突发公共卫生事件下心境障碍的特点与应对

突发公共卫生事件会给较大范围的人群造成相当的心理压力和情绪问题。突发事件发生时,社会心理因素对突发事件控制效果和进程的影响越来越显著,因疫情、疾病、生活、工作以及社会和人际关系等因素而致的情绪问题非常突出。突发事件时情绪问题的表现有疑病、恐慌、焦虑、抑郁和强迫心理等,对此应采取相应的对策,而不同群体如罹患人群、隔离人群、家属、普通就医者及一般公众的情绪问题有其独特的表现和应对措施。突发事件为情绪问题的研究提供了广阔的前景。     

Unique characteristics of neonatal classical conditioning: The role of the amygdala and locus coeruleus

The central nervous system of altricial infants is specialized for optimizing attachments to their caregiver. During the first postnatal days, infant rats show a sensitive period for learning and particularly susceptible to learning an attraction to their mother’s odor. Classical conditioning appears to underlie this learning that is expressed behaviorally as anincreased ability to acquire odor preferences and a decreased ability to acquire odor aversions. Specifically, in neonatal rats, pairing an odor with moderately painful shock (0.5mA) or milk produces a subsequent relativepreference for that odor. The neural circuitry supporting theincreased ability to acquire odor preferences appears to be the heightened functioning of the noradrenergic pontine nucleus locus coeruleus. Indeed, norepinephrine from the locus coeruleus appears to be both necessary and sufficient for learning during the sensitive period. On the other hand, thedecreased ability to acquire odor aversions seems to be due to the lack of participation of the amygdala in at least some aversive learning situations. The site of plasticity in the pup’s brain appears to be limited to the olfactory bulb. This neonatal sensitive period for learning ends around postnatal day 9–10, at which time pups make the transition from crawling to walking and classical conditioning becomes “adultlike”. The neonatal behavioral and neural induced changes are retained into adulthood where it modifies sexual behavior.     

Trajectories of Response to Treatment for Posttraumatic Stress Disorder

Research on the predictors of response to cognitive-behavioral treatments for PTSD has often produced inconsistent or ambiguous results. We argue this is in part due to the use of statistical techniques that explore relationships among the entire sample of participants rather than homogeneous subgroups. Using 2 large randomized controlled trials of Cognitive Processing Therapy (CPT), CPT components, and Prolonged Exposure, we employed growth mixture modeling to identify distinct trajectories of treatment response and to determine the predictors of those trajectories. We determined that the participants’ trajectories could be best represented by 2 latent classes, which we subsequently labeled responders (87% of the sample) and nonresponders (13% of the sample). Notably, there was not a separate class for partial responders. Assignment to the nonresponder class was associated with receiving the written accounts (WA) component of CPT, a pretreatment diagnosis of major depression (MDD), and more pretreatment hyperarousal symptoms. Thus, it appears that some individuals do not benefit from merely writing about their trauma and processing it with the therapist; they may also need to engage in cognitive restructuring to successfully ameliorate their symptoms. Additionally, those who meet criteria for MDD or have high levels of hyperarousal at the onset of treatment might require additional treatment or support.     

Has infantile sexuality anything to do with infants?

Classical psychoanalytic theory draws many concepts from mental processes that are assumed to arise in the infant and influence the adult mind. Still, psychoanalytic practice with mothers and infants has been integrated but little within general psychoanalytic theory. One reason is that only few analysts have utilized such practice to further theory. Another reason is that infant therapists tend to abandon classical psychoanalytic concepts in favour of attachment concepts. As a result the concept of infantile sexuality, so central to classical theory, plays an unobtrusive role in clinical discussions on infant therapy. The author argues that infantile sexuality plays an important role in many mother-infant disturbances. To function as a clinical concept, it needs to be delineated from attachment and be understood in the context of mother-infant interaction. Two examples are provided; one where the analyst's infantile sexuality emerged in a comment to the infant. Another is a case of breast-feeding problems with a little boy fretting at the breast. This is interpreted as reflecting the mother's infantile sexual conflicts as well as the boy's emerging internalization of them. Thus, to conceptualize such disorders we need to take into account the infantile sexuality in both mother and baby.     

Values and Beliefs of Vegetarians and Omnivores

Abstract

Following the claim by some anthropologists and sociologists that 1 symbolic meaning of meat is a preference for hierarchical domination (C. J. Adams, 1990; N. Fiddes, 1989; D. D. Heisley, 1990; J. Twigg, 1983), the authors compared the values and beliefs of vegetarians and omnivores in 2 studies conducted in New Zealand. They compared the full range of vegetarians and omnivores on right-wing authoritarianism, social dominance orientation, human values, and consumption values. The participants tending toward omnivorism differed from those leaning toward veganism and vegetarianism in 2 principal ways: The omnivores (a) were more likely to endorse hierarchical domination and (b) placed less importance on emotional states. Accordingly, the acceptance or rejection of meat co-varied with the acceptance or rejection of the values associated with meat; that finding suggests that individuals consume meat and embrace its symbolism in ways consistent with their self-definitions.     

Who Abuses Their Coworkers? An Examination of Personality and Situational Variables

ABSTRACT

This study examines predictors of abusive employee behavior toward coworkers. We examined two personality variables, negative affectivity and political skill, and two situational relationship variables—team member exchange and coworker relationship conflict. We tested our hypotheses with data obtained from a sample of 232 working employees. We found that political skill and team member exchange were negatively related to coworker abuse, whereas negative affectivity and relationship conflict were positively related. Additionally, we found statistical support for the negative affectivity-relationship conflict, political skill-team member exchange, and political skill-relationship conflict interactions. Practical implications and directions for future research are provided.     

Religiosity and Adolescent Substance Use in Central Mexico: Exploring the Influence of Internal and External Religiosity on Cigarette and Alcohol Use

This study explores the multidimensional nature of religiosity on substance use among adolescents living in central Mexico. From a social capital perspective, this article investigates how external church attendance and internal religious importance interact to create differential pathways for adolescents, and how these pathways exert both risk and protective influences on Mexican youth. The data come from 506 self-identified Roman Catholic youth (ages 14–17) living in a semi-rural area in the central state of Guanajuato, Mexico, and attending alternative secondary schools. Findings indicate that adolescents who have higher church attendance coupled with higher religious importance have lower odds of using alcohol, while cigarette use is lower among adolescents who have lower church attendance and lower religious importance. Adolescents are most at risk using alcohol and cigarettes when church attendance is higher but religious importance is lower. In conclusion, incongruence between internal religious beliefs and external church attendance places Mexican youth at greater risk of alcohol and cigarette use. This study not only contributes to understandings of the impact of religiosity on substance use in Mexico, but highlights the importance of understanding religiosity as a multidimensional phenomenon which can lead to differential substance use patterns.     

Conceptualizing Sex Offender Denial From a Multifaceted Framework: Investigating the Psychometric Qualities of a New Instrument

The authors examined the psychometric properties of a clinician‐rated measure of sex offender denial. Convergent and discriminant validity for the measure was supported, and given its relationship to treatment attitudes, the measure demonstrated utility for assessing treatment change and readiness.     

Competence in Delivering Cognitive Processing Therapy and the Therapeutic Alliance Both Predict PTSD Symptom Outcomes

Cognitive Processing Therapy (CPT) is efficacious in treating PTSD, but there remains a need to improve outcomes for individuals who do not fully respond to treatment. Differences between patient-therapist dyads in the fidelity (i.e., adherence and competence) of CPT delivery and the quality of the therapeutic relationship may partly explain differential levels of symptom improvement. Sessions were sampled from a randomized trial comparing different consultation conditions in training therapists new to CPT. Among 69 patients, one session from Sessions 1–3 and one session from Sessions 4–7 were reliably rated for adherence and competence using the CPT Therapist Adherence and Competence Scale, and for therapeutic alliance using the Working Alliance Inventory-Observer scale. Mixed models, including detrending using a fixed effect of session, predicted self-reported Posttraumatic Stress Disorder Checklist (PCL-IV) scores in one session using process scores from the previous session. The statistical interaction between fidelity and alliance scores to predict outcome was also examined. Alliance had significant, positive correlations (rs = 0.18–0.21) with same-session adherence and competence. Higher competence scores and higher therapeutic alliance scores in one session were independently associated with lower PCL-IV scores in the subsequent session. Adherence scores, which tended to be very high with relatively less variability, did not significantly relate to subsequent-session PCL-IV scores. Competence significantly interacted with alliance, such that sessions high in both competence and alliance predicted especially lower subsequent-session PCL-IV scores. A strong therapeutic alliance may have a synergistic, salutary effect with the competent delivery of CPT.     

Client Versus Clinicians’ Standards of Clinically Meaningful Change and the Effects of Treatment Expectations on Therapeutic Outcomes in Individuals With Posttraumatic Stress Disorder

There is limited research on the concordance between client perceptions and clinician standards of the degree of symptom change required to achieve meaningful therapeutic improvement. This was investigated in an adult sample (N = 147) who received trauma-focused cognitive-behavioral therapies for posttraumatic stress disorder (PTSD). We examined whether clients’ benchmarks of change were related to actual outcomes and the relationship between client expectations and their treatment outcomes. Clients completed measures indexing the level of symptom reduction required (in their view) to reflect a benefit or recovery from treatment and treatment expectations. Actual PTSD severity was indexed pre- and posttreatment via self-report and clinician-administered interview. Results demonstrated that the amount of change clients said they required to experience a benefit or recovery was significantly larger than typical clinical research standards. Nonetheless, the majority of client benchmarks of change (79.7–81.8%) were consistent with clinical research standards of what constitutes benefit or recovery. Client benchmarks were generally positively correlated with their actual outcomes. Clients’ belief that treatment would be successful was associated with greater reductions in PTSD symptoms. These findings provide preliminary evidence that the standards used to determine clinically significant change are somewhat consistent with clients’ own perceptions of required symptom change.