The relationship between beliefs about emotions and quality of life in irritable bowel syndrome

Suppression of undesirable emotions, as well as beliefs about the unacceptability of experiencing and expressing emotions, have both been shown to be related to poorer health-related outcomes in several clinical groups. Potential models through which these variables relate have yet to be tested in those with irritable bowel syndrome (IBS) and are therefore examined in the current article. Online questionnaires were administered to people with IBS (n = 84) to test a mediation model in which beliefs about the unacceptability of emotions are associated with greater emotional suppression, which in turn relates to increased affective distress and consequently poorer quality of life. An alternate model to test the direction of effect along with two further models using support-seeking as mediators of the same predictor and outcome were also tested. Emotional suppression and affective distress (in that particular order) mediate the relationship between beliefs about emotions and quality of life IBS. The models using support-seeking as mediators of the relationship between beliefs about emotions and the two outcomes were not supported. These findings suggest a role for emotional processing in medically unexplained symptoms and imply the need to address such beliefs about emotions in psychological therapies.     

Neural substrates of the ‘low‐level’ system for speech articulation: Evidence from primary opercular syndrome

We describe a patient with progressive disorder of speech, without language impairment (opercular syndrome). Morphometric analysis confirmed asymmetric volume reduction of the precentral areas (>left). Diffusion imaging showed significant white matter changes in the left frontal lobe, with specific involvement of the left corticobulbar tract and connections between supplementary/pre‐supplementary motor areas and the frontal operculum (frontal aslant tract). We suggest that the organization of expressive language includes a ‘low level’ motor system principally distributed in the left hemisphere that shows specific susceptibility to neurodegeneration, distinct from neural systems subtending praxic, and cognitive aspects of language.     

Obstructive sleep apnoea syndrome increases source‐confusion errors: A pilot study

We explored external source monitoring (i.e., discrimination between memories of two externally derived sources) in patients with obstructive sleep apnoea syndrome (OSAS). Our specific aim was to ascertain whether, relative to controls, patients exhibit more source‐confusion errors when there are similarities between two external memory sources. We recruited 22 patients with OSAS and 22 controls matched for sex, age, and education. The experimental procedure we used came in three phases. First, participants viewed a target film. Second, they were shown a mixed set of photographs, some taken from the film (target photographs), others not (photographs taken from other films not viewed by participants; lures). Lures differed either conceptually or perceptually from the target film. Third, the following day, participants were shown a set of photographs and urged to determine whether the photographs were taken from the target film or whether they were images they had seen for the first time in Phase 2. Patients correctly attributed the same number of target photographs to the target film as controls. By contrast, they incorrectly attributed more lures to the target film than controls did, especially when the lures were semantically similar to the film (perceptual lures). Both perceptual and conceptual source‐confusion errors were significantly correlated with oxygen desaturation during sleep. Results suggest that the higher number of source‐confusion errors observed in patients with OSAS was linked to an impaired ability to recollect specific perceptual details of the study items and that hypoxia is the main contributing factor to this deficit.     

Differences in alexithymia and emotional awareness in exhaustion syndrome and chronic fatigue syndrome

Symptoms of Exhaustion Syndrome (ES) and Chronic Fatigue Syndrome (CFS) are overlapping and create difficulties of differential diagnosis. Empirical studies comparing ES and CFS are scarce. This study aims to investigate if there are any emotional differences between ES and CFS. This cross‐sectional study compared self‐reported alexithymia and observer‐rated emotional awareness in patients with ES (n = 31), CFS (n = 38) and healthy controls (HC) (n = 30). Self‐reported alexithymia was measured with the Toronto Alexithymia Scale‐20 (TAS‐20) and emotional awareness with an observer‐rated performance test, the Level of Emotional Awareness Scale (LEAS). Additionally, depression and anxiety were scored by the Hospital Anxiety and Depression Scale (HADS). Results show that patients with ES expressed higher self‐reported alexithymia in the TAS‐20 compared to HC, but had similar emotional awareness capacity in the observer‐rated performance test, the LEAS. Patients with CFS expressed more difficulties in identifying emotions compared to HCs, and performed significantly worse in the LEAS‐total and spent more time completing the LEAS as compared to HC. Correlation and multiple regressions analyses revealed that depression and anxiety positively correlated with and explained part of the variances in alexithymia scores, while age and group explained the major part of the variance in LEAS. Findings of this study indicate that emotional status is different in patients with ES and CFS with respect to both self‐reported alexithymia and observer‐rated emotional awareness. Emotional parameters should be approached both in clinical investigation and psychotherapy for patients with ES and CFS.     

The Mobilizing Effect of Right‐Wing Ideological Climates: Cross‐Level Interaction Effects on Different Types of Outgroup Attitudes

The present research investigated a multilevel person‐context interactionist framework for the relationship between right‐wing ideologies and prejudice across two large, representative samples (Study 1: European Social Survey: N = 56,752; Study 2: World Values Survey: N = 74,042). Across three different operationalizations of right‐wing ideology, two contextual levels (regional and national) of right‐wing climate, and three types of outgroup attitudes (i.e., age‐, ethnicity‐, and gender‐based), the analyses consistently revealed cross‐level interactions, showing a strong association between right‐wing attitudes and negative outgroup attitudes at the individual level in contexts with a low right‐wing climate, whereas this relationship is weaker and often even absent in contexts with a high right‐wing climate. These cross‐level interactions remained significant after controlling for statistical artefacts (i.e., restriction of range and outliers). The authors propose norm setting as the mobilizing mechanism through which a right‐wing climate develops and curbs the influence of individual right‐wing social‐ideological attitudes on outgroup attitudes.     

Psychopathology and behavior problems in children and adolescents with Williams syndrome: Distinctive relationships with cognition

Several studies have documented the high prevalence of psychopathology and behavior problems in Williams syndrome (WS). However, the links between cognitive development and such symptoms need further clarification. Our study aims to expand current knowledge on levels of behavior problems and its links to cognition in a sample of Brazilian individuals with WS. A total of 25 children and adolescents with WS and their parents participated in this study. The participants’ IQs were assessed with the Wechsler Scales of Intelligence (for children or adults) and parental reports of psychopathology/behavior problems were collected using the Child Behavior Checklist (CBCL). The presence of clinically significant attention problems was a main feature in our sample of children and adolescents with WS. In the children, higher IQ scores were found to be significantly associated with less externalizing problems, while in the adolescents cognitive abilities were found to be associated with less internalizing symptoms. These results provide further insight into the links between psychopathology and behavior problems and cognitive abilities in WS, and suggest the need to take age into consideration when analyzing such relationships.     

Beyond differences between the body schema and the body image: insights from body hallucinations

The distinction between the body schema and the body image has become the stock in trade of much recent work in cognitive neuroscience and philosophy. Yet little is known about the interactions between these two types of body representations. We need to account not only for their dissociations in rare cases, but also for their convergence most of the time. Indeed in our everyday life the body we perceive does not conflict with the body we act with. Are the body image and the body schema then somehow reshaping each other or are they relatively independent and do they only happen to be congruent? On the basis of the study of bodily hallucinations, we consider which model can best account for the body schema/body image interactions.     

论中国多元化医疗公正的选择

生命伦理学面对的最大的道德困惑是公正问题,其中最为尖锐的问题是生命权利与医疗公正.公正原则在实际医疗领域运用中存在着种种误区.公正观的多元化是现代社会包括现代医疗的必然结果,体现在医疗公正方面合理的伦理选择就在于在不同的医疗境遇中,使用不同的公正原则,从而选择现实的生命伦理学道路.     

大连地区企业医院产权制度改革的实践与思考

企业医院社会化是区域卫生规划与卫生工作实行全行业管理的前提条件,也是国企改革和社会改革的需要,医企分离势在必行.在企业医院剥离过程中,医院产权制度改革已经成为医院改革的主要矛盾和深化医院改革的首要问题.通过大连地区企业医院产权制度改革的实践经验,对企业医院剥离模式进行探讨,阐述了对医院产权制度改革的认识,并提出合理化建议.