身体知觉方式及其对临床的意义

身体承载着人生物、心理和社会功能的全部,亦是感知、行动的工具。概述了西方身体现象学研究取向的基本特点,深入分析了五种不同处境下,人对身体的不同知觉方式,剖析了患者和医生对身体知觉和理解的不同方式,阐述了西方身体现象学和身体知觉方式的研究可能对临床工作带来的积极影响,呼吁医护人员要高度关注患者躯体体验的表达和意义问题,引导患者可以通过改变身体知觉叙述的策略减轻病患带来的痛苦,为医患沟通架起平等对话的桥梁,改善临床医学中的非人性化和医患沟通不良的现象。     

Extended similarity trees

Proximity data can be represented by an extended tree, which generalizes traditional trees by including marked segments that correspond to overlapping clusters. An extended tree is a graphical representation of the distinctive features model. A computer program (EXTREE) that constructs extended trees is described and applied to several sets of conceptual and perceptual proximity data.This research was supported in part by a National Science Foundation Pre-doctoral Fellowship to the first author.A magnetic tape containing both the EXTREE program described in the article and ADDTREE/P program for fitting additive trees can also be obtained from the above address. Requests for the program should be accompanied by a check for $25 made out to Teachers College, to cover the costs of the tape and postage.     

Body-image disturbances and bulimia nervosa: An empirical analysis of recent revisions of the DSM-III

In the recent revision of the DSM-III, the diagnosis of bulimia nervosa includes the criterion of persistent overconcern with body shape and weight, which may be conceptualized as a form of body-image disturbance. The new diagnostic criteria for bulimia nervosa include only those who exhibit a binge-purge eating patern, excluding binge-eaters who, in the older DSM-III, receive a diagnosis of bulimia. This study was conducted to investigate body-image disturbances in bulimia nervosa and simple bulimia (i.e., binge-eating without purging). The experimental design included two control groups, obese and normal subjects, in order to determine whether the binge-eater had body-image disturbances different form those of normal and overweight samples. The study evaluated 596 subjects (417 normals, 109 bulimia nervosa subjects, 50 binge-eaters, and 30 obese subjects) in terms of perception of current body size and selection of ideal body size. Results indicated that the bulimia nervosa group selected a current body size larger than that selected by normals and an ideal body size smaller than that chosen by normals. However, bingeeaters did not differ from the obese control group on either current or ideal body size. These results are discussed in terms of the recent debate regarding the diagnosis of bulimia nervosa and sociocultural influences upon body-image disturbances.     

THE STORY OF THE MIND: PSYCHOLOGICAL AND BIOLOGICAL EXPLANATIONS OF HUMAN BEHAVIOR

Abstract. Persons have a curious dual nature. On the one hand, they are subjects, whose actions must be explained in terms of beliefs, desires, plans, and goals. At the same time, however, they also are physical objects, whose actions must be explicable in terms of physical laws. So far no satisfying account of this duality has been offered. Both Cartesian dualism and the modern materialist alternatives (reductionist and antireductionist) have failed to capture the full range of our experience of persons. I argue that an exciting new approach to this difficulty can be found by considering developments in clinical psychology. The clinical debate between those endorsing biological models of mental illness and those endorsing psychodynamic models mirrors broader debates in the philosophy of mind. The possible resolution of this debate through the development of integrated psychobiological models suggests a promising way to reconcile the dual nature of persons in a far more appealing way than any yet proposed.     

Selective information processing and schematic content related to eating behavior

An adaptation of the Stroop color-naming task was used to investigate selective information processing related to eating behavior in 90 undergraduate women. This study differed from previous studies by (a) treating eating behavior as a continuous variable and (b) looking at five separate categories of words including color, neutral, food, body shape, and other emotionally salient words. We did not find a strong pattern of relation between the Stroop task and eating and body image measures. Results suggest that in a nonclinical population, direct methods of accessing cognitions related to eating may be more fruitful than indirect measures.     

Current and vestigial effects of overweight among women: Fear of fat,attitudinal body image,and eating behaviors

College females completed multiple, standardized measures of their fear of fat, attitudinal body image, and binge eating and dieting. Situational weigh-in measures were taken, including latency to get on the scale and anxiety while being weighed. Based on current weight and a structured weight history questionnaire, three groups were constructed: normal-weight subjects without an overweight history (NW; n=24), normal-weight subjects who were formerly overweight (FOW; n=16), and those currently overweight (OW; n=24). Group comparisons revealed, as expected, that OW females, relative to their NW peers, had more weight-related anxieties, more negative body experiences, and more frequent past-year dieting. Consistent with Stunkard's original proposition, the FOW group regarded their bodies as fatter and less affectively satisfying and expressed more weigh-in anxiety than NW participants. Currently normal-weight FOW subjects seldom differed from the currently OW individuals. Clinical and research implications are considered, particularly with regard to the psychological sequelae of weight loss.     

A Polyvocal Body

This essay aims to elucidate how multiple voices and traditions should interact with one another in the practice of ethics. First, it explores some of the major ways in which questions of bodily autonomy function in secular feminist and Jewish bioethical discourses. It then uses case studies to illuminate ways each discourse's concepts of bodily autonomy can be deeply problematic, and argues that the strengths in each discourse can serve as important correctives for the weaknesses in the other. It suggests that some formal features of rabbinic texts can serve as a model for a discourse of constant and animated mutual correction. Finally, it examines two case studies in light of this model.     

Infant psychopathology during the first year of life and its return during adolescence and adulthood

This is a presentation of different clinical cases having in common severe infantile traumatic events during the first year of life. From the disappearance of mother and father during Latin-American dictatorships, to another patient who hallucinates that bats fly out of his cheeks, this paper tries to bring light into the difficult times of these patients and how the analysts worked with infantile parts of the self which were inside the adult patients.     

Health-related quality of life in transgender adolescents: Associations with body image and emotional and behavioral problems

Background: Transgender adolescents who apply for treatment often experience a marked increase in body-related distress when entering puberty, accompanied by internalizing problems and poor peer relations. Although adolescence is a time of considerable psychosocial and physical change, generally associated with a decline in health-related quality of life (HRQoL), research on HRQoL in transgender youth and possible predictors is sparse. This study thus aims to explore the predictive value of body image factors and emotional and behavioral problems for HRQoL.

Methods: This cross-sectional one-group observational study was carried out at the Child and Adolescent psychiatric department (Gender Identity Service) in Hamburg, Germany. A sample of n = 126 (103 trans male and 23 trans female) adolescents, who were referred for counseling and/or treatment completed different standardized instruments before undergoing any sort of treatment. Firstly, five dimensions of HRQoL were explored in transgender adolescents and secondly, a linear regression model was applied to assess the impact of body image and emotional and behavioral problems on overall HRQoL.

Results: HRQoL was generally impaired in transgender adolescents compared to norm scores, especially with regard to aspects of psychological and physical well-being. Linear regression analysis revealed that greater internalizing problems and less body satisfaction significantly predicted lower HRQoL outcomes.

Conclusions: Impaired HRQoL may be explained by high degrees of internalizing problems and low body satisfaction. Thus, one important aim of mental health professionals working with youth should be to provide appropriate treatment and counseling options that may contribute to overall well-being in the long-term.