The significance of prognosis for a theory of medical practice

A typical problem of modern medicine results from the gap between scientific knowledge and its application in individual cases. Whereas scientific knowledge is generalized and impersonal information, medical practice takes place under conditions which are singular, individual and irreversible. The paper examines whether prognosis is able to bridge this gap or hiatus theoreticus. It is shown that diagnosis of a single case always relies on prognostic considerations. The individual prognosis (as distinguished from the nosologic prognosis of a certain disease) enables doctors to apply scientific knowledge and practice according to the actual situation, the history and personal preferences of the patient. Prognosis – not diagnosis – therefore legitimizes medical interference. A methodology of individual prognosis as the basis for a theory of practice is discussed.     

Huntington disease: A case study describing the complexities and nuances of predictive testing of monozygotic twins

When a candidate for predictive testing for the Huntington disease gene is a monozygotic twin, confidentiality of the co-twin's diagnosis and autonomy of participation are among the critical genetic counseling issues. Predictive testing can proceed when twins voluntarily and simultaneously request counseling and evaluation in an HD testing program. This case describes a young man referred for predictive testing to an HD testing site on the East Coast of the United States. Family history revealed a twin brother of unknown zygosity who resided on the West Coast of the United States. The genetic counselors on opposite coasts collaborated to provide genetic counseling and evaluation for voluntary, informed predictive testing of the twins, protecting their rights while observing national protocol guidelines.     

施动感研究的意向捆绑范式述评

施动感是自我意识的一个重要部分。意向捆绑即人的动作及动作的感觉结果两者的时间点主观上被感知为相互靠近的现象,为研究人类的施动感提供了一个重要的测量手段。本文综述意向捆绑的实验范式和认知机制,发现目前线索整合理论能最好的解释意向捆绑现象。意向捆绑的范式可以用于临床疾病和跨文化的研究。今后还应深入研究意向捆绑机制及意向捆绑与施动感的关系。     

人事选拔方法-Biodata测量研究综述

对近年来国外关于传记式资料(Biodata)测量,特别是传记式问卷(Biodata Inventory)的研究进行系统的分析介绍。首先,文章探讨了传记式问卷的主要理论基础和维度结构;其次,介绍传记式问卷的预测效度;最后,文章对传记式问卷测量的实施问题以及未来研究趋势进行了探讨。     

Neuropsychological predictors of conversion to probable Alzheimer disease in elderly with mild cognitive impairment

In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut‐off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables – sex, age, schooling – and others, such as follow‐up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3‐year follow‐up period. For the present study, the data were analysed at baseline. During the follow‐up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor.     

Cognitive content-specificity in future expectancies: role of hopelessness and intolerance of uncertainty in depression and GAD symptoms

The present study examined cognitive content-specificity in future-event predictions associated with symptoms of depression and generalized anxiety disorder (GAD). College undergraduates (N=284) completed measures of depression, GAD, and rated their certainty that a given set of positive and negative outcomes were or were not likely to happen in their future. Participants also completed measures of hopelessness and intolerance of uncertainty (IU). Individuals (N=263) completed the same measures again 6 weeks later. Certainty in an absence of positive future outcomes was associated with symptoms of depression but not GAD, and hopelessness mediated this relationship - concurrently and when examining change scores over 6 weeks. Certainty in negative outcomes was concurrently associated with both symptoms of depression and GAD, and hopelessness partially mediated these relationships. IU predicted concurrent increases in depression and GAD symptoms, and negative-outcome certainty partially mediated the IU-depression but not the IU-GAD symptom relationship. Change in certainty did not mediate the relationship between changes in IU and GAD symptoms but partially mediated the relationship between change in IU and depression symptoms over time. Hopelessness appears to play a unique role in the relationship between reduced anticipation of positive future outcomes and depression. Although less clearly suggested by the data, IU may contribute to both depression and GAD symptoms but may do so through different pathways.     

树鼩的社会挫败抑郁模型

创制理想的动物模型是突破抑郁症研究的技术难点之一。来自进化研究的证据提示, 树鼩属灵长类近缘的一种小型动物, 具有较为发达的神经系统和与人类相似的应激系统, 因而可能成为创制精神疾病行为模型的较佳选择。已有的研究表明, 树鼩社会挫败模型可能具有比啮齿类更好的表面效度、预测效度及结构效度。由于树鼩与人类的近缘关系, 对其抑郁行为的脑机制研究或药物评价可能更具潜在价值。但是, 该模型仍有待进一步利用、拓展和完善。     

视角对高频汉字识别的影响

用EyeLinkII型眼动仪为实验设备 ,以汉字与双眼形成的视角为自变量 ,研究了视角对高频汉字识别的影响特点。本实验中的视角分为 7个水平 :2°、4°、7°、1 0°、1 3°、1 6°、1 9° ,通过自编程序 ,计算出固定距离条件中不同视角下汉字的大小 ,呈现在计算机屏幕上 ,要求被试发声识别汉字。通过对反应时、注视时间、注视次数、眼跳时间、眼跳次数、眨眼时间、眨眼次数的分析。结果发现 :不同视角条件下的反应时总体差异不显著 ,反应时随视角的变化曲线为抛物线 ,开口向上 ;汉字识别的最适宜视角为 1 0°～ 1 1°。