Sleep locus of control and computerized cognitive-behavioral therapy (cCBT)

This study investigated the relationship between sleep locus of control and sleep in a secondary data analysis. Participants were 100 adults with chronic insomnia previously involved in a randomized controlled trial of 5 weeks of computerized cognitive-behavioral therapy (cCBT). Additionally, a sample of 46 completers of an in-person group for insomnia were utilized as a comparison group. At pre-treatment, participants completed the Sleep Locus of Control Scale, the Insomnia Severity Index, the Pre-Sleep Arousal Scale, 7 days of sleep diaries, and participated in structured interviews to assess for psychiatric and medical conditions. Measures were re-administered at post-treatment and at a 4 week follow-up. Results showed that sleep locus of control mediated the impact of cCBT on insomnia severity at follow-up. cCBT more than waiting list control or a convenience sample of individuals treated with in-person CBT, enhanced an internal sleep locus of control. Implications are that sleep locus of control may be an important variable to assess in the internet context and that internet programs for insomnia may want to consider amplifying or giving priority to interventions which enhance an internal sleep locus.     

Predictors of Partner Engagement in PTSD Treatment

A telephone survey was conducted to identify predictors of treatment engagement in 83 cohabitating female partners of 83 Vietnam theater veterans with combat-related post-traumatic stress disorder (PTSD). The survey assessed veterans for their trauma history and PTSD symptoms. Partners were assessed for caregiver burden, patient–partner involvement, PTSD treatment engagement, self-efficacy relating to PTSD, beliefs about benefits of PTSD treatment, and PTSD treatment barriers. Significant predictors of partner PTSD treatment engagement were the couple’s income, patient–partner involvement, and partner caregiver burden. These findings have implications for family interventions that may increase partner PTSD treatment engagement and improve PTSD treatment outcome.     

A New Unified Treatment Approach for Emotional Disorders Based on Emotion Science

ABSTRACT— Research on the nature of emotional disorders points toward a common set of diatheses (underlying psychological vulnerabilities) and functionally (but not superficially) similar expression of pathological emotional responding (e.g., Barlow, 2002 ). Successful drug treatments for different emotional disorders are very similar, with selective serotonin reuptake inhibitors or related compounds in wide use. Successful psychological treatments, on the other hand, are currently specifically targeted to each individual disorder. Distilling common principles among existing empirically supported psychological treatments, and giving attention to new findings on emotion regulation and dysregulation from emotion science, we propose and describe a new unified psychological treatment for emotional disorders.     

Primary care counsellors’ experiences of working with treatment resistant depression: A qualitative pilot study

Treatment resistant depression (TRD) is a severe and enduring form of depression that does not respond fully to medication. Although the evidence base for effective psychological treatments is not yet established, it is inevitable that counsellors working in primary care will encounter patients with this presentation. This pilot study explores the experience of four primary care counsellors with this patient group using Interpretative Phenomenological Analysis (IPA) and considers the implications for training and practice.     

The use of a linkage analysis as evidence in the conviction of the Newcastle serial murderer,South Africa

The linking of a series of crimes to one individual has always been problematic, especially in the absence of eyewitness or forensic evidence. During the investigation, another means whereby this can be done is through linkage analysis. Yet a linkage analysis can also play a role during the trial of a serial offender. This paper examines the use of a linkage analysis report as evidence during the trial of the Newcastle serial murderer in South Africa. The linkage analysis examined the circumstances of the crime, modus operandi, and signature behaviour of the offender, to come to the conclusion that all the offences were committed by one individual, despite the lack of eyewitness or forensic evidence linking the suspect to two of the four incidents. This evidence was admitted by the court and the presiding officer concurred that the accused was guilty of committing the crimes during the third and fourth incidents. Copyright © 2006 John Wiley & Sons, Ltd.     

辽宁省肿瘤规范化诊治情况调查分析及管理对策

按照卫生部推行的《中国常见恶性肿瘤诊治规范》的内容要求,对全省1991年~2000年6个市18所医院肿瘤诊治规范化情况进行了抽查,针对不规范诊治所存在的问题,制定出了科学的、可行性的管理对策。     

治疗目标定位与临床决策

治病如用兵,治疗皮肤病亦一样。临床实践中,许多皮肤科医生忽略了皮肤病的病机治疗,导致了起效慢、疗效差、病程迁延的结果。皮肤病的治疗应包括病因治疗、病机治疗、症状治疗、支持辅助治疗,四者缺一不可、协同互补;应用中可根据疾病矛盾的转化,分清先后主次,灵活调整组合,即运筹帷幄,辨证施治,辨病、辨症、辨药、辨方,“以正合取奇胜”,以求取得最快、最好、最稳定持久的疗效。     

如何降低ICU费用——规范ICU的建设和管理

ICU收费高的主要症结在于ICU的建设和管理需要规范化,包括在中国制定ICU的收治和转出指征规范,减少过度医疗和延迟医疗;积极配备ICU人力资源,提高监护质量,培训ICU专业医师上岗,掌握并运用专业知识施救,保证治疗的恰当性。允许恰当的家属陪护,对患者给予情感支持,或可降低镇静药物等的使用,缩短住院日;对于脑死亡、植物状态以及癌症晚期或其他晚期疾病的临终患者,提倡放弃治疗,避免无益救治造成卫生资源的浪费,对家属造成巨大的精神压力和经济负担。但是医生主动放弃治疗的决定尚需要政策的支持和法律的保障。