Sabina Spielrein's Siegfried and other myths: facts versus fictions

Sabina Spielrein's life events became known to posterity through a private correspondence with Freud and Jung, and through her diaries. Based on a misinterpretation of the documents, a myth, a fiction, was created about an alleged sexual affair with Jung and a case of misconduct during treatment. Another myth was that her relationship with Jung was a cause of the historic break-up between Freud and Jung. The biographical facts described by the author in a number of publications show that her treatment ended when she left the hospital to become Jung's student in the medical school, a situation with its own ethical rules. Furthermore, the alleged “scandal” was no public matter: it turned out to be no more than a personal quarrel. Before, during, and after that turbulent episode, Spielrein and Jung maintained a long and tender friendship and correspondence that included sharing creative ideas that enriched psychoanalysis. In these exchanges, a special role was played by the myth of Siegfried and other themes in Wagner's operas.     

Associations of spontaneous self-affirmation with health care experiences and health information seeking in a national survey of US adults

Objective: Self-affirming – such as by reflecting on one’s strengths and values – reduces defensiveness to threatening information, reduces negative effects of stereotype threat and promotes prosociality. These outcomes may promote physical health, highlighting a need to examine the role of self-affirmation in medical and health contexts.

Design: Data were collected as part of the nationally representative, cross-sectional, 2013 Health Information National Trends Survey. Items were completed by 2731 respondents.

Main Outcome Measures: Respondents answered questions about spontaneous self-affirmation tendencies, perceptions of providers and health care, involvement in medical appointments, health information seeking and engagement in medical research.

Results: Spontaneous self-affirmation was associated with more positive perceptions of communication with one’s provider, better perceived quality of care, greater likelihood of asking questions in a medical appointment, greater information seeking for oneself and multiple indices of surrogate information seeking (i.e. seeking information for others). Four of eight significant associations remained significant when controlling for optimism. The associations of self-affirmation with aspects of the patient–provider relationship were not modified by factors likely to be associated with stereotype threat (e.g. race or BMI).

Conclusion: Spontaneous self-affirmation was related to positive outcomes in health contexts. Experimental research is needed to further explore the causal nature of these associations.     

右侧基底节损伤遗忘症患者的知觉性启动效应与语义性启动效应的分离与定位

采用偏好、自由联想、字根补笔和字辨认等4项任务观察一例单纯性右侧基底节损伤遗忘症患者和两组正常对照的启动效应。结果发现：（1）该患者知觉性启动效应障碍,而语义性启动效应正常。认为知觉性启动效应的神经学基础可能在基底节。（2）该患者知觉性启动效应与语义性启动效应分离。认为神经组织的损伤可导致不同形式启动效应的分离,提出内隐记忆或启动效应的不同形式可能存在不同的神经学基础。     

Multidimensional Assessment of Chronic Low Back Pain: Predicting Treatment Outcomes

This study explored responses of chronic low back pain patients to treatment for different types of patients (dysfunctional, interpersonally distressed, and minimizer/adaptive coper), as classified using the Multidimensional Pain Inventory (MPI). In addition, changes in MPI scores during treatment were examined separately for each patient type. Finally, this study explored the relationships between changes in MPI scores and physical improvement. Between-group differences in improvement were significant, with dysfunctional patients showing the most improvement on several scales. MPI scales that best predicted physical improvement differed according to patient type. Implications for treatment of low back pain patients are suggested, based upon differential reactions to treatment and different predictors of physical improvement for each patient group.     

Emerging quality improvement measures in genetic counseling

The need to establish guidelines for total quality management in genetic counseling is now recognized as new genetic technologies are being introduced into genetics services and primary care. Genetic counselors have an important role in developing methods for assuring quality in the genetic counseling process. Emerging quality improvement measures as well as selected examples from the Quality Assurance Program in the Genetics Services Division at the Foundation for Blood Research are presented as examples of direct genetic counselor involvement. Suggestions for future directions of quality improvement activities for genetic counselors are discussed.     

Clinical Frequencies Recording System: Standardizing staff observations by event recording

Certain aspects of staff performance and resident behavior are less adequately assessed by standardized time sampling procedures than by complete recording of the incidence of specified events. An approach to gathering such data through systematizing the observations of clinical staff — the Clinical Frequencies Recording System — is described. Scores from the Clinical Frequencies System reflect the rate per opportunity with which individual behaviors are performed, with computer summarization providing higher-level behavioral indexes for research and evaluation purposes. Staff training and system implementation are discussed, and reliability and validity data from a system employed on two different treatment units over a period of several years are presented.The research reported in this article was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

Comment on “The Angry Patient”

This article formulates the main problem of the angry patient treated by Dr. Curtis as one of poor ego functioning. This is possibly of neuropsychological origin. Treatment would be training to strengthen ego functions and the patient–therapist relationship would be task oriented. The anger is not dealt with directly except as it interferes with the training. It is predicted that as the ego becomes stronger, the anger will become more controllable. There is some question of whether this patient would be able to cooperate with such a program.     

Duty to Re-Contact: A Study of Families at Risk for Fragile X

DNA testing for Fragile X syndrome is now routinely available through a large number of diagnostic laboratories. We have surveyed individuals from British Columbia Fragile X families identified prior to the availability of DNA testing for FMR1 to determine if they are subsequently receiving information about DNA testing. Of the 78 individuals first seen before the cloning of the FMR1 gene, 39 (50%) had not been seen in the clinic to discuss DNA testing. We initiated a contact program with these 39 patients to determine their interest in DNA testing. Contact was made with 28 individuals, 20 of whom stated interest in testing either for themselves or for a relative. Patient opinions about DNA testing were assessed through questionnaires. In those individuals who stated an interest in DNA testing, the most common reason for wishing testing was to provide information to children or grandchildren. The most common disadvantages of testing indicated by this group were that they had finished their families and that they felt the test would not have a direct impact. The most common reasons individuals were not interested in DNA testing were that there were no family members appropriate to test and that the respondent had completed his or her family. DNA testing has been performed for 13 of the 28 (46%) contacted individuals and/or at least one relative. In view of the high level of interest for testing in families who had not been seen since the cloning of the FMR1 gene, we feel that FMR1 screening programs should include actively contacting previously seen individuals.     

Aggressive encounters between patients and general hospital staff: Staff perceptions of the context and assailants' levels of cognitive processing

A considerable body of research has accumulated regarding aggression toward health care staff, yet little is known about the contextual factors involved. The present study examined the context within which aggressive incidents occurred and the dynamics of the interaction between staff and patients. Two aspects in particular were investigated; firstly, whether incidents were preceded by some anxiety provoking stimulus and secondly, the assailants' levels of cognitive processing apparent at the time of the incident. A prospective study collected data concerning incidents of physical assault and threatening behaviour in a general hospital. Staff were interviewed soon after the incident occurred. A content analysis determined that 82.8% of incidents involved experiences delivered by the staff victims likely to have provoked anxiety in the assailant. Most commonly, incidents involved staff intervening in the patient's intended behaviour. In addition, in 64% of cases, assailants were actually displaying some impairment in cognitive processing at the time of the incident Data suggest that many patients may not have been fully aware of their situation and might have experienced some difficulty in comprehending the staff member's actions. Patients who do not appear to understand what is happening may require additional time and effort to ensure they comprehend fully and accept what the staff member is intending to do, particularly if patients are experiencing an event likely to increase anxiety levels. Aggr. Behav. 30:534–543, 2004. © 2004 Wiley‐Liss, Inc.     

德与法有机结合--论和谐医患关系之建设

建设和谐的医患关系有赖于道德与法律的有机结合.既要发挥道德在法治建设中的作用,又要发挥法律在道德建设中的作用.在和谐的医患关系的建设中,道德与法律相互作用,但道德是统帅.