口腔种植诊疗实践中的思考

口腔种植现已经出现在人们的视线里,它具有一定的特殊性和优越性,能够解决常规修复手段不能解决的问题,然而在临床应用中,需要考虑和处理的问题往往很复杂。因此有必要在临床实践中运用辩证思维及循证医学的思想,在诊断中全面考虑、周密计划;在治疗中处理问题、解决难点;在随访中发现问题,促进发展。     

消化系统疾病与精神心理因素的辩证关系

消化系统疾病与精神心理因素相互影响,其相互作用呈现个体化差异,这与个体间的内环境以及外环境差别有关。主要病理生理学机制之一为"脑-肠轴"及"脑肠互动"学说。临床医生需要认识到二者之间辩证关系的普遍性和重要性,及时发现躯体症状背后潜藏的精神心理问题,综合运用各种心理干预和药物治疗手段。     

浅谈自发性脑出血诊断的辩证思维

自发性脑出血作为临床常见疾病,其背景复杂,对其予以准确诊断较为困难。除最常见于高血压性脑出血外,其既可作为某些疾病的首发表现,也可作为其他疾病的并发症或某些药物治疗的副作用而出现。其准确诊断除需具备完整临床知识结构外,亦要求我们具有辩证思维。本文旨在从辩证思维和临床角度探讨自发性脑出血的准确诊断。     

中医药隐性知识创造式思维的根源及内在发展逻辑

中医药知识具有隐性化特征,在传承过程中,是按照生成论思维方式对其进行吸取和更新,需要继承者通过直觉、体悟来理解,通过注释的方法进行解读,运用藏象、类比、辩证的方法进行意会性思维,构成形下与形上的统一.通过传统知识与时代知识的融通,传统思维与时代思维的互渗,同类知识和异类知识的同构,创造性地不断建构新的知识体系.     

知性思维的合理性问题

本文认为,知性思维尽管是一种“呆板”的、“教条”的思维范式,可它在人的认识过程中还是有一定的合理性存在的范围和根据的。它同辩证思维一样都是人的生存方式和需要的产物,都是人的创造性思维的表现,都是人的认识过程的环节。因此,不能简单地把知性思维与形而上学的思维方式划上等号。我们既要防止知性思维的不合理越界,即用它来反对、否定,甚至取代辩证思维的意义,也要防止辩证思维的不合理越界,即用它来贬低、消解,甚至取代知性思维的作用。     

Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research

Among adolescents, interpersonal trauma has been associated with severe post-traumatic stress disorder (PTSD) and impairments across multiple domains of functioning (e.g., Derosa, Amaya-Jackson & Layne, 2013; Ford, Courtois, Steele, van der Hart, & Nijenhuis, 2005; van der Kolk, 2005). Such difficulties can include high-risk behaviors such as active suicidality (Middlebrooks & Audage, 2008) and nonsuicidal self-injurious behavior (NSSI; Hu, Taylor, Li, & Glauert, 2017). While there have been many advances in the treatment of trauma, treatment dropout for adolescents seeking trauma-informed treatment is predicted by diagnostic comorbidity and complexity (Sprang et al., 2013), as well as the number of traumatic events endorsed (Wamser-Nanney & Steinzor, 2016). Many traumatized adolescents with high-risk behaviors are referred to Dialectical Behavior Therapy (DBT-A). However, DBT-A does not yet include a specific, evidence-based protocol for treating PTSD, without which treatment gains may not be sustained for traumatized adolescents (Harned, Korslund, & Linehan, 2014). While Prolonged Exposure (PE) is indicated as the gold-standard treatment for PTSD and has proven effective for adolescents (PE-A; Foa, McLean, Capaldi, & Rosenfield, 2013), it has not yet been validated with adolescents who are actively suicidal. However, PE has successfully been integrated within DBT for adults with co-occurring Borderline Personality Disorder and PTSD (e.g., DBT-PE; Harned et al., 2014). Based upon this model, the current paper proposes the integration of DBT-A and PE-A to treat adolescents with interpersonal trauma who also present with high-risk behaviors. The paper discusses anticipated complications related to adapting this model for adolescents and provides direction for future research.     

You are not alone – adolescents’ experiences of participation in a structured skills training group for ADHD

Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experience participating in group therapy, an important factor to consider when developing treatment methods for this age group. This study aimed to explore how adolescents with ADHD experience participating in a structured skills training group program based on dialectical behavioral therapy. Semi-structured interviews were conducted with 20 adolescents (15–18 years of age) with ADHD after participating in a structured skills training group. The interviews were transcribed verbatim and qualitative content analysis were used to analyze the text. The participants emphasized the value of meeting other adolescents with ADHD and the opportunity to exchange experiences, strategies and tips. Participating in the group treatment made the adolescents realize that they were not alone, and feelings of togetherness and an increased acceptance of themselves were described. The participants associated the treatment with elevated knowledge and understanding, for example, about ADHD, their own functioning and helpful strategies. They also described emotional and behavioral changes, such as higher self-esteem, fewer inter-personal conflicts and improved concentration. Activating and experiential exercises were considered important elements of the treatment, and the participants expressed a need for a variation of exercises, as well as more time for practicing skills, discussions and breaks. The results indicate that the group format add an extra value to the treatment and that the use of an active approach throughout the treatment is of importance for this group of patients.     

复合伤的"复合效应"中线性与非线性的辩证关系

复合伤的“复合效应”是非线性观在医学研究领域中的一个范例。它不仅具有重要的实际价值,而且具有较高的理论意义。复合伤效应不是单纯的“加重效应”,而是“复合效应”,即可加重,不加重,以至减轻。复合伤的复合效应规律的基本特征和本质是非线性特征,而复合效应中线性与非线性特征的关系是辩证统一的。     

Rethinking the Fallacy of Hasty Generalization

This paper makes a case for a refined look at the so- called fallacy of hasty generalization by arguing that this expression is an umbrella term for two fallacies already distinguished by Aristotle. One is the fallacy of generalizing in an inappropriate way from a particular instance to a universal generalization containing a for all x quantification. The other is the secundum quid (in a certain respect) fallacy of moving to a conclusion that is supposed to be a universal generalization containing a for all x quantification while overlooking qualifications that have to be added to the more limited kind of generalization expressed in the premise. It is shown that these two fallacies relate to two different kinds of generalization.The classification of fallacious generalizations is based on a new theory of generalization that distinguishes three kinds of generalizations – the universal generalization of the for all x type, used in classical deductive logic, the inductive generalization, based on probability, and the presumptive generalization, which is defeasible, and allows for exceptions to a general rule. The resulting classification goes beyond a logic-oriented analysis by taking into account how a respondent may oppose a potentially fallacious generalizing move by falsifying it. Using a dialectical interpretation of premise-conclusion complexes, the paper outline a richer concept of generalizing argument moves embedded in a communicational reconstruction of the strategic uses of such moves in which two parties take part in an orderly dialectical exchange of viewpoints.     

Dialectical Behavior Therapy Skills for Families of Individuals With Behavioral Disorders: Initial Feasibility and Outcomes

Family members of individuals with behavioral disorders are a valuable source of logistical and emotional support for patients. Family members may take on tremendous financial and/or psychological responsibility to care for their loved ones, which can result in poor psychological outcomes for the family and, in turn, impede the recovery of the patient. Dialectical Behavior Therapy (DBT) skills training is an effective treatment that has been utilized with numerous populations, including family members of individuals with behavioral problems, and has shown efficacy in improving various interpersonal outcomes; however, no study has examined feasibility and outcomes of delivering all four unabridged DBT skills modules to this population. Twenty participants attended weekly DBT skills classes for 6 months, where they acquired skills in mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. There were significant pre-post improvements for emotion dysregulation, stress reactivity, and various interpersonal outcomes; there were no significant changes in depression or anxiety. These results suggest that DBT skills may be effective at improving broad clinical domains in a sample of family members of individuals with behavioral problems. This research is the first step in demonstrating that DBT skills might benefit family members of patients with heterogeneous mental health problems and, therefore, fits in to the field’s growing interest in cost-effective transdiagnostic interventions.