神经性厌食症的生物-心理-社会模型

厌食症作为一种精神和躯体疾病严重危害个体健康。已有众多研究者从生物-心理-社会整体医学模型角度对厌食症进行了研究。厌食行为受到遗传基因易感性、中枢神经递质活性改变、人格特质、肥胖恐惧感、应激因素、"瘦"文化背景、家庭关系紊乱等的影响。未来应着力探讨神经内分泌与厌食症的因果关系并加强厌食症的预防、干预及治疗。     

Religious Involvement and Health Over Time: Predictive Effects in a National Sample of African Americans

In this study, two telephone interviews that assessed both religious involvement and health‐related quality of life were conducted approximately 2.5 years apart in a national sample of 290 African Americans. Religious involvement was assessed with an instrument that measured both personal religious beliefs (e.g., having a personal relationship with God) and more public religious behaviors (e.g., attending church services). Health‐related quality of life was measured with version 2 of the Medical Outcomes Study 12‐item short form (SF‐12v2). Structural equation models indicated that higher religious beliefs at baseline predicted better physical and mental health 2.5 years later. Higher religious behaviors at baseline contributed smaller, complementary suppression effects. Physical and mental health indicators from the SF‐12v2 at baseline did not predict changes in either religious beliefs or religious behaviors over time. These findings indicate that, for African Americans, personal religious beliefs lead to beneficial health effects over time, whereas individual differences in health do not appear to predict changes in religious involvement.     

Feedback on health status and peer popularity influences social risk decision-making processes in adolescents and young adults

Cognitive and dual-processes models, involving cognitive and socio-emotional components, for adolescents’ risky behaviour have been proposed. This study tested their predictions by manipulating the presence or absence of feedback about gains and losses in health and peer popularity in a decision-making task with peers. Risky (e.g., taking or refusing a drug) and ambiguous decisions (e.g., eating hamburger or hotdog) were examined in 256 adolescents (aged 13–14; 15–16; 17–18) and young adults (aged 19–20). Participants made more risky choices and required less decision time when receiving feedback about the negative consequences on health and positive consequences on peer popularity. Decision times were comparatively larger for risky than for safe options in late adolescence and young adulthood. Results supported the dual-processes model showing that, though late cognitive changes were observed that could eventually lead to the selection of safe options, feedback gains in peer popularity outweighed unhealthy consequences leading to risky decisions.     

Generality of the practical functional assessment and skill‐based treatment among individuals with autism and mental health disorders

A practical functional assessment format was recently developed that informed a skill‐based treatment for the problem behavior of children diagnosed with autism spectrum disorder. Since its inception there have been multiple replications of the procedures; however, the comprehensive model has rarely been applied to populations with more complex comorbid disorders and severe problem behavior such as those diagnosed with anxiety or depression. We conducted the current study to systematically replicate the entire practical functional assessment and skill‐based treatment model with two participants diagnosed with multiple mental health disorders admitted to a severe behavior outpatient unit. The practical functional assessment identified reinforcers that were provided contingent on increasingly complex forms of communication. Problem behavior remained low for both participants after reinforcement was thinned by increasing a response requirement of completing difficult tasks. Furthermore, the results were socially validated by the parents and teachers and the treatment was extended to the home setting.     

Rebooting Mental Health Care Delivery for the COVID-19 Pandemic (and Beyond): Guiding Cautions as Telehealth Enters the Clinical Mainstream

Across the COVID-19 pandemic, we have witnessed perhaps the field’s largest and most abrupt transformation in scope of practice. In the context of surging mental health needs and historically limited feasibility of traditional office-based services during the pandemic, telehealth has launched into the clinical mainstream and has become a dominant mode of outpatient mental health care delivery. The articles in this terrific Special Issue outline some of the field’s most exciting innovations from the past 18 months. The present commentary discusses how these unprecedented times have prompted unprecedented resourcefulness and innovation in the field. Issues related to evolving and uncertain telehealth regulation and reimbursement policies are discussed, and cautions for the road ahead are offered as we prepare for post-pandemic practices. The commentary concludes with a call to redouble efforts to move beyond the use of telehealth to largely treat only those populations who already enjoyed access to traditional office-based services. Understanding and overcoming barriers to telehealth care and ensuring equitable access to telehealth options are critical steps for actualizing the great potential of telehealth strategies for increasing the reach of supported care to underserved populations.     

A Public Health Framework for Preventing Mental Disorders in the Context of Pandemics

The COVID-19 pandemic has universally threatened the building blocks of mental health, well-being, and quality of life, namely, expectations of safety, connectedness, hope, and individual and societal efficacy. Consequently, unprecedently large numbers of individuals are significantly stressed and many are at risk for relapse of mental health problems, exacerbations of existing mental and behavioral health problems, and new onset clinical problems. Because of the scope of the problem, a population-based public health perspective is needed, which in the context of disasters has well-established theories and prevention approaches. Public health approaches to disasters and pandemics focus on preventing subclinical problems from becoming clinical disorders, in comparison to clinical care approaches that focus on treating established disorders. Fortunately, specialty care clinicians who typically think about assessing and treating established disorders have the training and clinical competencies to deliver prevention-focused interventions. This paper is designed to help specialty care clinicians who use cognitive-behavioral strategies to understand the biopsychosocial impacts and resource deficits associated with COVID-19-related stressors and the public health perspective to address them. We also provide ways clinicians can help people who are suffering from significant stress and resource deficits bounce back and regain functioning. We describe psychological first aid, stress management, repeated ecological assessment, writing about stressors, problem-solving, and behavioral activation approaches to assist individuals at risk for enduring stress-linked problems.     

Relationships,health, and stress: Validation of a relationship sense of coherence measure

Although all romantic relationships experience stress, some thrive when faced with adversity while others are unable to manage the inevitable relationship ups and downs. Rather than seeing stress as a risk factor, this study applied a Salutogenic framework, which posits that stress is a naturally occurring and potentially beneficial part of relationships, to develop a new measure of relationship health and well‐being. In Study 1, we created and tested a self‐report Relationship Sense of Coherence (RSOC) scale. Study 2 demonstrated evidence of convergent reliability for the RSOC. In Study 3, we tested the RSOC in a two‐wave sample of romantically‐involved individuals with a chronic health condition. Guidelines for use and implications for future research are discussed.     

Le processus d’intervention en santé au travail : éclairer les enjeux de l’action par un exercice de formalisation de l’activité

IntroductionThe quality of action in occupational health requires attention to its dynamic, for example analysing the activity of the intervenant consultant: what he manages to do in his activity and the obstacles he encounters.ObjectiveThis article proposes to feed the knowledge on the intervention from a qualitative approach and centered on the intervention process.MethodUsing the case study, the article shows the real of the intervention, its obstacles and the adjustments it imposes. The case studied is in a journal.ResultsThis intervention process shows the effects of variation caused by lack of accession and support from management and the trade unions, the difficulty of passing from knowledge to action.ConclusionThe difficulties have a function of revelation which the evaluation of the effects of an intervention can take into account.