COGNITIVE AND SOCIOEMOTIONAL FUNCTIONING AT 4½ YEARS IN CHILDREN BORN TO MOTHERS WHO HAVE RECEIVED TREATMENT FOR SUBSTANCE‐ABUSE PROBLEMS WHILE PREGNANT

Cognitive and socioemotional functioning at 4½ years of age were examined in children born to mothers with substance‐abuse problems (n = 22) recruited from residential treatment institutions while pregnant, and then compared to children born to mothers with mental health problems (n = 18) and children from a low‐risk group (n = 26). No significant group differences in cognitive functioning were found, but the children born to mothers with substance‐abuse problems showed more caregiver‐reported socioemotional problems than did the low‐risk children, like the children born to mothers with mental health problems. Birth weight had an effect on internalizing problems at 4½ years and mediated the relation between group and socioemotional problems, although not when controlling for caregiver education, single parenthood, and anxiety and depression. At 4½ years, 7 children born to mothers with substance‐abuse problems were placed in foster care. These children had lower birth weight and higher caregiver‐rated internalizing problems. In addition to emphasizing the importance of the quality of the prenatal environment, this study suggests that families with previous substance abuse are in need of long‐term follow‐up to address socioemotional problems and enhance further positive child cognitive development. The foster‐placed children may be in particular need of long‐term follow‐up.     

肿瘤防治的自然观与适度治疗

近年来,科技的进步未能阻止世界范围内肿瘤死亡率的攀升。自然稳态失衡在肿瘤防治中扮演重要的角色。肿瘤作为自然存在的一种生物学现象,传统根治性的肿瘤治疗思路与策略客易造成肿瘤的过度治疗、引起机体免疫的崩溃与生存质量的低下。严峻的现实已为我们敲响警钟,肿瘤治疗思维须从对抗转向和谐。本文从自然观的角度去探究肿瘤与机体、肿瘤与自身微环境的关系,反思肿瘤研究思路和治疗手段,以为进一步肿瘤的防治提供一个更为广泛的、确切的思路。     

现代阳痿辨治思路创立与思辨

阳痿是临床常见、难治性病症,自古以来多从肾论治,尤其是壮阳一法几乎成为辨治阳痿的代名词.在万艾可面市后,中医药辨治阳痿的市场日见萎退,表面看是中医缺乏速效性治疗手段,实质上是在辨治阳痿的理论及临床方面存在客观的问题.本文拟从心肝在勃起中的指令性调节、气血在勃起中的实质性支撑,以及肾精、天癸在勃起中的本质性作用等角度,从勃起生理、病理、治疗等方面构建中医现代阳痿辨治的临床思路.     

Do hospital treatments represent a ‘teachable moment’ for quitting smoking? A study from a stage-theoretical perspective

Hospital treatments are assumed to be a ‘teachable moment’. This phenomenon, however, is only poorly conceptualised and untested. A stage-theoretical perspective implies that a cueing event such as hospital treatments is a teachable moment if a stage progression, change of cognitions, or both occur. This concept is examined in a cross-sectional study by comparing smokers in two treatment settings, an emergency department (ED) and inpatient treatment after elective surgery, with smokers in a control setting. Setting differences were hypothesised in stage distribution, and levels of and stage differences in social-cognitive factors under control for possible confounders. Stage, social-cognitive factors and possible confounders were assessed in 185 ED smokers, 193 inpatient smokers and 290 control smokers. Compared to control smokers, ED and inpatient smokers were in higher stages; they perceived fewer risks and cons; inpatient smokers reported more concrete plans. Stage differences in self-efficacy among ED and inpatient smokers differed from those among control smokers, but the former corresponded more strongly to the theoretical stage assumptions. The results suggest that hospital treatments lead to a stage progression and change of corresponding cognitions, and thus represent a ‘teachable moment’. Stage-matched interventions should be provided but consider differences in cognitions to be effective.     

肠癌肝转移综合治疗的现状和展望

结直肠癌肝转移是影响结直肠癌预后的重要因素,目前提倡综合治疗,以手术为核心,辅以化疗、靶向治疗、局部治疗(放疗、介入治疗等).随着新药的研发,新技术的应用,个体化治疗、转化治疗的开展,其预后显著改善.而生物心理社会医学模式同样使患者获益.本文对结直肠癌肝转移的综合治疗进行综述.     

Satisfaction with therapist-delivered vs. self-administered online cognitive behavioural treatments for depression symptoms in college students

Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n=37), or eight sessions of computerised CBT self-administered treatment (cCBT; n=43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online treatment. Quantitative and qualitative analysis was employed to report outcomes. A sample of 25 participants(eCBT n=10; cCBT n=15) completed the satisfaction questionnaire. Both groups were satisfied with accessing and using an online treatment and that they had self-control over their treatment. Perceived anonymity was important for the eCBT group. For the cCBT group they found the treatment user-friendly, engaging and also a source of learning. Both groups disliked that the online treatment could at times be complicated and impersonal.     

In-Home Parent-Child Interaction Therapy: Clinical Considerations

ABSTRACT

Parent-Child Interaction Therapy (PCIT) is an empirically-supported behavioral parent training program designed to be administered in a clinic or laboratory-based setting. Recently, an empirical investigation revealed that in-home PCIT produced comparable results as the PCIT trials conducted in more controlled environments (this issue). Administering PCIT in a home setting carries both drawbacks and advantages. This article provides an overview of both the positive and negative clinical aspects of conducting in-home PCIT and presents effective solutions to potential treatment barriers.     

Does Depression Affect Clinical Practice?

Abstract

While recent autobiographical accounts of women psychotherapists with depressive illnesses have provided vivid and compelling portraits of therapists' experiences in therapy (e.g., Jamison, 1995; Manning, 1995), further research is needed to clarify the impact that depression and its treatment have upon both collegial relationships and clinical practice. A subset of the membership of the Association for Women in Psychology (AWP) was surveyed concerning therapists' experiences with depression and its treatment. Of 220 respondents, 76% reported some form of depressive illness. Eighty-five percent of respondents indicated that they participated in personal therapy. When evaluating their clinical work, respondents reported both positive and negative consequences resulting from their depression. While some respondents noted improvement in collegial relationships, many felt judged and avoided.     

An Evaluation of a Self-Protection Skills Program for the Mildly Handicapped

The purpose of the present investigation was to determine the effects of a self-protection curriculum with a group of 10 junior high special education students. The curriculum (Ryerson & Sunden, 1981) was designed to increase the student's ability to identify strangers, recognize unsafe situations, use refusal skill, and understand acceptable and unacceptable touch. The effects of the curriculum were examined using a multiple baseline pre-posttest design across subjects. The results indicated a significant improvement in self-protection skills. Post testing data indicated the self-protection skills ere maintained over time.     

Parents As Teachers:

A follow-up mail survey of the continuing use of behavior modification procedures was conducted with 30 families who had participated in a training program for parents of preschool children with autism four to seven years previously. According to their reports 86% of the parents had used behavioral procedures during the past week to manage their child's behavior and 54% said they used the techniques to teach their child a new skill. More than half of the parties said they no longer used “formal” behavior modification procedures including data collection. Mothers were more likely to use formal behavior modification than father and systematic paternal use of behavioral techniques was linked to maternal use- only one father used the techniques including data collection when his wife did not. Retrospective parental evaluations of the parent training workshop were all positive, although the parents who viewed their children as doing better gave stronger endorsements than the parents who say their children as more limited.