The Process of Transcending a Traumatic Childhood

This study used a qualitative, exploratory approach to develop a conceptual framework that illustrated the process by which spirituality emerged as one of the processes that helped people transcend a traumatic childhood. Ninety people described how they survived and transcended the difficult time. This article outlines the stages of the developmental process that culminated for many in a deeper spiritual awareness and how this helped them in their process of transcending. These findings have implications for marriage and family therapists, clergy, and others in the helping professions in providing therapy, resources, and support for those who have experienced difficult childhoods.     

初探健康管理与我国糖尿病的预防与控制

近年来,我国糖尿病发展的势头迅速,成为糖尿病患病率增长最快的国家之一,给社会和经济带来了巨大的负担。文章针对我国的糖尿病的流行现状及其带来的经济负担,分析了实施糖尿病健康管理的现实意义,并借鉴美国健康管理的经验,构思了我国社区的促进糖尿病防制的健康管理模式。     

糖尿病防治的策略转变——从关注糖化血红蛋白到着眼心血管事件

通过对2型糖尿病心血管终点事件的观察,更多的临床证据提示,糖尿病的治疗目标应该以减少心血管事件为主。糖尿病防治从策略上发生了两个转变,即以血糖为中心转向以防治心血管事件为中心的多危险因素综合防治策略;以糖化血红蛋白检测作为血糖评价的金标准转向以血糖量、质、时程控制的全面评价策略。     

糖尿病的免疫抑制治疗

淡化糖尿病的分型为我们提供了一个全新的思维空间。即传统的1型和至少部分2型糖尿病可能都是一种自身免疫性疾病,而目前流行的炎症学说可能是对认可免疫损伤是糖尿病发病理论的一个过渡,我们应该重新审视糖尿病的早期治疗和研究其慢性并发症的发病机理。我们则采用小别量、长时间的治疗理念,早期接受这种免疫治疗的患者出现低血糖的症状,遂减少胰岛素的剂量;再次出现低血糖,我们就继续减少胰岛素的剂量。结果,有部分患者完全摆脱了胰岛素。我们对糖尿病的再认识是建立在对多脏器活检的基础之上。我们的活检结果表明,糖尿病肾病存在着免疫损伤。糖尿病眼底病变是使患者致盲的主要病因,糖尿病患者的眼底病变是一种自身免疫损伤的结果。我们尝试用小剂量的免疫抑制剂环孢菌素A（25mgbid）治疗糖尿病眼底出血,取得了不错的疗效,也证实糖尿病眼底病变是一种血管炎,与自身免疫病变有关。其他的器官还包括垂体、大脑的血管、糖尿病足、冠心病、皮肤的病变和肌肉活检的免疫组化也均有证据表明,免疫损伤是导致多种慢性并发症的罪魁祸首,是一种多器官免疫损伤的结果无论是1型糖尿病,还是2型糖尿病,肌细胞表面或多或少均有免疫复合物沉积。这些免疫复合物的存在势必会影响胰岛素与肌肉细胞表面的胰岛素受体结合,即胰岛素抵抗的存在。为此,我们在临床上广泛采用了免疫抑制治疗的理念治疗糖尿病。应用小剂量胰岛素和小剂量环孢素A治疗早期发现的糖尿病取得了不错的疗效。唯一担心的副作用发生在肝脏,即部分糖尿病患者会出现总胆红素升高,而也有一部分患者总胆红素不升高。     

针对T细胞介导的胰岛自身免疫的治疗策略

1A型糖尿病是由T细胞所介导的器官特异性自身免疫性疾病。人们利用转基因技术、自身抗原疫苗接种、单克隆抗体治疗等新兴技术通过诱导自身免疫耐受,改变免疫调节因子,调节细胞凋亡等途径阻止了自身免疫反应对胰岛的攻击。这些针对其发病机制所提出的新型治疗策略让人们看到了治疗自身免疫型糖尿病的希望。     

心理性胰岛素抵抗及应对策略

糖尿病易导致严重的慢性并发症,已成为影响人们生活质量的一种常见疾病。早期应用胰岛素是使2型糖尿病患者血糖得到良好控制、减少并发症发生的有效手段。但许多患者不愿接受或延迟胰岛素治疗。本文旨在探讨胰岛素应用过程中患者及医护人员存在的心理障碍,即心理性胰岛素抵抗,并进一步阐述其应对策略。     

童年中期身体侵害、关系侵害与儿童的情绪适应

采用整群抽样法选取2603名小学儿童（平均年龄9.05 ± 0.53岁）作为被试,考察童年中期同伴侵害现象的基本特点,以及同伴侵害与情绪适应（孤独感、社交焦虑和抑郁）的关系。结果发现：（1）在性别差异方面,男生的身体侵害与关系侵害水平均显著高于女生,与身体侵害相比,关系侵害的性别差异程度较小。在同伴侵害的类型特点方面,儿童遭受身体侵害的水平显著高于关系侵害。（2）身体侵害、关系侵害与儿童的各情绪适应指标显著正相关,身体侵害和关系侵害能同时预测儿童的情绪适应不良;并且与身体侵害相比,关系侵害对情绪适应的影响更大。（3）身体侵害与社交焦虑的关系表现出性别差异,即身体侵害能预测女生的社交焦虑,而对男生的社交焦虑不存在预测作用;但同伴侵害与孤独感、抑郁的关系不受性别的调节。总体而言,有同伴侵害经历的男生和女生具有相似的情绪适应问题。     

Fathers' parenting hassles and coping: associations with emotional expressiveness and their sons' socioemotional competence

The present study examined fathers' daily parenting hassles and coping strategies to (a) determine their association with fathers' emotional expressiveness and (b) predict their sons' development of socioemotional competence. Fathers of 148 preschool‐aged boys reported on their parenting hassles, coping strategies, and emotional expressiveness; mothers also reported on fathers' emotional expressiveness; and teachers reported on boys' socioemotional competence. Parenting hassles were associated with less rational, more emotional, and more avoidance coping as well as negative emotional expressiveness. More emotional and less rational coping responses were related to more negative expressiveness, whereas more rational, more emotional, and less coping were related to more positive expressiveness. Fathers' negative expressiveness was predictive of their sons being rated as more aggressive and disruptive by their teachers. In addition, fathers' parenting hassles and coping both predicted teacher ratings of their sons' aggressiveness. Implications of the findings are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

Impact of neighborhood disadvantage on overt behavior problems during early childhood

Researchers have yet to examine the impact of neighborhood disadvantage on early child behavior problems (BPs) longitudinally. We examined the impact of neighborhood disadvantage on overt BPs in a low-income, urban sample of 281 African American and European American boys followed longitudinally from toddlerhood to school entry. Measures included census data and maternal report of BPs, sociocultural factors, parental criminality, and maternal depressive symptomatology. After controlling for age 2 overt BPs, family selection variables, and residential instability, neighborhood effects on boys' behavior emerged, but only at age 6 and only at the extreme of neighborhood disadvantage (i.e., underclass). Findings suggest boys in underclass neighborhoods are at risk for overt BPs as they make the transition to elementary school.     

Trajectories and predictors of indirect aggression: results from a nationally representative longitudinal study of Canadian children aged 2-10

The purposes of this study were to model the development of indirect aggression among a nationally representative sample of 1,401 Canadian children aged 4 at T2, 6 at T3, 8 at T4 and 10 at T5, and to examine predictors of trajectory group membership from T1 (age 2) child, familial, and parenting variables. Using a semi-parametric group-based modeling approach, two distinct trajectories were identified: "increasing users" comprising of 35% of the sample and "stable low users" comprising of 65% of the sample. Using logistic regression analyses to distinguish these two groups, we found that for girls, more frequent, increasing use of indirect aggression was associated with prior prosocial and physically aggressive behavior, low SES and low parental social support at age 2. For boys, increasing use of indirect aggression was associated with prior parenting issues at age 2-inconsistency and less positive parent-child interactions. Although this study provides unique information regarding the early development of indirect aggression and its predictors, more longitudinal research is needed to fully understand its development.