躯体症状障碍的特点及综合诊疗原则

从美国精神疾病诊断与统计手册第三版（DSM-Ⅲ）的躯体形式障碍,到甚至更早的诊断名称为DSM-5的躯体症状障碍,这类疾病的名称一直在变化;学界对躯体化症状的分类和定义也一直存在争议.进行分类和诊断的主要目的是为了治疗.本文从躯体症状障碍相关概念的变迁及本质特点入手,分析、总结躯体症状障碍的心理行为特点及接诊和治疗原则,以期对广大临床工作者治疗工作的开展有所帮助.     

身体健康抱怨评估工具的研究进展

准确评估个体身体健康抱怨状况是制定针对性预防、治疗措施的前提和基础。介绍国外6种身体健康抱怨评估工具,分别为学龄儿童健康行为症状自评量表、儿童躯体症状量表、儿童行为量表、患者健康问卷躯体症状群量表、科恩-霍伯曼身体症状量表和边缘性疲倦量表,对其发展、适用对象、关注角度、信效度、使用方法及特点进行分析,旨在为研制符合我国中医文化思想的身体健康抱怨评估工具提供参考。未来的研究需要结合网络时代特征补充、再评估和分类诊断个体身体健康抱怨状况。

     

Consumer complaints and recovery through guaranteeing self‐service technology

Self‐service technologies are shaping the future of consumer behaviour, yet consumers often experience service failure in this context. This conceptual paper focuses on self‐service technology failure and recovery. A consumer perspective is taken. Recovering from self‐service technology failure is fraught with difficulty, mainly because of the absence of service personnel. The aim of this paper is to present a theoretical framework and associated research propositions in respect to the positive role that service guarantees can play in the context of self‐service technology failure and recovery. It contributes to the consumer behaviour domain by unifying the theory pertaining to consumer complaint behaviour, service recovery, specifically consumers' perceptions of justice, and service guarantees, which are set in a distinctive self‐service technology context. It is advanced that service guarantees, specifically multiple attribute‐specific guarantees, are associated with consumer voice complaints following self‐service technology failure, which is contingent on the attribution of blame in the light of consumers' production role. Service guarantees are argued to be associated with consumers' perceptions of just recovery in the self‐service technology context when they promise to fix the problem, compensate only when the problem cannot be remedied, offer a choice of compensation that is contingent on failure severity, afford ease of invocation and collection, and provide a personalised response to failures. Previous classifications of SSTs are used to highlight the applicability of guarantees for different types of SSTs. Managerial implications based on the theoretical framework are presented, along with future research directions. Copyright © 2011 John Wiley & Sons, Ltd.     

sleep complaints,behavioral characteristics and vital exhaustion in myocardial infarction cases

Abstract

Prodromal symptoms of vital exhaustion and sleep complaints are increasingly being recognized as important risk indicators for myocardial infarction (MI). In this study, the relationships between vital exhaustion, behavioral characteristics, and MI, and between several sleep complaints and MI were investigated. The subjects were 133 male cases with first MI, 192 male hospital controls, and 133 male neighborhood controls. The instruments used were the Maastricht Questionnaire (vital exhaustion), the Life Styles Questionnaire (sleep complaints, coffee consumption, and current smoking), and the Structured Interview (Type A behavior). All sleep complaints, vital exhaustion, Type A behavior, excessive coffee consumption, and current smoking occurred significantly more often in MI-cases. After controlling for these potential confounders, and age, most sleep complaints retained significant associations with MI, in particular often taking naps during the day and waking up in the morning feeling tired and exhausted.     

Predicting adolescent health complaints by personality and Behaviors

Abstract

In a sample of 97 male adolescents, individual differences in health complaints were predicted by personality traits and by self-reported health/risk behaviors. Anxiety and loneliness were measured at Times 1 and 2, and health locus of control, various behaviors and health complaints were assessed at the end of the two-year study. A causal model was specified, employing anxiety and loneliness as distal predictors, health locus of control and behaviors as proximal predictors of health complaints. It turned out that anxiety was the most powerful single predictor, and that loneliness exerted a direct effect on health locus of control and behaviors and an indirect effect on health complaints. Risk behavior as well as health behavior were related to complaints. Social integration facilitated not only health behavior but also risk behavior.     

The relationship of depression and somatic focus to experimental and clinical pain in chronic pain patients

Abstract

The present study examined Fields' proposal that depression increases the sensory experience of pain in part through greater somatic focus. Experimental and clinical pain measures were compared to self-report of depression and somatic focus in 60 chronic pain patients. Depression scores were unrelated to pain threshold or tolerance on the cold-pressor test. However, as hypothesized by Fields, path analytic models suggested that depression had a direct influence on the evaluative and affective aspects of pain, but the relationship between depression and sensory pain was mediated by somatic focus. These results provide partial support for Fields' neurobiological model of pain and depression.     

Negative affectivity,coping, immune status,and disease progression in hiv iwected individuals

Abstract

The primary goal of the study was to assess the relationship between personality dispositions, coping styles, immune markers, clinical status, and subjective somatic symptoms in a mixed sample of HIV positive individuals. Specifically, the prognostic value of psychological and immunological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enrolled in the Oslo HIV Cohort Study. The partkipants were given self-administered questionnaires assessing behavioral, psychological, and psychdal variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed according to the Centers for Disurse Control criteria. The immune markers used were CD4 T cell counts, beta2-microglobulin concentration, sewn levels of HIV-1 p24 core protein, and levels of antibodies to core protein. In addition, subjective somatic symptoms were assessed.

The results showed that measure-s of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic symptoms and passivedefensive coping style. However, no amistent association between NA measures and immune markers was found. Individuals who developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-pmblem related wping (e.g. Positive reappraisal, Seeking social support) and passivedefensive coping (i.e. Escape-Avoidance, Self-control).

The results suggest (1) that coping styles may merit a specific focus in future research of psychological factors and medical outcomes in HIV infection, and (2) because of associations of NA measures with symptom reports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.     

How you ask matters: An experimental investigation of the influence of mood on memory self-perceptions and their relationship with objective memory

Stronger relationships often emerge between mood and memory self-efficacy (MSE) than between MSE and memory abilities. We examined how social desirability, mood congruency and framing influence the mood–MSE relationship. Social desirability correlated with all self-report measures, and covarying social desirability diminished the mood-MSE relationship while enhancing the relationship between MSE and objective memory. Participants rated their memory more harshly on positively than neutrally or negatively worded MSE items. Current mood state did not affect MSE overall or when items were worded positively or neutrally. However, on negatively worded items, participants in a negative mood exhibited lower MSE than participants in a positive mood. Thus, both MSE and the mood–MSE relationship depended upon question wording. These results indicate that controlling social desirability and item framing on MSE questionnaires may reduce their confounding influence on memory self-perceptions and the influence of mood on self-reported abilities, allowing subjective memory to more accurately reflect objective memory in healthy and clinical populations.     

Normative Impulsivity: Adorno on Ethics and the Body

Abstract

Adorno’s commitment to anti-foundationalism generates a concern over how his ethically normative appraisals of social phenomena can be founded. Drawing on both Kohlmann and Bernstein’s account, I produce a new reading which contends somatic impulses are capable of bearing intrinsically normative epistemic and moral content. This entails a new way of understanding Adorno’s contention that Auschwitz produced a new categorical imperative. Working with Bernstein’s account, I claim that Auschwitz makes manifest the hostility of the instrumentalization of reason to the somatic grounds of reason. One’s mimetic identification with the victims of Auschwitz arouses a self-preserving desire to intercede in and re-orient the progress of reason itself, for the sake of one’s own somatic integrity. In closing, I claim – contra Zuidervaart – that this reading allows us to place the ethical as primary in Adorno, without reducing the political to it.