医学基本功与临床决策

医学的基本理论、基本知识和基本技能,是临床医生的基本功底,是医疗实践的基础。任何疾病的发生、发展和治疗,都不能背离人体的生理病理规律。所提供的10个病例,充分地指明,掌握医学的基本功和对病情直接、全面、充分、持续的了解,是十分重要的。     

Is A Purely First Person Account Of Human Action Defensible?

There are two perspectives available from which to understand an agent's intention in acting. The first is the perspective of the acting agent: what did she take to be her end, and the means necessary to achieve that end? The other is a third person perspective that is attentive to causal or conceptual relations: was some causal outcome of the agent's action sufficiently close, or so conceptually related, to what the agent did that it should be considered part of her intention? Recent goods based views in ethics are divided as to whether only the first person perspective, or a mix of both perspectives, are necessary to understand intention and action. But resolution of the issue is necessary if goods based views are to be able to deploy to principle of double effect; for that principle requires an account of how to distinguish what is genuinely a matter of intention in human action from what is not. I argue that the pure first person account is better than the mixed account.     

Intuitive theories of group types and relational principles

Three studies investigated perceivers’ beliefs about the principles by which different kinds of social groups govern interactions among group members. In Study 1, participants rated a sample of 20 groups on a set of group properties, including measures of relational principles used within groups. Results showed that people believe that interactions in different types of groups are governed by different blends of relational principles unique for each type of group. Study 2 experimentally demonstrated that perceivers could use minimal group property characteristics of different types of groups (i.e., extent of group member interaction, group size, duration, and permeability) to make inferences about the relational principles used in different types of groups. Study 3 demonstrated that relational style information influences people’s judgments of a group’s entitativity and collective responsibility.     

A cross-cultural study of trait self-enhancement, explanatory variables, and adjustment

We investigated trait self-enhancement, explanatory variables, and adjustment in European American (n = 141), Asian American (n = 72), Mexican (n = 141), and Filipino (n = 174) college students. Consistent with trait perspectives, students in all cultural groups rated their traits with moderate to high accuracy, using peer ratings as a criterion. European Americans did not exhibit self-enhancement relative to peers, but both self and peer ratings were higher (i.e., more positive) for European Americans than for the other three groups. Support was found for some, but not all, cultural psychology explanations of self-enhancement. In all cultural groups, self-enhancement was more associated with personal (intrapsychic) adjustment than interpersonal adjustment, as judged by peers. The results provided support for an integration of trait and cultural psychology perspectives.     

父母自主支持与青少年未来规划:基本心理需要与个人成长主动性的中介作用

基于自我决定理论,采用问卷法对广州市2所初中（初一和初二）和2所高中（高一和高二）共562名学生进行调查,考察了父母自主支持与青少年未来规划的关系,以及基本心理需要和个人成长主动性在其中的链式中介作用。结果发现：（1）父母自主支持显著正向预测青少年未来教育规划,但对未来职业规划的预测作用不显著;（2）基本心理需要和个人成长主动性在父母自主支持和青少年未来教育、职业规划之间均起着显著的链式中介作用;（3）纳入基本心理需要和个人成长主动性的中介作用后,父母自主支持对未来职业规划具有显著的负向残余效应,但对未来教育规划的残余效应不显著,这表明父母自主支持对青少年未来规划的影响可能存在坏的一面。因此,基本心理需要和个人成长主动性是影响父母自主支持与青少年未来规划之间关系的重要内因。     

The Comprehensive Resource Model®: Overview of basic affects in adversity & effective treatment for complex reactions to trauma

Much of the theoretical focus in post‐traumatic stress disorder has been on the role of the amygdala, the hippocampus and the prefrontal cortex. Crucially, in unresolved traumatic experiences that underlie clinical presentations, this focus misses the brain areas key to the defence responses of fight, flight and freeze—and the associated affects of anger, fear and grief. The periaqueductal gray in the midbrain, with the hypothalamus, is essential for these somatic and emotional responses to traumatic experiences. We argue that when treatment approaches thought to work at the higher brain levels have been ineffective, it is because they have failed to engage the midbrain and hypothalamic sources of the affective responses to the trauma and to the memory of it. Basic affects have been so overwhelming that dissociation, or a similarly protective neurochemical capping mechanism, has prevented full resolution of the affective content of the adversity. Treatment with the Comprehensive Resource Model^® (CRM) aims to clear the clinically relevant residues of adverse experiences by resolving the emotional responses accessed through the body memories. When the trauma has led to overwhelming distress, and/or dissociation, there is a necessity for robust resourcing to be in place before the emotional intensity of that distress is accessed. Resourcing needs to be as proximal to the re‐experience as possible to promote complete resolution and in some psychotherapy modalities, the supports provided are somewhat remote from the crucial moments of processing. Therefore, we describe how the CRM seeks to have robustly resourced states present concurrently with traumatised states to avoid overwhelming emotional distress. This allows safe entry into the deepest pain residual from the traumatic event so that it is not overwhelming during processing of the memory, and does not lead to further dissociation, allowing the individual to remain fully present throughout. This “stepping into the affect” can then be so rapidly effective that we also argue that CRM is not an exposure treatment; re‐orientation to the deepest content of the experience resolves the residual distress quickly and permanently through memory reconsolidation. Re‐learning at upper brain levels will then follow from the revoking of the affective power, which has previously driven stimulus/context and response learning in the amygdala, hippocampus and prefrontal cortex.     

常人疾病观及其对医患关系的影响

常人疾病观是普通人对于某一疾病的认知、解释和态度的集合。与专业医务人员相比, 普通人更关注心理、家庭和社会因素而非生物学因素的致病作用, 就医选择多元而并不遵循标准化的就医模式, 同时更愿意将疾病体验视为个人生活的特殊问题加以建构性理解。常人疾病观与科学医学观之间的不一致性可能降低患者的就医满意、对医信任和医嘱依从性, 从而影响治疗效果。立足中国社会的医学文化与医疗制度, 研究中国人的常人疾病观, 并探讨其对医患关系的影响作用与社会心理机制, 可为改善当下中国医患关系紧张现状提供有益建议。     

员工何以蓬勃旺盛?影响工作旺盛感的组织情境与理论模型

工作旺盛感是个体在工作中同时感受活力和学习一种心理状态。组织情境中领导、组织支持和公平、工作特征和同伴均影响工作旺盛感。基于特质激活和自我决定理论, 构建“组织情境影响工作旺盛感的心理机制”模型：“全景式”和“离散式”组织情境能直接影响基本心理需求的满足, 或者先激活特质, 再影响基本心理需求满足, 进而影响工作旺盛感。未来应加强“全景式”组织情境及其中介机制研究, 开展个体和组织情境变量以及社会层和任务层等多层次整合研究, 并运用动态研究方法研究组织情境与工作旺盛感之间的联动变化规律, 预测工作旺盛感。     

Intuitions as Evidence Facilitators

There is currently an important debate about whether philosophical intuitions are intended as evidence for the theories philosophers promote. On one side are those who argue that philosophers do rely on intuitions as evidence; on the other side are those who deny any such role for philosophical intuitions. This paper argues that both sides of this debate are partially right and partially wrong. Intuitive judgments do not, as psychological states, function as evidence in most well‐known philosophical thought experiments. Philosophers nevertheless strongly depend upon these intuitive judgments. Where both sides go awry is in assuming that the importance of intuitive judgments rests solely upon their role as evidence. We need to distinguish between evidence, as such, from various nonevidential psychological states that are needed for something else to serve as evidence. The paper calls these latter conditions “evidence facilitators” and argues that intuitive judgments belong in this category.