精神疾病患者遭受社会歧视的现状及其原因与对策分析

社会对精神疾病患者的歧视由来已久,这种歧视广泛存在于不同的阶层与民族当中,且各有其特点。其对精神病患者及其家属带来的负面影响是显而易见而且是深刻的,这种影响涉及到了患者生活的各个方面。本文对各种歧视的特点及其深层次原因进行了初步分析和探讨,并对如何减少这种歧视进行了探讨。     

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

Was William James a Patient at McLean Hospital for the Mentally Ill?

Rumors that William James was a patient at McLean Asylum near Boston have persisted for several decades. I focus on the reasons why the question has been so difficult to answer in any definitive way; assess the evidence presented in support of the rumors; note that two different periods in James’s life (late twenties and early sixties) have been judged the most likely; and explore the diagnostic question as well: If he was in fact a patient, for what was he being treated? I also discuss evidence that his younger brother Robertson was a patient at McLean and consider the bearing of this evidence on the question of whether William James was a patient at McLean and on the diagnostic issue.     

Psychological Illness in Presidents: A Medical Advisory Commission and Disability Determinations

Although the 25th Amendment is intended to provide for instances of presidential disability, critics claim that it is impractical since it requires vice presidents and cabinet members to move overtly against the president—which they are unlikely to do. Also, they warn that medical information about the president is likely to be concealed. To overcome these problems, they recommend that a Medical Advisory Commission be established at the outset of every presidential administration to examine the president annually and then provide formal medical input so that the vice president and cabinet would be "compelled" to act in the presence of medically determined "inability," whether physiological or psychological. This paper argues, however, that such a proposal is badly flawed and quite unworkable, particularly in the case of psychological illness where accurate diagnosis typically depends on long-term, continuous doctor-patient interaction rather than through sporadic and superficial interchange. It concludes that less draconian measures in implementing the Amendment are far more sensible, such as those proposed by the Working Group on Presidential Disability which are discussed here.     

Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults

The goal of this study was to examine stress-ameliorating effects of religiosity, spirituality, and healthy lifestyle behaviors on the stressful relationship of chronic illness and the subjective physical well-being of 221 older adults. We also investigated whether the intervening variables functioned as coping behaviors and orientations or as adaptations in late life. Guided by the stress paradigm, path analysis was used to assess these relationships in a stress suppressor model and a distress deterrent model. No suppressor effects were found; however a number of distress deterrent relationships were detected. Spirituality, physical activities, and healthy diet all contributed to higher subjective physical well-being, as counter-balancing effects, in the distress deterrent model. The findings have implications for future research on the role of spirituality, religiosity and lifestyle behaviors on the well-being of chronically ill older adults. Findings also support the need for studying different dimensions of religiosity and spirituality in an effort to understand coping versus adaptation in behaviors and orientations. Gracie H. Boswell, Ph.D., M.Ed. (Case Western Reserve University) and (M. Ed.- Kent State University). She is a Carolina Program in Health and Aging Research Scientist at the Institute on Aging- University of North Carolina at Chapel Hill. Her research interests have been social gerontology and quality of life, emphasizing religiosity/spirituality. Eva Kahana, Ph.D. (University of Chicago) is Pierce T. and Elizabeth D. Robson Professor of Humanities and Director of the Elderly Care Research Center- Case Western Reserve University. Her research concentration has been the sociology of aging (coping & stress and institutionalization). Peggye Dilworth-Anderson, Ph.D. (Northwestern University) is Director- Center for Aging and Diversity, Institute on Aging, Professor- School of Public Health, Department of Health Policy and Administration at University of North Carolina at Chapel Hill. Her research interests have been caregiving and minority health disparities.     

中国古代辟疫思想的当代启示

通过对以未病先防为主导的中国古代主要辟疫思想及方法的回顾与思考,探讨了其对今天传染病预防的参考价值。认识到在当代传染病预防工作中,借鉴中国古代医学的思想与实践之精粹或许可为当代新发传染病的防治另辟新径,以期能对现代传染病的预治有所启示。     

Introduction to Three Diagnoses of God

This brief article introduces the three articles diagnosing God by Helsel, Capps, and Carlin as examples of a skeptical strain that has been present throughout Judeo–Christian history, suggesting that psychology as an “interrogative” mode is a necessary counterpoint to theology’s dogmatic mode. The three articles are recommended on the basis of their heuristic value for instruction about mental illness, their playfulness and humor, and their potential for reshaping traditional images of God that have been harmful.     

Factor Structure of the Illness Intrusiveness Rating Scale in Patients Diagnosed with Anxiety Disorders

The Illness Intrusiveness Rating Scale (IIRS) is a measure designed to assess the impact of illness on various domains of functioning (G. M. Devins, 1994). In anxiety disordered patients, illness intrusiveness ratings are higher than those of chronically ill medical patients, suggesting that the IIRS may have a different underlying structure in a sample of individuals with anxiety disorders. To examine this possibility, IIRS items were submitted to an exploratory and confirmatory factor analysis in 2 samples (total N = 294). These solutions were compared to solutions in chronically ill populations from a previous study. In the exploratory analysis, both a one-factor and a three-factor solution were identified, accounting for 42 and 61% of the variance, respectively. Confirmatory analyses showed adequate similarity between the three-factor structure of the IIRS from a medically ill population and the current three-factor structure, suggesting that elevated IIRS scores in anxiety disordered samples cannot be explained simply by a different structure of the instrument.