Predictors and impact of psychotherapy side effects in young adults

What should we tell our younger clients—who may or may not have chosen to come to therapy—about possible risks of engaging in psychotherapy? To explore this question, we examined psychotherapy side effects in 366 young adults with a history of psychotherapy or counselling. Psychotherapy side effects were common, with 41% of participants reporting at least one. Perceived lack of control over the decision of when and how to engage in therapy was the strongest predictor of experiencing therapy side effects. Of the different kinds of side effects, feeling that therapy had gone on too long and experiencing worsening of existing symptoms were the most strongly predictive of poor therapy outcomes such as dissatisfaction with care and lower perceived improvements. Finally, there was a significant association between reporting side effects of psychiatric medications and side effects of psychotherapy, suggesting common factors that contribute to side effect experience across treatment modalities. These findings highlight the need to monitor possible side effects during psychotherapy and counselling, and to have an open dialogue with our youngest clients and their families about the likelihood for negative outcomes when they are compelled to engage in therapy.     

‘I never talked about,ever’: A comprehensive process analysis of a significant client disclosure event in therapy

Aims: The present study was intended to examine how a particular client disclosure came about and what made it important to the client. Method: A client‐identified significant therapy event involving disclosure of childhood abuse was analysed using Comprehensive Process Analysis (CPA), a qualitative interpretive method for examining the process, effects and context of significant events in therapy. Results: The analysis identified therapist invitation and client universalisation as the key elements of the disclosure event. The context analysis showed how the event linked to the client's symbolisation of her fear earlier in the session and in the previous session. The client gained insight into how the earlier abuse had affected her life, linking it to the victimisation that was her primary reason for seeking therapy, and to her relationship with her mother. The therapist facilitated the event by following up the client's hints, trusting the strength of the alliance, and staying close to the client's frame of reference. Conclusion: The findings suggest that the initial significance of an invited disclosure event may diminish for a client over the course of therapy.     

5-HTTLPR与抑郁相关性的研究动态

摘 要 5-HTTLPR是5-羟色胺转运蛋白基因启动子区域上的多态性位点,对其转录效率具有调节作用。5-HTTLPR基因型与抑郁存在相关,但必须把二者的关系置于一个多基因与环境交互作用的框架下考察。一方面,环境因素的作用不容忽视：S等位基因携带者暴露于负性生活事件时,表现出更多情绪问题,更易发生抑郁。另一方面,CYP2C9、BDNF等基因与5-HTTLPR有交互作用,共同影响抑郁的发生。此外,年龄、性别等因素会对研究结果造成混淆。未来研究应侧重于对机制的探讨。     

Factors affecting medial temporal lobe engagement for past and future episodic events: an ALE meta-analysis of neuroimaging studies

Remembering the past and envisioning the future are at the core of one's sense of identity. Neuroimaging studies investigating the neural substrates underlying past and future episodic events have been growing in number. However, the experimental paradigms used to select and elicit episodic events vary greatly, leading to disparate results, especially with respect to the laterality and antero-posterior localization of hippocampal and adjacent medial temporal activations (i.e., parahippocampal, entorhinal and perirhinal cortices, amygdala). Although a central concern in today's literature, the issue of hippocampal and medial temporal lobe laterality and antero-posterior segregation in past and future episodic events has not yet been addressed extensively. Using the activation likelihood estimation (ALE) procedure (Turkeltaub, Eden, Jones, & Zeffiro, 2002), we performed a meta-analysis of hippocampal and adjacent medial temporal coordinates extracted from neuroimaging studies examining past remembering and future envisioning. We questioned whether methodological choices could influence the laterality of activations, namely (1) the type of cue used (generic vs. specific), (2) the type of task performed (recognition vs. recall/imagine), (3) the nature of the information retrieved (episodic vs. "strictly" episodic events) and (4) the age of participants. We consider "strictly" episodic events as events which are not only spatio-temporally unique and personal like episodic events, but are also associated with contextual and phenomenological details. These four factors were compared two-by-two, generating eight whole-brain statistical maps. Results indicate that (1) specific cues tend to activate more the right anterior hippocampus compared to the use of generic cues, (2) recall/imagine tasks tend to recruit more the left posterior parahippocampal gyrus compared to recognition tasks, (3) (re/pre)experiencing strictly episodic events tends to activate more the bilateral posterior hippocampus compared to episodic events and (4) older subjects tend to activate more the right anterior hippocampus compared to younger subjects. Importantly, our results stress that strictly episodic events triggered by specific cues elicit greater left posterior hippocampal activation than episodic events triggered by specific cues. These findings suggest that such basic methodological choices have an impact on the conclusions reached regarding past and future (re/pre)experiencing and their neural substrates.     

Stressful Events and Temperament Change during Early and Middle Adolescence: The TRAILS Study

This project investigates how stressful events are related to deviations from normative temperament development during adolescence. Temperament traits were assessed at ages 11 and 16 years. Life‐event data was captured using an interview (total n = 1197). Normative changes were found in all traits. A linear trend was found between the experience of stressful events and temperament development. Adolescents exposed to stressful events showed smaller decreases in fear and shyness, stronger decreases in effortful control and affiliation and smaller increases in high intensity pleasure. Exposure to stressful events was related to increases in frustration instead of decreases. Our results show that whereas normative development is mostly in the direction of maturation, adolescents who experienced stressful events showed less maturation of their temperament. Copyright © 2011 John Wiley & Sons, Ltd.     

What constitutes traffic event severity in terms of human danger perception?

This study focuses on the severity gradation of non-collision events. Earlier theoretical work has suggested that a proper severity measure for an event should reflect the risk of personal injury, which is often split into two components, including the risk of a collision and the potential consequences had the collision taken place. While a great number of severity measures have been suggested, most of them fail to address both components, thus resulting in counter-intuitive event gradations and inconclusive outcomes in validation studies. Conversely, it has been shown that human observers often show very good agreement when given a task to rank traffic situations by their severity or level of danger. The aim of this study is to investigate in depth how human judgements of the severity of traffic situations can be expressed by means of objective safety indicators. In this study, a set of video-recorded traffic situations, in which a cyclist passes straight through an intersection while a left or right-turning motor vehicle crosses the cyclist’s path, were analysed. Binary logistic regression was used to develop models assessing the most important traffic severity indicators associated with human feelings of danger. The results showed that the initial conditions of a traffic event, defined as a start of an evasive action, contain the most important information for explaining its severity. Moreover, variables related to both proximity and collision consequences are important and should be integrated into severity measures.     

Why did this happen to me? Religious believers’ and non-believers’ teleological reasoning about life events

People often believe that significant life events happen for a reason. In three studies, we examined evidence for the view that teleological beliefs reflect a general cognitive bias to view the world in terms of agency, purpose, and design. Consistent with this hypothesis, we found that individual differences in mentalizing ability predicted both the tendency to believe in fate (Study 1) and to infer purposeful causes of one’s own life events (Study 2). In addition, people’s perception of purpose in life events was correlated with their teleological beliefs about nature, but this relationship was driven primarily by individuals’ explicit religious and paranormal beliefs (Study 3). Across all three studies, we found that while people who believe in God hold stronger teleological beliefs than those who do not, there is nonetheless evidence of teleological beliefs among non-believers, confirming that the perception of purpose in life events does not rely on theistic belief. These findings suggest that the tendency to perceive design and purpose in life events—while moderated by theistic belief—is not solely a consequence of culturally transmitted religious ideas. Rather, this teleological bias has its roots in certain more general social propensities.     

鼻咽癌患者调强放疗与常规放疗毒副反应对比研究

探讨鼻咽癌患者常规放射治疗(CRT)与调强放射治疗(IMRT)的疗效和常见副反应,为鼻咽癌患者放疗方法选择提供科学依据.选取2010年11月至2013年5月行CRT和IMRT的初治鼻咽癌患者共56例,比较IMRT和CRT组的急性毒性反应和晚期放射性损伤.IMRT组和CRT组在局部复发和远处转移方面,两组差异无统计学意义(P＞0.05),常见急性毒性反应如:口干、吞咽疼痛、听力下降、皮肤和黏膜反应的发生率CRT组高于IMRT组,差异有统计学意义(P＜0.05);晚期损伤中口干、皮肤纤维化发生、吞咽困难等方面CRT组高于IMRT组,差异有统计学意义(P＜0.05),而在视力下降和脑损伤的发生等方面,两组差异无统计学意义(P＞0.05).与CRT技术相比较,IMRT技术能够有效减少急性毒副反应和晚期损伤的发生率,可提高患者生活质量(QOL).     

鼻咽癌患者调强放疗与常规放疗毒副反应对比研究

探讨鼻咽癌患者常规放射治疗（CRT）与调强放射治疗（IMRT）的疗效和常见副反应,为鼻咽癌患者放疗方法选择提供科学依据.选取2010年11月至2013年5月行CRT和IMRT的初治鼻咽癌患者共56例,比较IMRT和CRT组的急性毒性反应和晚期放射性损伤.IMRT组和CRT组在局部复发和远处转移方面,两组差异无统计学意义（P＞0.05）,常见急性毒性反应如：口干、吞咽疼痛、听力下降、皮肤和黏膜反应的发生率CRT组高于IMRT组,差异有统计学意义（P＜0.05）;晚期损伤中口干、皮肤纤维化发生、吞咽困难等方面CRT组高于IMRT组,差异有统计学意义（P＜0.05）,而在视力下降和脑损伤的发生等方面,两组差异无统计学意义（P＞0.05）.与CRT技术相比较,IMRT技术能够有效减少急性毒副反应和晚期损伤的发生率,可提高患者生活质量（QOL）.     

应激性生活事件对森林公安民警心理健康的影响

目的:探讨应激性生活事件对森林公安民警心理健康的影响。方法:对160名森林公安民警采用症状自评量表和生活事件量表进行心理状态评定和生活事件调查分析,并分析应激性生活事件对森林公安民警心理健康的影响。结果:共发放问卷160份,收回有效问卷124份。森林公安民警的心理健康水平及各因子得分均高于国内常模,除强迫因子和精神病性因子外,差异不显著;应激性生活事件中家庭有关问题强度频度偏重,工作学习中的问题强度频度次之,社交及其它问题强度频度最轻;森林公安民警的应激性生活事件与心理健康水平成正相关,应激性生活事件能有效预测森林公安民警的心理健康状况。结论:森林公安民警的心理问题比较突出,应激性生活事件能有效预测森林公安民警的心理健康状况。