降压治疗的决策思考

尽管降压药物有了很大发展,高血压的控制率仍很低下。降压治疗中还存在包括医生和患者两方面的许多误区。目前已取得的共识是:降压治疗的益处主要来自血压控制。因此,非常重要的是要达到血压的有效和长期稳定的降低。根据患者的年龄、基线血压、伴随的临床状况等,因人而异地选择副作用小、降压效果好的药物,提高顺应性是改善高血压控制率的关键。     

The effect of reinforcement probability on time discrimination in the midsession reversal task

We examined how biasing time perception affects choice in a midsession reversal task. Given a simultaneous discrimination between stimuli S1 and S2, with choices of S1 reinforced during the first, but not the second half of the trials, and choices of S2 reinforced during the second, but not the first half of the trials, pigeons show anticipation errors (premature choices of S2) and perseveration errors (belated choices of S1). This suggests that choice depends on timing processes, on predicting when the contingency reverses based on session duration. We exposed 7 pigeons to a midsession reversal task and manipulated the reinforcement rate on each half of the session. Compared to equal reinforcement rates on both halves of the session, when the reinforcement rate on the first half was lower than on the second half, performance showed more anticipation and less perseveration errors, and when the reinforcement rate on the first half was higher than on the second half, performance showed a remarkable reduction of both types of errors. These results suggest that choice depends on both time into the session and the outcome of previous trials. They also challenge current models of timing to integrate local effects.     

Human walk-to-run transition in the context of the behaviour of complex systems

This study had two main aims: 1) to investigate if the walk-to-run (WR-) transition occurs when the speed of locomotion is kept constant below the WR-transition speed (speed clamp) and the stride rate is increased monotonously using a metronome and 2) to investigate if diversion of attention and awareness from the locomotion process influences the position of the WR-transition in stride rate, stride length, and locomotion speed (SrSlLs) space.Eighteen healthy individuals (13 men and 5 women) were recruited (age: 23.9 ± 1.5 years, height: 1.77 ± 0.10 m and body mass: 77.3 ± 12.8 kg). Stride-by-stride stride rates, stride lengths, locomotion speeds, and duty factors were determined on a treadmill in 4 different tests: 1) reference WR-transition, 2) preferred walking speed, 3) dual-task test including arithmetic calculations and 4) four speed clamp bouts with different initial velocities.Walk-to-run transitions were elicited in all participants in the speed clamp bouts. When the stride rate ramp was clamped at preferred walking speed the WR-transition stride rate was not significantly different from the WR-transition stride rate during the reference test (t = 2.2, p = 0.312). However, in the SrSlLs space the speed clamp WR-transitions all deviated from the position of the reference WR-transition. Additionally, it was demonstrated that intensive attentional diversion using a dual-task paradigm had very little influence on the position of the WR-transition in the SrSlLs space.It is argued that these observations can be explained in the context of the behavior of complex systems.     

低静息心率与反社会行为的关系

由于静息心率易测性, 对静息心率的研究成为研究攻击和犯罪行为生理机制的重要手段之一。研究发现低静息心率与多种反社会行为存有关, 无论是动物研究, 人类研究还是跨文化的研究都表明了这种关系的存在。但元分析的结果表明低静息心率与反社会行为之间关系的效应量只是中等水平。同时, 社会经济因素和人格因素对低静息心率与反社会行为之间的关系有影响。低静息心率可能与低恐惧或低唤醒的特质、去甲肾上腺素功能减弱、大脑右半球功能减弱等因素有关。     

Thought suppression enhances memory bias for threat material

The current study examined the impact of thought suppression on indices of anxiety, including memory indices (implicit and explicit memory biases) and physiological indices (heart rate). The participants, 81 undergraduates scoring in the top quartile of a self-report measure of trait anxiety, were randomly assigned to one of three experimental groups: thought suppression (TS), thought concentration (TC), and thought wandering (TW). The TC and TW groups were included to control for the effects of effortful processing and exposure to stimuli, respectively. One block of threat words and one block of neutral words were presented under conditions of cognitive load, and participants' physiological responses and memory biases were measured. The thought suppression group exhibited an enhanced overall memory bias for threat words, driven by an elevated explicit memory bias, relative to the other two groups, a result that has implications for ironic processes theory and may inform information-processing models of anxiety.     

A case history: from traumatic repetition towards psychic representability

This paper is devoted principally to a case history concerning an analytic process extending over a period of almost ten years. The patient is B, who consulted the author after a traumatic episode. Although that was her reason for commencing treatment, a history of previous traumatogenic situations, including a rape during her adolescence, subsequently came to light. The author describes three stages of the treatment, reflected in three different settings in accordance with the work done by both patient and analyst in enabling B to own and work through her infantile and adult traumatic experiences. The process of transformation of traumatic traces lacking psychic representation, which was undertaken by both members of the analytic couple from the beginning of the treatment, was eventually approached in a particular way on the basis of their respective creative capacities, which facilitated the patient's psychic progress towards representability and the possibility of working through the experiences of the past. Much of the challenge of this case involved the analyst's capacity to maintain and at the same time consolidate her analytic posture within her internal setting, while doing her best to overcome any possible misfit (Balint, 1968) between her own technique and the specific complexities of the individual patient. The account illustrates the alternation of phases, at the beginning of the analysis, of remembering and interpretation on the one hand and of the representational void and construction on the other. In the case history proper and in her detailed summing up, the author refers to the place of the analyst during the analytic process, the involvement of her psychic functioning, and the importance of her capacity to work on and make use of her countertransference and self-analytic introspection, with a view to neutralizing any influence that aspects of her 'real person' might have had on the analytic field and on the complex processes taking place within it.     

Relative reinforcer rates and magnitudes do not control concurrent choice independently

One assumption of the matching approach to choice is that different independent variables control choice independently of each other. We tested this assumption for reinforcer rate and magnitude in an extensive parametric experiment. Five pigeons responded for food reinforcement on switching-key concurrent variable-interval variable-interval schedules. Across conditions, the ratios of reinforcer rates and of reinforcer magnitudes on the two alternatives were both manipulated. Control by each independent variable, as measured by generalized-matching sensitivity, changed significantly with the ratio of the other independent variable. Analyses taking the model-comparison approach, which weighs improvement in goodness-of-fit against increasing number of free parameters, were inconclusive. These analyses compared a model assuming constant sensitivity to magnitude across all reinforcer-rate ratios with two alternative models. One of those alternatives allowed sensitivity to magnitude to vary freely across reinforcer-rate ratios, and was less efficient than the common-sensitivity model for all pigeons, according to the Schwarz-Bayes information criterion. The second alternative model constrained sensitivity to magnitude to be equal for pairs of reinforcer-rate ratios that deviated from unity by proportionately equal amounts but in opposite directions. This model was more efficient than the common-magnitude-sensitivity model for 2 of the pigeons, but not for the other 3. An analysis of variance, carried out independently of the generalized-matching analysis, also showed a significant interaction between the effects of reinforcer rate and reinforcer magnitude on choice. On balance, these results suggest that the assumption of independence inherent in the matching approach cannot be maintained. Relative reinforcer rates and magnitudes do not control choice independently.     

AN ESSAY ON DREAMING,PSYCHICAL WORKING OUT AND WORKING THROUGH2

In this paper the author attempts to expand the idea put forward by Freud who considered dreams as a special form of unconscious thinking. It is the author's contention that the psychical working‐out function performed by dreams is a form of unconscious thinking, which transforms affects into memories and mental structures. He also attempts to clarify the way in which meaning is built and transformed in mental life. In that respect the unconscious internal world is seen as a form of unconscious thinking, a private theatre where meaning is generated and transformed. He focuses on what happens to feelings in dreams in connection with the meanings as a result of and an expression of the several stages of working through. The dream world is described as the setting where the mind gives expressive pictorial representation to the emotions involved in a conflict: a first step towards thinkability. The dreamwork also constitutes a process through which meaning is apprehended, built on and transformed at an expressive non‐discursive level, based on representation through figurative/pictorial images. The author draws on Meltzer's formulation to conjecture that the working‐through function of dreams, mainly in response to interpretations, is performed by a process of progression in formal qualities of the representations made available by dreaming in the form he has called affective pictograms. It is through progression in formal qualities of the representation that the thinking capabilities of the affective life develop and become part of the process of what is called metaphorically the metabolisation of emotional life. This process takes place through migration of meaning across various levels of mental process. In this perspective the analyst'sinterpretations of dreams effect what linguists call transmutation of the symbolic basis, a process that is necessary to help the mind to improve its capacity to think. Something expressed on the evocative plane and condensed into a pictographic image is then transformed into verbal language that expresses meaning. These conceptions are illustrated by a detailed clinical case.     

The association between auditory memory span and speech rate in children from kindergarten to sixth grade.

This study reexamined the association between speech rate and memory span in children from kindergarten to sixth grade (N = 152) in order to potentially account for the inconsistencies within the published literature on this topic. Some of the inconsistencies in past research may reflect the different methods adopted in assessing speech rate. In particular, repeating word triples may itself involve memory demands, contaminating the correlation between speech rate and memory span in younger children. Analyses using composite speech rate and memory span measures showed that speech rate for word triples shared variance with memory span that was independent of speech rate for single words. Moreover, speech rate for word triples was largely redundant with age in explaining additional variation in memory span once the effects of speech rate for single words were controlled.