THE FUNCTIONS OF SELF-INJURIOUS BEHAVIOR: AN EXPERIMENTAL-EPIDEMIOLOGICAL ANALYSIS

Data are summarized from 152 single-subject analyses of the reinforcing functions of self-injurious behavior (SIB). Individuals with developmental disabilities referred for assessment and/or treatment over an 11-year period were exposed to a series of conditions in which the effects of antecedent and consequent events on SIB were examined systematically by way of multielement, reversal, or combined designs. Data were collected during approximately 4,000 experimental sessions (1,000 hr), with the length of assessment for individuals ranging from 8 to 66 sessions (M = 26.2) conducted over 2 to 16.5 hr (M = 6.5). Differential or uniformly high responding was observed in 145 (95.4%) of the cases. Social-negative reinforcement (escape from task demands or other sources of aversive stimulation) accounted for 58 cases, which was the largest proportion of the sample (38.1%). Social-positive reinforcement (either attention or access to food or materials) accounted for 40 (26.3%) of the cases, automatic (sensory) reinforcement accounted for 39 (25.7%), and multiple controlling variables accounted for 8 (5.3%). Seven sets of data (4.6%) showed either cyclical or inconsistent patterns of responding that were uninterpretable. Overall results indicated that functional analysis methodologies are extremely effective in identifying the environmental determinants of SIB on an individual basis and, subsequently, in guiding the process of treatment selection. Furthermore, an accumulation of assessment data from such analyses across a large number of individuals provides perhaps the most rigorous approach to an epidemiological study of behavioral function.     

Associations between narrative transportation,risk perception and behaviour intentions following narrative messages about skin cancer

Objective: Narrative messages may be an effective strategy to increase risk perceptions and motivate preventive behaviours related to cancer. The aim of this research was to examine associations between narrative transportation (i.e. psychological absorption into a narrative), risk perceptions, and intentions following narrative messages about skin cancer.

Design: In two studies, women who reported indoor tanning read first-person narrative messages about skin cancer. We examined associations between narrative transportation and the women’s responses to the narratives, including risk perceptions for skin cancer and behaviour intentions to reduce risk. Associations between transportation, knowledge and worry were also examined.

Results: Greater transportation was associated with higher intentions to perform skin self-examination, talk to one’s doctor about skin cancer, and look for more information. Greater transportation was also associated with higher gut feelings of risk and higher worry about skin cancer, but not deliberative risk perceptions or knowledge from the message. Additional analyses showed that after controlling for risk perception and worry, transportation had unique associations with some behaviour intentions.

Conclusion: Findings suggest that narrative transportation may be an important component to the persuasion of cancer narratives. Future research should explore ideas such as the role of the experiential system in narratives’ influence.     

The young women's network: a case study in community development

While young women have been found to be at additional risk for psychological morbidity after a breast cancer diagnosis, their specific needs in relation to support are not well described. A community development approach was utilized to develop the Young Women's Network, a peer support programme for young women who have been diagnosed with breast cancer that addresses their specific psychological and social needs. Central to this approach was the key role of the target group in both the definition of the problem and the generation of the solutions. This article describes the steps involved in developing this programme and guidelines for health professionals and community members who may wish to replicate either the Young Women's Network or this particular approach to programme development. Copyright © 2001 John Wiley & Sons, Ltd.     

人类基因组流行病学

近年,人类基因组计划取得飞速发展并获得大量的研究成果,迫切要求对将其成果转化为维护人类健康的过程各环节进行综合评价,包括经济效益、预防和治疗疾病效果,甚至伦理等问题,为此人类基因组流行病学（Human genome epidemioliogy,HuGE）应运而生。概述（HuGE）产生背景、研究内容及提出个人建议等,以促进国内该领域研究的发展。     

How Do Geneticists and Genetic Counselors Counsel Women from High-Risk Breast Cancer Families?

This qualitative study asked Australian Genetic Counselors and Clinical Geneticists working in cancer genetics to describe their practice when a woman attends a consultation about her family history and her risk of developing breast cancer. Twenty-nine out of 36 Clinical Geneticists/Genetic Counselors returned the questionnaire (82%). Participants identified the key goals of the consultation as (a) identifying the individual needs and concerns of the woman, (b) providing information on genes and chromosomes, (c) giving an individual risk assessment in the context of supportive interaction, and (d) discussing the pros and cons of genetic testing and putting a surveillance plan into place. Respondents emphasized the dual importance of counseling/support and information provision in this setting, suggesting that one could not be given without the other. Implications for clinical practice are discussed.     

Writing Effective Insurance Justification Letters for Cancer Genetic Testing: A Streamlined Approach

The topic of insurance coverage and justification letters for cancer predisposition testing has been the subject of much discussion on the National Society of Genetic Counselors Cancer Special Interest Group (NSGC Cancer-SIG) listserv. Some counselors have stated that they have had difficulty in obtaining insurance coverage for their patients, while others have indicated that they would appreciate seeing examples of successful letters. The purpose of this paper is to provide practical guidance in writing successful letters of justification and to share insurance success stories in the area of cancer genetic testing.     

Depression in a Cancer Patient Population

The main goal of this study was to examine depression and its components in cancer patients as compared with healthy control subjects and psychiatric inpatients. The participants were 54 cancer patients (28 females with breast cancer, 26 males with prostate cancer), 59 healthy controls (33 females, 26 males), and 75 psychiatric patients (27 females, 48 males). Participants were administered the Beck Depression Inventory (BDI) and the State Trait Personality Inventory (STPI) Depression scales. Cancer patients had higher overall depression scores than did healthy controls as measured by BDI, but the difference was due primarily to the significantly higher scores of the cancer patients on the BDI Somatic–Performance subscale. No differences were found on the BDI Cognitive–Affective subscale. Cancer patients also scored significantly higher than healthy controls on the State-Trait Personality Inventory (STPI) State Depression (S-Dep) scale because of higher Euthymia subscale scores. The psychiatric inpatients scored significantly higher than the other groups on all measures of depression. The findings of this study suggest that cancer patients may be erroneously labeled as depressed because of somatic–performance difficulties they may experience, which are similar to symptoms of depressed individuals. In addition, it is essential to delineate the various components of depression in evaluating cancer patients.     

简明心境量表(POMS)在中国的试用报告

该研究引进ＰＯＭＳ,采用随机对照的方法将２８９名放化疗病人分成实验组和对照组,分别在治疗前中后测查三次,同时测查３８５名正常人,以验证其在中国大陆的适用情况。研究发现：ＰＯＭＳ各量表同质性信度高,三种方法检验的临床效度均较高,尤其是对心理干预的效果更敏感;但该问卷的区分效度不高,对正常人心境变化的敏感性不如对病人。由此得出,ＰＯＭＳ在中国大陆癌症病人中是可行的、可靠的、有效的和敏感的,可作为心理干预的一个敏感指标。     

原发性肝癌诊断和治疗的发展演化

论述原发性肝癌的诊断及治疗的演化过程,探讨认识论在诊治原发性肝癌中的作用以及现代科学技术的进步在提高原发性肝癌治愈率、生存率、生活质量方面的重要作用。