健康领域的跨期决策与健康行为

健康领域的跨期决策关系着个体和国民的健康和福祉。目前学界对该领域的研究主要停留在参考传统金钱领域的相关理论模型和方法的阶段, 但健康跨期决策具有领域特异性, 沿袭金钱领域理论模型和方法, 导致该领域在研究方法和结果上存在较大的不一致性。健康跨期决策的行为后果是该领域关注重点, 多数研究均报告个体的低时间折扣率、高未来时间取向与其健康保护行为正相关, 与健康风险行为呈负相关。该领域也关注健康跨期决策的影响机制, 如决策对象和决策主体的核心特征等因素。未来研究亟需发展适用于健康领域的跨期决策模型和研究范式, 明确健康行为与跨期决策偏好的关系, 深入探讨健康跨期决策的内在选择机制, 并在健康行为干预和医疗卫生政策应用方面进行更多的尝试和探索。     

隔代教育对孙辈和祖辈的影响：双刃剑效应

隔代教育是指祖辈对孙辈的抚养和教育, 随着经济社会的发展, “隔代教育”已成为“亲代教育”的一种重要补充形式。隔代教育对祖孙两辈人的身心健康均存在“双刃剑”效应。生物进化论、社会交换理论和家庭系统理论为理解隔代教育对孙辈的影响提供了理论支持, 角色紧张和角色强化理论可以加深隔代教育对祖辈影响的认识。未来研究应明确隔代教育的定义和类型, 控制边界因素进行更为深入的综合性研究, 并进一步推进隔代教育的本土化研究。     

基于助推的健康饮食行为干预策略

在干预国民健康饮食行为方面, 更“隐性”的助推策略因其针对直觉思维系统发挥作用, 比传统的干预政策更具优势。基于助推策略对食物选择决策影响机制的不同, 健康饮食助推策略可构建为提供决策信息、改善决策选项、影响决策结构和提醒决策方向4个大类及9个小类的框架体系。助推策略在实践中仍存在争议, 因而在中国实施时需与传统政策结合使用, 充分考虑中国国情和消费群体特征, 并充分利用信息技术和大数据优势, 助力健康中国。     

父母消极教养方式对中国性少数心理健康的影响：基于Bifactor模型

中国性少数群体普遍存在严重的心理健康问题,家庭是其最大的压力来源。在性少数压力模型的背景下,本研究基于Bifactor模型探究父母消极教养方式对中国性少数（LGB）心理健康的特殊影响。采用父母教养方式问卷、抑郁-焦虑-压力量表和金赛量表对649名LGB进行网络问卷调查,结果发现：（1）父母消极教养方式的Bifactor模型存在部分差异;（2）对于LGB心理健康,父母消极教养方式的一般因子和拒绝特殊因子具有损害作用,过度保护特殊因子具有保护作用。     

家庭功能对青少年早期外化问题行为的影响：心理韧性的中介作用和性别的调节作用

为探讨家庭功能对青少年早期外化问题行为的影响,以及心理韧性和性别在二者关系中的作用机制,采用家庭功能量表、心理韧性量表和青少年外化问题行为量表对1284名初一学生进行测查。结果显示：（1）家庭功能显著负向预测青少年外化问题行为。（2）心理韧性在家庭功能和青少年外化问题行为中起部分中介作用,即家庭功能可以通过心理韧性间接影响青少年外化问题行为。（3）家庭功能对青少年外化问题行为中介过程的前半条路径和直接路径受到性别调节,具体而言,相比于男生,在女生群体中,家庭功能对心理韧性的影响更大;相比于女生,在男生群体中,家庭功能对外化问题行为的影响更大。     

Beyond bruises and broken bones: the joint effects of stress and injuries on battered women's health

We investigated the joint mediating effects of injuries and stress on the relationship between abuse and women's health. A community sample of 397 women, half of whom had been assaulted by an intimate partner within the prior 6 months, was interviewed about their experience of intimate partner violence, injuries, stress, income, depression, and physical health problems. Structural equation modeling techniques confirmed the complex model of hypothesized indirect effects of abuse on women's physical health problems through injuries, stress, and depression. Stress accounted for 80% of the indirect effect of abuse on women's physical health. Its direct effect on physical health was somewhat larger than its indirect effect through depression, but both processes played a key role in determining the effect of abuse on women's physical health problems. Furthermore, abuse was a stronger predictor of women's stress than was poverty. Implication and future research are discussed.     

Causal Responsibility and Rationing in Medicine

The article addresses the issue of rationing health care services, a topic currently being hotly debated in many countries. The author argues that the aspect of causal responsibility ought to play a decisive role in the allocation of limited medical resources. Starting out from Ronald Dworkin's distinction between option luck and brute luck, the appropriate and meaningful uses of the term causal responsibility are clarified first. A discussion of the conditions which might justify giving lower priority to patients whose illnesses are the result of unhealthy behavior, like e.g. alcohol abuse, follows. Causal responsibility is then viewed in the context of private health insurance and the club model of organ donation. It is argued that individuals themselves are basically responsible for their decisions regarding insurance coverage and membership in organ donors' clubs. Causal responsibility is shown to be a more suitable criterion for rationing scarce medical resources than other criteria which might alternatively be considered, such as patients' age.     

Pace of Life and Enjoyment of Life

The paper addresses the paradox that people in modern societies believe themselves to be very happy and satisfied with their lives while simultaneously are subjected to increasing time pressure and pace of life. It starts with presenting evidence for time pressure covering objective and subjective indicators. Evidence for Germany is given by comparing time-budgets in 1991/92 and in 1999. Time use among full time employed in Germany and other EU-societies in the 1990s is compared to the US and Japan by means of diary-data. As regards work life, overwork and the gap between actual and preferred working hours are examined. Survey-results on the relationship between work load, time pressure, stress and health are reported.Most of these data support the conclusion that time pressure has emerged as a major social problem. Hence citizens are beginning to consider time prosperity as a dimension of their well-being beyond their consumer wealth.However, this growing pace of life does not reduce life satisfaction and happiness. Here a paradox evolves as increasing time pressure goes hand in hand with increased subjective well-being (SWB) at country level in cross-cultural comparison as well as at individual level.In the third section some answers to this paradox are explored: A first answer is offered through the modernization theory: life satisfaction and QOL are proliferating along with economic growth and living standards. This process at the same time accelerates social life. Hence, the negative effects of time pressure are counterbalanced by various yields of the modernization process resulting in a pattern of "heavy-going" satisfaction.A second explanation is the psychological approach: time pressure fulfils positive functions for mobilizing individual resources. A variation of this argument is that the multiple-choice-society offers a wide variety of attractive options resulting in people engaging in too many activities. Here, the enjoyment of life is equated with taking advantage of every opportunity.However, this paper prefers a third approach based on Simmel's explanation of the ambivalent consequences of modernity. Even where the majority of citizens report high levels of happiness and life satisfaction – which can be explained through "arousal" or "eu-stress" – the need to ease the time-burden of disadvantaged groups and to down-speed work and social life in general is essential.     

Hotep's Story: Exploring the Wounds of Health Vulnerability in the US

A wide variety of forms of domination hasresulted in a highly heterogeneous health riskcategory, ``the vulnerable.' The study of healthinequities sheds light on forces thatgenerate, sustain, and alter vulnerabilities toillness, injury, suffering and death. Thispaper analyzes the case of a high-risk teenfrom a Boston ghetto that illuminatesintersections between ``race' and class in theconstruction of vulnerability in the US.Exploration of his ``wounds' helps specify howlarge-scale social and cultural forces becomeembodied as individual experience of disparatehealth risk. The case demonstrates that healthinequities would not occur if resources –employment, income, wealth, education, housing,profiling in the legal system, and health care– were more justly managed in keeping withstandards outlined in the Universal Declarationof Human Rights. Professional responses to the``wounds of vulnerability' may reveal importantaspects of who we are and what our work asscholars, practitioners, and advocates mustbecome.     

The Role of Referent and Expert Power in Mutual Help

This study explored the roles of referent power (i.e., influence based on sense of identification) and expert power (i.e., influence based on knowledge and expertise) in Schizophrenics Anonymous (SA), a mutual-help group for persons experiencing a schizophrenia-related illness. The study describes SA participants' experience of referent and expert power with SA members, SA leaders, and with mental health professionals. It also examines whether or not referent and expert power ascribed to fellow SA participants predicts the perceived helpfulness of the group. One hundred fifty-six SA participants were surveyed. Participants reported experiencing higher levels of referent power with fellow SA members and leaders than with mental health professionals. They reported higher levels of expert power for mental health professionals and SA leaders than for SA members. The respondents' ratings of their SA group's helpfulness was significantly correlated with ratings of referent and expert power. Although expert power was the best independent predictor of helpfulness, a significant interaction between referent and expert power indicated that when members reported high referent power, expert power was not related to helpfulness. These results are interpreted to suggest that there are multiple forms of social influence at work in mutual help.