should therefore be supported to establish or confirm secure models of attachment experiences, to facilitate their ability interact sensitively and form a secure relationship with their children.     

Occupational Therapy Interventions for Children with Attention Deficit Hyperactivity Disorder: A Systematic Review

This systematic review examined evidence published 2005–2015 for occupational therapy interventions for children with Attention Deficit Hyperactivity Disorder (ADHD). We identified 590 abstracts with 17 full-text articles eligible for review. Fourteen articles were included in the final analysis with two level I studies, two level II studies, eight level III studies, and two level IV studies. Occupational therapy interventions focused on play, sensory, motor, and cognitive skills. While the interventions yielded good results, there were limitations in study design, interventions, and outcome measures. Future research should include larger sample size, randomization, control groups, and interventions that can be replicated.     

儿童青少年创伤后应激障碍(PTSD)治疗的研究热点——基于美国文献的知识图谱分析

为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结果表明,近10年来美国儿童青少年PTSD治疗研究可分为两个大的研究领域。领域一为儿童青少年PTSD的精神科和神经生物学相关的治疗,包括了两个小的研究热点:(1)儿童青少年PTSD精神科药物治疗相关的研究;(2)儿童青少年PTSD眼动脱敏再加工治疗等神经生物学机制的疗法。领域二为儿童青少年PTSD的心理学治疗,包括了两个小的研究热点:(1)家庭暴力导致的儿童青少年PTSD心理学治疗研究;(2)儿童青少年PTSD的认知行为治疗研究。其中关于儿童青少年PTSD的认知行为治疗研究是研究的热点和重点领域,但关于儿童青少年PTSD治疗效果的长期纵向研究还较为缺乏,未来研究者应加强对儿童青少年PTSD治疗效果的追踪研究,并开展心理治疗与药物治疗相结合的疗效研究。     

Parent–Child Relationships and ADHD Symptoms: A Longitudinal Analysis

Evidence both from psychological research and clinical intervention studies suggests that there are bidirectional influences between overt child behavior problems and parent–child relations. Very little research however, has considered the pattern of relations that exists between Attention Deficit Hyperactivity Disorder (ADHD) and the parent–child relationship within a longitudinal context. Using a longitudinal community sample from the United Kingdom which included 194 school aged children (46% male and 54% female) and both parents, this study examined the relationship between child ADHD symptoms and displays of rejection in the parent–child relationship. These relationships were investigated separately for mothers and fathers using cross-lagged panel correlation and reciprocal effects analysis. Mothers and fathers reported on ADHD symptoms and children reported on their feelings of rejection in the mother–child and father–child relationships. Results suggested differences in the direction of effects linking mother– and father–child rejection and child ADHD symptoms; with ADHD symptoms affecting the mother–child relationship and the converse pattern of effects noted for fathers. Implications for future research focusing on the link between ADHD symptoms and parent–child relationships are discussed.     

Hot and Cool Forms of Inhibitory Control and Externalizing Behavior in Children of Mothers who Smoked during Pregnancy: An Exploratory Study

This study examined whether children exposed to prenatal smoking show deficits in “hot” and/or “cool” executive functioning (EF). Hot EF is involved in regulation of affect and motivation, whereas cool EF is involved in handling abstract, decontextualized problems. Forty 7 to 9-year-old children (15 exposed to prenatal smoking, 25 non-exposed) performed two computerized tasks. The Sustained Attention Dots (SA-Dots) Task (as a measure of “cool” inhibitory control) requires 400 non-dominant hand and 200 dominant hand responses. Inhibitory control of the prepotent response is required for dominant hand responses. The Delay Frustration Task (DeFT) (as a measure of “hot” inhibitory control) consists of 55 simple maths exercises. On a number of trials delays are introduced before the next question appears on the screen. The extent of response-button pressing during delays indicates frustration-induced inhibitory control. Prenatally exposed children showed poorer inhibitory control in the DeFT than non-exposed children. A dose–response relationship was also observed. In addition, prenatally exposed children had significantly higher (dose-dependent) conduct problem- and hyperactivity-inattention scores. There were no significant group differences in inhibitory control scores from the SA-Dots. These results indicate that children exposed to prenatal smoking are at higher risk of hot but not cool executive function deficits.     

The inclusion of antisocial behavior in the construct of psychopathy: A review of the research

The psychopathic personality, or the construct of this disorder, has a long and contentious history. Psychopathy has been identified anecdotally for centuries; however, the ability to accurately define this construct continues to challenge researchers and clinicians. Of preliminary concern is the relevance of antisocial behavior to this disorder. Theoretical conceptualizations of psychopathy have changed over the past 65 years. Some have stressed the interpersonal and affective deficits of psychopathy [Cleckley, H. (1941). The mask of sanity (1st ed.). St. Louis, MO:C.V. Mosby.], while later conceptualizations have included both personality traits as well as antisocial behavior as criteria of psychopathy [Hare, R. D. (1991/2003). The Hare Psychopathy Checklist—Revised. Toronto, Canada: Multi-Health Systems]. This article will review the literature, particularly the relevance of antisocial behavior to the core personality structure of the psychopath. In doing so, historical theories will be reviewed, followed by later theoretical and empirical research. A great deal of this research has been conducted over the past 15 years, since the publication of the Psychopathy Checklist (PCL) and the Psychopathy Checklist-Revised (PCL-R; [Hare, R. D. (1991/2003). The Hare Psychopathy Checklist—Revised. Toronto, Canada: Multi-Health Systems]). The PCL-R has provided the field of psychopathy research with a consistent measurement device, and, therefore will be discussed at length. The limitations of the psychopathy construct will be discussed as well as needed future research and the policy implications of such research.