Therapists’ perspectives about working with meaning in life in psychotherapy: A survey

Of 212 practicing therapists who completed a survey about working with meaning in life (MIL) in psychotherapy, 129 (61%) had recently worked with MIL with at least one client and reported on their work with a client in this survey. Those therapists who had worked with a client on MIL as compared with those who had not were older, more experienced, more humanistic/existential/experiential in orientation; reported more MIL training; and felt more competent working with MIL. Clients reported on primarily had internalizing, interpersonal, and career issues. Only 12% of clients explicitly labeled MIL as an issue coming into therapy. The three most frequently used interventions involved offering support; helping clients examine thoughts, feelings, and behaviors to discover hopes and goals; and facilitating exploration of MIL cognitions and experiences. Therapists reported many positive consequences from working with MIL. Therapists reported minimal training in MIL and moderate competence in working with MIL. Implications for practice, training, and research are presented.     

心理治疗的会谈间体验对治疗效果的影响——来自追踪研究的证据

采用多层线性分析方法,在短程心理咨询的连续会谈中检验来访者的会谈间体验对咨询效果的影响。以36名个案、151次会谈为样本,结果发现,来访者的症状总体呈线性下降趋势;不同来访者症状变化的速率存在个体差异,会谈间体验的情绪因子能解释症状变化速率总变异的40.79%。结论：在短程心理咨询中,来访者想起咨询会谈或/和咨询师时的情绪体验能显著预测咨询效果。     

Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome

Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on fatigue related measurements, physical impairment, depression, somatic and psychological attributions, somatic focus, and sense of control over symptoms. Pre-treatment physical activity level was measured with an actometer. At baseline, post-treatment and 6-month follow-up individual strength, subjective fatigue and physical impairment, were reassessed. Large effect sizes were found on subjective fatigue (1.2 post-treatment; 1.2 follow-up) and physical impairment (−.9 post-treatment; −.9 follow-up), Clinically significant improvement was found in 33.8% of the participants at post-treatment and 30.6% at follow-up. Individual strength at post-treatment was predicted by level of physical activity before treatment, and by sense of control over symptoms and physical activity at follow-up. Clinically significant improvement in subjective fatigue was predicted by not receiving a disablement insurance benefit, shorter duration of fatigue, higher sense of control over symptoms and, at follow-up by more pre-treatment physical activity. In conclusion, the intervention was effective for CFS patients. Cognitive behavioural factors that perpetuate fatigue symptoms are also predictors of treatment outcome.     

The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder

Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioral therapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment.     

环境损益的社会折扣:利他人格的影响

他人与自我之间的社会距离越远,则他人的获益或损失带给自我的效用就越小,此现象被称为社会折扣。虽然有一些研究探讨了金钱结果的社会折扣现象,但作为公共品的环境结果的社会折扣规律及其影响因素并未得到应有的研究。本研究以优劣空气天数为例,采用选择滴定程序,在损益两种情境下探索环境结果的社会折扣现象,并考察利他人格对社会折扣的影响。结果发现:(1)相比双曲模型,指数模型在损益两种情境下皆能更佳地拟合环境结果的社会折扣函数;(2)损益情境与社会距离的交互作用影响环境结果的社会折扣程度,损失情境下的社会折扣程度随社会距离的增加而变大的幅度大于收益情境;(3)利他人格在社会距离对社会折扣的影响中起调节作用。相比高利他人格者,低利他人格者的社会折扣受社会距离的影响较大。本研究对理解环境结果社会折扣和环保决策行为具有重要意义。     

“金钱-环境”复合收益的风险决策:价值取向的影响

现实中的环境决策,往往要在多个由"金钱-环境"复合而成的结果间做选择。人们如何对异质复合结果进行评估与选择,是决策研究面临的新课题。本研究着重考察个体金钱取向和环境取向的相对强度对复合收益风险决策的影响。结果表明,无论是采用自陈量表(实验1)或内隐联想测验(实验2)来测量价值取向,还是采用混词造句任务(实验3)来启动价值取向,均发现价值取向相对强度对复合风险决策有显著影响。(1)相比于金钱取向占优的个体,环境取向占优的个体在进行复合风险决策时更偏好环境风险较小的复合选项;(2)在复合选项等价匹配任务中,环境取向占优的个体会赋予复合选项中的环境收益以更高权重,倾向于用更多的金钱收益来弥补环境收益的风险折扣;(3)在复合收益风险概率匹配任务中,环境取向占优的个体更倾向于为获取倍增的环境收益而承担更大的复合收益风险。作为对复合结果风险决策的首次探索,本研究初步回答了不同价值取向的个体在金钱-环境复合风险决策中更倾向于规避什么风险、拿什么冒险以及为什么冒险等问题,为今后进一步开展复合决策研究打下了理论和方法基础。     

Peer and cyber aggression in secondary school students: the role of moral disengagement,hostile attribution bias,and outcome expectancies

This study investigated the relationship between cognitive mechanisms, applied by people to rationalize and justify harmful acts, and engagement in traditional peer and cyber aggression among school children. We examined the contribution of moral disengagement (MD), hostile attribution bias, and outcome expectancies, and we further explored the individual contribution of each MD mechanism. Our aim was to identify shared and unique cognitive factors of the two forms of aggression. Three hundred and thirty‐nine secondary school children completed self‐report measures that assessed MD, hostile attribution bias, outcome expectancies, and their roles and involvement in traditional and cyber aggression. We found that the MD total score positively related to both forms of peer‐directed aggression. Furthermore, traditional peer aggression positively related to children's moral justification, euphemistic language, displacement of responsibility and outcome expectancies, and negatively associated with hostile attribution bias. Moral justification also related positively to cyber aggression. Cyber aggression and cyber victimization were associated with high levels of traditional peer aggression and victimization, respectively. The results suggest that MD is a common feature of both traditional and cyber peer aggression, but it seems that traditional forms of aggression demand a higher level of rationalization or justification. Moreover, the data suggest that the expectation of positive outcomes from harmful behavior facilitates engagement in traditional peer aggression. The differential contribution of specific cognitive mechanisms indicates the need for future research to elaborate on the current findings, in order to advance theory and inform existing and future school interventions tackling aggression and bullying. Aggr. Behav. 36:81–94, 2010. © 2009 Wiley‐Liss, Inc.     

妊娠合并卵巢良性肿瘤的治疗进展

卵巢肿瘤是妊娠期较常见的并发症之一,以良性多见,其并发症发生率高于非妊娠期,孕妇常因并发症引起急腹症就诊,甚至危及母儿的生命,其治疗方式和处理时机与非妊娠期卵巢良性肿瘤明显不同。     

异位妊娠诊治的临床思考

异位妊娠是妇产科常见急症之一,也是目前早期妊娠妇女死亡的首要原因。其检查方法多种,治疗也趋于多样化。在异位妊娠的诊治中,我们应从整体上认识了解患者,掌握疾病的发展变化,作出最佳的诊治方案,并随时根据病情发展变化,对诊治方案做出相应的合理的改变。