乳腺癌患者的心理状况及相关因素分析

乳腺癌患者常常被各种心理问题所困扰,特别是乳腺癌根治术对女性性特征所带来的严重影响,各种心理问题更为突出。这些心理问题不但影响患者的生活质量,而且影响疾病的发生、发展及转归。本文回顾了患者的个人因素、疾病本身和治疗因素及其他社会心理因素与心理状况的关系,对乳腺癌患者进行心理干预、临床的综合诊治和防治过程提供新思路。     

The Prevention Delivery System: Organizational Context and Use of Comprehensive Programming Frameworks

The purpose of this exploratory study is to investigate organizational‐level mechanisms in the Prevention Delivery System (PDS) and their influence on implementing comprehensive programming frameworks (e.g., Communities that Care‐CtC) as the innovation. The PDS is part of the Interactive Systems Framework for Dissemination and Implementation (ISF) and describes key characteristics of innovation implementation and dissemination. The study addresses two research questions: (1) What types of organizational characteristics are related to successful use of each of the programming processes (i.e., planning, implementation, evaluation, and sustainability) that are part of comprehensive programming frameworks?; and (2) What are the similarities and differences in the organizational patterns correlated with use of each of the programming processes? Surveys, interview data, and other documents designed to assess organizational characteristics and extent of use of a comprehensive programming framework over time, were collected from 8 Community boards and 23 provider agencies. These organizations were responsible for planning and delivering substance abuse prevention services as part of a statewide initiative in Ohio. Data were analyzed using Spearman rho (and rank‐biserial) correlations, with an emphasis on effect sizes. Results indicated that leadership, shared vision, process advocates, and technical assistance were common correlates of use across programming processes. However, the role played by these organizational variables differed for each programming process, pointing to complex interactions of the organizational infrastructure with other variables (i.e., characteristics of the innovation itself and external macro‐level factors). This exploratory study provides preliminary data on the organizational‐level mechanisms of the PDS and the complexity of their relationships with the other Systems in the Interactive Systems Framework.     

Personality traits and body mass index: Modifiers and mechanisms

Objective: To identify how demographic factors (sex, age, ethnicity) modify the association between personality traits and body mass index (BMI) and to test the extent that diet and physical activity account for the personality-BMI relations.

Design: Cross-sectional study with a diverse sample (N = 5150, 50% female, 19% African American, 15% Hispanic). Participants completed a measure of the five major dimensions of personality and reported on their physical activity, diet and food intake behaviour, and height and weight.

Main Outcome Measures: BMI and obesity (BMI ≥ 30).

Results: High Neuroticism was associated with higher BMI and risk for obesity, whereas Conscientiousness and, to a lesser extent, Extraversion and Openness were protective. These associations were generally stronger among women and older participants; there was less evidence for ethnicity as a moderator. Personality had similar relations with the behavioural factors, and physical activity, diet and regular meal rhythms accounted for approximately 50% of the association between Neuroticism and Conscientiousness and BMI.

Conclusion: This study supports the links between personality traits and BMI and suggests that physical activity, more than diet, is a key factor in these associations.     

Long-term Consequences of Childhood Bullying in Adults who Stutter: Social Anxiety,Fear of Negative Evaluation,Self-esteem,and Satisfaction with Life

Purpose: Psychosocial disorders have been reported in adults who stutter, especially social anxiety disorder. Social anxiety has been linked to childhood victimization. It is possible that recalled childhood victimization could be linked to psychosocial problems reported in some adults who stutter.Method: Participants were 36 adults who stutter and 36 adults who do not stutter (mean age = 21.9 years). The Retrospective Bullying Questionnaire was completed for primary school, secondary school and university environments for physical, verbal, relational and cyber bullying. Participants were categorized into one of five groups (bully, victim, bully-victim, bystander and uninvolved) based ontheir responses. Participants completed four psychosocial scales: social interaction anxiety, fear of negative evaluation, self-esteem and satisfaction with life scales.Results: The two groups differed with adults who stutter having higher social interaction anxiety, fear of negative evaluation and satisfaction with life. Analyses of variance revealed that victims had the highest scores among both groups on all four scales.Conclusion: Adults who recalled being victimized during childhood were more likely, regardless of whether they stutter or did not stutter, to have poorer psychosocial scale scores. These results show the lingering effects of childhood victimization, common in some children who stutter, may contribute to the reported psychosocial problems in adulthood. The need for early intervention for children who are bullied and future research with larger samples is warranted.     

Does temperament influence language development? Evidence from preterm and full-term children

The aims of this study are: (1) to describe language and temperament characteristics of one group of low risk preterm (PR) children and a group of full-term (FT) children and (2) to identify those factors which can predict language outcomes at 30 months of age, with special attention on temperament. There is evidence of differences between very or extremely PR and FT children in relation to characteristics of temperament and language development. However, not many studies have been carried out with healthy PR children.The participants were 142 low risk PR children (mean gestational age (GA): 32.60 weeks) and 49 FT children (mean GA 39.84 weeks). The temperament of the children was assessed at 10 months of age through the Infant Behavior Questionnaire-Revised (IBQ-R). At 22 months of age the cognitive development of the children was assessed through the Spanish adaptation of the Batelle Developmental Inventory (BDI). In order to assess the children's language development the Galician adaptation of the MacArthur–Bates CDI was applied at 30 months of age. In addition, socio-demographic information about the children and their families was gathered at birth.The results indicate that there were no significant differences in the language measures of interest (word production, MLU3, and sentence complexity) between groups. The only differences found between the PR and the FT children in the IBQ-R were restricted to the smiling and laughter and the fear subscales. Hierarchical regression analyses performed indicate that GA did not have any predictive effect on language measures taken at 30 months. Cognitive scores were an important predictor of language measures, although certain temperament subscales contributed in a significant way to the variance of language measures, particularly low intensity pleasure, approach, high intensity pleasure, sadness, and vocal reactivity. Therefore, extroverted (positive affectivity) temperament seems to be beneficial for language development.     

Identification of biological and environmental risk factors for language delay: The Let's Talk STEPS study

The aim of this population-based study was to identify demographic factors for language delays at an early age. The risk analysis covered 11 biological and 8 environmental factors. The mothers’ concerns regarding language development were also examined. A total of 226 children from a Finnish cohort study were invited to participate in language assessments at 36 months. The test results for word finding and language comprehension were compared with parental questionnaires about children's vocabulary at 13 and 24 months.Regression analysis revealed that the father's social class (t = −2.79, p = 0.006) and working full time (t = −2.86, p = 0.005) significantly predicted children's language delay. In addition, language comprehension was significantly predicted by the mother's social class (t = −2.06, p = 0.041) and by gender, with an advantage to girls (t = −2.71, p = 0.008). Vocabulary at 24 months was a powerful predictor for lexical development (t = 4.58, p < 0.0001) and language comprehension (t = 4.85, p < 0.0001) at 36 months. Mothers’ concerns were correlated with children's limited lexicons as early as 24 months (r = 0.31, p < 0.0001) and poor language comprehension (r = −0.35, p < 0.0001) at 36 months. Mothers were especially concerned if the parents needed special education during school years.At the population-level, gender was the most powerful biological factor in predicting language delays. Similarly, both parents’ social status had predictive value for the child's language development. In addition, it was found that the mother's concern about her child's slow language acquisition should be taken into account when making decisions regarding special support.     

压抑遗忘的影响因素

人在生活中的一些负性经历或无效信息可以通过压抑提取而遗忘,这种遗忘称为压抑遗忘。压抑遗忘不仅受压抑时长、压抑次数、实验材料的情绪效价和唤醒度、期待效应等的影响,还受个体的年龄和精神障碍等的影响。今后应着重考察精神疾病个体记忆控制网络内的连接强度与压抑遗忘的关系,澄清压抑遗忘是否存在补偿机制。     

韧性（resilience）——在压力下复原和成长的心理机制

韧性是指面对丧失、困难或者逆境时的有效应对和适应。当生活变化对人们造成威胁时,这种自我保护的生物本能就会展现出来。来自个人、家庭、社会三方面的保护性因素之间会相互作用而组成动力系统,共同抵抗环境的不利影响。韧性的过程模型认为韧性是瓦解和重新整合之后达到的更高平衡状态,与一般意义上的“复原”有区别。在不同人生发展阶段上,韧性呈现出具有不同适应意义的层次结构,其内涵也会因情境而变化。尽管在如何测量韧性的问题上研究者们仍未达成一致意见,但一些简便有效的韧性量表得到了广泛应用。韧性研究的目的是探索个人生存和成长的力量源泉,在教育、医疗、社区和企业中开展的韧性干预训练已经显示出良好效果。     

A dimensional analysis of claustrophobia

The present study investigated whether situational and cognitive dimensions of claustrophobia exist. To this end, the Claustrophobia Situations Questionnaire (CSQ) and the Claustrophobia General Cognitions Questionnaire (CGCQ) were developed and exploratory factor analyses were performed on these scales. Two-factor solutions for both the anxiety and the avoidance ratings on the CSQ were obtained, accounting for 40.1% and 34.2% of the variance, respectively. Two subscales were created from the two-factor solution of the anxiety section of the CSQ: (1) Fear of Entrapment and (2) Fear of Physical Confinement. Two subscales were also created from the two-factor solution of the avoidance section of the CSQ: (1) Avoidance of Crowds and (2) Avoidance of Physical Confinement. A three-factor solution was obtained for the CGCQ, accounting for 54.4% of the variance, from which the following three subscales were created: (1) Fear of Loss of Control, (2) Fear of Suffocation, and (3) Fear of Inability to Escape. Cronbach alphas for all subscales ranged from .84 to .94. Exploratory correlational analyses were conducted between the situational and the cognitive dimensions.     

Marital discord and psychiatric disorder in children and adolescents

The relationship between marital discord and any DISC-2.1/DSM-III-R child psychiatric diagnosis was explored. Interview data from a community sample of 90 parent/child pairs and a clinic sample of 37 parent/child pairs were analysed. The data were collected at Columbia University/the New York State Psychiatric Institute as part of the pilot project of a multi-site methodological study. Rates of marital discord and DISC diagnoses were found higher in the clinic sample than in the community sample. The association between marital discord and any diagnosis remained significant when other risk and protective factors were controlled. Policy implications and recommendations for future research strategies suggested by the current exploratory study were discussed.