证候存在的逻辑回答

认为存在的就是客观的,包含了自然客观、思维客观和理性客观;把疾病现象和疾病本质划等号,在症状层面规范证候标准,抛弃中医辨证思维,就等于否定中医。物质不能等于客观,不能取代存在。证候属于理性客观,发生于中医学,是中医“阴阳神气”观念临床实在化(还原)的必然。     

Lupus Symptoms Inventory (LSI): Development and Validation of a Self-evaluation Inventory of the Subjective Symptoms of Systemic Lupus Erythematosus

The goal of this study was to develop a simple, easy, and quick self-report measure, the Lupus Symptom Inventory (LSI), designed to evaluate subjective symptoms of Systemic Lupus Erythematosus (SLE). The internal consistency of the LSI was tested, as well as its concordance with physician reports and serological indicators of disease activity by evaluating the self-reports of 46 patients with SLE who completed the LSI daily for a one-month period. Throughout this one-month period, parameters of serological activity and routine medical check-up were obtained. The results showed a high internal consistency of the LSI, with a Cronbach alpha of .86. Additionally, a contingency analysis showed agreement between medical report and patient self-report on the same day for six of seven lupus symptoms (difficulty breathing (p < .004), joint pain (p < .001), loss of appetite (p < .003), general malaise (p < .005), fatigue (p < .005), and skin rash (p < .018)) but not for abdominal symptoms. Finally, differences were found between LSI scores of patients with high versus low serological activity (χ²(1) = 5.302; p < .021), with the former presenting higher LSI scores than the latter. These results show that the LSI may be a reliable and valid instrument for evaluating the subjective symptoms of the disease as well as its fluctuations.     

Effects of exposure to community violence on school functioning: The mediating role of posttraumatic stress symptoms

This study investigated the association between exposure to community violence (ECV) and school functioning, as well as posttraumatic stress (PTS) symptoms as a potential mediator of the relationship. PTS symptoms are commonly associated with ECV, and are characterized by difficulty regulating emotions and behaviors. Thus, PTS symptomatology may be one mechanism through which community violence impacts school functioning. The community-based sample included 47 low-income African American children (aged 10-13). Results revealed that ECV was inversely related to academic performance and attendance. Symptoms of posttraumatic stress emerged as a mediator of the relation between ECV and academic performance. Results have implications for urban students who face violence in their communities, and emphasize the need for school-based mental health services.     

Temperament and Risk for Depressive Symptoms in Adolescence: Mediation by Rumination and Moderation by Effortful Control

The present study examined the relations between temperament, ruminative response style and depressive symptoms both cross-sectionally and prospectively (1 year follow-up) in a community sample of 304 seventh- through tenth-graders. First, higher levels of negative affectivity (NA), lower levels of positive affectivity (PA) and lower levels of effortful control (EC) were found to be associated with higher levels of depressive symptoms. Second, the association between NA and PA on the one hand and depressive symptoms on the other was significantly moderated by level of EC (low PA and high NA are associated with depressive symptoms only if EC is low) and these relations were moderated by sex in the cross-sectional data. In the prospective data, T1 depressive symptoms and PA predicted T2 depressive symptoms; with EC approaching significance. Third, rumination also predicted T1 as well as T2 depressive symptoms. Finally, support was found for a model of moderated mediation: higher levels of NA were associated with higher levels of ruminative response style, which was in turn related to more depressive symptoms but only in individuals with low EC and this was true for the cross-sectional as well as the prospective data albeit with noteworthy differences in pattern. These findings confirm and extend previous findings on the associations between temperament, response styles and depression in adolescence and, as such, add to the growing body of research providing support for the applicability of cognitive vulnerability theories to depression in younger populations.

Depressive symptoms and parenting competence: An analysis of 13 regulatory processes

Mechanisms that lead depressive symptoms to undermine parenting are poorly understood. This review examines cognitive, affective, and motivational processes thought to be responsible for the impact of depressive symptoms on parenting. We present a five-step, action-control model and review 152 studies relevant to 13 regulatory processes. Evidence suggests that depressive symptoms undermine parenting because they reduce child-oriented goals, undermine attention to child input, increase negative appraisals of children and parenting competence, activate low-positive and high-negative emotion, and increase positive evaluations of coercive parenting. Yet, this review reveals significant limitations in knowledge of these processes. Evidence that they mediate depression-parenting relations is scare; important processes remain unstudied; conceptions of regulation are undifferentiated; children’s contributions are largely unexamined; moderating variables are largely unexplored; and methods fail to capture the dynamics of processing input from children. Rigorous testing of such process models holds promise for clarifying the basis of depression-related parenting problems.     

Depressive Symptoms in Young Adults: The Role of Attachment Orientations and Romantic Relationship Conflict

Although romantic involvement in adulthood has generally been associated with enhanced well-being, some aspects of adults’ romantic relationships (e.g., maladaptive conflict behaviors) have been linked with depressive symptoms. In order to better understand the role of romantic involvement in well-being, the present study examined links among attachment orientations, conflict behaviors with romantic partners, and depressive symptoms in an undergraduate sample of young adults (N = 110). Correlational analyses generally supported the hypothesized links. When a regression series was applied to the data in order to determine whether young adults’ conflict behaviors serve as a mediator in the link between their attachment orientations and depressive symptoms, mediation was not supported. Instead, results supported a model wherein attachment orientations and conflict behaviors (attacking) were independent predictors, explaining unique variance in young adults’ depressive symptoms. Findings underscore the importance of considering specific aspects of young adults’ romantic relationships in the prediction of their depressive symptoms and illuminate the role attachment orientations and conflict behaviors in their depressive symptoms.     

Children’s Feedback Preferences in Response to an Experimentally Manipulated Peer Evaluation Outcome: The Role of Depressive Symptoms

The present study examined the linkage between pre-adolescent children's depressive symptoms and their preferences for receiving positive vs. negative feedback subsequent to being faced with an experimentally manipulated peer evaluation outcome in real time. Participants (n = 142) ages 10 to 13, played a computer contest based on the television show Survivor and were randomized to either a peer rejection (i.e., receiving the lowest total 'likeability' score from a group of peer-judges), a peer success (i.e., receiving the highest score), or a control peer evaluation condition. Children's self-reported feedback preferences were then assessed. Results revealed that participants assigned to the negative evaluation outcome, relative to either the success or the control outcome, showed a significantly higher subsequent preference for negatively tuned feedback. Contrary to previous work and predictions derived from self-verification theory, children higher in depressive symptoms were only more likely to prefer negative feedback in response to the negative peer evaluation outcome. These effects for depression were not accounted for by either state mood at baseline or mood change in response to the feedback manipulation.     

Being Admired or Being Liked: Classroom Social Status and Depressive Problems in Early Adolescent Girls and Boys

This study investigates associations between depressive problems and classroom social status in a large population cohort of Dutch early adolescents (N = 1046, age 13.52 +/- 0.51, 52.4% girls). Depressive problems were assessed by parent and self-reports and classroom status by peer nominations. We assessed peer status with respect to both achievement-related (being a good learner, being good at sports, being good-looking) and affection-related (being liked, being disliked, being best friend) areas. In boys, depressive problems were most strongly associated with not being good at sports, while in girls the association was strongest for not being liked. The risk of a low status in one area could largely be compensated by a high status in another area.     

Trajectories of adolescent stressful life events and young adults’ socioeconomic and relational outcomes: Weight and depressive symptoms as mediators

Little is known about how biological and psychological consequences of adolescent stressful life events (SLEs) are jointly associated with socioeconomic and relational outcomes in adulthood. To address this gap, the present study involved testing a model based on the life course perspective that posits adolescent SLE trajectories produce parallel trajectories of depressive symptoms and weight status, which are jointly associated with socioeconomic status and intimate relationship quality in adulthood. Prospective data over 13 years from a nationally representative sample of 11,677 US adolescents was utilized. The results demonstrated that trajectories of BMI and depressive symptoms, which showed contemporaneous and longitudinal comorbidities over the early life course, were influenced by adolescent SLEs. Both BMI and depressive symptoms trajectories are additively and jointly associated with socioeconomic status and intimate relationship quality in adulthood. Additionally, adolescent SLE trajectories are directly associated with these adult outcomes. These observed associations persisted even after controlling for early family socioeconomic adversity and race/ethnicity. The theoretical and practical implications of these findings are discussed.     

Reported prevalence of attentional difficulties in a general sample of college students

The present study investigated the self-reported prevalence of attention-deficit hyperactivity disorder (ADHD)symptoms in 770 college students using the Adult Rating Scale and the Wender Utah Rating Scale. Psychometric properties of these scales were explored. The study also investigated the performance of students with ADHD symptoms, relative to students without ADHD symptoms, on a battery of neuropsychological tasks. Results revealed that 7 and 8% of the students reported significant symptoms (i.e., 1.5 SD above the mean) on the Adult Rating Scale and the Wender Utah Rating scale, respectively, and 2.5% reported significant symptoms on both the Adult Rating Scale and the Wender Utah Rating Scale. Using more stringent criteria (two standard deviations), fewer (i.e, 4, 3.8%, and 0.5%) subjects reported significant symptoms associated with ADHD. Between-group differences were found on one of the neuropsychological tasks. The construct validity of the rating scales was supported. Limitations and implications for future research are advanced.Presented at the International Neuropsychological Society's Sixteenth European Conference, Angers, France, June 1994, and the Annual Convention of the American Psychological Association, Los Angeles, CA, August 1994.