Reactions following the sudden death of a classmate

Findings from a study of adolescents grief reactions following the sudden death of a friend and a classmate are presented. The group (26 classmates) was followed up after one and nine months. Interviews and a questionnaire including the Imapact of Event Scale and the Hogan Grief Inventory were used. The general grief scores on the Hogan Grief Inventory indicated that the grief level was similar to that of adolescents who had lost siblings. The scores on the Impact of Event Scale showed a descline in distress level from 1 to 9 months. However, after 9 months about 1/5 of the students still scored above a clinical cut-off point indicating post-traumatic stress levels. Recommendations for improving help following such events are presented.     

Depression After Mild Traumatic Brain Injury: A Review of Current Research

Research pertaining to the occurrence of depression and/or depression symptomatology after a Mild Traumatic Brain Injury (MTBI) was reviewed. We found that methodological differences such as the criteria used to assess MTBI and depression, time that elapsed since brain injury, and control group variations confounded comparisons across studies. Nevertheless, the studies are consistent with at least a 35% prevalence of, and left frontal damage with depression after MTBI, an overlap of symptoms of depression and Postconcussion Syndrome (PCS), and indicate that depression can continue for many years following the injury. Our conclusion is that MTBI is the triggering event for a set of pathophysiological changes and a concomitant depressive episode in a vulnerable subset of the population. Due to a paucity of research, it cannot be definitively concluded that the underlying substrates of depression seen after MTBI and clinical depression are the same. Implications for future investigations are discussed.     

创伤暴露对青少年暴力行为和自杀意念的影响:创伤后应激障碍和抑郁的中介作用

采用创伤暴露问卷、基于DSM-5的创伤后应激障碍症状核查表、流调中心用抑郁量表和青少年行为问题调查表,在雅安地震3.5年后对地震极重灾区的703名中学生进行调查,考察创伤暴露对暴力行为和自杀意念的影响,并检验创伤后应激障碍和抑郁在其中的中介作用。结果发现：创伤暴露可以直接正向预测暴力行为和自杀意念,PTSD在创伤暴露对暴力行为和自杀意念的影响间起中介作用,抑郁仅在创伤暴露对自杀意念的影响间起中介作用,而在创伤暴露对暴力行为影响间的中介效应不显著。     

Attention Bias for Threatening Information in Children Following a Distressing Medical Procedure

Attention bias is common in adults with post‐traumatic stress disorder (PTSD) but is less studied in children. Children (n = 22) who experienced a potentially distressing procedure in an outpatient clinic (removal of K‐wires from orthopaedic fractures) and a group of medically unwell children (illness group; n = 27) were compared with healthy controls (n = 32). Children's baseline level of PTS symptoms were indexed prior to the medical procedure, and again at 1‐week follow‐up. Immediately after the K‐wire removal, children completed a dot probe task using two categories of target words (medical threatening and emotionally threatening). While K‐wire children showed an overall bias away from negative words relative to healthy controls, the illness group did not significantly differ from healthy controls. Attention bias in K‐wire and illness groups was unrelated to later PTS symptoms.     

Grief in Comparison: Use of Social Comparison Among Cold Case Homicide Survivors

The current qualitative study examines the use of social comparison among cold case homicide survivors as a method of defining their grief. Twenty-four cold case homicide survivors completed in-depth interviews about the trauma of living with an unsolved homicide. Survivors compared themselves to individuals coping with non-homicidal deaths and fellow homicide survivors. Results indicate survivors of unsolved homicides utilize downward elevation, lateral comparison, and upward contacts in their journey of grief and coping. The direction and type of comparison can have both positive and negative effects on the survivors' views of self and progress made towards emotional recovery. Implications are discussed.     

动作疗法在灾后心理康复中的运用

在四川经历了汶川大地震后两年,青海又发生了玉树地震。地震灾害不仅对灾区幸存者造成了身体上的伤害,让人们失去家园和亲人,在心理上也给他们造成了严重的创伤。因此,对于这类人群的灾后心理康复治疗尤为重要。然而,幸存者心理的康复,单纯依靠心理辅导和治疗是不够的,而肢体上的运动能够起到缓解心理症状的良好效果。动作疗法就是一种行之有效的疗法。本文将介绍动作疗法在灾后心理康复的治疗中的运用,并提出具有针对性的动作疗法的措施。     

DSM‐5 and Bereavement: The Loss of Normal Grief?

The mood disorder work group has proposed to eliminate the bereavement exclusion criterion from the diagnosis of major depression in the 5th edition of the American Psychiatric Association's (2012) Diagnostic and Statistical Manual of Mental Disorders. The proposal would break tradition with the long‐held distinction between depression and normal bereavement. This article reviews the development of the bereavement exclusion, discusses evidence for and against the proposal, and offers some relevant implications for counselors in light of the research on depression and bereavement.     

关于口腔科临床误诊病例的深层次原因分析

口腔疾病有时表现并不典型,需要医生拥有强烈的责任心,对患者详细问诊和检查,方能得出正确结论,避免误诊给患者带来身心痛苦。笔者在以下几个方面对误诊原因进行了深层次的分析：（1）医生缺乏批判性思维;（2）医生的人文关怀精神不够;（3）医生对医患沟通重视不够;（4）专科医生往往思路狭隘。通过对3例临床误诊患者就医过程的介绍和分析,再一次提醒广大口腔医务工作者,在临床工作中要重视详细问诊,仔细查体,不断拓展临床其他学科知识,避免思路狭隘和惯性思维。