从比较治疗学角度看老年性黄斑变性的治疗决策

老年性黄斑变性(AMD)是发达国家中老年人群主要致盲眼病,患病率逐年上升。近年来其治疗方面取得很大进展,但治疗方法诸多,各种方案的疗效参差不齐。为了促进老年性黄斑变性治疗选择的最佳途径,本文通过利用检索国内外报道的文献,对其中老年性黄斑变性的治疗方法归纳总结,并运用比较治疗学的研究方法进行比较分析,旨在寻求最有效的治疗方案。     

An 8-year follow-up of treated obese children: Children’s, process and parental predictors of successful outcome

Objective

This study presents an 8-year outcome of overweight children who were treated in an outpatient program and aims to identify child and familial variables associated with long-term weight regulation.

Methods

A total of 90 children participated with a mean age of 10.1 years ± 2.6 at baseline and a mean adjusted BMI (actual BMI/50th percentile of BMI for age and gender × 100) of 153.1 ± 20.7% at baseline participated in the 8-year follow-up (retrieval rate 71%; response rate 89%). Children’s and parental factors, administered at baseline and at follow-up were related to the success of the treatment.

Results

The children obtained a mean reduction of 8% in adjusted BMI at the 8-year follow-up. A total of 59 children (66%) were successful in obtaining weight control (i.e. maintaining their original % adjusted BMI); 40% even decreased their adjusted BMI by 10% or more. Analyses revealed that the child’s age, the degree of overweight at baseline and the child’s global self-worth were positive predictors of long-term weight loss 8 years after treatment, whereas psychopathology in the mother was a negative predictor. The total explained variance was R² = 35%.

Discussion

Treatment of childhood obesity by means of a multidisciplinary cognitive-behavioural program enables the majority of children to control their weight in the long term. In order to predict the success of the treatment, it is recommended to take into account the child’s age, its degree of overweight, its global self-worth and the occurrence of maternal psychopathology.     

Predictors of reading development in deaf children: A 3-year longitudinal study

The development of reading ability in a group of deaf children was followed over a 3-year period. A total of 29 deaf children (7-8 years of age at the first assessment) participated in the study, and every 12 months they were given a battery of literacy, cognitive, and language tasks. Earlier vocabulary and speechreading skills predicted longitudinal growth in reading achievement. The relations between reading and the predictor variables showed developmental change. Earlier reading ability was related to later phonological awareness skills, suggesting that deaf children might develop their phonological awareness through reading. Deaf children who had the most age-appropriate reading skills tended to have less severe hearing losses and earlier diagnoses and also preferred to communicate through speech. The theoretical implications of the role for speechreading, vocabulary and phonological awareness in deaf children’s literacy are discussed.     

论直接深入无意识的积极想象与内视方法——兼论作为单纯觉察的意识

运用现象学等研究方法,对积极想象、内视等方法及其共同要素单纯觉察的意识awareness做了探讨;提出把握单纯觉察的意识,是掌握积极想象与内视等方法的关键;而心身整体的调整,才是让无意识自由涌现的根本与保障。     

叙事研究的方法论意义

叙事研究有着从客观主义到构成主义(constructivism)的认识论背景,叙事研究的方法分为编码主题分析和意义诠释两大类,最后重点总结了叙事研究的方法论意义。叙事研究是研究人类思想的一条可供选择的道路,而纯粹的客观的量化的研究方法去研究人类思想的某些方面并非是最好的选择。叙事研究中研究者和被试互相影响,叙事研究的平民性,叙事研究打开了研究者的思路,丰富了研究者对问题的理解。     

Being a psychoanalyst: An everyday audacity1

This paper is the work of fi ve psychoanalysts who came together as a group in order to refl ect on their work as analysts. How are we analysts to identify the unconscious resistances that may sometimes hold us back from offering psychoanalysis to some patients? Do these resistances sometimes hamper the inner freedom that we require in order to maintain a psychoanalytic focus once that process is under way? How do we manage from time to time to overcome these resistances or, better, make use of them in order to develop our understanding of the unconscious dynamics that create the link between analyst and patient? The authors discuss these issues with particular reference to clinical situations taken from classic psychoanalytic treatment cases during which the analyst had to fi nd within him‐ or herself the audacity to be a psychoanalyst. Each clinical situation is different: preliminary interviews, in the course of the actual treatment, issues that emerge in the training of candidates. One of the signifi cant features of this group lies in the fact that the participants are at different stages in their development as psychoanalysts (student, associate member, full member, training analyst). This means that their experiences complement one another and encourage a discussion of issues such as how psychoanalysis can be passed on, and the relationship between supervisor and supervisee.     

A Propensity Score Adjustment for Multiple Group Structural Equation Modeling

In the behavioral and social sciences, quasi-experimental and observational studies are used due to the difficulty achieving a random assignment. However, the estimation of differences between groups in observational studies frequently suffers from bias due to differences in the distributions of covariates. To estimate average treatment effects when the treatment variable is binary, Rosenbaum and Rubin (1983a) proposed adjustment methods for pretreatment variables using the propensity score. However, these studies were interested only in estimating the average causal effect and/or marginal means. In the behavioral and social sciences, a general estimation method is required to estimate parameters in multiple group structural equation modeling where the differences of covariates are adjusted. We show that a Horvitz–Thompson-type estimator, propensity score weighted M estimator (PWME) is consistent, even when we use estimated propensity scores, and the asymptotic variance of the PWME is shown to be less than that with true propensity scores. Furthermore, we show that the asymptotic distribution of the propensity score weighted statistic under a null hypothesis is a weighted sum of independent χ² ₁ variables. We show the method can compare latent variable means with covariates adjusted using propensity scores, which was not feasible by previous methods. We also apply the proposed method for correlated longitudinal binary responses with informative dropout using data from the Longitudinal Study of Aging (LSOA). The results of a simulation study indicate that the proposed estimation method is more robust than the maximum likelihood (ML) estimation method, in that PWME does not require the knowledge of the relationships among dependent variables and covariates.     

Chickens or eggs? A follow‐up case study exploring links between physical and psychological impact of Tourette's syndrome and sexual abuse

This follow‐up case study highlights the complex relationship when working at the interface between physical and psychological symptoms. The paper draws upon conversations between an ex‐client and myself, held seven years after the end of our six year therapeutic relationship. Conversational interviews, based upon social constructionist beliefs, led to an unexpected exploration of the client's subsequent diagnosis of Tourette's syndrome (given several years after the end of therapy) and evolved into a struggle to reach a shared understanding of how she now makes connection between her problem with eating in public, her neck and facial tics, and childhood sexual abuse. Our research relationship provided both of us with a rare opportunity to reflect upon how she had made meaning of her counselling and its outcomes. The paper draws attention to the impact of counselling and therapy discourses concerning sexual abuse on the work we did at the time and asks how that work might be different today. It also helps us understand the layers of complexity and ambiguity contained within the client's stories. This multi‐layered case study represents the overlap and ‘messiness’ that mirrors the ‘lived experience’ of the persons involved, and provides an example of how co‐constructed research conversations can evoke stories that create meaning as they are told.     

重新审视肠易激综合征

肠易激综合征(IBS)作为新近日益受到重视的疑难疾病,以其固有的复杂性冲击着西医传统的疾病观。以其高发病率和对人类生活质量的严重影响促使复杂性探索研究在医学中应用并促进东方整体观在现代医学中复兴,从而用于解决诸如肠易激综合征等的医学疑难。重新审视IBS这种典型的心身相关特点显著的功能性疾病,促进对医学疑难问题研究和认识中观念的更新,特别是促进整体观在医学研究中的深化,从而有助于寻找到更有效的医学疑难病的解决方法。     

关于中国教育心理学史研究的几个问题

全文讨论三个问题:什么是中国教育心理学史?为什么要研究中国教育心理学史?怎样研究中国教育心理学史?以便了解中国心理学史的对象与范围,目的与意义,指导思想、原则与方法。