Self-Discrepancy and Mental Health in Older Women with Chronic Illnesses

Self-discrepancy was investigated as a self-enhancing mechanism by which older women maintain their mental health and psychological well-being while coping with declines in physical health. In this 6-year longitudinal study, the mediating and moderating effects of self-discrepancy on mental health outcomes in older women with chronic health problems were tested. Participants were 103 community-dwelling older women who completed multiple, self-report measures of physical and mental health and self-discrepancy. There was a decline in physical health over time but an improvement in self-discrepancies. Low self-discrepancy (i.e., little discrepancy between the actual and ideal self) mediated and moderated the effects of physical health decline on mental health and psychological well-being. Thus, self-discrepancy appears to play a significant role in maintaining mental health in the face of declining physical health in older women.     

Healthy and chronically‐ill children's generalisation of illness to biological and non‐biological categories

Using children's naïve theory of biology as a framework, this study investigated children's developing understanding of illness by examining their generalisation of illness to biological and non‐biological categories. In addition to differences associated with age, the children's health status was investigated for any possible linkwith their understanding. Healthy and chronically‐ill children, aged 4–11 years, were randomly assigned to one of three conditions, according to which exemplar (child, dog or duck) was described as suffering from an imaginary illness. Using a card‐sorting technique, the children assessed whether each entity out of 30 entities (five representatives in each of six categories: humans, mammals, non‐mammals, birds, plants and artifacts) could be afflicted by that illness. The children's generalisations indicated a grasp of the distinctiveness of the various categories, although they seemed less certain about the biological status of plants. Furthermore, the type of exemplar on which the children had been taught influenced their responses. However, the children's reasoning appeared unaffected by their health status and largely unaffected by age or gender. Copyright © 2004 John Wiley & Sons, Ltd.     

Cognitions associated with recovery from alcohol dependence1

The present study examined the cognitive factors uniquely associated with the status of alcohol dependence recovery, assessing Korean patients who were recovered (n = 57), having been alcohol‐abstinent for 4 months or more after treatment, and who were nonrecovered (n = 213), being still in treatment. Compared with the nonrecovered group, the recovered group reported lower levels of denial of drinking problems and rationalization of drinking (two dimensions of specific beliefs that facilitate alcohol use), dysfunctional attitudes, depressed mood, and emotion‐focused coping. The recovered group also showed higher levels of alcohol abstinence self‐efficacy and problem‐focused coping. Both denial and alcohol abstinence self‐efficacy were uniquely associated with alcohol dependence recovery, when we controlled for the other relevant predictors, whereas neither dysfunctional attitudes nor rationalization were so associated. These findings could be useful in refining psychological interventions facilitating the recovery of alcohol‐dependent patients.     

抢救一例Rh阴性稀有血型危重孕妇的体会与思考

Rh阴性稀有血型危重患者的临床救治相当棘手。本文通过回顾对一名Rh阴性血型危重孕妇的临床救治经过,探讨了应急情况下Rh阴性血型危重患者的临床救治策略和采供血应急措施,建议我国尽快建立稀有血型血库和制定相关法律法规,为应急情况下抢救Rh阴性血型患者提供依据和保障。     

躯体化的心身交互机制及其中的文化因素

基于神经生物学的心身交互作用是当前躯体化病理机制的一个研究重点。在生理-心理的功能连续体中, 认知学习、感觉监控、注意、记忆过程等都会影响躯体症状的呈现。文化则会通过这些过程塑造个体对症状的归因和解释, 引发躯体症状的呈现和扩大, 最终通过不同文化特有的民族生理学模式形成具有文化特异性的疑病焦虑和医学无法解释症状。     

A Randomized Trial of a Mental Health Consumer-Managed Alternative to Civil Commitment for Acute Psychiatric Crisis

This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n = 393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, self-esteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewer-rated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment.     

Coping self-efficacy mediates the effects of negative cognitions on posttraumatic distress

Although cognitive distortions have predicted posttraumatic distress after various types of traumatic events, the mechanisms through which cognitive distortions influence posttraumatic distress remain unclear. We hypothesized that coping self-efficacy, the belief in one's own ability to manage posttraumatic recovery demands, would operate as a mediator between negative cognitions (about self, about the world, and self-blame beliefs) and posttraumatic distress. In the cross-sectional Study 1, data collected among 66 adult female victims of child sexual abuse indicated that coping self-efficacy mediated the effects of negative cognitions about self and about the world on posttraumatic distress. The same pattern of results was found in a longitudinal Study 2, conducted among 70 survivors of motor vehicle accidents. Coping self-efficacy measured at 1 month after the trauma mediated the effects of 7-day negative cognitions about self and about the world on 3-month posttraumatic distress. In both studies self-blame was not related to posttraumatic distress and the effect of self-blame on posttraumatic distress was not mediated by coping self-efficacy. The results provide insight into a mechanism through which negative cognitions may affect posttraumatic distress and highlight the potential importance of interventions aimed at enhancing coping self-efficacy beliefs.     

Integrating Social Information Processing and Attachment Style Research with Cognitive-behavioral Couple Therapy

The majority of the empirically validated interventions for relational distress focus primarily upon improving behavioral functioning, particularly couples’ communication patterns in conflict situations. However, although communication is highly predictive of relationship distress and later divorce, research on the effectiveness of premarital and marital interventions based on communication training has shown limited results. Therefore, although the skills-based approaches can be effective in treating relational discord and instability, they also often neglect another potentially powerful mechanism in the development of relational distress: the social cognitions and/or schemata regarding relationships that individuals carry into their marriages that stem from negative attachment experiences. Thus, this article describes how blending information gleaned from attachment style research with the body of literature addressing social information processing can enhance current methods for the treatment of relational discord. The existing research on adult romantic attachment styles is placed within a social-cognitive information processing framework and a case study demonstrating the utility of this approach with difficult couples is described.     

精神疾病患者遭受社会歧视的现状及其原因与对策分析

社会对精神疾病患者的歧视由来已久,这种歧视广泛存在于不同的阶层与民族当中,且各有其特点。其对精神病患者及其家属带来的负面影响是显而易见而且是深刻的,这种影响涉及到了患者生活的各个方面。本文对各种歧视的特点及其深层次原因进行了初步分析和探讨,并对如何减少这种歧视进行了探讨。     

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.