Ethics in Supervision: Consideration of the Supervisory Alliance and Countertransference Management of Psychology Doctoral Students

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship.     

Paranoia predicts out-group prejudice: preliminary experimental data

This article examines the relationships between exposure to terrorism news and state social paranoia, death anxiety and Islamophobia. In two experiments we show that, contrary to previous research in this area, the terrorism news condition did not significantly increase state social paranoia, death anxiety and prejudice towards Muslims, but that paranoid thinking was the sole predictor of Islamophobia. Trait paranoia is associated with both poor well-being and with negative perceptions of Muslim competitive players – a form of inter-relational prejudice. Results indicated that the frequency of paranoid thoughts mediates the relationship between death anxiety and anti-Muslim prejudice and trait paranoia is the main predictor of the negative perceptions of a Muslim competing player. This study elucidates new pathways to understanding terror management theory, by including paranoia as a type of thinking that predisposes individuals to be suspicious of salient out-groups.     

A general proof of consistency of heuristic classification for cognitive diagnosis models

The Asymptotic Classification Theory of Cognitive Diagnosis (Chiu et al., 2009, Psychometrika, 74, 633–665) determined the conditions that cognitive diagnosis models must satisfy so that the correct assignment of examinees to proficiency classes is guaranteed when non‐parametric classification methods are used. These conditions have only been proven for the Deterministic Input Noisy Output AND gate model. For other cognitive diagnosis models, no theoretical legitimization exists for using non‐parametric classification techniques for assigning examinees to proficiency classes. The specific statistical properties of different cognitive diagnosis models require tailored proofs of the conditions of the Asymptotic Classification Theory of Cognitive Diagnosis for each individual model – a tedious undertaking in light of the numerous models presented in the literature. In this paper a different way is presented to address this task. The unified mathematical framework of general cognitive diagnosis models is used as a theoretical basis for a general proof that under mild regularity conditions any cognitive diagnosis model is covered by the Asymptotic Classification Theory of Cognitive Diagnosis.     

Doctors,Patients, and Nudging in the Clinical Context—Four Views on Nudging and Informed Consent

In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction.     

The protection of patients’ rights in clinical trials

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005. The author is Chairman, Bioethics Committee of the Warsaw Regional Chamber of Physicians and Dentists.     

Efficacy of self-administered treatments for pathological academic worry: A randomized controlled trial

Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed.     

要注意中药对肝的损伤作用

含有生物碱类、皂苷类、萜类、毒蛋白类、重金属类成分的中药易致急性肝损伤.中药对肝脏损伤的原因及机制较为复杂,可能与药物对肝脏的直接毒性或特异性体质有关.此外,中药炮制方法、给药途径、剂型、剂量、疗程及配伍不当也会引起药物性肝损伤.中药所致的药物性肝损伤的诊断主要依据用药史、发病的时间、过程和临床表现并排除其他因素.治疗可选用还原型谷胱甘肽、S-腺苷蛋氨酸、多烯磷脂酰胆碱、熊去氧胆酸、水飞蓟素等药物,重症可选择人工肝脏支持治疗.     

阿尔茨海默病生物学标志物研究进展

阿尔茨海默病（AD）是常见的中枢神经系统变性疾病,是痴呆最常见的病因,发病率高.病理特征为老年斑及神经元纤维缠结.AD的确诊有赖病理学,临床诊断极其耗时.由于尚无准确的早期诊断方法,常使AD患者错过早期治疗的时机,这成为制约有效防控AD的瓶颈问题.因此寻找高敏感性、特异性、无创性的生物学标志物对AD的早期诊断至关重要.本文仅将目前较为广泛研究的生物学标志物及其研究现状作一概述.分别对脑脊液、血液、尿液及唾液中的AD标志物作逐一介绍.