系统生物学引导阿尔茨海默病治疗新策略

阿尔茨海默病（AD）是一种发生于中老年期的退行性脑神经变性疾病,临床上以进行性智能衰退,伴有人格改变为主要特征.其发病过程涉及许多途径和靶点.现代医学认为脑内胆碱能递质功能紊乱、β-淀粉样蛋白沉积、tau-蛋白过磷酸化、炎症反应以及基因突变等在其发病过程中起着重要作用.治疗方法从胆碱酯酶抑制剂、神经递质受体阻滞剂到补气活血、益精填髓、化痰开窍等中医药疗法不等.但抑制剂、阻滞剂等药物阻滞疗法,从单一环节阻断发病途径,忽略了AD发病的整体复杂性.中医辨证论治从整体观念出发,在宏观上治疗AD,对AD的发病缺乏微观深入研究.AD治疗需要借助于“系统生物学”理论的指导.中西医结合为AD的治疗提供了较为科学、有效的途径和发展空间.     

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.     

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.     

Short- and Long-Term Effects of Inpatient Cognitive-Behavioral Treatment of Adolescents With Anxious-Depressed School Absenteeism: A Within-Subject Comparison of Changes

The effects of inpatient treatment, including manual-guided cognitive-behavioral treatment (CBT), were examined for 36 adolescents (12–18 years) with chronic school absenteeism and mental health problems. Using a within-subject control group design, no changes were noted during the untreated waiting period, whereas there was a strong, statistically significant reduction in school absence rates and mental health problems from the start to the end of inpatient treatment. At discharge, 88.9% of adolescents attended school regularly or were employed (86.1 and 63.9% at 2- and 9-months follow-up, respectively). Self- and parent-reported mental health problems were significantly reduced during treatment and remained stable during follow-up.     

Parents May Hold the Keys to Success in Immersion Treatment of Adolescent Obesity

This study examined the potential impact of parents on the long-term results of an immersion program for the treatment of adolescent obesity. Teenagers participated in a 4- to 8-week therapeutic camp. Those who continued losing weight 8- to 12-months postcamp were identified as “Losers”; those who regained weight were considered “Gainers.” Parents from both groups were interviewed about their own current lifestyle habits 1 to 1.5 years after camp ended. Results indicate that more of the initially overweight parents from the Loser group lost weight during the follow-up period than the overweight parents of Gainers. Losers' parents also reported better implementation of several aspects of the weight control program. The present results suggest that helping parents adopt lifestyle changes for themselves, even within the context of relatively short immersion treatments, may maximize outcomes for obese teenagers.     

Family Stress and Adjustment as Perceived by Parents of Children with Autism or Down Syndrome: Implications for Intervention

ABSTRACT

This study examined stress and adjustment in parents of three groups of families: those with an autistic child, those with a Down syndrome child, and those with only developmentally normal children. A total of 54 families participated, with 18 representing each group. Parents of autistic children generally reported more family stress and adjustment problems than parents of children with Down Syndrome who, in turn, reported more stress and adjustment problems than parents of developmentally normal children. Although parents of disabled children reported more stress associated with caring for their child, they generally showed resilience in adjusting to the presence of a severely disabled family member. Implications for family intervention are discussed.     

Contextual Intervention for Caregiver Non-Adherence With Behavioral Intervention Plans

The extent to which parents and other caregivers implement behavioral interventions with integrity has an important impact on treatment effectiveness. This article considers popular interventions that train caregivers and improve treatment integrity in applied behavior analysis. After considering these interventions a contextual approach is described, whereby the function of caregiver non-adherence is considered. In particular, interventions aimed at manipulating setting factors are reviewed. The examples of respite and social support groups are provided as function-based interventions to improve caregiver adherence to behavioral recommendations. Implications for more contextual, coordinated, and comprehensive function-based behavioral services are provided.     

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.     

Inconsistent parenting and anxiety in the child

Abstract

This study has examined children's estimates of dental anxiety and pain before and after a standard dental treatment session consisting of a local analgesic and drilling procedures. A method of assessing intensity of pain while receiving dental treatment was devised, and measures of the child's uncooperativeness and the dentist's supportive behaviour including treatment time was collected. Results showed that there was an immediate reduction in dental anxiety following exposure to dental procedures for those children referred because of their previous uncooperativeness. The reduction in anxiety was not attributed to supportive behaviour of the dentist. Children referred as unco-operative recorded higher pain intensity to comparison children.