Conducting Prolonged Exposure for PTSD During the COVID-19 Pandemic: Considerations for Treatment

The unprecedented effects and duration of the COVID-19 crisis are likely to elevate the population’s level of anxiety due to psychological stress, economic hardship, and social isolation. This effect may be especially potent for individuals with preexisting mental health conditions, such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) therapy is a highly effective treatment for PTSD across trauma-exposed populations, and has been implemented effectively via telehealth. Nevertheless, PE implementation via telehealth may require specific adaptations during the COVID-19 crisis due to public health mandates calling for sheltering in place and physical distancing. This paper discusses strategies for implementing PE for PTSD during the COVID-19 pandemic, which may also be applied to other situations in which physical distancing must be considered.     

即刻消退缺损的原因分析及其神经生物学机制

即刻消退缺损(immediate extinction deficit, IED)是指在条件性恐惧习得后, 立即进行的消退训练不能长期抑制恐惧记忆的现象。IED可能与消退起始时的应激水平和事件分割等因素有关。在高应激水平下, 消退记忆的巩固受损导致IED; 而在中等或较低的应激水平条件下, 即刻消退有效但效果可能容易受事件分割的影响。IED的神经生物学机制涉及应激激活蓝斑去甲肾上腺素能系统, 去甲肾上腺素引起杏仁核基底外侧核(basolateral amygdala, BLA)过度兴奋, 然后BLA通过投射突触抑制在恐惧消退中起核心作用的内侧前额叶神经元的活动。未来研究应注意即刻消退缺损引起的长期后果, 并深入探讨如何优化即刻消退在临床上的应用。     

辩证行为疗法：理论背景、治疗效果及作用机制

辨证行为疗法（Dialectical Behavior Therapy, DBT）于20世纪90年代初由美国治疗师Linehan创立。作为第三代行为治疗之一,该疗法以行为主义理论、辩证哲学、生物社会理论及禅宗为哲学基础,通过增加患者的技能使用,提高其情绪调节能力,以达到治疗目的。临床研究已证明其在边缘人格障碍,自杀及自伤行为中具有良好的治疗效果,除此之外也广泛适用于其他心理障碍及群体。DBT的临床效果、改变机制及拓展应用都需进一步研究。     

青少年创伤后应激障碍症状与网络成瘾症状的关系：惩罚敏感性和孤独感的中介及性别的调节

汶川地震9.5年后,对汶川县和都江堰市767名中学生进行调查,考察惩罚敏感性和孤独感在创伤后应激障碍症状和网络成瘾症状之间的多重中介作用及性别差异。结果发现：（1）PTSD症状正向预测网络成瘾症状,并分别通过惩罚敏感性、孤独感的单独中介作用及两者的链式中介作用显著预测网络成瘾症状;（2）女性的PTSD症状显著正向预测网络成瘾症状,并分别通过惩罚敏感性和孤独感间接影响网络成瘾症状;男性的网络成瘾症状仅被PTSD症状正向预测。     

四周简易正念减压训练对初中生焦虑的影响

选取68名初一学生并以班级为单位分为四周正念减压(mindfulness-based stress reduction,MBSR)训练组和对照组,探讨四周MBSR对初中生焦虑和正念水平的影响,以及训练效果是否存在基线效应与性别差异。结果发现:(1)四周MBSR可以提高初中生的正念水平,缓解其焦虑情况;(2)“不判断”和“特质焦虑”基线水平影响正念训练的效果;(3)四周MBSR对初中生的训练效果不存在性别差异。     

Coping strategies in obsessive-compulsive patients during Covid-19 lockdown

Background/ObjectiveThe main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.     

Pregrouping aggression and defense scores influences alcohol consumption for dominant and subordinate rats in visible burrow systems

Five male/two female rat colonies were established in visible burrow systems, with males selected for pregrouping attack scores and also evaluated in open field and cat odor tests. Dominant-subordinate pregrouping attack differences suggested that the males becoming dominant are those showing more persistent and higher level attack. For six colonies showing dominant-subordinate behavioral differences, pregrouping defense tests failed to predict subordinate status. However, pregrouping defense scores were reliably correlated with subordinate pre-postgrouping change scores for voluntary ethanol consumption. Subordinates showed higher ranked ethanol consumption than dominants, but these groups were not different on pregrouping ethanol consumption. Subordinate postgrouping ethanol consumption was positively correlated with pregrouping attack toward an adult intruder, consonant with previous findings that highly aggressive subordinates are the targets of more intense attack by dominants. These results provide further support for a view that subordination stress increases voluntary ethanol consumption in male rats and suggest some additional individual differences factors that may be involved in increased ethanol consumption for male subordinates. © 1992 Wiley-Liss, Inc.