1型和2型糖尿病患者的心理疾患差异

对98例1型糖尿病和520例2型糖尿病进行心理分析。糖尿病合并抑郁症的患者比例较高,且1型和2型糖尿病在心理障碍上存有差异。抑郁症和糖尿病的相关性涉及各个方面,有必要进行研究以进一步阐明二者在流行病学、神经内分泌及神经化学等方面的相关性和机制。     

进食障碍发病机制的研究进展与思考

进食障碍是一组典型而严重的心身疾病。随着现代医学模式的转变,生物-心理-社会因素对进食障碍的影响日益受到关注。本文拟从生物学、心理学、社会学因素方面,综述近年来国内外对进食障碍发病机制的最新研究,并结合哲学相关理论对进食障碍发病机制的研究进行探讨分析。     

EVALUATING PROGRESS IN BEHAVIORAL PROGRAMS FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS VIA CONTINUOUS AND DISCONTINUOUS MEASUREMENT

We evaluated the influence of two different frequencies of data collection on skill acquisition and maintenance within behavioral treatment programs for children with autism spectrum disorders. Six children were taught multiple skills in up to four different behavioral programs. Half of the skills were measured continuously (i.e., trial by trial), and the other half were measured discontinuously (i.e., first trial only). When differences were detected, quicker acquisition was typically associated with discontinuous measurement, and stronger maintenance was typically associated with continuous measurement.     

FUNCTIONAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED INAPPROPRIATE MEALTIME BEHAVIOR

Functional analyses identified children whose inappropriate mealtime behavior was maintained by escape and adult attention. Function‐based extinction procedures were tested individually and in combination. Attention extinction alone did not result in decreases in inappropriate mealtime behavior or a significant increase in acceptance. By contrast, escape extinction alone resulted in a decrease in inappropriate mealtime behavior and an increase in acceptance. However, inappropriate mealtime behavior did not decrease to clinically acceptable levels. A combined extinction technique (i.e., escape and attention extinction) resulted in a decrease in inappropriate mealtime behavior to clinically acceptable levels and high and stable acceptance.     

Positive attributional style,life events and their effect on children's mood: Prospective study

The present study extended previous research into the role of cognitive style in predicting depressive symptoms in children by examining positive attributional style for positive events in a prospective manner, with a focus on the influence of prior life experience. A non‐clinical sample of 102 children (aged 10–12 years) was recruited. Participants completed self‐report measures of depression, attributional style, stressful life events, and positive life events on two occasions (approximately 6 months apart). Positive attributional style for positive events moderated the relationship between negative life events and follow‐up depressive symptoms. Number of positive events did not significantly moderate the negative life events–depression symptoms relationship although there was a trend in the expected direction. Positive attributional style for positive events appeared to act as both a mediator and moderator in the positive events–depression symptoms relationship. Theoretical and clinical implications of these findings are discussed.     

Still living in a war zone: Perceived health and wellbeing of partners of Vietnam veterans attending partners' support groups in New South Wales,Australia

Post‐traumatic stress disorder (PTSD) in veterans is well documented, less so the long‐term impact on the health of their partners and families. The perceived health and wellbeing of women partners of Australian Vietnam veterans who were members of partners of veterans support groups is reported. This qualitative study used data from 76 participants in 10 focus groups in metropolitan, regional, and rural and remote areas of New South Wales (NSW). The data were tape‐recorded, transcribed and thematically analysed using constant comparison methods. The impact of living with a partner with war‐related PTSD appears to be significant and ongoing with women drawing parallels to living in a war zone. The biggest negative impact was on their mental health. They felt burdened as carers and struggled to find explanations for their husbands' problems. Support groups were very helpful. There are implications for partners of veterans who have returned from active military duty and from peacekeeping in current conflicts.     

Selective attention and avoidance on a pictorial cueing task during stress in clinically anxious and depressed participants

Although it is well established that attentional biases exist in anxious populations, the specific components of visual orienting towards and away from emotional stimuli are not well delineated. The present study was designed to examine these processes. We used a modified spatial cueing task to assess the speed of engagement and disengagement from supraliminal and masked pictorial cues depicting threat, dysphoria, or neutral content in 36 clinically anxious, 41 depressed and 41 control participants. Participants were randomly assigned to a stress or neutral condition. During stress, anxious participants were slow to disengage from masked left hemifield pictures depicting threat or dysphoria, but were quick to disengage from supraliminal threat pictures. Information processing in anxious participants during stress was characterized by early selective attention of emotional stimuli, occurring prior to full conscious awareness, followed by effortful avoidance of threat. Depressed participants were distinct from the anxious group, displaying selective attention for stimuli depicting dysphoria, but not threat, during the neutral condition. In sum, attentional biases in clinical populations are associated with difficulties in the disengagement component of visual orienting. Further, a vigilant-avoidant pattern of attentional bias may represent a strategic attempt to compensate for the early activation of a fear response.     

Personality disorder cognitions in the eating disorders

The eating disorders are frequently found to be comorbid with Axis II cluster B and C personality disorders. It is important to identify the personality-level cognitions that typify these disorders. This study of a clinical group examines the personality disorder cognitions in the eating disorders. The cognitions that were most relevant to the eating disorder pathology were those relating to avoidant and obsessive-compulsive personality disorder. Other personality disorder cognitions were associated with comorbid psychopathology in largely clinically meaningful ways. These findings extend our understanding of the comorbidity of eating disorders and personality pathology, suggesting that some cases need to be assessed and formulated with such cognitions in mind. Treatment strategies are required that address both the eating and the personality pathology, while considering the impact of these cognitions on the therapeutic relationship.     

Changes in maternal expressed emotion toward clinically anxious children following cognitive behavioral therapy

The aim of this study was to determine whether maternal expressed emotion (criticism and emotional overinvolvement) decreased across treatment for childhood anxiety. Mothers of 48 clinically anxious children (aged 6-14 years) were rated on levels of criticism (CRIT) and emotional overinvolvement (EOI), as measured by a Five Minute Speech Sample (FMSS) from mothers, prior to and following cognitive behavioral therapy (CBT) for their children’s anxiety. Results showed a significant decrease in the proportion of mothers who expressed high levels of criticism and emotional overinvolvement from pretreatment to posttreatment. This finding suggests that interventions aimed at reducing symptoms of child anxiety can also result in a decrease of maternal expressed emotion (criticism and emotional overinvolvement).     

Predicting Treatment and Follow-up Attrition in Parent–Child Interaction Therapy

Predictors of attrition from individual parent–child interaction therapy were examined for 99 families of preschoolers with disruptive behavior disorders. Seventy-one percent of treatment dropouts were identified by lower SES, more maternal negative talk, and less maternal total praise at pretreatment. Following PCIT, families were randomly assigned to an Assessment-Only or Maintenance Treatment condition. Higher maternal distress predicted 63% of dropouts in the Assessment-Only condition. Lower maternal intellectual functioning predicted 83% of dropouts from Maintenance Treatment. Findings highlight a continuing need for evidence-based retention strategies at various phases of engagement in PCIT. This study was funded by the National Institute of Mental Health (RO1 MH60632). We thank the members of the UF Child Study Laboratory for their contributions to this study.