上海市中学生心理健康自评量表的研究

本研究以中学生心理健康八条标准为理论构架,编制《上海市中学生心理健康自评量表(SISMSS)》。该量表共140个项目,由三个分量表组成,即适应性诊断量表、疾病性诊断量表和测谎量表,适应性诊断量表包含8个小测验,即主动学习、情绪乐观与稳定、自制力、自我认知、成就动机、与人沟通、责任感、性意识;疾病性诊断量表包含7个小测验,即精神分裂症倾向、抑郁症倾向、轻躁狂倾向、强迫症倾向、焦虑症倾向、恐怖症倾向、歇斯底里症倾向。适应性诊断量表与疾病性诊断量表之间并不是相互独立的,而是存在着一定程度的相关,有对应关系。SISMSS的内在一致性系数为0.9081(p<0.01),SISMSS与SCL-90之间的相关为0.589(p<0.01),SISMSS与MHT之间的相关为0.734(p<0.01)。     

‘It’s the unknown’ – understanding anxiety: from the perspective of people with multiple sclerosis

Objective: A qualitative study of PwMS who had clinically significant levels of anxiety was conducted to gain a richer perspective on their experience. The objective was to explore PwMS’ experiences of anxiety and their perspectives on causes and outcomes. Design: Twenty in-depth, semi-structured interviews were conducted with PwMS consecutively recruited from the Neurology Department of a NHS University Hospital. Sixteen had a relapsing-remitting course, three had a secondary progressive course and one person had primary progressive multiple sclerosis (MS). Interviews were recorded, transcribed and analysed using inductive thematic analysis. Results: Although participants thought different factors had initially triggered their anxiety, being given the diagnosis of MS appeared to be the most significant factor for many participants. Difficulties in the workplace and in relationships, particularly related to perceived dependence on others were also important themes. A wide range of emotional responses and negative thinking patterns were associated with anxiety; this suggested the presence of comorbid depression. Participants were able to acknowledge the positive and negative coping strategies that impacted on their anxiety. Conclusion: This review confirms that anxiety can have many negative implications for PwMS and suggests that early detection and intervention are necessary in order to improve patient’s well-being.     

Perfectionism and Depression Among Low-Income Chronically Ill African American and White Adolescents and Their Maternal Parent

Most research on perfectionism is based on convenience samples of university students or clinically distressed samples, and therefore relatively less is known about the development and implications of perfectionism for other groups. In this study, we examined perfectionism and depression in low-income African American (n = 39) and White (n = 55) adolescents with chronic illnesses (most with diabetes, asthma, and/or hypertension) and their primary parents. We specifically examined the association between parent and child perfectionism, and the link between perfectionism and depression in both groups. The African American adolescents reported significantly more maladaptive perfectionism than did the White adolescents, and the African American parents reported significantly higher scores on depression than did the White parents. Correlations and regression analyses revealed similarities and differences in perfectionism-depression associations that might be explained in light of cultural differences and the unique physical and emotional challenges faced by youth with chronic illnesses. The word “parent” in this study is used to represent a parent or other adult who was identified as a primary caregiver for the adolescent.     

South African Muslim Faith Healers Perceptions of Mental Illness: Understanding,Aetiology and Treatment

The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession—all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.

Adolescent Neurodevelopment and Psychopathology

Adolescence is a high-risk period for the onset of psychopathology. The occurrence of depression increases markedly in the years following the onset of puberty, and most individuals who are eventually diagnosed with a psychotic disorder show a marked rise in adjustment problems during adolescence. It is well established that puberty involves increases in the secretion of gonadal hormones. More recently, research has shown that stress hormones show a similar normative rise following puberty. Accumulating findings indicate that the postpubescent period is also characterized by significant neurodevelopment; there are changes in brain structure and function that are partially a consequence of hormonal factors. Researchers are now challenged to elucidate the neural mechanisms relating postpubertal neurodevelopment with the elevations in risk for psychopathology that characterize adolescence. One plausible mechanism is the effect of hormones on gene expression. The normal neuromaturational processes observed in adolescence partially reflect the effect of gonadal hormones on the expression of genes that control brain development. Hormone surges following puberty may also trigger the expression of genes that code for brain abnormalities that give rise to mental disorders.     

Secondary Beliefs: A Mediator between Illness Representations and Coping Behavior in Arthritis Sufferers

The aim of the current study was to investigate the factors of secondary beliefs and illness representations, and their relationship with particular coping strategies used in the management of arthritis, and more specifically, if secondary beliefs, as defined in Rational Emotive Behavioral Therapy (REBT), mediated the relationship between illness representations and coping, as outlined by the Self-Regulatory Model (SRM). A sample of 63 arthritis sufferers aged between 32.0 and 100.1 years was recruited. Participants were asked to complete three questionnaires: Ways of Coping Questionnaire (WOCQ); revised Illness Perception Questionnaire (IPQ-R); Secondary Beliefs Scale (SBS). Analyses revealed that all eight coping strategies measured were significantly related to one or more illness representation, lending support to the SRM. Furthermore, secondary beliefs were found to mediate the relationship between illness representations and coping for three of the strategies measured: confrontive coping, accepting responsibility and seeking social support, while they also appeared to be directly related to the escape-avoidance strategy. Therefore, support for the REBT model was also evidenced. Overall, these results have highlighted the importance of cognitive factors in influencing coping behavior, a finding that could prove useful when designing interventions aiming to promote beneficial coping in arthritis sufferers.     

国外心理疾病烙印影响研究概述

心理疾病污名足加诸在心理疾病患者身上的耻辱标记,世界卫生组织2001年指出"心理和行为障碍患者康复的最大阻碍就是社会对他们的污名和与之相连的歧视".作者对国外污名领域的研究进行了回顾,论述了心理疾病污名的概念、有关其影响机制的理论和实证研究.从公众污名和自我污名两方面论述了污名对心理疾病患者的影响以及消除污名的方法.     

Changes in Attitudes Toward Religion Among Those with Mental Illness

Despite the increased attention given to the religious experiences of those with mental illness, the specific nature of the changes in religious attitudes that occur within this population remain yet unknown. In this study, 406 individuals with persistent mental illness who attended one of 13 Los Angeles County Mental Health facilities completed a demographic questionnaire, an adapted version of the Religious Coping Index, and the Symptom Checklist 90-R. Over 54% of the participants reported a change in their religious beliefs such that their faith became stronger or weaker as a result, and 66% perceived these changes to be positive in nature. Qualitative codings suggest that a constructive or destructive use of religion and the quality of one's self-image and relationship with God are the primary themes underlying these changes. Those changes that were predominantly positive were associated with less severe symptomatology and more religious coping when compared to predominantly negative changes. These findings suggest that religious attitudes may be an ongoing and dynamic part of the experience of mental illness that should be considered in the treatment and research afforded by mental health professionals.     

Occupational Therapy in the Rehabilitation of the Patient with Anorexia Nervosa

The first part of this paper develops an ecological and rehabilitative stance for the occupational therapist in relation to the anorexic patient. Maximizing the individual's level of psychosocial functioning is regarded as the primary aim of treatment. A model for approaching the anorexic patient is described which examines environmental factors, and the importance of assessment and follow up. The cognitive behavioral approach is discussed and suggestions are made for adapting it to the occupational therapist's orientation towards practical activity. In the second part of the paper concrete suggestions for therapy are made.     

神经症躯体症状的特点与诊断原则

作为临床医生,难免与一些难以解释的躯体症状打交道,这其中有些最终可以确定是精神障碍的躯体症状。从躯体症状识别精神障碍,没有捷径可走,除了良好的医学基础,更要了解精神障碍的特点。这样即便是躯体疾病同样存在的情况下,也能发现精神障碍。套用政治术语,叫做"两手抓,两手都要硬"。即便如此,还有一些医学难以解释的症状,其发生基础无论从生物学医学还是精神病学角度都还不清楚,而这正是需要我们着力研究的学科交叉点。