Measuring Experiential Avoidance: Reliability and Validity of the Dutch 9-item Acceptance and Action Questionnaire (AAQ)

Three studies evaluated psychometric properties of the Dutch version of the 9-item Acceptance and Action Questionnaire (AAQ)—a self-report measure designed to assess experiential avoidance as conceptualized in Acceptance and Commitment Therapy (ACT). Study 1, among bereaved adults, showed that a one-factor model, with AAQ-items constituting a single dimension of experiential avoidance, fitted the data well. The internal consistency and temporal stability of the AAQ were satisfactory. In Study 2, among undergraduate students, and Study 3, among 60 outpatients, higher AAQ scores were found to be significantly associated with psychopathology, maladaptive coping strategies, and neuroticism, attesting to the validity of the measure. In support of its incremental validity, Study 3 showed that the AAQ remained significantly associated with depression and anxiety after controlling for neuroticism and thought suppression. The current studies complement prior research supporting the psychometric properties of the AAQ and the ACT conceptualization of experiential avoidance.

Marriage and Family Therapy with Low-Income Clients: Professional,Ethical, and Clinical Issues

Economic stress greatly increases the likelihood of mental health issues occurring within a family. Although this is widely known within the mental health profession, there is a lack of literature that assists therapists in working effectively with low-income clients. As a result, marriage and family therapists may be ill equipped to meet the needs of those in poverty, and may even be conducting therapy that is ethically unsound. The authors of this article discuss several ethical and professional issues regarding therapy with families in poverty. A number of suggestions are presented for improving the effectiveness of therapy with low-income clients. Michele E. Grimes and Alyssa D. McElwain are masters students in Marriage and Family Therapy at Purdue University Calumet, Hammond, IN. Michele E. Grimes and Alyssa D. McElwain contributed equally to this article.     

Family Therapy and Childhood-Onset Schizophrenia: Pursuing Clinical and Bio/Psycho/Social Competence

Childhood-onset schizophrenia is perceived as more complicated because of its complexity, pervasive duration, and impact on individual and family functioning. Viewing the symptoms of childhood schizophrenia as creating a bio/psycho/social competence within which the therapist and family must interact may help contribute to treatment success. Competent family therapists working within this culture should be knowledgeable about the characteristics of childhood-onset schizophrenia, aware of their own biases towards psychosis, and skillful in its treatment. Guidelines are provided to help therapists identify their attitudes about schizophrenia and understand appropriate skills for treating the disorder.     

From Cognitive Behaviour Therapy (CBT) to Cognitive Behaviour Coaching (CBC)

This article focuses on how the principles and practice of cognitive behaviour therapy (CBT) can be adapted to the field of coaching to become cognitive behaviour coaching (CBC) and the current empirical status of CBC is discussed. The centrepiece of CBC practice is the ABCDE model of identifying psychological blocks and their removal. Typical tools and techniques used in CBC are outlined and ten key questions to ask in coaching are advanced. What CBC can offer coaches is discussed and, finally, suggestions are made to point out when coaching should really be counselling.     

Impact of play therapy on parent-child relationship stress at a mental health training setting

This study investigated the impact of Child-Centred Play Therapy (CCPT)/Non-Directive Play Therapy on parent-child relationship stress using archival data from 202 child clients divided into clinical behavioural groups over 3-74 sessions in a mental health training setting. Results demonstrated significant differences between pre and post testing on the Parenting Stress Index. CCPT appeared to be especially effective with children identified with clinical externalising behavioural problems, combined externalising and internalising behavioural problems, and children who were not categorised with clinical problem behaviours but whose parents sought counselling services for them. There were also significant differences determined by length of therapy. Results are discussed concerning implications for clinical practice and further research.     

美托洛尔常规治疗与基因导向治疗高血压病的比较

比较基因导向美托洛尔个体化治疗与常规治疗高血压病的临床疗效、安全性和经济性。从300例1或2级原发性高血压患者中随机抽取165例进入常规治疗组（A组,n＝165）,其余135例患者进行CYP2D6基因、β1肾上腺素能受体（β1-AR）基因多态性检测,将β1-AR基因389位携带了Arg等位基因的原发性高血压患者133例分入基因导向治疗组（B组,n＝133）;基因导向治疗组患者按照CYP2D6基因分型分为弱代谢组（PMB,n=43）、中等代谢组（IMB,n=54）和强代谢组（EMB,n=36）。常规治疗组给予美托洛尔100mg/日,基因导向治疗组中PMB组、IMB组、EMB组分别给予美托洛尔25 mg/d、100mg/d、200mg/d,均分2次口服降压治疗,共随访8周,观察血压和不良反应等指标。应用成本-效果分析方法对基因导向型个体化治疗方案进行药物经济学评估。结果为基因导向治疗组降压总有效率明显高于常规治疗组（65.08% vs 47.4%, P＜0.05）;基因导向治疗组的不良反应发生率明显低于常规治疗组（P＜0.05）。成本效果分析,基因导向治疗组的平均成本效果比稍高于常规治疗组（350.05 vs 249.96）,与常规治疗组相比增量成本效果比（ICERs）为618.38。依据基因导向的前瞻性美托洛尔个体化降压治疗较传统给药模式更为安全、有效,但短期治疗难以体现其更优的经济学价值。     

子宫内膜干细胞与子宫内膜异位症的治疗

子宫内膜异位症（EMs）是妇科最常见的疾病之一,引起痛经、月经不调、不孕等,严重危害妇女的身心健康,影响患者生活质量。其发病率逐年升高,发病机制不清,疗效差,一直是困扰妇科医生的难题之一。最近提出的子宫内膜干细胞（SC）学说认为EMs起源于SC,EMs病灶的维持和发展是子宫内膜SC不断更新和分化的结果。因此,治疗的关键应是针对子宫内膜SC,通过靶向子宫内膜SC及其异常调节的信号转导通路来治疗EMs。这对传统的治疗方式提出了巨大的挑战,也为有效的根治EMs开辟了新的思路。     

关于糖尿病的几点认识

糖尿病及其并发症严重影响了人类的健康。随着科学技术的不断发展,人们对糖尿病 的认识逐步加深。目前关于糖尿病的命名、诊断分型标准和治疗原则在临床工作中逐渐显露 出其不足之处,这势必会影响人们对于糖尿病的进一步研究。本文从糖尿病的命名、诊断、 分型、治疗和糖尿病研究等方面发表了作者的看法,旨在引起大家的思考。     

临床指征优先谨慎使用抗菌药物

抗菌药物是临床广泛应用的一类药物。根据卫生部全国医院感染监测网监测结果,我国临床抗菌药物使用率较高。抗菌药物压力是细菌产生耐药性最重要的原因。对于临床谨慎使用抗菌药物来说,知晓和掌握使用指征是非常重要的,在任何情况任何时候,指征是优先考虑的。抗茵药物使用指征包括治疗性用药指征和预防性用药指征,尤其是预防用药方面。本文讨论抗菌药物应用指征,包括感染诊断与治疗性用药的关系、手术前预防性使用抗菌药物预防手术部位、内科患者预防性使用抗菌药物指征与药物选择等。