The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.     

Differences in High and Low Anxiety Sensitive Women's Responses to a Laboratory‐Based Cold Pressor Task

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain‐related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16‐item measure of AS. Participants were tested individually on a lab‐based cold pressor task using a variety of self‐report and observer‐measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire – Short Form (SF‐MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF‐MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain‐related fear as a mediating variable between AS and increased perceived pain intensity.     

个人化设计在临床研究中的应用——从个体角度研究个体差异

本文从有关研究证据的基础上,介绍了个人化设计的理论基础和实验设计,并在此基础上讨论了个人化设计在临床研究领域中的应用价值,总结出一种适合临床病人使用的研究程序。个人化设计允许对个体的个人价值进行分析,并能同时研究不同刺激信息的作用,在个体水平上分析个体差异。通过简化了的实验程序,个人化设计为解决临床研究中的问题提供了一种新的思维方式。文中还对相关研究法的局限进行了讨论。     

Political and interpersonal aspects of ethics consultation

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record.     

Observational assessment of behavioral changes accompanying clinical improvement in hospitalized psychiatric patients

Naturalistic observational techniques were employed over a four-week period to assess the behavior of clinically improved (n=7) and unimproved (n=12) hospitalized patients suffering from acute psychiatric disorders. The population was selected from four clinical diagnostic groups. Patients were sampled on an individual basis. Categories of recorded behaviors included social behavior as well as spatial proximity measures between individuals. Social behavior was further divided into components of sending and receiving. Results showed that patients who clinically improved had significantly different behavioral profiles and greater degrees of behavioral change for the following categories: send affiliation, receive affiliation, send assertion, and receive assertion. Improved patients also maintained closer distance to other individuals during the latter stages of hospitalization. In most cases, week 2 of hospitalization marked the point at which behavioral divergence between improved and unimproved patients occurred. Clinical and theoretical implications of observational procedures are discussed.     

Exploration of Prelicensed Counselors’ Experiences Prioritizing Information for Clinical Supervision

This qualitative study explored prelicensed counselors’ experiences prioritizing information for clinical supervision. Through phenomenological interviews, 7 counselors seeking licensure discussed how they self‐report salient information to their supervisors. Using interpretative phenomenological analysis, the authors identified 3 themes: (a) learned to maximize supervision based on structure of supervision, (b) influences on decision to present, and (c) rationale for presenting client case. Implications for counselors and supervisors are discussed.     

So many lifetimes locked inside: reflecting on the use of music and songs to enhance learning through emotional and social connection in Trainee Clinical Psychologists

Music is universal; it can provide a common language that speaks from the heart enabling others to connect with the private felt experiences of others regardless of differences within or between people. This ability to empathise with, and understand, the position of others from differing backgrounds is an important competency within the therapeutic work of Clinical Psychologists. There are many facets to diversity just as there are many facets to music. Diversity in music genres can reflect diversity in people. Indeed, there is music to cater for all tastes, cultural/ethnic backgrounds, gender, age and generations with listening often being guided by individual preferences. In the United Kingdom training to become a Clinical Psychologist consists of a university-based 3-year full time professional research doctorate funded through the National Health Service. Trainees work on placements 3 days a week and attend university for academic and research teaching 2 days a week. As part of the academic programme, Trainees undertake experiential learning through workshops and methods such as Problem-Based Learning (PBL). One of the PBL exercises is based on a typical referral within an Adult Mental Health (AMH) service. For the AMH PBL exercise music is used to enhance trainees’ ability to connect emotionally with the personhood of referrals, consider associated complexities, and to reflect on personal and professional boundaries and reflective practice during training and beyond. This paper reflects on the utility of music and songs to enhance the learning experience.     

“三番式”临床技能教学模式的建立及其在临床医学教学中的应用与思考

传统的临床技能教学存在诸多弊端,从而影响了医学生临床技能的培养及合格医学人才的培养。我们在多年的临床教学实践基础上,构建了临床技能学实践教学平台,创建了“三番式”临床技能教学模式,并将其应用于临床实践教学中,对所取得的显著教学效果进行深入剖析。