Application of focusing‐oriented psychotherapy in dealing with issues of Asian immigrants: A single‐case study of a Korean immigrant in Japan

A single case study is presented of the successful application of focusing‐oriented therapy in the case of a Korean woman who migrated to Japan. The client had a host of problems related to the discrimination she faced from her own family and from Korean society for being female, as well as relationship and cultural difficulties in trying to adjust to married life in Japan. Through 10 sessions of focusing‐oriented therapy, the client was able to re‐examine her situation from a positive perspective and began to accept herself as a person, not necessarily as a woman or a Korean in Japan. Issues related to Korean women immigrants in Japan are explored and the related effectiveness of focusing‐oriented therapy for the particular population is discussed.     

‘Mr K’ – A successful case of analytic oriented therapy documented empirically: the role of the therapeutic relationship and reflexive self-awareness

A successful case of analytic treatment over the course of 250 sessions is described from different perspectives, including considerations from the two-year follow-up. The therapeutic alliance and the patient’s experiencing were evaluated. Pre-treatment diagnosis was validated via diagnostic interview. Symptoms and interpersonal problems were assessed at intervals. Data were analysed using two different time-series analyses. Aspects of agency with regard to mentalizing capacity were assessed with the Metacognitive Assessment Scale. We obtained the following main results: (1) Symptoms and interpersonal problems improved continuously until the end of treatment. Symptom severity fell to below the clinical cut-off. This successful outcome remained stable at the two-year follow-up. (2) The therapeutic relationship improved during the therapeutic process. (3) The patient’s capability for reflexive self-awareness, operationalized as experiencing, decreased. (4) The metacognitive mastery of the patient increased. The following conclusions were made after combining the empirical data with the clinical observations: (1) Mr K improved clinically in terms of symptoms, self-regulation and interpersonal problems as a result of his gaining affect control. (2) The patient’s experiencing does not capture a positive outcome in all cases. (3) Aspects of agency (i.e. metacognitive mastery) deserve further attention in psychoanalytic treatments.     

DRD2基因TaqIA多态性与同伴侵害对青少年早期抑郁的交互作用

本研究运用问卷法与DNA分型技术,对1063名青少年(初次测评年龄为12.32±0.47岁,50.3%女生)进行间隔2年的追踪调查,考察DRD2基因TaqIA多态性与同伴身体侵害和关系侵害对青少年早期抑郁的交互作用及其性别差异。结果发现,TaqIA多态性与身体侵害、关系侵害均对男青少年抑郁存在显著的交互作用。在携带A2A2基因型的男生中,身体侵害和关系侵害可以显著正向预测其抑郁水平,而在携带A1等位基因的男生中,同伴侵害对抑郁无预测作用。此外,TaqIA多态性与身体侵害、关系侵害对女生抑郁均无显著交互作用。研究结果提示,同伴侵害是一种重要的候选环境指标,与TaqIA多态性交互影响青少年早期抑郁,并且性别在这一基因×环境交互作用中起到重要的调节效应。     

MAOA基因rs6323多态性与同伴关系对男青少年早期抑郁的影响

以683名男青少年为被试(初次测评时M = 13.35岁; SD = 0.51), 综合运用传统回归分析和新兴显著性区域检验, 考察了MAOA基因rs6323多态性与同伴关系对青少年早期抑郁的交互作用及其表现形式。结果表明：当同伴接纳水平较低时, G等位基因携带者的抑郁水平表现出高于T等位基因携带者的趋势, 当同伴接纳水平较高时, G型基因携带者的抑郁水平显著低于T等位基因携带者; 同伴接纳可以显著预测G等位基因携带者的抑郁, 但对T等位基因携带者的抑郁无显著预测作用; rs6323多态性与同伴拒绝的交互作用亦不显著。研究结果提示, 同伴关系对MAOA基因与男青少年早期抑郁的关联起调节作用, 且其作用形式部分支持不同易感性模型观点。     

CONSISTENT VISUAL ANALYSES OF INTRASUBJECT DATA

Visual inspection of single‐case data is the primary method of interpretation of the effects of an independent variable on a dependent variable in applied behavior analysis. The purpose of the current study was to replicate and extend the results of DeProspero and Cohen (1979) by reexamining the consistency of visual analysis across raters. We recruited members of the board of editors and associate editors for the Journal of Applied Behavior Analysis to judge graphs on a 100‐point scale of experimental control and by providing a dichotomous response (i.e., “yes” or “no” for experimental control). Results showed high interrater agreement across the three types of graphs, suggesting that visual inspection can lead to consistent interpretation of single‐case data among well‐trained raters.     

COMT基因rs6267多态性与青少年攻击行为的关系:性别与负性生活事件的调节作用

运用问卷法与DNA分型技术, 以153名高和低攻击组初中生为被试, 考察COMT基因rs6267多态性与攻击行为的关系, 重点探讨性别与负性生活事件的调节作用。结果表明：rs6267多态性与男青少年攻击行为的发生显著关联, T等位基因显著降低了男青少年攻击行为发生的概率, 但该位点与女青少年的攻击行为无关; rs6267多态性与负性生活事件存在交互作用的趋势, 在那些经历高水平负性生活事件的青少年中, GG型基因携带者发生攻击行为的概率高于T等位基因携带者。     

个体化用药--医药治疗的革命

遗传药理学和药物基因组学的发展,促进了药物反应种族差异的发现及其机制的阐明,使药物治疗模式开始由过去的诊断导向治疗向根据个体的遗传机构实行基因导向性治疗的新模式转换.     

Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process (research)

This paper gives an overview of psychoanalytic process research, which brings to light the complexity of psychotherapy sessions. This complexity is so rich that many instruments intended to make the process measurable failed in the past because they initially used a strategy of complexity reduction. This method however did not help to further our understanding of the complexity involved. Three former presidents of the Society for Psychotherapy Research (Stiles, Hill, Elliot 2015) decided to solve the following equivalence paradox: many therapies work successfully though they all follow different theories, produce a heterogeneity of processes and often enough a misfit between what theories maintain to be a good process and their realization in the treatment room. As theories are often compared to maps, a driver would wonder which route to take. But therapists‐as‐drivers go undaunted ‐ and nevertheless achieve their goals together with their patients. Norcross and Wampold (2018) found that good therapists invent new therapies with every new patient. They hypothesize that it is because of conversation. This is in accord with the 3 former presidents’ proposal to return to detailed single case analyses including the micro‐analytic power of conversation analysis of which a few insights are outlined in this article.     

COMT基因Val158Met多态性与抑郁的关系

抑郁的发生具有重要的遗传学基础。COMT基因Val158Met多态性是抑郁的重要候选基因位点。目前有关COMT基因Val158Met多态性与抑郁关系的研究主要采用单基因设计、单基因-环境设计以及多基因-环境设计。有资料显示负性情绪偏向及其相关脑区可能在COMT基因Val158Met多态性与抑郁间起中介作用, 但具体机制仍有待探究。未来研究可以进一步考察被试的种族、年龄和性别等因素对COMT基因Val158Met多态性与抑郁关系的调节作用, 并通过采用多基因-环境设计, 综合运用积极与消极环境指标等措施深入考察负性情绪偏向和相关脑区在COMT基因Val158Met多态性与抑郁间的作用及其机制。     

美托洛尔常规治疗与基因导向治疗高血压病的比较

比较基因导向美托洛尔个体化治疗与常规治疗高血压病的临床疗效、安全性和经济性。从300例1或2级原发性高血压患者中随机抽取165例进入常规治疗组（A组,n＝165）,其余135例患者进行CYP2D6基因、β1肾上腺素能受体（β1-AR）基因多态性检测,将β1-AR基因389位携带了Arg等位基因的原发性高血压患者133例分入基因导向治疗组（B组,n＝133）;基因导向治疗组患者按照CYP2D6基因分型分为弱代谢组（PMB,n=43）、中等代谢组（IMB,n=54）和强代谢组（EMB,n=36）。常规治疗组给予美托洛尔100mg/日,基因导向治疗组中PMB组、IMB组、EMB组分别给予美托洛尔25 mg/d、100mg/d、200mg/d,均分2次口服降压治疗,共随访8周,观察血压和不良反应等指标。应用成本-效果分析方法对基因导向型个体化治疗方案进行药物经济学评估。结果为基因导向治疗组降压总有效率明显高于常规治疗组（65.08% vs 47.4%, P＜0.05）;基因导向治疗组的不良反应发生率明显低于常规治疗组（P＜0.05）。成本效果分析,基因导向治疗组的平均成本效果比稍高于常规治疗组（350.05 vs 249.96）,与常规治疗组相比增量成本效果比（ICERs）为618.38。依据基因导向的前瞻性美托洛尔个体化降压治疗较传统给药模式更为安全、有效,但短期治疗难以体现其更优的经济学价值。