Increasing access to low‐intensity interventions for childhood anxiety: A pilot study of a guided self‐help program for Scandinavian parents

Cognitive Behavior Therapy (CBT) is an effective treatment for child anxiety. However, access to treatment is limited. It has been suggested that low‐intensity formats of parent‐delivered CBT may improve access to treatment. Our aim was to develop and pilot‐test the acceptability and effect of a low‐intensity therapist‐guided parent‐delivered group program for anxious children (age 7–12 years) adjusted to the Scandinavian culture. The program required 1.5 hours of therapist‐time per family. Mothers, fathers and children reported on revised child anxiety and depression scale (RCADS) at referral, pre‐ and post‐treatment. Mothers and fathers also gave a qualitative account of their experiences. Thirty‐one families were enrolled and only one family dropped out. Mean age of the children was 9 years. Intent‐to‐treat analyses revealed significant reductions in anxiety and depressive symptoms from pre‐ to post‐treatment for all informants. Large effect sizes were found for child anxiety symptoms as reported by mothers and fathers, and for child depressive symptoms as reported by mothers. Medium to large effect sizes was found for the self‐reported anxiety symptoms by the children, and for depressive symptoms reported by both children and fathers. More than 93% of the parents would recommend the program. Results suggest that our program may provide a new approach to improve access to treatment for anxious children in Scandinavia; however, further research must be conducted before firm conclusions can be drawn.     

Enactment controversies: a critical review of current debates

This critical review of the current disputes concerning countertransference enactment systematically outlines the various issues and the perspectives adopted by the relevant psychoanalytic authors. In the light of this the 'common ground ' hypothesis concerning the unifying influence of contemporary countertransference theory is challenged. While the existence of enactments, minimally defined as the analyst's inadvertent actualization of the patient's transference fantasies, is widely accepted, controversies regarding the specific scope, nature, prevalence, relationship to countertransference experience, impact on the analytic process, role played by the analyst's subjectivity, and the correct handling of enactments abound. Rather than taking a stand based on ideological allegiance to any particular psychoanalytic school or philosophical position, the author argues that the relative merits of contending perspectives is best evaluated with reference to close process scrutiny of the context, manifestation and impact of specific enactments on patients' intrapsychic functioning and the analytic relationship. A detailed account of an interpretative enactment provides a context for the author's position on these debates.     

The effects of different intensity levels of background noise on dichotic listening to consonant-vowel syllables

It has previously been shown that the right ear advantage in dichotic listening to consonant-vowel syllables is affected if a background noise is presented at the same time as the dichotic stimuli. What is not known is, however, if there is also an effect of varying the intensity level of the background noise. We therefore presented conversation or traffic noise background noise simultaneously with the dichotic syllable stimuli to healthy adult subjects. The intensity of the background noises varied between 50-65 dB in steps of 5 dB. The results showed that the right ear correct reports decreased, while left ear correct reports increased as a consequence of increasing background noise intensity. The effects were also stronger for the right ear, and for the traffic background noise condition, particularly at the two highest intensity levels. The results are discussed in terms of alertness and attentional mechanisms.     

我国非瓣膜病房颤抗凝的现状与思考

心房纤颤增加缺血性脑中风4倍～5倍,抗凝治疗可减少60％的缺血性脑中风,但是同时会增加出血的风险,尤其是脑出血。我国是脑中风,特别是出血性脑中风的高发国家,所以对于房颤抗凝的临床决策往往偏保守,造成我国房颤患者抗凝比例很低。本文就如何在我国房颤患者中进行抗凝提出意见。     

不同刺激强度训练后一日龄小鸡的记忆形成

一日龄小鸡,分别接受不同浓度的回避性刺激物邻氨基苯甲酸甲酯（ＭｅＡ）训练,间隔一定时间后测试记忆保持。主要结果为：５％和２０％ＭｅＡ训练,分别使动物记忆保持１５分钟和５０分钟左右,相当于记忆形成多阶段模型中的ＳＴＭ和ＩＴＭ阶段。４０％ＭｅＡ训练,记忆保持到训练后８－１０小时,相当于不依赖新糖蛋白合成的ＬＴＭ形成的早期阶段。只有６０％以上浓度的ＭｅＡ训练才使记忆保持至少２４小时。上述结果提示,利用弱化训练的方法,不仅可以将ＳＴＭ,ＩＴＭ和ＬＴＭ分离开,而且可把ＬＴＭ形成的早期阶段分离出来独立研究,增加了对ＬＴＭ新的理解,为进一步探讨记忆形成机制提供了一条新的途径。     

运动强度和持续时间对运动后过量氧耗的影响

本研究采用双因素实验设计探讨了运动负荷强度和持续时间对 E-POC的影响。实验结果发现 ,运动过程中机体净耗氧量主要取决于运动持续时间 ,而运动后的 EPOC既受运动强度 ,也受持续时间的影响 ,但以前者的作用更加明显 ;运动后 VO2 的恢复速度快于血乳酸的消除 ,不同运动条件下的氧亏量变化主要取决于运动负荷的强度。     

Reinventing the Self in the Face of Received Transgenerational Hatred in the African American Community

There are many clinical methods for understanding and transforming the impact of historical trauma, and reinventing the self in the clinical process. However, the approach advocated here requires that regardless of what clinical method of intervention is chosen, a particular strand must run through the process of treatment to produce durable and meaningful change. This strand must run through psychoanalysis, creative and expressive arts therapies, as well as many forms of intervention in aggrieved communities. The strand includes understanding human suffering, the way that particular suffering is mentalized by the victimized group and subsequently reenacted by generations to come. In technical terms there must first be many profiles of understanding of the historical injury. Then there must be an understanding of how the aggrieved community has stored in their communal memory those psychological hurts—those feelings of humiliation and changing historical accounts of the actual injuries. Subsequently those sendimentations of historical grievances are enacted within the transference in the clinical situation where the grievances are not only staged, but re-staged, distorted or extended. Then comes the most decisive obligation the clinician has towards the analysand, patient, client or community that is attempting to transform itself. That decisive obligation is to extract the errand or ambush towards extinction and to undergo the unpleasant drudgery of constantly engaging the mandate to die or destroy oneself in order to find new and more flexible forms of adaptation.     

The influence of the victim on shock induced aggression in rats.

In two studies, free-roaming male rats (aggressors) were shocked in the presence of male target rats restrained in either an upright or a supine posure. In addition, in Experiment II, two levels of aggressor shock intensity (0.8 mA or 2.0 mA) were used while targets received one of three levels of shock (0.5 mA, 1.5 mA, or 2.5 mA). In both studies, upright targets were attacked less than supine targets. Frequency of aggression was directly related to level of aggressor shock intensity in Experiment II. Also, attack by 0.8-mA aggressors against supine targets was inversely related to level of target shock intensity. The low level of attack against upright targets was interpreted in terms of a threat diaplay. Similarily, it was concluded that the target shock-intensity effect in Experiment II was due to specific threat behaviors displayed by those supine rats that received the highest-intensity shocks.