权力、知识和精神病学主题——福柯的视角

精神病学领域有关权力因素的讨论日渐增多,法国哲学家福柯对权力和知识的含义及其关系进行了讨论,同时也对当代精神病学领域的相关的主题,如精神疾病、精神病院、诊断、治疗等,提出了批判性的思考,指出了其中隐含的权力因素及其历史性、文化性构成,有助于我们重新理解精神病的主题,更加关注人文因素的强大作用     

非传统理念指导下的传统技术导致应用医学重大课题的突破--关于2005年诺贝尔生理学或医学奖

发现幽门螺杆菌(Helicobacter pylori,以下简称Hp)导致慢性胃炎和消化性溃疡,是沃伦和马歇尔获得2005年诺贝尔医学奖的原因.他们在1982年得出的这一假说,违反了关于这一类慢性病传统的发病机制理念.可能因为这一理念的反传统性,其假说被世界同行基本接受大概经历了20年时间.值得强调的是,对HP的观察、分离、培养、鉴定和人体试验,以及它与疾病相关的诊断、治疗、临床流行病学等研究,应用的都是传统的医学技术.从而表明,即使到了20世纪80年代,传统技术仍能导致诺贝尔奖级科研成果的出现.     

Impulsivity as a predictor of newly-diagnosed peptic ulcer disease: A prospective cohort study

We examined the role of impulsivity in the development of peptic ulcer disease (PUD). The subjects were initially healthy 4636 hospital employees aged 19–62 who responded to a questionnaire on personality, health habits, mental health, and PUD in 1998 and 2000. We used multivariate logistic analyses to determine the relationship between impulsivity and newly-diagnosed PUD among those employees who did not have PUD at baseline. Impulsivity was assessed with the Karolinska Scale of Personality. High level of impulsivity was associated with increased 2-year incidence of doctor-diagnosed PUD after adjustment of age, gender, education and shift work (odds ratio = 2.42, 95% confidence interval = 1.21–4.82). Additional adjustment for the effects of smoking, alcohol consumption, BMI, physical activity, minor psychiatric morbidity and diagnosed depression and other psychiatric disease had little effect on this relationship. The present study suggests that impulsivity may be a risk factor for the development of PUD.     

A narratological methodology for identifying archetypal story patterns in autobiographical narratives

Based on Jung's definition of archetype the concept 'archetypal story pattern' is developed as well as a research method drawing on narrative analysis and biographical research to identify these archetypal story patterns in life stories. Jung pointed out that personal myths, archetypal patterns found, e.g., in mythology, can govern the life course of individuals unconsciously. In the Theory of Narrative Identity comparable concepts have been mentioned but were never fully developed. In my research I try to combine Jung's concept of the archetype with the elaborated methodology of narrative analysis. Archetypes can manifest as narratives and the identity construction of a person via narrating the life story can be influenced or even totally structured by archetypal stories which give a specific form as well as a specific meaning to the person's identity. The method of extracting an underlying archetypal pattern from an autobiographical narrative is demonstrated. The results of the research on 20 autobiographical interviews and the inherent archetypal patterns are summarized. The major aim of this paper is to describe in detail the application of a well established method of the social sciences on a key concept of Jungian psychology to show that these concepts can be integrated into recent research frameworks of academic sciences. On the other hand it shows that Jungian concepts can be investigated through established and well defined research methods in empirical research settings.     

The relationship between the Five‐Factor Model personality traits and peptic ulcer disease in a large population‐based adult sample

The current study examined the relationship between the Five‐Factor Model personality traits and physician‐confirmed peptic ulcer disease (PUD) diagnosis in a large population‐based adult sample, controlling for the relevant behavioral and sociodemographic factors. Personality traits were assessed by participants themselves and by knowledgeable informants using the NEO Personality Inventory‐3 (NEO PI‐3). When controlling for age, sex, education, and cigarette smoking, only one of the five NEO PI‐3 domain scales – higher Neuroticism – and two facet scales – lower A1: Trust and higher C1: Competence – made a small, yet significant contribution (p < 0.01) to predicting PUD in logistic regression analyses. In the light of these relatively modest associations, our findings imply that it is certain behavior (such as smoking) and sociodemographic variables (such as age, gender, and education) rather than personality traits that are associated with the diagnosis of PUD at a particular point in time. Further prospective studies with a longitudinal design and multiple assessments would be needed to fully understand if the FFM personality traits serve as risk factors for the development of PUD.     

Normal values for Type A behaviour patterns in Danish men and women and in potential high-risk groups

The Jenkins Activity Survey (JAS) was administered to a normal population of randomly selected Danish adults, to patients consulting a cardiologist, and to physicians in order to compare those groups in terms of their coronary-prone (Type A) behaviour patterns. The standard procedure of rating the JAS was used in order to obtain scores for each of the four subscales: Type A (time urgency and ambitiousness), Factor S (speed and impatience) Factor H (hard-driving and competitive) and Factor J (job involvement). Gender differences were observed in the normal population for each of the four subscale scores, and age-related differences were obtained for Factor J. Elevated scores for Factor S were obtained by physicians and by people in the population who had a cardiovascular disorder. Physicians had also elevated scores for Factor J, whereas their Factor H scores tended to be reduced. No reliable differences in JAS subscale scores were observed between four groups of heart patients (i.e. angina pectoris, arterial hypertension, atrial fibrillation and atherosclerosis), although there was a tendency for Factor J to be elevated in atherosclerosis. The findings provide normal values for JAS scores in Danish men and women, and suggest that some facets of coronary-prone behaviour may be enhanced in Danish high-risk groups.     

Disgusting clusters: trypophobia as an overgeneralised disease avoidance response

Individuals with trypophobia have an aversion towards clusters of roughly circular shapes, such as those on a sponge or the bubbles on a cup of coffee. It is unclear why the condition exists, given the harmless nature of typical eliciting stimuli. We suggest that aversion to clusters is an evolutionarily prepared response towards a class of stimuli that resemble cues to the presence of parasites and infectious disease. Trypophobia may be an exaggerated and overgeneralised version of this normally adaptive response. Consistent with this explanation, individuals with trypophobia, as well as comparison individuals, reported aversion towards disease-relevant cluster stimuli, but only the trypophobic group reported aversion towards objectively harmless cluster stimuli that had no relevance to disease. For both groups the level of aversion reported was predicted uniquely by a measure of disgust sensitivity. Scaled emotion ratings and open-ended responses revealed that the aversive response was predominantly based on the disease avoidance emotion, disgust. Many open-ended responses also described skin sensations (e.g. skin itching or skin crawling). These findings support the proposal that individuals with trypophobia primarily perceive cluster stimuli as cues to ectoparasites and skin-transmitted pathogens.     

Understanding memory impairment with memory models and hierarchical Bayesian analysis

The study of human episodic memory is a topic that interests cognitive and mathematical psychologists as well as clinicians interested in the diagnosis and assessment of Alzheimer’s disease and related disorders (ADRD). In this paper, we use simple cognitive models for the recognition and recall tasks typically applied in clinical assessments of ADRD to study memory performance in ADRD patients. Our models make use of hierarchical Bayesian methods as a way to model individual differences in patient performance and to facilitate the modeling of performance changes that occur during multiple recall tasks. We show how the models are able to account for different aspects of patient performance, and also discuss some of the predictive capabilities of the model. We conclude with a discussion on the scope to improve on our results by discussing the link between memory theory in psychology and clinical practice.     

What is happening in the world of therapeutic communities?

This overview of the contributions to the special edition illustrates something of how the collection of papers reflects the marginal nature of therapeutic communities, and makes parallels as to how they are forever struggling to survive, yet generate a passion of ideas and intellectual resilience that no project-managed health service can extinguish. It briefly describes the theoretical and geographical terrain covered, and signals how the cross-disciplinary incorporation of congruent ideas can be added to the traditional bedrock of therapeutic community practice. It ends by stating the context of the new, and seemingly successful, organization which assembled these contributions into its inaugural conference – and suggests that the journey could, and ultimate should, go further.