A Prospective Analysis of Near-Death Experiences in Cardiac Arrest Patients

The objective of this study was to assess prospectively the frequency of near-death experiences (NDEs) in patients suffering a cardiac arrest, to characterize these experiences, and to assess their impact on psychosocial and spiritual attitudes. We prospectively evaluated all patients who suffered a cardiac arrest at Barnes-Jewish Hospital from April 1991 through February 1994, excluding those in the surgical intensive care unit, using a scale designed to specify criteria for NDEs, a recorded interview regarding the experience, an experience rating form, and a follow-up questionnaire regarding psychosocial attitudinal life changes. Of the 174 patients who suffered a cardiac arrest, 55 patients survived, of whom 30 patients were interviewable. Of those 30 patients interviewed, seven (23 percent) had a NDE, and four others (13 percent) reported an NDE during a prior life-threatening illness. The experiences were most frequently characterized by ineffability, peacefulness, painlessness, lack of fear, detachment from the body, and no sense of time or space. Significant differences were noted in the follow-up psychosocial assessment between patients who experienced an NDE and those who did not with regard to personal understanding of life and self, attitudes toward others, and changes in social customs and religious/spiritual beliefs. Of importance, patients reported it was beneficial to receive psychosocial support before hospital discharge after having an NDE. The results suggest that NDEs are fairly common in cardiac arrest survivors. The experiences consisted of a number of core characteristics and changed psychological, social, and spiritual awareness over both the short and long term.     

当代的危机与哲学的开端--论胡塞尔与海德格尔的关系

对于当代的危机,胡塞尔与海德格尔都曾做出过诊断。作者试图借助于胡塞尔现象学的手段,将海德格尔的一个指路性明察具体化,从而表明对生活世界的遗忘源于古希腊哲学中。     

Asthma-Specific Quality of Life in Older Adolescents and Young Adults with Long-Standing Asthma: The Role of Anxiety and Depression

The present study examined the influence of psychological comorbidity (i.e., anxiety and depression) on asthma-specific quality of life (QOL). Sixty-four older adolescents and young adults with childhood onset asthma completed measures of anxiety, depression, and asthma-specific QOL. Objective assessments of illness severity were obtained via a semistructured interview and pulmonary function test. Results revealed that the combination of anxiety and depression severity contributed significant variance to asthma QOL after statistically controlling demographic and disease covariates. Moreover, anxiety demonstrated a significant main effect on asthma QOL. Findings suggest that assessment of anxiety may help identify individuals who are at risk for poorer asthma-specific quality of life. Such early interventions can be effectively incorporated into comprehensive biopsychosocial treatment and behavioral self-management programs for individuals with asthma.     

心理干预在化疗患者中的应用

本研究针对化疗患者常见的恶心呕吐、烦躁不安等副作用．运用心理行为技术．采用病例对照研究方法,对129名化疗患者进行了比较研究。结果为：各项情绪指标和总的情绪状况以及恶心呕吐反应。干预组患者比对照组改善明显;生活质量各指标在组问和组内比较中,有不同程度的改善,角色、社会、认知功能和疼痛症状在两组比较中改善不明显。由此认为,对化疗患者实施恰当的心理行为技术．干预效果是明显的     

"生活世界"与"生活-世界"--一种中国哲学本体诠释的可能性

本文论述了胡塞尔现象学中作为科学奠基的“生活世界”概念,把它放在中国哲学的传统加以观照,试图对其进行一种新的本体诠释,由此拓展对“生活世界”的理解。     

Life experiences of people who stutter, and the perceived impact of stuttering on quality of life: personal accounts of South African individuals

The purpose of the study was to investigate the life experiences of a group of South African adults who stutter and the impact of stuttering on their quality of life. Participants were 16 adults with a mean age of 28.9 and ranging from 20 to 59 years. Methods involved individual interviews designed to explore the life domains of education; social life; employment; speech therapy; family and marital life; and identity, beliefs and emotional issues. Main findings of the study indicated that the majority of participants perceived their stuttering to have impacted on their academic performance at school, and relationships with teachers and classmates. Although their stuttering was not perceived to adversely influence their ability to establish friendships, people generally reacted negatively to their stuttering. Many felt that their stuttering did not have an adverse effect on their choice of occupation, ability to obtain work, and relationships with managers and co-workers, although it was perceived to influence their work performance and hamper their chances for promotion. Although the majority viewed their speech therapy experiences as being negative; more than half the sample believed that speech therapy had, nevertheless exerted a positive effect on their quality of life. Overall, stuttering did not appear to have influenced participants’ family and marital life. Most participants felt that stuttering had affected their self-esteem and self-image, and had evoked strong emotions within them. Findings are taken to suggest the need to incorporate subjective feelings about stuttering into the clinical practice of speech-language therapy; to provide information and coping strategies for teachers and employers; and for further research.

Educational objectives: After completing this activity, the reader will be able to: (1) describe and explain the perceived impact of stuttering on quality of life in terms of education; social life; employment; speech therapy; family and marital life; and identity, beliefs and emotional issues; (2) to interpret and utilize the subjective meanings that individuals attach to their stuttering to improve stuttering treatment, counseling and research.     

Depression in the Context of Disability and the “Right to Die”

Arguments in favor of legalized assisted suicide often center on issues of personal privacy and freedom of choice over one's body. Many disability advocates assert, however, that autonomy arguments neglect the complex sociopolitical determinants of despair for people with disabilities. Specifically, they argue that social approval of suicide for individuals with irreversible conditions is discriminatory and that relaxing restrictions on assisted suicide would jeopardize, not advance, the freedom of persons with disabilities to direct the lives they choose. This paper examines the idea promoted by some proponents of assisted suicide that it is reasonable to be depressed about one's diminished quality of life in cases of irreversible illness or disability and, therefore, such depression should not call into question the individual's competence to request assistance in dying. The concept of rational depression is defined and examined in the context of: four real-life cases involving individuals with disabilities who requested assistance in dying; a set of criteria commonly applied to decision-making to determine rationality; and research bearing on the emotional status of people with disabilities. It is concluded that although disability is associated with particular socially mediated stressors, there is no theoretical or empirical evidence to indicate that depression and its role in the right to die is dynamically different, more natural, or more reasonable for disabled people than for non-disabled people.     

Romantic relationships of young people with childhood and adolescent onset antisocial behavior problems

Using prospective longitudinal data from the Christchurch Health and Development Study, this paper examines the extent to which early onset, life course persistent and adolescent limited antisocial behavior problems place young people at risk of violent and unsatisfactory romantic relationships in early adulthood. Results revealed the presence of clear linear associations between the developmental timing of antisocial behavior and later partnership risks, with these risks including partner violence perpetration and victimization, interpartner conflict, and increased ambivalence about the relationship. Young people with childhood onset antisocial behavior problems reported higher rates of partnership difficulties than young people with adolescent limited antisocial behavior problems, while those with adolescent limited antisocial behavior reported higher levels of partnership difficulties than young people without a history of antisocial behavior problems. These associations persisted even after extensive control for a range of social, family, and individual factors that were correlated with the timing of antisocial behavior. Results highlight the importance of distinguishing between early and late onset antisocial behavior, and provide further support for existing life course models of the development of antisocial behavior problems in children and adolescents.     

2001 INVITED ADDRESS: The Mystery of Human Context and Coping: An Unraveling of Clues

Community and clinical psychology share a fundamental focus: to understand the interplay between human contexts, coping, and adaptation. To highlight recent progress in this area, I offer a guiding conceptual framework and discuss 8 propositions about environment and coping. The propositions consider such issues as patterns of social climate and coping and their links to personal development and dysfunction, the connections between ongoing life circumstances and intervention programs, the role of personal characteristics in matching individuals and environments, and the value of placing specific settings in an ecological context. I then focus on 8 enigmas, such as how to identify conceptually unifying dimensions of diverse social contexts, how to model the processes involved in person–environment transactions, how to understand the link between adversity and personal growth, how to examine the generality of models across ethnic and cultural groups, and how to enhance positive carryover from intervention programs to ongoing life contexts. I close by addressing some implications of these issues for a vision of a dynamic community psychology.