Krankheitsbewältigung bei multipler Sklerose

Zusammenfassung Obwohl ein erheblicher psychosozialer Versorgungsbedarf bei Patienten mit multipler Sklerose (MS) unstrittig ist, stehen die theoretische Aufarbeitung belastender Aspekte des Krankheitsverlaufs wie die Entwicklung standardisierter Interventionsmaßnahmen nach wie vor am Beginn. In vorliegendem Beitrag werden Konzepte und Modelle der Krankheitsbewältigung als geeigneter theoretischer Bezugsrahmen charakterisiert. Im Anschluss an eine knappe Bestandsaufnahme von Versorgungsbedarf und vorhandenen Versorgungsansätzen werden zunächst kurz Modelle der Krankheitsbewältigung (Coping) vorgestellt, die zur Abbildung spezifischer belastender Folgen der MS geeignet erscheinen. Weiterhin werden in einer Befundübersicht neuere Ergebnisse bewältigungsorientierter Forschung dargestellt, die auch erste Berichte zur Evaluation von Bewältigungstrainings einschließen. Ferner werden Ziele und Techniken, die als Bausteine eines umfassenden Trainings zur Bewältigung von Folgen der MS unverzichtbar erscheinen, erörtert. Abschließend werden offene Forschungsfragen, die die Gestaltung von Bewältigungstrainings betreffen, diskutiert.     

生命伦理学挑战和机遇:人类行为学时代

2002年11月绘制思想图计划在自然杂志上发表(Nature 420:121,2002).它具有从发展对于跨文化和多学科的生命伦理学的描述性方法,到制定代表更多少数人想法和观点的下策的几个目的.为了获得绘制想法的最适当的方法,绘制思想图计划设立了个方法组,其目的是发展平行的方法,建立一个对行为进行描述的全面基本的结构.对于确定第二年计划应该向哪个方向发展和集中精力于何处,我们考虑了一些方法组的意见.我们邀请更多的人成为这个计划的参与者.     

幼儿心理状态术语的运用与心理理论的发展

本研究目的在于探讨幼儿在假装游戏中心理状态术语的应用,以及与错误信念的理解是否存在相关并具有一定的发展特征。57名3—5岁的幼儿参加了实验。研究程序包括两类标准错误信念任务及假装游戏的拍摄、麦卡锡幼儿言语智力测验。结果发现：(1)幼儿的一般言语能力与错误信念的理解存在显著相关;(2)幼儿心理状态术语的使用存在情境差异,且随年龄的增长具有“指向愿望一指向信念”的维度特征;(3)在控制相关因素之后,幼儿错误信念的理解与心理状态术语的应用及其特定范畴(习惯用语)之间仍然存在显著相关;与“真正涉及心理状态”之间的相关不再显著。     

Intervention-based school psychology services: Training for child-level accountability; preparing for program-level accountability

This research evaluated the outcomes of a school psychology training practicum by replicating intervention-based service delivery procedures established in prior research. The key components include describing a service delivery model, teaching the model, deriving practice guidelines that fit the model, supporting trainees in carrying out the steps, and evaluating the outcomes. Procedures to determine outcomes were based on single-case design facets including accountability design (A-B), visual analysis of graphic data, and social validity ratings. Meta-analysis techniques included calculation of effect sizes and percent of nonoverlapping data (PND). Goal attainment scaling (GAS) also was used to summarize outcomes. The analyses indicated that the interventions led to positive changes for most children. For example, the median effect size was 1.42 across cases. Social validity evidence showed that consumers judged the outcomes positively. Achieving ideal baseline and technical adequacy checks (e.g., observer agreement, intervention adherence) represented challenges for many consultations. The contributions of the study include describing methods for child- and program-level accountability in training and areas for improvement including further supporting the completion of technical checks for intervention services.     

The search for peer advice in cyberspace: An examination of online teen bulletin boards about health and sexuality

The physical, emotional, and psychological changes that occur in adolescence prompt youths to have serious questions about their bodies, relationships, and health that are often personal, sensitive, or embarrassing. Past research has shown that adolescents are often reluctant to consult physicians, peers, and others for personal health questions due to concerns about confidentiality. One new venue for health information is the Internet, which is a promising resource due to its accessibility, interactivity, and anonymity. This study is a snapshot investigation of a popular health support website, which utilized a peer-generated bulletin board format to facilitate the discussion of adolescent health and social issues. Analyses of two health bulletin boards—one on teen issues and one on sexual health—were conducted on the questions and replies found on 273 topics of mainly anonymous adolescents collected over a 2-month period. Results revealed that the questions most frequently posted and viewed reflected interests and concerns about their changing physical, emotional, and social selves: Romantic relationships were the most frequent topic on the teen issues bulletin board; sexual health was the most frequent topic on the sexuality bulletin board. The bulletin boards proved to be a valuable forum of personal opinions, actionable suggestions, concrete information, and emotional support and allowed teens to candidly discuss sensitive topics, such as sexuality and interpersonal relations.     

Population sex differences in IQ at age 11: the Scottish mental survey 1932

There is uncertainty whether the sexes differ with respect to their mean levels and variabilities in mental ability test scores. Here we describe the cognitive ability distribution in 80,000+ children—almost everyone born in Scotland in 1921—tested at age 11 in 1932. There were no significant mean differences in cognitive test scores between boys and girls, but there was a highly significant difference in their standard deviations (P<.001). Boys were over-represented at the low and high extremes of cognitive ability. These findings, the first to be presented from a whole population, might in part explain such cognitive outcomes as the slight excess of men achieving first class university degrees, and the excess of males with learning difficulties.     

Parentification,Stress, and Problem Behavior of Adolescents who have a Parent with Mental Health Problems

When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so‐called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross‐sectionally and longitudinally in a sample of 118 adolescents living with a parent suffering from mental health problems. In addition, the study examined a possible indirect effect via perceived stress. Path analyses were used to examine the direct associations between parentification and problem behavior as well as the indirect relations via perceived stress. The results showed that parentification was associated with both internalizing and externalizing problems cross‐sectionally, but it predicted only internalizing problems 1 year later. An indirect effect of parentification on adolescent internalizing and externalizing problems via perceived stress was found, albeit only cross‐sectionally. These findings imply that parentification can be stressful for adolescents who live with a parent with mental health problems, and that a greater awareness of parentification is needed to prevent adolescents from developing internalizing problems.     

Changes in Families’ Caregiving Experiences through Involvement as Participants then Facilitators in a Family Peer‐Education Program for Mental Disorders in Japan

A family peer‐education program for mental disorders was developed in Japan, similar to existing programs in the United States and Hong Kong. Families that serve as facilitators in such programs may enhance their caregiving processes and, thereby, their well‐being. This study's aim was to describe how families’ caregiving experiences change, beginning with the onset of a family member's mental illness, through their involvement in a family group or peer‐education program as participants then facilitators. Thus, this study was conducted in a family peer‐education program for mental disorders in Japan. Group interviews were conducted with 27 facilitators from seven program sites about their experiences before, during, and after becoming facilitators. Interview data were coded and categorized into five stages of caregiving processes: (1) withdrawing and suppressing negative experiences with difficulty and regret; (2) finding comfort through being listened to about negative experiences; (3) supporting participants’ sharing as facilitators; (4) understanding and affirming oneself through repeated sharing of experiences; and (5) finding value and social roles in one's experiences. The third, fourth, and fifth stages were experienced by the facilitators. The value that the facilitators placed on their caregiving experiences changed from negative to positive, which participants regarded as helpful and supportive. We conclude that serving as facilitators may improve families’ caregiving processes.     

Parents Plus Systemic,Solution‐Focused Parent Training Programs: Description,Review of the Evidence Base,and Meta‐Analysis

Parents Plus (PP) programs are systemic, solution‐focused, group‐based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child‐focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta‐analysis of 10 controlled studies for child behavior problems compares favorably with those of meta‐analyses of other well‐established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front‐line mental health and educational professionals.