An Empirical Evaluation of the Diagnostic Criteria for Premenstrual Dysphoric Disorder: Problems with Sex Specificity and Validity

Premenstrual dysphoric disorder is a psychiatric disorder that reportedly affects between 3 to 8% of women. Although not an official diagnosis in the current Diagnostic and Statistical Manual of Mental Disorders, premenstrual dysphoric disorder has received increasing attention in the clinical literature, and considerable debate exists regarding the validity of this proposed condition. This study examined the prevalence of premenstrual dysphoric disorder in a sample of women and men and assessed the construct validity of the disorder. Twenty percent of women met the criteria for provisional diagnosis of premenstrual dysphoric disorder using Diagnostic and Statistical Manual criteria. In addition, 4% of men met these criteria when given sex-neutral assessment forms. Self-reported psychological distress and impaired interpersonal functioning did not predict women's likelihood of meeting the criteria for premenstrual dysphoric disorder. Results cast doubt on the sex-specificity of the diagnostic criteria of premenstrual dysphoric disorder and the construct validity of the disorder. Limitations of this study are discussed.     

多目标追踪在各类人群评价与训练中的应用

多目标追踪范式主要用来探讨动态情景下对多个目标的视觉注意和记忆加工过程, 早期研究侧重于追踪过程中的影响因素及加工机制。近年来, 越来越多的研究应用多目标追踪范式对各类人群进行评价与训练, 包括儿童、老年人、神经发育障碍患者、驾驶员、运动员、电子游戏玩家以及一些其他职业群体。总体来看, 多目标追踪表现越好, 在复杂快速的动态情境中的专业表现越好; 反之, 多目标追踪表现差, 标志着认知功能可能发育不成熟或出现衰退。并且, 多目标追踪还可作为认知训练的手段, 改善老年人和神经发育障碍患者的认知功能, 提高各职业人群的专业表现。未来, 多目标追踪作为评价和训练的方法还有很大的发展空间, 包括加强特殊职业人群的模拟训练, 扩展目标人群, 结合立体视觉和真实场景, 结合身体活动, 探索多人合作的多目标追踪, 拓展用于进行情绪和社会功能的评价与训练等。     

Stability criteria

Three approaches to the determination of behavioral stability were examined. In the first, a learning curve was fit to acquisition data (from Cumming and Schoenfeld, 1960), and the “experiment” stopped when the data approached sufficiently close to the theoretical asymptote. In the second, the data were analyzed for variability and linear and quadratic trend. In the third, the experiment was stopped when the magnitude of the daily changes in the data fell below a criterion. Accuracy was measured as deviation between the average value of the dependent variable when the experiment was stopped, and the average value over the last 100 sessions. The first approach was most accurate, but at the cost of requiring the most sessions and being the most difficult to apply. Both the second and third approaches provided acceptable criteria with a reasonable cost-accuracy tradeoff. The second approach permits a continuous adjustment of the criteria to accommodate the variability intrinsic in the experimental paradigm. The third, nomothetic, approach also takes into account the decreasing marginal utility of extended training sessions.     

药物性肝损伤的诊断思维

药物性肝损伤（DILI）是指由于药物或其代谢产物引起的肝脏损害。DILI的诊断尚无金标准,目前国际上比较常用的诊断标准分别从数个不同方面各自进行量化评分,根据得分情况做出诊断。本文归纳DILI的产生机制、诊断标准、临床分型及病理类型,总结推论其临床诊断思维与决策,以供临床医生参考,提高诊断水平。     

负性情绪刺激对大学生多目标追踪能力的影响

探讨了负性情绪对大学生多目标追踪能力的影响以及其影响机制。实验要求被试在观看国际情绪图库中的负性或中性图片后,完成多目标追踪和点探测任务,同时设置基线条件作为对照。采用状态-特质焦虑量表和贝克抑郁自评量表考察不同情绪图片条件下被试的诱发情绪状态。研究结果发现：（1）被试观看负性情绪图片后状态焦虑程度和抑郁量表评分显著提高,观看情绪图片有效诱发了被试的负性情绪;（2）基线条件下的被试追踪正确率显著低于中性条件,基线条件和负性图片条件下的追踪正确率无差异,说明训练可以提高被试的多目标追踪能力,但负性情绪抑制了被试在基线追踪任务中的训练效果;（3）负性图片条件下的点探测觉察率显著低于中性图片条件,说明负性情绪影响了被试的注意资源分配。研究结果表明：负性情绪可能干扰了被试目标导向的注意系统,使得个体更易受刺激驱动的注意系统影响,并且在追踪过程中影响被试中央执行系统的抑制和转移功能。     

影响儿童至老年人“位置法”记忆训练效果的因素探析

１１８名儿童、少年、青年、中年和老年被试参加＂位置法＂记忆训练,在训练前后对被试进行了一些认知功能的测查,以探讨被试的年龄及认知能力诸因素对记忆训练效果的影响及其预测性。结果表明：①训练前字词和图形记忆成绩、＂数字符号＂测验成绩与训练后记忆成绩相关极其显著,＂词汇＂测验成绩和想象力与训练后记忆成绩的相关也达到显著性水平;②年龄与训练后记忆效果的关系是非线性的;③除＂词汇＂成绩外,各项认知成绩均可预测训练后字词记忆成绩,训练后的图形记忆迁移效果可由＂数字符号＂测验成绩预测。     

Giving meaning to illness: An investigation of self-defining memories in patients with relapsing-remitting multiple sclerosis patients

Multiple sclerosis (MS) patients are often unable to adequately fulfill their established roles due to physical disabilities and cognitive changes, making this chronic illness particularly threatening to personal identity. Twenty-five MS patients and 25 healthy controls were asked to recall five self-defining memories (SDM). Overall characteristics of SDM did not differ between patients and controls; MS patients displayed preserved capacity to draw meaning upon past events. Moreover, almost two-thirds of MS patients mentioned at least one illness related SDM and about 25% of patients’ SDM referred to MS. These memories were experienced as more negative and associated with more tension than other SDM but led toward more positive emotion and less negative emotion over time; they were also more central and more integrated to the personal identity. We concluded that self-challenging events due to MS may trigger both cognitive and emotional processes enabling the integration of illness in patients’ self-representations.     

Plenary address – A year of living ‘dangerously’: Reflections on risk,trust, trauma and change

This paper examines the role of emotions in the construction and performance of mis/trustful relations; with medical professionals, their technologies, and ultimately, with oneself. Using personal experience of two common conditions as illustrative examples, it questions what it means and feels like to trust, and how, where and by whom such feelings can be enhanced or undermined. It explores some of the ways in which discourses of risk are mobilized and embodied to create a crisis of trust, asking; what kind of selves and emotionalities surface, and what are the health outcomes, when bodies are viewed as ‘at risk’? Visualizing technologies that probe the interior for data play an increasingly prominent role in healthcare, and are typically considered more trustworthy sources of knowledge about the body than anything that might be produced by the tech-free sensing self. However, not all (even ‘physical’) trauma can be seen or quantified, and not all information is equal. The paper reflects on the emotional dissonance that ensues when one's own perceptions and representations are at odds with those of medical experts for whom one is supposed to perform trust. It examines the feeling rules that are broken when we fail to appreciate our treatment at their hands, and asks: What happens when we resist expert author-ity by telling different stories about our embodied selves, ones that make space for emotions in contexts where they are rarely seen to count, and where only what can be measured matters?     

The effects of different mastery criteria on the skill maintenance of children with developmental disabilities

The acquisition of skills by individuals with developmental disabilities typically includes the attainment of a certain mastery criterion. We conducted a survey of practitioners who indicated the most commonly used mastery criterion as 80% accuracy across three consecutive sessions. Based on these results, we conducted a series of three experiments to evaluate the relation between mastery criterion and subsequent skill maintenance with 4 individuals with various developmental disabilities. Results suggest that 80% accuracy across three consecutive sessions may be insufficient for producing maintenance in some cases.     

Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design

Background & objectives: Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design.Methods: Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points.Results: There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months.Conclusions: Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.