疾病诊断谁说了算：临床诊断？影像诊断？

影像诊断是临床诊断的一个重要组成部分,与问诊、体格检查、实验室检查等一同构成临床诊断。影像诊断不能脱离临床诊断工作而单独存在,影像诊断的结论是否正确需要其他非影像学证据的支撑,其结论不能脱离症状、体征而存在。影像诊断专注于分析图像特征、从图像中寻找诊断证据,不需要采纳其他非影像学证据完善其结论;由于影像诊断是完全来源于图像分析,因而具有不可避免的局限性。影像诊断和其他诊断技术的融合推动了临床诊治技术的进步。     

病例报告与临床科研思维

病例报告属于描述性研究方法,是通过记录非同寻常的临床现象,可能揭示新病种、特殊机制、新疗法等,为临床工作经验介绍、总结的初步形式。在医学科学探索的历程中,病例报告拥有特殊的地位和曾经的辉煌,目前仍是医学研究的一种重要体裁。"一个好的病例报告就是一个有教育意义的好故事",一个不同寻常的现象,可能是一个新的病种、一个特殊的机制或一种特殊的组织病变或生理功能紊乱所致。一篇好的病例报告为临床医生和科研工作者提供直接生动的第一手临床资料,能促进临床医生和医学生热爱临床工作,养成面对难题、独立思考、追根朔源、发现与解决问题的能力,值得重视。     

Is talking to yourself thinking?

The question whether talking to yourself is thinking is considered from two viewpoints: radical behaviorism and teleological behaviorism. For radical behaviorism, following Skinner (1945), mental events such as ‘thinking’ may be explained in terms of private behavior occurring within the body, ordinarily unobservable by other people; thus, radical behaviorism may identify talking to yourself with thinking. However, to be consistent with its basic principles, radical behaviorism must hold that private behavior, hence thinking, is identical with covert muscular, speech movements (rather than proprioception of those movements). For teleological behaviorism, following Skinner (1938), all mental terms, including ‘thinking,’ stand for abstract, temporally extended patterns of overt behavior. Thus, for teleological behaviorism, talking to yourself, covert by definition, cannot be thinking.     

Episodic Future Thinking Reduces Delay Discounting of Gains and Losses: The Role of Regulatory Focus1,2

We examined the moderating effect of regulatory foci on the efficacy of episodic future thinking in reducing delay discounting. We hypothesized that the impact of imagining positive future events (vs. recent positive events) on delay discounting of gains would be stronger for individuals with a high promotion focus than for those with a high prevention focus (Hypothesis 1). Conversely, the effects of imagining adverse future events (vs. recent negative events) on delay discounting of losses would be stronger for individuals with a high prevention focus than for those with a high promotion focus (Hypothesis 2). We conducted two experiments in which participants, randomly allocated to episodic future thinking (EFT) or episodic recent thinking (ERT) groups, completed a delayed discounting task of gain (Experiment 1) or loss (Experiment 2). Experiment 1 (N = 73) weakly supported Hypothesis 1; Experiment 2 (N = 99) did not support Hypothesis 2. Our findings suggest positive EFT is particularly effective for individuals with a high promotion focus compared to individuals with a high prevention focus, which further reveals how EFT attenuates delay discounting.     

A 21st century cognitive portrait of the Himba,a remote people of Namibia

This research sketches the cognitive portrait of the Himba, a remote population from Northern Namibia living in a non-industrial society almost completely devoid of modern artefacts. We compared the Himba sample to a French sample, exploring cognitive reflection, moral judgement, cooperative behaviour, paranormal beliefs, and happiness. We looked for both differences and similarities across cultures, and for the way cognitive functioning is associated with a range of demographic variables. Results showed some important group differences, with the Himba being more intuitive, more religious, happier, and less utilitarian than the French participants. Further, the predictors of these beliefs and behaviours differed between the two groups. The present results provide additional support to the recent line of research targeting cultural variations and similarities, and call for the need to expand psychology research beyond the Western world.     

Future-Oriented Positive Mental Imagery Reduces Anxiety for Exposure to Public Speaking

Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.     

Separating the wheat from the chaff: does discriminating between diagnostic and nondiagnostic information eliminate the dilution effect?

The dilution effect refers to the finding that judgments are often unduly influenced by nondiagnostic information, producing regressive judgment. Because the dilution effect is a problem in various domains, strategies to control the impact of nondiagnostic information were explored by drawing on a perceptual and a conversational account of the dilution effect. Three experiments (n = 259) demonstrate that explicit instructions to discriminate between diagnostic and nondiagnostic information did not reduce the dilution effect. Rather, consistent with a perceptual explanation but not consistent with a conversational explanation, the dilution effect disappeared only when participants engage in perceptual control, that is, when they actively remove nondiagnostic pieces of information before making a judgment. Copyright © 2004 John Wiley & Sons, Ltd.     

关于基因检测的伦理思考

随着基因组学的发展,在临床医学中出现了基因检测的新方法,它的临床应用带来了一些伦理、法律和社会问题.从伦理学的角度出发,对基因检测中出现或有可能出现的伦理问题进行探讨,提出进行基因检测应遵循的伦理原则.     

论《鬼谷子》心术的心理思想依据

该文旨在探讨《鬼谷子》心术的心理依据。分析了它的基本心理观、知虑心理思想、意志心理思想、情欲心理思想;还就其心理培养的问题进行了研究。     

从一个康复“缺憾”个案看科学思维方法的意义

本文就一例截瘫患者从因分娩诱发患病、误诊误治到康复治疗实施的过程进行分析,通过总结在诊断、治疗和康复过程中的失误与经验,讨论我们在日常的工作中如何正确建立科学思维方法以及利用科学思维方法解决实际问题,以达到提高自身诊疗水平和独立思考能力的目的。