Pain and Pain-Related Impairment in Adults with Cystic Fibrosis

The Multidimensional Pain Inventory (MPI) was utilized in a sample of adult outpatients with cystic fibrosis (CF) to assess their perception of pain and its psychosocial consequences. Subsequently, the data were compared to the ratings of pain and pain-related impairment in these patients as perceived by two nurses from the CF treatment team, as well as to a quantitative measure of illness severity. The results of these comparisons demonstrate that the majority of adult outpatients with CF reported experiencing lower levels of pain and pain-related impairment than expected, although the male patients tend to report experiencing significantly less impact in these domains than do the female patients. Additionally, the nurses do not underestimate the degree to which patients, especially males, experience pain and pain-related interference from chronic illness. Finally, there was no significant relationship between patients' self-report of pain severity or pain-related interference and an objective measure of disease severity.     

Eternity in an hour: experiences of time related to psychotherapy sessions

In this paper I consider the individual nature of the way a person develops senses of time. I suggest that something of a patient's early, unvoiced, experience is revealed through the temporal rhythms of interaction with the therapist. I refer to development, cycles of experience, metabolism, transgenerational emotions, experiences of beginnings and endings, early interactions with (m)other, together with narrative and its relation to unconscious processes. Experiences of time within the session indicate the nature of the feelings that are being lived, or refused life. I consider the paradox of living in the present and its relation to chronology. Lastly I give an example of the difficulty of timing comments when there is no flow of feeling, which is, itself, a communication.     

Personality accounts for stable preferences and expectations across a range of simple games

Behaviour on even simple experimental games shows considerable individual differences, but previous attempts to link these preferences to stable personality traits have had mixed results. Here we address three limitations of earlier studies, namely: (1) uncertainties concerning the reliability of preferences; (2) use of personality instruments with limited cross-study comparability; and (3) confounds where more than one psychological motive can lead to a particular choice. Sixty-seven participants completed 12 distinct real-money games twice over a two-week interval along with 6 measures concerning their expectations about other players’ choices. Personality was measured using the full NEO-PI-R. Choices were highly stable across time (r = .84). Moreover, choices on the 12 games and 6 expectations reflected a single underlying dimension of “prosocial orientation”, measuring concern for the payoffs received by other players. Scores on the prosocial orientation dimension were related to personality, with openness, (low) neuroticism, and (low) extraversion retained as significant predictors.     

It has been said that, “There are three degrees of falsehoods: Lies,damn lies,and statistics”

Applied behavior analysis (ABA) researchers have historically eschewed population-based, inferential statistics, preferring to conduct and analyze repeated observations of each participant's responding under carefully controlled and manipulated experimental conditions using single-case designs (SCDs). In addition, early attempts to adapt traditional statistical procedures for use with SCDs often involved trade-offs between experimental and statistical control that most ABA researchers have found undesirable. The statistical methods recommended for use with SCDs in the current special issue represent a welcome departure from such prior suggestions in that the current authors are proposing that SCD researchers add statistical methods to their current practices in ways that do not alter traditional SCD practices. Further refinement and use of such methods would (a) facilitate the inclusion of research using SCDs in meta-analyses and (b) aid in the development and planning of grant-funded research using SCD methods. Collaboration between SCD researchers and statisticians, particularly on research that demonstrates the benefit of these methods, may help promote their acceptance and use in ABA.     

反复胸闷胸痛伴心理精神障碍的诊疗进展

近年来,临床中关于反复胸闷胸痛患者的较高误诊率引起了广大医务工作者的重视,此类患者伴有的心理精神障碍往往被忽视,得不到合理的治疗,预后较差.本文主要讨论关于反复胸闷胸痛患者病因的鉴别、心理精神障碍引起胸闷胸痛的机制、胸闷胸痛与心理精神障碍的关系、“双心”医学诊疗模式以及反复胸闷胸痛的治疗进展,通过增强临床医生对“双心”医学的认识降低胸闷胸痛患者的误诊率、漏诊率,减少过度治疗,通过心血管医学和心理干预联合治疗,改善心血管疾病患者的预后、降低死亡率.     

The moral behavior of ethics professors: Relationships among self-reported behavior,expressed normative attitude,and directly observed behavior

Do philosophy professors specializing in ethics behave, on average, any morally better than do other professors? If not, do they at least behave more consistently with their expressed values? These questions have never been systematically studied. We examine the self-reported moral attitudes and moral behavior of 198 ethics professors, 208 non-ethicist philosophers, and 167 professors in departments other than philosophy on eight moral issues: academic society membership, voting, staying in touch with one's mother, vegetarianism, organ and blood donation, responsiveness to student emails, charitable giving, and honesty in responding to survey questionnaires. On some issues, we also had direct behavioral measures that we could compare with the self-reports. Ethicists expressed somewhat more stringent normative attitudes on some issues, such as vegetarianism and charitable donation. However, on no issue did ethicists show unequivocally better behavior than the two comparison groups. Our findings on attitude-behavior consistency were mixed: ethicists showed the strongest relationship between behavior and expressed moral attitude regarding voting but the weakest regarding charitable donation. We discuss implications for several models of the relationship between philosophical reflection and real-world moral behavior.     

伊斯兰教临终关怀与癌性疼痛心理治疗的探讨

如何利用伊斯兰教的信仰关怀、情感关怀和死亡关怀“三关怀”,提高癌症患者临终关怀质量和癌性疼痛心理治疗效果,作者根据在宁夏回族地区癌症患者中开展临终关怀的五年实践体会,从临终关怀的宗旨和目的出发,探讨了伊斯兰教的临终关怀之信仰关怀、情感关怀和死亡关怀三种形式和内容,解释了癌性疼痛的原因、疼痛的主观和客观影响因素及心理治疗的常用方法和原则,总结了在宁夏回族地区开展临终关怀应用伊斯兰教的信仰关怀、情感关怀和死亡关怀”三关怀”与癌性疼痛心理治疗之间的关系。     

慢性疼痛与抑郁的心身医学整合观

生物医疗观对慢性疼痛患者的诊疗作用较差。慢性疼痛常因为心理应激、个性、行为和疾病状况而复杂化,增加了患者诊疗的难度。患者常因情感症状、生活压力,而失去信心,陷入无助地痛苦选择冲突中。应用一种系统的跨学科方法重建和保持医生的共情和患者的积极心理,采用疾病状态、生活经历、个性特征和行为模式的四种心身整合观点,综合评估抑郁和慢性疼痛患者。设计综合诊疗方案评定的痛苦作用,在方案制定的过程中认识到这四个观点彼此不同,相互补充,全面阐释影响患者痛苦的生物、心理和社会的多种原因。心身整合观点为设计合理的治疗方案提供了方法,提高了医生成功治疗慢性疼痛患者的可行性。     

Cognitive-behavioral treatment and antidepressants combined with virtual reality exposure for patients with chronic agoraphobia

In this study we compared the efficacy of virtual reality exposure combined with cognitive-behavioral therapy (VRET) to that of traditional cognitive-behavioral therapy (CBT) alone in reducing phobic symptoms in a sample of patients with long-term agoraphobia. The study was a between-subject design with three experimental conditions (VRET group, N = 30; CBT group, N = 30; and medication only group, N = 20) and repeated measures (pre-treatment, post-treatment, and six-month follow-up). All patients were receiving antidepressant medication. Results showed that all therapies were statistically effective both at post-treatment and six-month follow-up. The VRET group showed clinical improvement in most variables measured at follow-up. The CBT group showed the highest dropout rates. These results are discussed pointing out that VRET probably serves as an intermediate procedure for an efficient exposure to phobic stimuli. Besides describing the advantages of VRET for the treatment of agoraphobia symptoms in cost-benefit terms, the study also considered issues related to higher treatment adherence and motivation.