How does mindfulness-based cognitive therapy work?

Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression ( [Kuyken et?al., 2008], [Ma and Teasdale, 2004] and [Teasdale et?al., 2000]). To date, no compelling research addresses MBCT’s mechanisms of change. This study determines whether MBCT’s treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with ≥3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction.MBCT’s effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group.MBCT’s treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.     

案例概念化在临床上的应用

随着心理治疗方法的发展, 案例概念化作为治疗工作的重要组成部分, 日益成为临床关注的热点。案例概念化主要指在一定治疗理论的基础上, 就来访者的问题成因和维持因素提出假设, 为构建治疗方案提供指导蓝图。西方的临床研究表明案例概念化能有效地促进咨询师和来访者对于问题的认识和理解, 提高治疗效果。以认知行为治疗理论为基础, 具体地介绍案例概念化技术在焦虑症和抑郁症的临床应用。     

Family therapists in trauma-response teams: bringing systems thinking into interdisciplinary fieldwork

Attention to the mental health facets of disaster-preparedness and trauma-response teams has increased considerably over the past decade. As family therapists take part in these efforts, they bring with them a worldview that adds valuable contributions to the nature in which fieldwork is conducted and the manners in which interdisciplinary teams function on the ground. In this article, we present how systems thinking sensitizes trauma workers to a variety of clinical presentations and biopsychosocial complexities inherent in this work. We describe common clinical- and practice-related challenges, alongside practical strategies for effectively dealing with these challenges. We draw upon our experiences as family therapists trained in the field of trauma, and our work as field responders, supervisors and team leaders across a variety of local and large-scale disaster events and contexts.     

子宫内膜异位症引起的盆腔疼痛的诊断和治疗

子宫内膜异位症(endometriosis,EMT)是妇科最常见的疾病之一,且发病率呈逐年上升趋势,盆腔疼痛是它常见的症状之一,其发病机制尚未明确,易复发,成为妇科研究的热点和难点。随着对EMT引起盆腔疼痛的发病机理的不断认识,其诊治也相应得到完善和发展。本文从哲学的角度以认识和实践等观点对EMT引起盆腔疼痛的诊断和治疗进展进行综述,以助于临床诊治。     

生长激素对心血管系统的影响

生长激素（GH）是出生后主要刺激生长的激素,GH相当高比例的促生长作用是由胰岛素样生长因子-I（IGF—I）介导完成的。不同的代谢功能如碳水化合物和脂类代谢也受GH的直接影响。GH还对心血管及大脑有影响,本文拟对其分泌机制及作用和对心血管及大脑的影响作一综述。     

急性肾损伤肾脏替代治疗模式的临床决策

急性肾损伤是指病程3个月内的,包括血、尿、组织学及影像学检查所见的肾脏结构与功能异常。目前,急性肾损伤肾脏替代治疗的模式尚无明确定论。常用的模式有间断性血液透析、持续性肾脏替代治疗、杂合式肾脏替代治疗、腹膜透析。临床上应根据患者的年龄、病因、病情危重程度、所在医院的条件和经济状况等选择合适的治疗模式。     

A “RESOLUTE” LATER WITTGENSTEIN?

Abstract: “Resolute readings” initially started life as a radical new approach to Wittgenstein's early philosophy, but are now starting to take root as a way of interpreting the later writings as well—a trend exemplified by Stephen Mulhall's Wittgenstein's Private Language (2007) as well as by Phil Hutchinson's “What's the Point of Elucidation?” (2007) and Rom Harré's “Grammatical Therapy and the Third Wittgenstein” (2008). The present article shows that there are neither good philosophical nor compelling exegetical grounds for accepting a resolute reading of the later Wittgenstein's work. It is possible to make sense of Wittgenstein's philosophical method without either ascribing to him an incoherent conception of “substantial nonsense” or espousing the resolute readers' preferred option of nonsense austerity. If the interpretation here is correct, it allows us to recognize Wittgenstein's radical break with the philosophical tradition without having to characterize his achievements in purely therapeutic fashion.     

家庭治疗在我国临床实践中的应用

家庭治疗作为心理治疗领域的“第四势力”,将个体置于关系之中去考察其心理问题,通过改变家庭成员围绕症状所表现出来的交往方式,从而达到治疗症状的治疗方法。该疗法的研究与实践很快渗透到心身疾病,成瘾、抑郁、强迫、精神分裂症等许多领域,在临床实践中得到广泛的使用并取得了较好的效果。     

肿瘤内科治疗的疗效评价

肿瘤内科治疗是肿瘤综合治疗三大手段之一,在肿瘤治疗中占有举足轻重的地位。肿瘤内科治疗的疗效评价也逐步发展和完善。新的疗效评价指标逐渐被接受,延长生存期和提高肿瘤病人的生存质量已成为肿瘤内科治疗疗效评价的原则,临床肿瘤学工作者应转变观念,以利于更好地开展临床工作。     

Case Report—Loyalty, Legacy, and Ledger: Contextual Therapy in a Patient with a Family History of Ovarian Cancer

A client's emotional experiences and reactions to those experiences are influenced by his/her family of origin and direct or indirect interactions with various family members. Contextual therapists propose that a client's satisfaction with a relationship depends on the equity of his/her emotional interactions with family members. When relationships are inequitable, trust between individuals disintegrates. In order to reestablish trust in a relationship, a balance of interests must be restored. If not, imbalances may be passed down to future generations. A case of a woman with a family history of ovarian cancer is reviewed with the principles of contextual therapy in mind. In her family, several legacies have resulted in unbalanced relationships between family members that lead to difficulty in establishing trust within the genetic counseling session.