发展性协调障碍的神经机制

发展性协调障碍是一种特殊的发育障碍, 它的一个显著特征是动作协调困难, 这种障碍影响着5%~8%学龄儿童的学业成绩和日常生活。发展性协调障碍常常与其他类型的学习困难并存。发展性协调障碍的病因非常复杂, 这种障碍与一定程度的视觉空间认知能力受损有关, 早期精细运动技能发育与脑神经发育进程可能存在时间的重合。近年来, 研究者们试图探索影响发展性协调障碍的神经基础, 并先后提出不同的神经关联假说。这些理论假说主要涉及到小脑、顶叶、胼胝体、基底神经节和大脑白质等脑区。本文全面回顾了该领域研究的最新进展, 并提出未来研究应该关注的方向与问题。     

经颅直流电刺激在抑郁症治疗中的应用

已有的神经影像学研究成果揭示, 抑郁症发作的重要原因之一是大脑前额叶皮层结构和功能受损。经颅直流电刺激(tDCS)作为一种无创脑刺激, 选取前额叶皮层作为刺激区域, 通过调节皮层兴奋性来治疗抑郁症, 能够有效缓解抑郁症状和改善受损的认知功能, 疗效明显且持久稳定。针对tDCS在抑郁症治疗研究中的问题, 未来可从有效性、个体差异以及预防干预等六个方面进一步研究, 以期tDCS作为一种具有潜力的治疗手段, 在临床上有更为广泛地应用。     

Provoked vestibulodynia: Psychological predictors of topical and cognitive-behavioral treatment outcome

Psychological factors have been found to impact the pain experience and associated sexual impairment of women suffering from provoked vestibulodynia (PV). Despite a lack of randomized treatment outcome studies, particularly concerning psychological predictors of outcome, recent studies have shown that topical applications and cognitive-behavioral therapy (CBT) are among the most popular first-line interventions for PV. The present study aimed to determine the extent to which baseline fear-avoidance variables and pain self-efficacy were differentially associated with topical application and CBT outcomes at six-month follow-up. Data were obtained from 97 women who completed a randomized trial comparing these two treatments. Regression analyses revealed that for topical treatment, higher levels of baseline avoidance predicted worse pain and sexual functioning outcomes, whereas higher levels of pain self-efficacy predicted better outcomes. For CBT, higher levels of baseline fear of pain and catastrophizing contributed to higher pain intensity at follow-up, whereas higher levels of pain self-efficacy were associated with less pain. Psychological factors did not predict sexual functioning outcomes for CBT. Consistent with biopsychosocial models of pain and sexual dysfunction, results indicate that psychological factors contribute to pain and sexual impairment following treatment for PV. Specifically, findings suggest that fear-avoidance variables and pain self-efficacy are significant predictors of topical and CBT treatment outcomes in women with PV.     

An examination of the construct validity of posttraumatic stress disorder with veterans using a revised criterion set

Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there were few statistically significant differences in PTSD caseness, associated psychiatric comorbidity, functional status, and structural validity across the two diagnostic criterion sets. These data provide further support that removing items that overlap with other psychiatric disorders does not significantly impact the prevalence of PTSD, its associated comorbidity and functional impairment, or its structural validity. Although the revised criterion set represents a more parsimonious model, the current study findings generally support the strong construct validity of PTSD. The implications of these study findings for research and clinical practice are discussed.     

授权风险考量与授权行为：领导－成员交换和集权度的作用

授权能够有效提升员工绩效和组织利益, 但中国企业管理者不授权现象比比皆是。本研究从授权风险的角度探讨管理者不愿授权的原因, 并检验领导－成员交换(LMX)和组织集权度的调节作用。通过17家企业收集到的157位管理者与471位下属的配对资料, HLM分析结果显示：任务绩效、组织利益风险考量与管理者授权行为负相关, 且这种负向关系还受到LMX的强化; 此外, 组织集权度在权力地位、组织利益风险考量与授权行为的负向关系中具有显著的调节作用。     

Liberation social psychology: learning from Latin America

Liberation Social Psychology (la psicología social de la liberación, LSP) has developed amongst a body of psychologists in Latin America over the last decade. There has been no survey of the field in English, although some of the ideas are of relevance for those working with oppressed groups elsewhere in the world. This article explores the context in which LSP grew from the work of Ignacio Martín‐Baró and was developed by Maritza Montero, amongst others. Within LSP, key concepts emerge, including ‘conscientization’, ‘realismo‐crítico’, ‘de‐ideologization’, a social orientation, ‘the preferential option for the oppressed majorities’ and methodological eclecticism. The application of LSP is explored with reference to three domains. First, it is suggested that community social psychology as practised in some parts of Latin America reflects LSP in its emphasis on social transformation and participatory methods. Second, psycho‐social work with victims of state oppression, which adopts a highly social and societal orientation embodies LSP. Third, social analyses which explicitly adopt socio‐psychological‐political analyses of the social realities confronting countries in Latin America embrace, in different ways, principles and concepts of LSP. Some of the challenges facing LSP are discussed and open dialogue is encouraged between LSP and critical, community and applied social psychologists. Copyright © 2004 John Wiley & Sons, Ltd.     

华人人际关系的概念化--针对中国香港地区大学生的实证研究

以杨中芳所构建的华人人际关系概念化理论模型为蓝本,并采用以往的实证研究方法为基础,揭示了当代华人对人际关系如何进行概念化及其潜在的认知维度。杨氏模型认为华人人际关系主要由既定成分、情感成分和工具成分组成。该研究以中国香港地区的大学生为被试进行调查,首先采用访谈的形式,分家族、学校及日常生活情境建立人际关系清单。然后采用多维量法(Multi-dimensional scaling)处理被试对关系进行分类的数据。结果发现,在不同的生活情境中,被试均依据情感程度对关系进行分类。在等级差异明显的家族和学校情境中,被试依据辈份和等级差异的突显性进行分类;而在等级差异小的生活情境中,则采用功利程度为标准。本文对被试在不同情境中所采用的不同维度进行了讨论,并提出华人人际关系的义务具有工具性质的实证结果。     

循证医学在眼科临床实践中的应用

循证医学是在Internet蓬勃发展并极大推动社会信息化和网络化的大背景下,将临床流行病学、现代信息学与临床医学相互交叉融合的新兴边缘学科。它的出现使临床医学面临巨大的挑战,已使得行医模式由理论知识加以个人经验为指导的传统经验医学转向现代循证医学。这将是传统医学模式向循证医学模式转变的一场深刻变革,也是本世纪临床医学发展的必然趋势。     

医院数字化管理在临床决策中的作用

医院数字化建设是管理行为中的重要手段,借助这一工具,医疗决策的制定和执行将更加科学和规范,但同时医院数字化管理在法律和具体操作上对临床决策的管理还有一定的影响。讨论医院数字化在医疗决策中的合法性、安全性及对临床决策基本原则的作用。     

中西早期的“适度”思想及适用范围的扩展——从人间伦理到生态伦理

此文从中西“中道”和“中庸”的翻译和理解入手,进而讨论和比较了中西“中道”和“适度”思想的一些相近内涵和意义层面,主张把主要是作为人间伦理的“适度”观念引用到生态伦理之中,以建立人与自然的和谐关系。