Elasticity of Technique: The Psychoanalytic Project and the Trajectory of Ferenczi's Life

The object of this paper is the Elasticity of Psychoanalytic Technique in the work of Sándor Ferenczi. The author sustains that this can be considered neither as an ultimate arrival point nor as a particular stage of Ferenczi's clinical–theoretical body of work, but rather as an ensemble of affective qualities, attitudes and values, which he gradually developed through experience, signalling a paradigm shift in the history of psychoanalysis. The following areas will be explored: the new sensitivity demonstrated by Ferenczi concerning the relational and communicative factors present in the analytic session, his subtle and acute attention to the participation of the analyst's own subjectivity in the therapeutic process, and how these enduring elements of Ferenczi's technique anticipate several significant future developments in psychoanalysis.     

非严重遗传病产前诊断及PGT的伦理思考

随着近年基因诊断技术的飞速发展,出现了要求通过产前诊断或胚胎植入前遗传学检测（preimplantation genetic testing,PGT）技术阻断某些非严重遗传病在家族中传递的新需求。从非严重遗传病定义,目前产前诊断及PGT技术发展现状、适应证及各自本身存在的伦理问题,遗传咨询原则等进行阐述,并以白化病和成人多囊肾为例,讨论遗传咨询医师应该如何根据国情、现行法律以及伦理原则对这类患者进行知情同意并实现医患共同决策。呼吁国家组织专家探讨共识,明确相关规定,遵循相关医学伦理学原则。     

适宜技术与诊疗最优化的可行性研究

在案例分析的基础上,作出了医生是临床诊疗中适宜技术的主要选择者的判断;论证了运用适宜技术实现诊疗最优化的可行性;认为适宜技术难以选择和实施的主要原因是利益关系、责任心不强和管理措施不到位;提出了必须着力培育适合于适宜技术生长的土壤的对策,即:实行政策引导与资金支持、进一步加大监管力度、营造良好的氛围、高度重视并加强医生道德素质的培养。     

走出慢性乙型、丙型病毒性肝炎诊断的误区

我国病毒性肝炎是一个非常重要的肝病,病毒性肝炎的诊断不仅依靠临床表现,肝功能指标的改变,也依赖于病毒标志物的检测。病毒血清学检查是确定诊断的唯一标准。乙、丙、丁型病毒性肝炎的血清标志物项目繁多,临床意义相差较大,正确理解能为诊断提供很大帮助。     

Attitudes toward maternal serum screening in Chinese women with positive results

Maternal serum screening for fetal Down syndrome has been integrated into routine antenatal care in most clinics in Taiwan. We examined the attitudes toward serum screening and the possible implications in women with positive results. From January to July 1995, 276 women were referred to the Genetic Counseling Clinic, Mackay Memorial Hospital for amniocentesis because of positive screening results, and 214 participated in this study. All women opted for amniocentesis after genetic counseling. Over 40% stated that they made decisions independently after being informed of the serum screening. Need for certainty was the most frequently mentioned reason. Two-thirds believed that serum screening could provide a diagnosis. Almost all women would apply for maternal serum screening for future pregnancies. This study demonstrated that Chinese women need more counseling and autonomy regarding maternal serum screening.     

Visual search by chimpanzees (Pan): assessment of controlling relations.

Three experimentally sophisticated chimpanzees (Pan), Akira, Chloe, and Ai, were trained on visual search performance using a modified multiple-alternative matching-to-sample task in which a sample stimulus was followed by the search display containing one target identical to the sample and several uniform distractors (i.e., negative comparison stimuli were identical to each other). After they acquired this task, they were tested for transfer of visual search performance to trials in which the sample was not followed by the uniform search display (odd-item search). Akira showed positive transfer of visual search performance to odd-item search even when the display size (the number of stimulus items in the search display) was small, whereas Chloe and Ai showed a transfer only when the display size was large. Chloe and Ai used some nonrelational cues such as perceptual isolation of the target among uniform distractors (so-called pop-out). In addition to the odd-item search test, various types of probe trials were presented to clarify the controlling relations in multiple-alternative matching to sample. Akira showed a decrement of accuracy as a function of the display size when the search display was nonuniform (i.e., each "distractor" stimulus was not the same), whereas Chloe and Ai showed perfect performance. Furthermore, when the sample was identical to the uniform distractors in the search display, Chloe and Ai never selected an odd-item target, but Akira selected it when the display size was large. These results indicated that Akira's behavior was controlled mainly by relational cues of target-distractor oddity, whereas an identity relation between the sample and the target strongly controlled the performance of Chloe and Ai.     

A comparison of trichotillomania and obsessive-compulsive disorder

The validity of conceptualizing trichotillomania (TCM) and obsessive-compulsive disorder (OCD) as separate and distinct diagnoses was examined in a study of 20 patients with each disorder. A comparison of demographic, psychometric, and clinical features between the two groups revealed a number of statistically significant differences. Patients meeting the criteria for OCD scored higher on measures of psychiatric symptomatology including ratings of obsessions and compulsions, depression, interpersonal sensitivity, general anxiety, phobic anxiety, and psychoticism. Patients meeting the criteria for TCM reported an earlier age at onset than those with OCD. Stressors associated with onset were also significantly different between groups. These results support the validity of conceptualizing TCM and OCD as differing behavioral disorders.Portions of this paper were presented at the annual meeting of the Anxiety Disorders Association of America (March 1992) in Dallas, TX, and at the annual meeting of the American Psychiatric Association (May 1992) in Washington, DC.     

A support group for couples who have terminated a pregnancy after prenatal diagnosis: Recurrent themes and observations

Genetic Counselors are increasingly becoming involved in organizing and facilitating support groups for couples who have terminated a pregnancy because of an abnormal fetal diagnosis. This paper discusses recurrent themes which have emerged in the FATE (Feelings After the Termination Experience) support group which was founded in New Jersey in 1990. By becoming familiar with the issues we have observed in our support group, genetic counselors should be better able to understand and empathize with their patients who make the decision to terminate a much wanted pregnancy. They may also feel better prepared to become involved in organizing and facilitating such support groups.     

从黑夜走向黎明：动脉粥样硬化从早期发现到消退

年１０年来,动态粥样硬化的早期诊断已成为可能,影像学能无创直接检测血管功能和形态学变化。在此基础上,动态粥样硬化的防治也进入了一级预防的时代。一级预防使早期粥样硬化消退,特效降脂药也可使中、晚期粥样硬化患者明显受益。随着对动态粥样硬化发病机制认识的不断深入,到下世纪初,人类有可能终止动态粥样硬化在全球的肆虐。     

Training class inclusion responding in typically developing children and individuals with autism

In a class inclusion task, a child must respond to stimuli as being involved in two different though hierarchically related categories. This study used a Relational Frame Theory (RFT) paradigm to assess and train this ability in three typically developing preschoolers and three individuals with autism spectrum disorder, all of whom had failed class inclusion tests. For all subjects, relational training successfully established the target repertoire and subsequent testing demonstrated both maintenance and generalization. Limitations and future research directions are discussed.