The effect of stress on craving for methadone depends on the timing of last methadone dose

Background

This study examined the extent to which the timing of last methadone dose moderates the influence of a laboratory stressor on craving for methadone in a sample of methadone maintenance patients.

Methods

Methadone maintenance patients (N = 41) completed a computerized stress manipulation with two levels (low and high stress) on two separate days: (1) immediately following the administration of their standard daily methadone dose and (2) immediately prior to receiving their standard daily dose. The impact of stress, timing of methadone dose and their interaction were examined on self-report measures of stress and craving for methadone.

Results

Craving ratings varied according to the timing of last methadone dose. Immediately following methadone dose (i.e., day 1), there was no effect for stress on craving (0.12; p = 0.30). However, prior to receiving methadone dose (i.e., day 2), the high stress effect on craving was significant (1.51; p < 0.001).

Discussion

The present findings indicate that patients currently receiving methadone maintenance treatment may be particularly vulnerable to stress-related relapse immediately prior to daily methadone dosing.     

易感人格的工作记忆特征对药物成瘾的调节机制

药物成瘾是指持续使用成瘾药物, 出现耐受性和戒断症状并严重阻碍正常社会功能的精神疾病。工作记忆在调节药物成瘾行为中扮演了中心角色：在神经易感性和易感人格特质基础上, 低工作记忆容量导致危险决策和去抑制性, 进而影响寻求药物和复吸行为。目前的研究基于已经产生成瘾的个体, 无法区别神经易感性、人格特质以及工作记忆缺陷是药物成瘾的原因还是结果; 而且, 仅从认知角度研究药物成瘾的原因, 会忽视该行为受多个因素影响的事实。     

温尼科特的精神分析客体关系理论的治疗观

温尼科特是英国精神分析客体关系学派的重要代表人物,提出了独特的精神分析治疗观,以提供抱持性的分析情境为核心,强调退行至依赖的治疗过程,重视精神分析师的反移情中的恨的情绪体验,珍视病人的主动不交流等,在很多方面颠覆了经典的精神分析治疗观。     

基于预期理论的参照依赖

参照依赖是指个体基于某一参照点对得失价值进行判断:参照点之上,个体感受为收益,反之即为损失.参照依赖现象广泛存在于生活中的各种领域.当前,对参照依赖心理机制的解释主要有预期理论、后悔理论和三阶段参照点理论.参照依赖的影响因素主要包括经验、情绪状态、文化、目标和认知对象的特点等.未来的研究应主要集中于参照依赖的产生根源,深入探讨参照依赖的神经机制,加强动态参照点、多重参照点以及群体中参照依赖现象的研究.     

THE RELIGIOUS ETHICS IMPLICIT IN SCHLEIERMACHER'S DOCTRINE OF CREATION

There is a religious ethics implicit in Schleiermacher's doctrine of creation based on the universal feeling of absolute dependence “prior to” its being informed by any historical tradition. The “highest good” which fundamentally characterizes his religious ethics is found at the intersection of God and the World. The “original perfection of man” and the “original perfection of the world” come together when human life in the world is fully informed by the feeling of absolute dependence. Although Schleiermacher did not develop his religious ethics to the same extent as his philosophical and Christian ethics, it should still be of interest to ethicists in many religious traditions, as it establishes contours and sets limits for the ethics of any monotheistic religious tradition.     

Winnicott’s foundation for the basic concepts of Freud’s metapsychology?1

In a recent paper, Fulgencio shows how Winnicott rejected the basic speculative concepts of Freud’s metapsychology – Trieb, psychical apparatus and libido – and replaced them with non-speculative concepts that promoted a factual theorization. In this paper, the author examines some of Winnicott’s concepts and attempts to demonstrate how, rather than replacing Freud’s concepts, he provides a factual foundation for the metapsychology in the double dependence of the infant in care. Freud never actually disregards the necessity of early mothering but he takes it for granted. By differentiating between ego needs and id needs, ego-relatedness and id-relatedness, object-mother and environment-mother, Winnicott attempts to theorize what Freud takes for granted: the function of the holding environment as a framework for id-experiences and the function of object-presenting as a condition of reality-testing. Furthermore, by differentiating between pure male and pure female elements, he is also able to construct a highly speculative theorization in order to distinguish two basic principles: doing and being. Although the death drive is clearly rejected, this rejection follows from his theorization of double dependence. Consequently, the author suggests that Winnicott did not discard metapsychological concepts but theorized the conditions for using both these and the intrapsychic topography.     

消费决策中的零：零价格效应和零比较效应

数字“0”由于自身所具有的特性(最小的自然数和不可作为被除数),当其与商品的价格维度和属性维度相结合时会对消费者的决策产生影响。已有研究表明商品的零价格和零属性会对消费决策产生影响,即零价格效应和零比较效应。情绪和社会规范是零价格效应产生的心理机制,参照依赖则是零比较效应产生的心理机制。商品价格、商品类型和消费者的心理因素是零价格效应的边界条件;而选项的数量是零比较效应的边界条件。未来的研究可以从不同商品类型、不同社会规范、“价格-损失”与“价格-质量”、注意等角度对零价格效应进行深入研究;也可以从结构匹配模型和齐当别模型的角度进一步探索零比较效应的“比较”机制;可以探讨价格是否能被视为商品的“坏属性”,进而讨论零价格效应和零比较效应二者之间的关系。     

论德性与独立的实践推理者

德性对于人的兴盛是必不可少的。没有道德德性,我们就不能实现从动物性理智到实践推理的转变,其次不能继续有推理的实践;如果不发展某种程度的德性,我们就不能适当地关怀和教育他人。所以,德性必须首先获得,然后才能维持在推理的实践之中。最后,我们在成为实践推理之后,我们仍然需要他人的维护,这种需要同时也是一种对德性的需要。     

Direction of Effects in Multiple Linear Regression Models

Previous studies analyzed asymmetric properties of the Pearson correlation coefficient using higher than second order moments. These asymmetric properties can be used to determine the direction of dependence in a linear regression setting (i.e., establish which of two variables is more likely to be on the outcome side) within the framework of cross-sectional observational data. Extant approaches are restricted to the bivariate regression case. The present contribution extends the direction of dependence methodology to a multiple linear regression setting by analyzing distributional properties of residuals of competing multiple regression models. It is shown that, under certain conditions, the third central moments of estimated regression residuals can be used to decide upon direction of effects. In addition, three different approaches for statistical inference are discussed: a combined D’Agostino normality test, a skewness difference test, and a bootstrap difference test. Type I error and power of the procedures are assessed using Monte Carlo simulations, and an empirical example is provided for illustrative purposes. In the discussion, issues concerning the quality of psychological data, possible extensions of the proposed methods to the fourth central moment of regression residuals, and potential applications are addressed.