Betrayal And Paranoia: The Psychotherapist's Function as an Intermediary

We present an approach to the problem of structuring a therapeutic alliance with patients presenting paranoid symptoms, using both psychoanalytical and cognitive techniques. Initially, we focused on one of the main aspects of the paranoid worldview: the fear of being betrayed and the tendency to betray. This is a defense maneuver, through which patients deny their passivity, and the impotence in the relationship with their own internal needs and with the significant people in the external world, including the therapist. In our experience to build up a working relationship, both a psychoanalytical interpretation of unconscious conflicts and the cognitive analysis of dysfunctional beliefs are needed. Often, in more serious cases, the role of nonqualified object must be accepted at the beginning, due to the patient's need to be in control of the situation. Only then can a therapeutic phase begin, in most cases, through an integrated approach that includes pharmacological, psychodynamic, and cognitive modalities.     

Pathways of Economic Influence on Adolescent Adjustment

An important part of a science aimed at the prevention of human dysfunction involves the development of empirically based models that identify processes of risk for or protection from emotional distress or behavioral problems over time. The present study developed and evaluated such a model that proposed two pathways through which family economic pressure was expected to influence change in adolescent internalizing symptoms (depression and anxiety) during the period from the eighth to the tenth grades. A total of 377 rural families in a midwestern state provided data for the analyses. The results were generally consistent with the conceptual model in that family economic pressure increased adolescent perceptions of family economic hardship, which, in turn, reduced the adolescent's sense of control or mastery over time. Lowered mastery was associated with increases in emotional distress. Also consistent with the model, prior levels of mastery appeared to reduce the magnitude of economic stress experienced by the adolescent, whereas prior emotional distress intensified the economic stress process. Although gender differences were found in these processes, the overall pattern of results suggests that girls and boys are both at risk for internalizing problems when families experience economic pressure. Implicatios of the findings for the dvelopment of effective preventive interventions with financially stressed families in rural areas are discussed.     

The elderly and high technology medicine: A case for individualized,autonomous allocation

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age.     

All on the Same Side: Reflections on the Dialogue Between Science and Religion

The 'war' between religion and science is winding down, creating new opportunities for fruitful dialogue. The foundations of indirect religion-science dialogue, where the perspectives of the two disciplines illuminate some third subject, are not well established. A detailed comparison of the Roman Catholic bishops' dialogues and a similar program within the American Association for the Advancement of Science illustrates the variety in formalscience-religion interactions and reveals much about the promise, achievements, and limitations of different approaches. Success depends in large part on controlling the diversity of the dialogue group, choosing topics carefully, and adopting positive and cooperative attitudes.     

论医学哲学的特征

医学哲学也称为医学辩证法,是在总结医学科学成就的基础上,通过对医学理论和实践中一般、普遍、共性问题的研究,揭示医学认识主体思维活动普遍规律的科学：是人们认识和处理健康和疾病问题的一般方法论。无论是与医学还是与哲学相比。医学哲学都有着显著的区别,运用对比分析的方法。对医学哲学的研究对象、理论体系特别是思维方式等不同方面的特征,进行理论探讨。     

Swedish adolescents’ experiences of cybervictimization and body-related concerns

The aim of this study was to examine the relationships between cybervictimization and three body-related concerns: body-esteem, self-objectification, and internalization of body ideals. The aim was also to examine these relationships not only to cybervictimization in general but also to appearance-related cybervictimization more specifically. The sample comprised 482 adolescents (233 girls and 247 boys aged 13–15; two participants did not answer the question about gender) from four Swedish schools. The results showed that victims of appearance-related cyberbullying suffered from more body-related concerns: they had a poorer view of their general appearance and of their weight. They also reported more body shame, thin-ideal internalization, and appearance-related pressure from the media. This study shows that cyberbullying that focuses on the victim's appearance is associated with several body-related concerns that have not previously been studied. A novel finding was also that body-related concerns were not related to cyberbullying in general, as has been implied in earlier research, but specifically related to cyberbullying directed at the victim's appearance. The findings suggest that there is a need to include attention to the specific relationships between appearance-related cyberbullying and body-related concerns in future prevention and intervention work.