高血压从肺论治机理探讨

通过分析肺在高血压现代医学病理机制及治疗中的地位,肺的中医生理特性与高血压的关系,中医脏腑相关性所提示的肺在高血压病机中的作用以及临床和药物应用例证等四个方面探讨了高血压从肺论治机理,为临床治疗提供思路和方法。     

获得性阅读障碍的“主要系统”假说

认知神经心理学为阅读机制的探讨提供了大量的证据,认为不同阅读障碍是不同加工通道选择性受损的结果。近年来,基于联结主义的三角模型理论,研究者提出了主要系统假说（primary system hypothesis）,认为阅读障碍是主要的认知系统（如视觉、语义和语音系统）受损导致的：表层障碍是因为语义系统受损导致的阅读困难,语音和深层障碍是语音和语义系统同时受损时综合症状的连续体。该理论认为各主要系统可能同时是多个认知活动的加工成分,一个系统的受损会影响所有与之相关的认知过程,从而把阅读障碍与其它认知功能障碍联系起来。统一的主要系统受损下对各种获得性阅读障碍形成机制在文中得到详细的解释     

小学儿童羞耻情绪理解能力的发展

先通过收集和验证羞耻情境故事和情绪词来编制考察小学儿童羞耻情绪理解能力的测量材料,然后对300名1-6年级小学儿童的羞耻情绪理解能力的发展特点进行测查。结果表明：（1）小学儿童的羞耻情绪理解能力随年级增长而发展,并且在2-3年级有一个快速发展阶段。（2）4种羞耻情境中,小学儿童在公德情境中的羞耻情绪理解能力最高,其次是当众出丑情境和欺骗情境,最低是学习情境。（3）小学儿童的羞耻情绪理解能力无显著性别差异;4种羞耻情境中,只有在公德情境中的羞耻情绪理解能力有显著性别差异,即男生高于女生。     

Patients taking the lead. A naturalistic investigation of a patient led approach to treatment in primary care

In an earlier paper (Carey, T. A. (2005). Can patients specify treatment parameters? A preliminary investigation. Clinical Psychology and Psychotherapy, 12, 326–335) an approach to treatment delivery was examined in which the duration and frequency of the appointments was scheduled by patients. Results of this approach were encouraging but the generalizability of the results was constrained because only one clinician trialed the approach and no standardized assessment measures were used. In the present study there are two clinicians involved and the Depression Anxiety Stress Scale (DASS) was used. The approach was introduced at one GP practice and monitored over a six-month period. Results suggest that this approach might be an effective way of promoting patient access to, and involvement in, service delivery as well as reducing waiting times.     

小学教师课堂信息加工能力的研究

研究采用小学语文和数学教学录像为实验材料,以98名小学语文数学教师、其他学科教师和非教师为研究对象,运用反应时测量法探讨小学教师加工不同类型课堂信息的速度和辨别能力。结果表明:有学科教学经验的教师(语文和数学教师)在重视学科教学内容的同时,也重视课堂教学活动的组织和课堂气氛的调节;学科知识、学科教学经验和课堂教学经验对教师的课堂信息加工能力和教学专长发展有显著的影响;研究结论对提高教师课堂教学能力、教学专长以及教师培训提供了有力的实验证据。     

中小学生的师生关系与其学校适应

采用问卷法,考察了小学五年级到初中三年级665名学生的师生关系及学校适应特点。结果表明,在师生关系的亲密性维度,初中三年级显著低于其他3个年级,而在冲突性维度则显著高于其他3个年级;在冲突性维度上,女生得分显著低于男生。师生关系可以归为3种类型:亲密型、一般型和冲突型。亲密型师生关系的学生在学校态度、学业行为和社会行为方面均显著好于一般型和冲突型师生关系的学生;师生关系对学校态度、学业行为和亲社会行为均有显著的预测作用;学校喜欢和回避对学业行为、退缩行为有显著的预测作用。     

不同问题情景对小学生运用乘法运算策略的影响

通过设置不同问题情景引导被试利用乘法运算定律解决数学问题,探讨不同问题情景对小学四、六年级学生运用乘法运算策略的影响。结果表明:(1)被试掌握交换律的情况均好于分配律;即使没有正式学过交换律,四年级被试使用交换律的成绩与六年级被试没有显著差异。(2)六年级被试在同形问题情景中利用分配律线索的成绩好于其它的问题情景,两个年级后进生同形问题的成绩均好于其它问题情景。总体而言,相对于面积问题情景和笛卡尔积问题情景,同形问题表征方式更有利于小学生利用乘法运算策略。     

基层医院医生常见的五种错误诊断思维

为了分析临床及X线诊断医师错误的临床诊断思维,探讨正确的临床诊断思维,以减少临床的误漏诊,通过具体分析基层临床医院医生与X线诊断医生五种错误的诊断思维及形成原因,结果显示,错误的诊断思维容易将肺癌误诊为结核,肺癌误诊为肺炎,肺炎消散期易误诊为结核,将结核渗出性病变误诊为肺炎。因此,科学的诊断思维是减少误漏诊的基础和关键。     

Supervision, transference and countertransference

The author discusses supervision, transference and countertransference as seen in the context of the clinical case of a patient who had been first seen as a training analysis case and who later, in a fortuitous way, was treated by the supervisor of the training analysis. The supervisor, who in the first instance did not recognize the patient, discusses the reasons for this unusual experience in terms of the presence and absence of transference during the analysis of this patient as a training case and the problems inherent in the task of supervising. The patient's feelings towards the first and the second analyst and the vicissitudes of transference and countertransference during the supervision of the training analysis and its influence on the presentation of the analytical sessions by the student are also detailed and discussed. The question of recorded supervision presentations and their possible influence on the dynamics of supervision is raised.     

Dreaming as a primordial state of the mind: The clinical relevance of structural faults in the body ego as revealed in dreaming1

Thetherapeuticactionofpsychoanalysis, attributedformanyyearstotheinterpretation of the repressed libido, has shifted its focus to object relationships. Some modern analysts maintain that the primary factor of psychic change is the new model of object relationship provided by analysis, and do not consider signifi cant the knowledge of episodes comprising implicit memories, whose irrecoverable nature is demonstrated by neuroscience. Nevertheless, the author proposes that the knowledge of specifi c archaic events, useless as their interpretation may be, offers a glimpse of the make‐up of the mind, contributing to the improvement of the empathy indispensable for inducing changes in the patient. Episodes linked to absolute narcissism, in the beginnings of the body ego, which do not appear either in associations or in transference, emerge in dreams. Neuroscience has made possible the understanding of aspects of dreaming capable of providing a glimpse of the genesis of the ego, whose development from the bodily phase of absolute narcissism to the psychic object phase can thus be traced. The unearthing of the genesis of primary structural faults in dreaming furnishes the analyst with an estimate of the possibilities for development of the ego, and this knowledge provides fi ne tuning capable of guiding the analyst's conduct. A clinical case illustrates how these phenomena occur, showing the intersubjective relationship as the silent primary generator of psychic changes, consolidated and developed secondarily by means of the analytical dialogue.