Deconstructing executive deficits among persons with autism: implications for cognitive neuroscience

Individuals with autism demonstrate impairments on measures of executive function (EF) relative to typically developing comparison participants. EF is comprised of several processes including inhibition, working memory and set shifting that develop throughout the lifespan. Impairments in EF may appear early in development and persist, or may represent a more transient delay which resolves with time. Given the unevenness of the cognitive profile of persons with autism, understanding the development of EF poses methodological challenges. These issues include those related to matching measures and the choice of comparison participants to which the performance of persons with autism will be compared. In the current review, we attempt to break down the processes of inhibition, working memory and set shifting among persons with autism. We propose to do this within a developmental perspective that highlights how matching measures and comparison participants can affect the interpretation of research findings.     

The facilitative effect of positive stimuli on 3-year-olds’ flexible rule use

This study examined the effect of emotional stimuli on 3- to 4-year old children's flexible rule use, as measured by the Dimensional Change Card Sort (DCCS). In Experiment 1, children in two countries (Canada and China) were given 2 versions of the DCCS. The Standard version required children to sort red and blue boats and rabbits first by shape and then by color (or vice versa); the Emotional Faces version required children to sort happy and sad male and female faces first by emotion and then by gender (or vice versa). Children performed significantly better on the Emotional Faces version, and performance on the 2 versions was related. Order in which dimensions were presented had no effect. Experiment 2 examined which aspects of the emotional faces were responsible for the facilitation of children's performance. Performance on the Standard version was compared to performance on three contextual faces versions, in which children were shown happy, sad, or neutral faces and required to sort them by age (child versus adult) and then by gender (or vice versa). Facilitation was only seen in the context of happy faces. Results are consistent with the suggestion that positive stimuli promote cognitive flexibility, perhaps by increasing dopamine levels in prefrontal cortex.     

司法论证充分性辨析

司法论证充分性问题是一个和法学理论与司法实践都密切相关的问题,各种关于法律论证的争议是和规则治理与纠纷解决两种司法职能的互相冲撞息息相关的。什么样的法律论证才是最合适的,在法律资源有限的情况下,如何运用有限的资源达到司法实践的目的,是各国法制建设的一个永恒话题。文章试图以我国的司法情景为例,从理性思考与现实实践两个层面,展示法官在裁决中所运用的具有地方性知识性质的辅助资源具有实践合理性,说明司法论证应该也必须追求其充分性。     

Neuropsychological effects of stress on social phobia with and without comorbid depression

BACKGROUND: The influence of stress on neuropsychological functioning was assessed in socially phobic (SP), comorbid socially phobic/major depression (CM), and asymptomatic control subjects (AC) under baseline and stressor conditions. METHODS: Subjects were 33 clinically diagnosed undergraduates aged 18 to 41 years. Neuropsychological measures included the Trail Making Test, Wisconsin Card Sorting Test (WCST), Spatial Span, and Digit Span administered during a baseline condition and a psychosocial stress condition (videotaping). RESULTS: Spatial Span scores were reduced for SP during stress, improved for AC, and showed no change for CM. TMT B times showed an interaction effect, with completion time improving significantly less for SP than for AC and CM during stress. Analyses of the normative data for WCST total errors indicated that AC and CM improved significantly during stress, while SP performance declined during stress. CONCLUSIONS: The present findings suggest that comorbid depressed versus non-depressed SP subjects respond uniquely to stress in terms of their neuropsychological functioning and self-reported mood and experiences; generalized social phobia may be associated with spatial working memory disturbance during social stress. Therefore, situations involving potential social and personal evaluation (e.g., examinations or presentations) may have a significant impact on the neuropsychological functioning of SP individuals.     

Creativity and dialectical phenomena From dialectical edge to dialectical space1

The seeds of creativity have the potential to germinate and flourish within the rich, ambiguous and unsettling tapestry of the core dialectical tensions related to the central organizing dialectic, life and death, generated in the patient‐analyst relating. The author introduces the concept of the ‘dialectical edge’ and describes it as the pivotal point in the dialectical struggle within these core dialectical dilemmas. This is a fluid, emotionally evocative threshold, where there is maximum potential for change, as well as for homeostatic stagnation. Drawing on Winnicott, the author illustrates how the presence of an edge within these dialectical dilemmas has the potential to open up into a creative, reflective space. He suggests that this, however, will depend on the therapist's capacity to contain/hold at this edge the arousing and intense affects‐such as anxiety, dread, excitement and passion‐that are inevitably generated at these pivotal relational moments. This will determine whether the patient will move forwards into the light of a creative, reflective, dialectical space, or backwards into collapsed, non‐reflective darkness, where fluid oscillation is transformed into rigid ossification. The author uses a clinical example to illustrate these dialectical phenomena, with a special focus on two clinically relevant dialectics, i.e. ‘ritual versus spontaneity’ and ‘closeness versus separateness’.     

动脉功能评价与降压质量

高血压的治疗中降压是最重要的原则,降压达标可以带来心血管事件的下降已是不争的事实。流行病学调查证实动脉功能是心血管事件的独立预测因子。动脉功能的评价不仅可以筛查高危人群,还可作为降压质量评价的指标,临床研究已证实其意义。未来的高血压治疗领域,除监测血压外,可能需要监测和评估动脉功能。     

国外卫生“守门人”制度功能演变对我国的启示与思考

卫生体制的改革是令各国政府关注的世界性议题。对卫生系统的研究既要关注宏观结构的转变又要关注微观具体政策的功能,既要考虑政策实施的刚性又要注重发挥市场的配置效应。着重讨论非市场体制的代表英国、市场体制的代表美国、混合体制的代表澳大利亚三个国家“守门人”的特征功能,及不同时期其角色和功能的演变,尤其是对我国现行医疗体制的启示与思考。     

脑功能可塑性与灾后心理功能康复

神经系统具有惊人的可塑性,这种可塑性可以终生保留。大脑不仅可因个体的经验与行为而改变,也可因内在思维、放松和注意的不同而发生改变。如汶川地震这样的大型自然灾害,因其突发性和巨变性,可使身临其境的人大脑功能状态在瞬间就发生持久的改变,从而表现为认知、情感等心理功能的改变。反过来,利用有关神经可塑性的认识,同样可使受损的大脑得以修复,使发育障碍的个体增强功能,亦可使由各种内外因素导致的心灵扭曲重新舒展开来。利用放松、修复、重建的3R脑功能重塑技术,可望解决包括地震灾后心理健康重建在内的各种神经和心理问题,具有广泛的应用前景     

西方人格工具在中国:文化的思考——以多元文化人格问卷为例

本文以多元文化人格问卷在中国施测的结果为例,从中国文化的角度,探讨中国文化对语言等值和功能等值的影响,如时间观、面子观、关系观、人际沟通观、谦虚观等对项目的具体影响,思考西方人格工具在中国应用时遭遇的文化冲撞.     

单纯性肾囊肿外科手术适应证的选择

单纯性肾囊肿是临床常见的肾脏疾病之一,临床常采用去顶减压术治疗,但外科治疗的适应证目前尚不统一。除症状性肾囊肿及由囊肿引起尿路梗阻外,对于高血压病合并肾囊肿者,如囊肿直径大于5cm,考虑囊肿有可能对高血压产生影响,因此,有必要采取外科治疗措施;但如果不合并高血压,是否一定需要治疗有待进一步探讨。肾囊肿对肾功能影响目前尚无定论,对于小于60岁的肾囊肿患者其肾功能下降可能与肾脏原发病变有关,应积极查找病因并密切随访。对于肾囊肿Bosniak分型为Ⅰ、Ⅱ、ⅡF型的患者,可以不需要手术治疗,密切随访;对于Ⅲ、Ⅳ型患者,应进行外科手术治疗。