Psychologists' perspectives on the diagnostic classification of mental disorders: Results from the WHO‐IUPsyS Global Survey

This study examined psychologists' views and practices regarding diagnostic classification systems for mental and behavioral disorders so as to inform the development of the ICD‐11 by the World Health Organization (WHO). WHO and the International Union of Psychological Science (IUPsyS) conducted a multilingual survey of 2155 psychologists from 23 countries, recruited through their national psychological associations. Sixty percent of global psychologists routinely used a formal classification system, with ICD‐10 used most frequently by 51% and DSM‐IV by 44%. Psychologists viewed informing treatment decisions and facilitating communication as the most important purposes of classification, and preferred flexible diagnostic guidelines to strict criteria. Clinicians favorably evaluated most diagnostic categories, but identified a number of problematic diagnoses. Substantial percentages reported problems with crosscultural applicability and cultural bias, especially among psychologists outside the USA and Europe. Findings underscore the priority of clinical utility and professional and cultural differences in international psychology. Implications for ICD‐11 development and dissemination are discussed.     

Type D personality and cardiac output in response to stress

Type D personality is predictive of adverse clinical outcome and psychological distress in cardiac patients. However, the mechanisms by which Type D affects health are largely unknown. This study (1) investigated the relationship between Type D and cardiovascular reactivity to experimentally induced stress and (2) tested the influence of Type D on subjective feelings of stress. Eighty four healthy young adults (50% males, mean (SD) age 22 (6.84) years), completed measures of Type D personality, stress arousal and a stress-inducing procedure involving a taxing mental arithmetic task. Cardiovascular measures were recorded throughout the experiment. Mixed measures ANOVA showed a significant main effect of Type D and a significant group by time effect of Type D on cardiac output in male participants. Type D males exhibit significantly higher cardiac output during the stressor phase compared to non-Type D males. However, there was no relationship between Type D and cardiovascular reactivity in females. In addition, Type D individuals exhibited significantly higher feelings of subjective stress compared to non-Type D's. These findings provide new evidence on Type D and suggest that Type D may affect health through increased cardiac output and higher subjective feelings of stress following acute stress.     

Effort and negative affect interact to predict cardiovascular responses to stress

Objective: Although traditional models posit that negative emotional responses to stress increase cardiovascular reactivity (CVR), laboratory studies have generally not found a strong emotion–CVR association. In this paper, we took a multidimensional approach to examining psychological reactions to stress in three studies.

Methods: In each study we assessed the amount of effort exerted by a participant and the negative affect (NA) felt by the participant with different self-reported measures and an effort behavioural measure.

Results: Our findings consistently demonstrated that NA was associated with CVR when effort was relatively high, but not when effort was relatively low.

Conclusion: This suggests that the weak NA–CVR correlations reported in past research may have been confounded by a third effort-related variable and that CVR is significantly associated with NA under certain circumstances. Furthermore, our findings suggest that by considering the multidimensional nature of psychological responses to stress, we may come to better understand the links between stress-related emotion and physiology.     

Coping strategies,depressive symptoms and quality of life in hypertensive patients: Mediational and prospective relations

This study examined whether depressive symptoms mediated the association between coping strategies and quality of life (QoL) in a sample of hypertensive patients, and the prospective contribution of depressive symptoms and coping strategies in the prediction of their QoL. One hundred and fifty patients (50% males and 50% females) with a diagnosis of essential hypertension were recruited from a general hospital. Symptoms of depression, coping and QoL measures (global score and dimensions) were collected at baseline. Sixty-three participants completed the QoL questionnaire again one year later (T2). The results indicated that the relations between emotion coping and QoL (global score, satisfaction and social support) were totally mediated by depressive symptoms. The association between emotion coping and well-being was, however, partially mediated by depressive symptoms. Furthermore, only baseline instrumental coping strategies predicted higher levels of QoL (global score, well-being and social support) at T2. Neither emotion coping nor depressive symptoms were significantly associated with prospective QoL. These findings suggest that depressive symptoms may be a mechanism linking the manner in which patients cope with their hypertension and their QoL. They also emphasise the adaptive role played by instrumental coping responses in the management of hypertension in the long term.     

Topic-relevant cognition and empathic accuracy in laboratory discussions of safer sex

Abstract

The present study sought to identify some of the mechanisms that make safer sex such a difficult topic to talk about. Fifty six dating couples participated in a laboratory study in which the opposite-sex members of two pairs of couples engaged in two discussions of safer sex (or a control topic), each time with a different opposite-sex partner (their own dating partner or an opposite-sex stranger). The results indicated that discussions of safer sex evoke in dating partners a high level of perceived goal-incompatibility, difficulty maintaining one's focus on the topic, and difficulty in reading the other partner's thoughts and feelings. These reactions did not occur in response to the control topic. This initial demonstration study is important with respect to the processes it implicates, but further clarification is needed regarding the specific real-life conditions in which these processes do, and do not, occur.     

Differential hemodynamic effects during the provision of active and passive support in the laboratory

Objective: Recent research has pointed to the cardiovascular benefits of providing social support to others in times of stress; however, little is known about what factors influence such benefits.

Design and measures: In a between-groups design, we investigated the possible interaction between intimacy (friend vs. stranger) and support type (active vs. passive) in determining the cardiovascular responses of support providers. Eighty participants had their blood pressure and heart rate monitored while providing either active or passive social support to a friend or a stranger who completed a stress task.

Results: Although there was no interaction effect, a significant main effect showed that those who provided passive support showed larger decreases relative to those in the active support condition. There was no effect of intimacy. Further, these effects withstood adjustment for a number of potential confounds (e.g. sex and body mass index).

Conclusion: It appears that the greatest physiological benefit for social support providers may come from providing passive, rather than active support, regardless of whether the support receiver is a friend or a stranger.     

HMGB1在心血管疾病中的研究进展

高迁移率族蛋白B1(high mobility group protein box1protein,HMGB1)是一组高度保守的非组织核蛋白,存在于多种真核细胞的细胞核中。其可通过活化细胞的主动分泌和坏死细胞的被动释放进入胞外,并与配体结合引发信号转导,诱导炎症介质的产生,扩大炎症反应。大量研究表明,HMGB1在心血管疾病的发生发展及转归中起着重要作用,并受到人们越来越多的关注。     

对心血管病临床强化治疗的质疑

强化治疗是最近几年反复提到的话题。很多临床试验研究各种强化治疗对心血管疾病预后的影响,但结果显示强化治疗并未能带来更多的益处,甚至有害。因此我们必须理性地看待这些所谓的强化治疗。更应该倾向于个体化治疗、综合治疗,包括控制各种危险因素,改善生活的方式。把治疗的眼光放到疾病发生的早期,早治疗,以求更多获益。     

Nasal diseases and psychological distress

A high rate of ENT doctors were murdered by nasal disordered patients in China recently. It is obviously important and urgent to find out whether there is any potential relationship between nasal diseases (ND) and psychological distress that might contribute to violent behavior. For this purpose, we carried out this literature review. There is a complex relationship between ND and psychiatric distress, which is mainly considered as a bidirectional causal relationship with other controversy opinions. However, most of the previous studies were found to be focused on allergic rhinitis and chronic rhinosinusitis, while reports about other ND were rare. Further study is still needed to uncover the secret aspects in this field, and more attentions need to be paid to other ND.     

2型糖尿病餐后高血糖与心血管危险

餐后高血糖比空腹高血糖更易引起全身大血管、微血管、肌肉、脂肪以及胰岛β细胞等功能和结构的改变,导致一系列慢性并发症的早期发生,因此,积极有效控制2型糖尿病患者餐后高血糖是心血管和内分泌科临床医师的重要任务.