The nature of clinical depression: symptoms, syndromes, and behavior analysis

In this article we discuss the traditional behavioral models of depression and some of the challenges analyzing a phenomenon with such complex and varied features. We present the traditional model and suggest that it does not capture the complexity of the phenomenon, nor do syndromal models of depression that dominate the mainstream conceptualization of depression. Instead, we emphasize ideographic analysis and present depression as a maladaptive dysregulation of an ultimately adaptive elicited emotional response. We emphasize environmental factors, specifically aversive control and private verbal events, in terms of relational frame theory, that may transform an adaptive response into a maladaptive disorder. We consider the role of negative thought processes and rumination, common and debilitating aspects of depression that have traditionally been neglected by behavior analysts.     

Neuroimaging as a New Tool in the Toolbox of Psychological Science

ABSTRACT— During the past quarter century, advances in imaging technology have helped transform scientific fields. As important as the data made available by these new technologies have been, equally important have been the guides provided by existing theories and the converging evidence provided by other methodologies. The field of psychological science is no exception. Neuroimaging is an important new tool in the toolbox of psychological science, but it is most productive when its use is guided by psychological theories and complemented by converging methodologies including (but not limited to) lesion, electrophysiological, computational, and behavioral studies. Based on this approach, the articles in this special issue specify neural mechanisms involved in perception, attention, categorization, memory, recognition, attitudes, social cognition, language, motor coordination, emotional regulation, executive function, decision making, and depression. Understanding the contributions of individual and functionally connected brain regions to these processes benefits psychological theory by suggesting functional representations and processes, constraining these processes, producing means of falsifying hypotheses, and generating new hypotheses. From this work, a view is emerging in which psychological processes represent emergent properties of a widely distributed set of component processes.     

组织咨询心理学的三种取向及其比较研究

基于不同的理论预设和方法学路线,组织咨询心理学领域形成了三种代表性的研究取向,即经验实证取向、临床治疗学取向以及实践-知识创生取向.文章在系统阐述三种取向基本观点的基础上,就组织观、研究方法、实践特征等同题对三者加以分析比较,并指出了各取向所面I临的挑战.     

用循证医学证据指导股骨粗隆间骨折的治疗决策

用循证医学证据指导股骨粗隆间骨折的治疗决策,在权威评价系统中查询最佳证据。结果显示,外固定架和髁一头型钉不适用粗隆间骨折;DHS具有明显优势;不能证明人工关节置换和内固定何者占优。提示应用循证医学证据指导股骨粗隆间骨折的治疗决策,可以对患者实施个体化治疗。     

科学分析临床试验结果维护公众健康

近20多年来,循证医学对推动我国疾病访治的科学化、规范化和现代化起到了积极推动作用。但以临床试验为基础的循证医学在我国的20年历程也出现了一些值得关注的问题。本文将向临床医生提供如下信息：如何正确分析临床试验结果,如何合理地将临床试验结果用于临床,以及如何向患者传递科学的医学信息,保护患者利益。     

代谢综合征在临床应用中的去留

代谢综合征的概念由来已久,迄今已有数千个围绕代谢综合征的相关研究,探讨其病理生理机制、诊断标准、流行病学、与心血管疾病的相关性及治疗等。然而近年来,代谢综合征的临床适用性及对心血管病和糖尿病的防治意义被质疑,引发了诸多争议。对于“代谢综合征之去留”问题,目前仍不是盖棺定论之时。     

Assessing Child and Adolescent Pragmatic Language Competencies: Toward Evidence-Based Assessments

Using language appropriately and effectively in social contexts requires pragmatic language competencies (PLCs). Increasingly, deficits in PLCs are linked to child and adolescent disorders, including autism spectrum, externalizing, and internalizing disorders. As the role of PLCs expands in diagnosis and treatment of developmental psychopathology, psychologists and educators will need to appraise and select clinical and research PLC instruments for use in assessments and/or studies. To assist in this appraisal, 24 PLC instruments, containing 1,082 items, are assessed by addressing four questions: (1) Can PLC domains targeted by assessment items be reliably identified?, (2) What are the core PLC domains that emerge across the 24 instruments?, (3) Do PLC questionnaires and tests assess similar PLC domains?, and (4) Do the instruments achieve content, structural, diagnostic, and ecological validity? Results indicate that test and questionnaire items can be reliably categorized into PLC domains, that PLC domains featured in questionnaires and tests significantly differ, and that PLC instruments need empirical confirmation of their dimensional structure, content validity across all developmental age bands, and ecological validity. Progress in building a better evidence base for PLC assessments should be a priority in future research.     

内科临床实习医师的带教思考

针对新形势下教学医院内科实习医生的特点,从教学方法、医学模式转变、能力培养、实习管理、医惠关系和医德教育以及就业指导等6个方面进行了分别阐述,强调了教学实习的新特点、新任务,主张教师的角色转换,真正实行弹性化管理,从而达到最佳的实习效果。     

医本仁术 命大于天——反思一尸两命案

孕妇因呼吸道感染求诊,必须实施剖腹产手术,医院因陪同人员拒不在手术知情同意书上签字,未能进行手术并眼睁睁地看着孕妇和胎儿死亡。本案是个极其个别的案例,但是仔细反思足以说明当前的相关法律法规尚有不足,医院处理也有许多值得商榷之处。除了法律法规之外,不仅医患沟通出了障碍,临床医务人员之间的交流,更是需要大大加强。