价值观对蓄意创伤受害者创伤后应激障碍症状的影响

探讨价值观对蓄意创伤受害者创伤后应激障碍（Posttraumatic Stress Disorder ,简称PTSD）症状的影响方式。方法：采用事件冲击量表、受害人认可评价量表、施瓦兹价值观量表作为测查工具,测查了163 名蓄意创伤受害者。结果：（1）蓄意创伤受害者的PTSD三大症状表现有显著差异,闯入症状水平最高,回避症状水平次之,高警觉症状水平最低。（2）蓄意创伤受害者所持的价值观和对外界接纳的评价能较好地预测PTSD三大症状。（3）内敛价值类型通过诸如社会接纳等反映外在标准的因素影响PTSD的闯入症状。结论：蓄意创伤受害者PTSD症状表现有其自身的特点,对外界接纳的评价和自身所持的价值观对其PTSD症状有直接或间接的影响     

Etiologic Subtypes of Attention-Deficit/Hyperactivity Disorder: Brain Imaging, Molecular Genetic and Environmental Factors and the Dopamine Hypothesis

Multiple theories of Attention-Deficit/Hyper- activity Disorder (ADHD) have been proposed, but one that has stood the test of time is the dopamine deficit theory. We review the narrow literature from recent brain imaging and molecular genetic studies that has improved our understanding of the role of dopamine in manifestation of symptoms of ADHD, performance deficits on neuropsychological tasks, and response to stimulant medication that constitutes the most common treatment of this disorder. First, we consider evidence of the presence of dopamine deficits based on the recent literature that (1) confirms abnormalities in dopamine-modulated frontal-striatal circuits, reflected by size (smaller-than-average components) and function (hypoactivation); (2) clarifies the agonist effects of stimulant medication on dopaminergic mechanisms at the synaptic and circuit level of analysis; and (3) challenges the most-widely accepted ADHD-related neural abnormality in the dopamine system (higher-than-normal dopamine transporter [DAT] density). Second, we discuss possible genetic etiologies of dopamine deficits based on recent molecular genetic literature, including (1) multiple replications that confirm the association of ADHD with candidate genes related to the dopamine receptor D4 (DRD4) and the DAT; (2) replication of differences in performance of neuropsychological tasks as a function of the DRD4 genotype; and (3) multiple genome-wide linkage scans that demonstrate the limitations of this method when applied to complex disorders but implicate additional genes that may contribute to the genetic basis of ADHD. Third, we review possible environmental etiologies of dopamine deficits based on recent studies of (1) toxic substances that may affect the dopamine system in early development and contribute substantially to the etiology of ADHD; (2) fetal adaptations in dopamine systems in response to stress that may alter early development with lasting effects, as proposed by the developmental origins of health and disease hypothesis; and (3) gene-environment interactions that may moderate selective damage or adaptation of dopamine neurons. Based on these reviews, we identify critical issues about etiologic subtypes of ADHD that may involve dopamine, discuss methods that could be used to address these issues, and review old and new theories that may direct research in this area in the future.     

Family Impact of Tourette's Syndrome

Tourette's syndrome (TS) is a neuropsychological disorder characterized by vocal and motor tics. TS is also associated with several behavior disorders such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, conduct disorder, and Obsessive-Compulsive Disorder. We examined the impact of Tourette's syndrome with and without comorbid psychiatric disorders on the family. TS complicated by comorbid disorders had a greater impact on the family than uncomplicated TS. Tourette's symptom severity was significantly correlated with the level of impact on the family and with the number of comorbid disorders. TS is a disorder with effects that extend beyond motor and vocal tics.     

Fast screening of eating disorders among patients with bipolar disorder: Validation of the French version of BEDS questionnaire

IntroductionThe prevalence and morbidity of eating disorders (ED) is high in patients with bipolar disorder (BD). Simple tools are necessary to easily and rapidly screen for ED in bipolar patients.ObjectiveThe aim of this study was to validate the French version of Bipolar Eating Disorder Scale (BEDS-F).MethodED and BD diagnoses were established with a structured-interview in 80 patients according to the DSM-IV criteria. The BEDS was translated into French using appropriate methods. Patients were administered the following scales: BEDS-F, SCOFF, Bulimic Investigatory Test Edinburgh (BITE) and Eating Disorder Inventory-two (EDI-2).ResultsBEDS-F score were significantly higher in bipolar patients with ED. The BEDS-F showed high feasibility (no omission response), excellent discriminating abilities (ROC AUC = 0.97) with a sensibility of 98% and specificity of 85% for BEDS ≥ 11, high internal consistency (Cronbach's alpha coefficient = 0.86) and test-retest reliability (ICC = 0.99). No floor/ceiling effect was observed. The BEDS-F sensitivity was equivalent to that of the BITE and EDI-2 subscale B. The BEDS-F specificity was slightly lower than that of the EDI-2 subscale B, but equivalent to that of BITE.ConclusionThe BEDS-F is a valid scale for fast ED screening in patients with bipolar disorder, and easier to administer than other currently used scales.     

The Vancouver Obsessional Compulsive Inventory (VOCI)

The original Maudsley Obsessional Compulsive Inventory (MOCI) has been widely used and is considered to be one of the best available self-report instruments for measuring observable obsessive-compulsive problems such as washing and checking. However, it has several limitations and requires updating. Our revision of the MOCI, the Vancouver Obsessional Compulsive Inventory (VOCI), was designed to provide assessment of a range of obsessions, compulsions, avoidance behaviour, and personality characteristics of known or theoretical importance in obsessive-compulsive disorder (OCD). The development of the VOCI is described, and we provide evidence of its reliability and validity. Our findings in samples of people with OCD, people with other anxiety disorders or depression, community adults, and undergraduate students suggest that the VOCI is a promising new measure. We anticipate that, like its predecessor, the VOCI will have widespread use in both research and clinical settings.     

A meta-analysis of psychological and pharmacological treatments for Body Dysmorphic Disorder

Although psychological and pharmacological treatment approaches for Body Dysmorphic Disorder have been evaluated, the relative effectiveness of these two types of interventions has not been examined. We conducted a meta-analysis of randomized clinical trials and case series studies involving psychological (i.e., behavioural, cognitive-behavioural, cognitive) or medication therapies. Our findings support the effectiveness of both types of therapy, but suggest that cognitive-behavioural treatment may be the most useful. These findings require cross-validation through large-scale clinical trials.     

The relationship between viewing US-produced television programs and intentions to drink alcohol among a group of Norwegian adolescents

The aim of this study was to examine the influence of exposure to US-produced television programs and family rules prohibiting alcohol use on the development of normative beliefs, expectancies, and intentions to drink alcohol in the next 12 months among a group of Norwegian adolescents who reported that they had not previously consumed alcohol. Data were collected via a survey administered to 622 eighth and ninth graders enrolled at ten junior highs in southeastern Norway. To examine these relationships we tested the fit of a structural equation model which was based on the Theory of Planned Behavior (Ajzen, 1988). Data from the non-drinkers (n= 392, 63% of the respondents) were used. To control for the influence of peer drinking on behavioral intentions, our model was tested under two group conditions: (1) those subjects reporting that they have no friends who drink alcohol and (2) those subjects reporting that they have one or more friends who drink. The findings indicate that the influence of TV exposure was a significant predictor (directly) of normative beliefs, expectancies (indirectly) and intentions to drink (both directly and indirectly) only for those subjects who reported having no friends who drink. For the group with non-drinking friends, family rules constrain intentions only indirectly by influencing normative beliefs. For those with friends who drink, however, family rules have a direct (inverse) effect on intentions. It is concluded that exposure to US-produced television programs functions as a limited knowledge source only for those subjects who had little or no personal experience with alcohol while the presence of family rules have limited impact on behavioral intentions.     

Performance and Private Speech of Children with Attention-Deficit/Hyperactivity Disorder While Taking the Tower of Hanoi Test: Effects of Depth of Search,Diagnostic Subtype,and Methylphenidate

We administered the Tower of Hanoi to demographically comparable samples of control participants (n = 34) and children with the Combined (n = 22) and Inattentive subtypes (n = 19) of Attention-Deficit/Hyperactivity Disorder (ADHD). Controls excelled over children with the Inattentive subtype, who outperformed patients with the Combined subtype. These results replicated findings of greater executive deficits in the Combined than in the Inattentive type of ADHD. Double-blind administration of methylphenidate improved task performance only for patients with the Inattentive subtype. In a drug-free Baseline session, children with both subtypes of ADHD made more private verbalizations than controls, particularly when failing puzzles. In later sessions, regardless of drug condition, the inattentive sample exhibited a smaller increase in self-regulatory utterances under failure. In contrast, the combined sample decreased self-regulatory verbalizations under failure only under methylphenidate. The results support some differences between the two subtypes of ADHD in executive functioning and in their response to stimulant therapy. Portions of these results were submitted as part of H. Theresa Chang's PhD dissertation (Chang, 2000) and Helena Kopecky's unpublished master's research, both conducted at the University of Rochester and supervised by Rafael Klorman.     

Clinically useful,research validated assessment of persons with alcohol problems

Advances in treatment approaches available for persons with alcohol problems, particularly the advent of cognitive behavioral and motivational approaches, have made systematic assessment of these problems more important than ever for clinicians. There is a plethora of assessment instruments available, and it is a difficult task for clinicians to conceptualize, select and use these instruments in a coherent fashion. Particularly important in this task is the identification of research validated instruments that provide both clinically useful and psychometrically sound data. This paper presents a model of alcohol assessment and reviews selected research validated instruments that can be assembled into an assessment battery that provides useful data to guide treatment of alcohol problems while also addressing practical concerns encountered by clinicians in practice.     

A comparison of a brief and long version of the Situational Confidence Questionnaire

Assessing confidence to resist drinking in high risk situations is an important part of behavioral treatments for alcohol problems. The present study assessed the reliability and validity of the original 100-item Situational Confidence Questionnaire (SCQ) and of an 8-item brief version (BSCQ). Using a visual analog scale, the BSCQ asked respondents to report their confidence to resist urges to drink heavily using the original eight SCQ subscales (e.g., pleasant times with others, social pressure). Data were collected from 120 adult problem drinkers who voluntarily entered an outpatient alcohol treatment program. The comparability of the BSCQ and the SCQ-100 was evaluated through intraclass correlations between the eight subscales and comparison of both instruments' underlying factor structures. Correlation coefficients for the subscales ranged from 0.56 to 0.80. Both instruments showed similar, but not identical factor structures. The present results indicate that the BSCQ provides comparable information to the SCQ-100. Limitations, as well as the clinical advantages, of using the BSCQ over longer versions are discussed.