道家“因”论

＂因＂是道家政治哲学的核心范畴,＂因者,君之纲＂。道家＂因＂论包含有因循、因仍、因应和因凭四重内涵,其价值功用是＂因则无敌＂。道家＂因＂论作为一种＂君术＂,强调＂因臣之为＂和＂因民之性＂两个基本面,其总的原则是＂曲因其当＂,而核心本质则凸显为＂舍己而以物为法＂。     

Experiences related to expert supervisors' views of ideal therapeutic practice

Aims: This study examines the relationship between expert supervisors' professional experiences and their views about the importance of different psychotherapy techniques. Method: Thirty psychodynamic‐interpersonal (PI) supervisors and 13 cognitive‐behavioural (CB) supervisors (N=43) were instructed to rate 20 therapeutic techniques according to how characteristic each technique is of an ideally‐conducted session within their theoretical orientation. The measure used for this assessment was the Comparative Psychotherapy Process Scale. Results: Findings demonstrated that supervisors' beliefs about ideal therapeutic techniques are related to their number of years in post‐graduate clinical practice, training, and supervising trainees, as well as to the number of publications they have authored. Further, experience within a given orientation tends to lead to a greater endorsement of techniques within that orientation, although this finding is more uniform for CB supervisors than PI supervisors. Finally, differential types of experience lead to differential focusing on specific techniques. Discussion: The clinical importance of these findings is explored.     

Treatment manuals: use in the treatment of bulimia nervosa

As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians’ most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and “eclecticism” is at odds with efforts to disseminate manuals into clinical practice.     

多项选择题认知诊断潜能的最大化

多项选择题是认知诊断中常用的测验项目形式, 其正确答案选项和经过特殊编制的干扰项都能提供诊断信息。为了提取干扰项的信息, 需要采用不同于传统认知诊断模型的心理计量模型。分类介绍能使干扰项提供诊断信息的多项选择题编制方法, 分析这类多项选择题的认知诊断模型, 认为未来应加强干扰项编制方法和能提取干扰项信息的认知诊断模型的选择和开发等方面的研究。     

共同方法变异的影响及其统计控制途径的模型分析

共同方法变异(common method variance, CMV)指两个变量之间变异的重叠是因为使用同类测量工具而导致, 而不是代表潜在构念之间的真实关系。虽然以往研究显示CMV不一定导致研究结果的偏差, 在实际研究中应当加以考量。特别是在使用测量方法的研究中, 如果数据来源越单一, 测量方法越类似, CMV效应使研究结果产生偏差的可能性越大。CMV效应的控制方法包括过程控制法和统计控制法。在统计控制法的选择和使用上, 需要重点考虑该方法是否分离了三大变异(特质变异、方法变异和误差变异), CMV效应是在测量构念层面还是题目层面, CMV效应是加法效应还是乘法效应。控制潜在方法因子途径是统计控制方法中最重要的一类方法, 理解其模型是正确使用这类方法的前提。未来研究应当关注多个研究的CMV效应和侧重评估某个理论研究中CMV所引起的潜在的效度威胁。     

变长CD-CAT中的曝光控制与终止规则

本研究借鉴传统计算机化自适应测验的思想, 并结合认知诊断的特点, 在认知诊断框架下提出了4种变长CD-CAT的终止规则, 分别是属性标准误法(SEA)、邻近后验概率之差法(DAPP)、二等分法(HA)以及混合法(HM)。在未控制曝光和采用不同曝光控制条件下, 与HSU法及KL法进行了比较。研究结果表明：(1) 终止条件越严格, 平均测验长度越长, 按测验长度最大值终止的测验百分比越大, 模式判准率越高。(2) 当未加入曝光控制时, 4种新的终止规则均有较好表现, 与HSU法十分接近。随着最大后验概率预设值的增加或e的减小, 模式判准率呈上升趋势, 平均测验长度逐渐增加, 但在题库使用率方面均较差。(3) 当加入项目曝光控制时, 6种变长终止规则下的题库使用率有了极大的提升, 仍能保持较高的模式判准率, 并且不同的曝光控制方法对终止规则的影响是不同的。其中, 相对标准终止规则极易受到曝光控制方法的影响。(4) 综合来看, SEA、HM以及HA法在各项指标上的表现与HSU法基本一致, 其次为KL法和DAPP法。     

问诊的诊断价值及其方法学探讨

问诊作为临床诊断的开始和方法,具有促进医患良性沟通、明确诊断、减少医疗纠纷和贯彻新医学模式的重要价值。问诊过程中,医生除了注重其技术性和程序性内容以外,更要坚持哲学的普遍联系、辨证发展、病人个体差异和巧用过渡性语言等思维方法。     

药物性肝损伤的诊断思维

药物性肝损伤（DILI）是指由于药物或其代谢产物引起的肝脏损害。DILI的诊断尚无金标准,目前国际上比较常用的诊断标准分别从数个不同方面各自进行量化评分,根据得分情况做出诊断。本文归纳DILI的产生机制、诊断标准、临床分型及病理类型,总结推论其临床诊断思维与决策,以供临床医生参考,提高诊断水平。