Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients’ illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline – cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?<?0.05). In multiple regression analyses, controlling for demographic, clinical and psychological factors (age, gender, ethnicity, social deprivation, ACS severity, negative affectivity and cardiac symptom recurrence), more intense emotional representations (β?=?0.146, p?=?0.041) and reduced illness coherence (β?=??0.133, p?=?0.029), emerged as independent predictors of posttraumatic symptom severity at six months. There was a near significant effect for personal control (β?=??0.113, p?=?0.058). These results demonstrate the importance of illness representations of ACS in predicting longer-term posttraumatic stress symptoms.     

急性一氧化碳中毒高压氧治疗的中美指南比较

急性一氧化碳（carbonmonoxide,CO）中毒是中美最常见的意外中毒原因之一。高压氧能促进碳氧血红蛋白解离,加速体内CO排出,明显缩短CO半清除时间,是治疗急性CO中毒的一种重要治疗方法。比较中美现有急性CO中毒治疗指南及推荐意见。发现其中在高压氧治疗应用的适应证、具体方案、治疗费用等方面有很大差异。我们对此差异进行比较分析,为临床治疗及科研提供参考,也对通过进一步研究以充分证实高压氧治疗急性CO中毒的有效性,制订高压氧治疗最佳方案提出展望。     

健康焦虑的研究现状

健康焦虑是一种由轻到重的连续性的症状谱,它的极端形式被称之为疑病症.关于健康焦虑的流行病学数据很少,发病的机制和原因也不清楚,但大多数的研究证实健康焦虑与焦虑障碍有相同的认知过程.疑病症的临床表现为疾病观念、躯体症状、歪曲信念和行为,健康焦虑只是在程度上轻于疑病症,并没有发生质的改变.在健康焦虑的治疗中最受关注的应属正念认知疗法,它在很多方面都优于传统的认知行为疗法,当然其他治疗方法也能起到一定的辅助作用.健康焦虑带来的危害是巨大的,因此社会将面临重大挑战.     

J波、fQRS、Tp-ec对ST段抬高性心肌梗死溶栓治疗后恶性心律失常的预测价值

探讨ST段抬高性心肌梗死(STEMI)患者成功溶栓治疗后J波、校正Tp-e间期(Tp-ec)、碎裂QRS波(fQRS)对恶性心律失常事件(MAE)的预测价值及其相关性.选择STEMI患者108例,成功溶栓治疗后随机分为MAE组(29例)和非MAE(NMAE)组(79例),72例正常人的心电图作为对照组.结果示MAE组J波阳性、fQRS阳性、Tp-ec≥100ms显著高于NMAE组(P＜0.05);STEMI患者Tp-ec较对照组显著延长(P＜0.05),经溶栓治疗后,Tp-ec1周和1个月时逐渐恢复,但Tp-ec仍较对照组显著延长(P＜0.05);J波阳性(OR=3.612)、fQRS阳性(OR=2.905)、Tp-ec≥100ms(OR=3.226)(均P＜0.05)与MAE的发生独立相关.以此认为J波、Tp-ec、fQRS和MAE正相关,对溶栓后MAE有预测作用.     

Perceptions of Submissiveness: Implications for Victimization

Some researchers have suggested that a precondition of affective submissiveness may increase the likelihood of female victimization in sexual assault, whereas others have suggested that criminal offenders use perceptions of vulnerability when selecting a victim. In this study, based on American college students, men (decoders) rated videotaped women (encoders) dominant versus submissive using a semantic differential instrument. Cue evaluators analyzed the body language and appearance of the videotaped women using a Likert instrument. The results suggest that (a) men form differentiated perceptions of dominant versus submissive women, (b) such perceptions substantially rely on nonverbal cues, (c) dominant and submissive women display visually different behaviors and appearances, and (d) men tend to select submissive females for exploitation.     

3例误诊为急性冠脉综合征实施介入诊治死亡病例的启示

探讨3例被误诊为急性冠脉综合征（ACs）而急诊实施介入诊治死亡病例的,搭床特点及误诊原因,提高对ACS的诊断意识。收集我院比较典型的3例误诊死亡病例进行回顾性分析。3例死亡病例中1例为肺栓塞、1例为主动脉夹层动脉瘤（AD）、1例为流行性出血热,3例均实施了冠状动脉造影,1例于前降支植入了1枚支架。ACS患者临床表现复杂,误诊原因多为首诊医师思路狭窄,应充分利用现代影像技术,仔细分析临床症状和体征,可减少误诊死亡的发生。     

Some Diagnostic Observations of Post-September 11, 2001 Crisis Groups

Crisis groups following the September 11 attack in New York were an opportunity to learn about people in crisis. The many groups that were formed to assist individuals' return to work, school, and home offered opportunities to observe how people managed their personal crises. While diagnoses such as Post-traumatic Stress Disorder were used, they offer no help in understanding group dynamics and individual behavior in groups. In this paper a psychoanalytic group orientation is offered to help learn about the impact of such terrible crises on individuals and the use of psychoanalytically oriented groups to aid in their path to recovery.     

急性应激与风险倾向：兴奋易感性的调节作用

为探索应激对决策的作用机理及其个体差异,减少工程作业中因应激导致的决策失误,本研究采用特里尔社会应激测试和气球模拟风险任务考察应激反应与应激下风险倾向的关系,并探索兴奋易感性在其中的调节作用。研究结果表明,应激下个体的皮质醇反应越大,行为越冒险。且这一作用受到兴奋易感性的调节：兴奋易感性较高的个体,应激下皮质醇反应越大,行为越冒险;而兴奋易感性较低的个体,其皮质醇变化不能预测风险倾向。该发现提示了兴奋易感性在应激影响中的重要作用,也为高压岗位的人员选拔提供了科学启示。     

FUNCTIONAL ANALYSIS AND TREATMENT OF EYE POKING

In four studies we analyzed the eye poking of a youth with profound disabilities. In Study 1, a functional analysis showed that eye poking occurred during the no-attention condition, but not during demand, attention, or recreation conditions. The analysis did not identify socially mediated variables involved in the maintenance of eye poking; rather, eye poking may have been maintained by consequences produced directly by the response. In Study 2 we had the student wear goggles to prevent potential reinforcement from finger—eye contact. The results of Study 2 indicated that eye-poking attempts were reduced when the student wore goggles. We then tested in Study 3 the effects of two alternative topographies of stimulation. Study 3 demonstrated that eye poking was reduced when a video game was provided as a competing source of visual stimulation, and that music was less effective in reducing eye poking. In Study 4, a contingency analysis using the video game was conducted in an attempt to (a) reduce the frequency of eye poking and (b) study whether the video game functioned as a reinforcer. The results of Study 4 demonstrated substantive reductions in the frequency of eye poking, and suggested that the video game served as a reinforcer.