The association between retrospective outcome evaluations and pre-post-treatment changes in psychodynamic group-psychotherapy

In the present study of 203 patients in psychodynamic group psychotherapy, we explore associations between patient and therapist global retrospective outcome evaluations (ROE), and pre-post-treatment changes on the Symptom Check List 90 Revised (SCL-90-R) and non-symptomatic focus of therapy. There were no significant associations between ROE, diagnoses and demographic variables, and pre-treatment SCL-90-R associations were negligible (less than 4% of overlapping variance). SCL-90-R subscale improvement expressed as residual gain score explained the overall largest percent of variance in both patients and therapists (44% and 25%, respectively) when compared with raw difference scores (32% and 18%), and percent reduction from baseline (34% and 23%). Moreover, ROE/end-state adjustment associations were substantial (42% and 24%). Therapists' evaluation of change showed the strongest association with improvement in non-symptomatic focus of therapy, while patients' evaluation had the strongest association with improvement in SCL-Depression. It is concluded that retrospective evaluations reflect changes related to treatment. However, unexplained variance may be independent of symptomatic state, and associated with personality factors or domains not captured by standard questionnaires.     

Personality Trait Change in Adulthood

ABSTRACT— Recent longitudinal and cross-sectional aging research has shown that personality traits continue to change in adulthood. In this article, we review the evidence for mean-level change in personality traits, as well as for individual differences in change across the life span. In terms of mean-level change, people show increased self-confidence, warmth, self-control, and emotional stability with age. These changes predominate in young adulthood (age 20–40). Moreover, mean-level change in personality traits occurs in middle and old age, showing that personality traits can change at any age. In terms of individual differences in personality change, people demonstrate unique patterns of development at all stages of the life course, and these patterns appear to be the result of specific life experiences that pertain to a person's stage of life.     

Perceptions of social changes and social identity: Study focusing on Hong Kong society after reunification

Based on the social identity theory and the need for closure theory, the present study investigates how Hong Kong people's perceptions of social changes after the reunification with China are related to their social identities. A randomly selected sample of 315 Hong Kong residents participated in a telephone survey to report their perceptions of major changes in five social areas, as well as their social identities. A series of logistic regression analyses confirmed, as predicted, that the perceived pace of social change was related to the participants' preference for a single identity ('Hongkonger' or 'Chinese') over dual identities ('Hongkonger and Chinese', or 'Chinese and secondarily Hongkonger') through the mediation of social uncertainty. The results indicate that for individuals with dual social identities, perceptions and evaluations of social change are important factors contributing to social identity preference.     

Clinical considerations for the treatment of body dysmorphic disorder with cognitive-behavioral therapy

Although cognitive behavior therapy has been found to be very effective in the treatment of body dysmorphic disorder (BDD), there still remain a number of challenges that clinicians face in the treatment of individuals with BDD. In this article, we discuss issues related to comorbid depression, suicidality, substance use disorders, personality disorders as well as the role of early life experiences, delusional intensity of beliefs, and motivation to change. The aim of this review is to provide a treatment aid to clinicians by offering specific recommendations for improved care based on the available literature as well as our clinical experience.     

A model of career success: A longitudinal study of emergency physicians

Objective and subjective career success were hypothesized to mediate the relationships between sociodemographic variables, human capital indices, individual difference variables, and organizational sponsorship as inputs and a retirement decision and intentions to leave either the specialty of emergency medicine (EM) or medicine as output variables. Objective career success operationalized as the number of leadership positions held did not mediate the relationship, but income change and career satisfaction mediated the relationship between the hours worked and years employed in emergency medicine. Work centrality was significantly related to subjective career success more so for men than women and perceptions of success or self-efficacy were positively related to subjective career success for women, but not for men. The expected pattern of women indicating more difficulties with personal time and family time did not emerge; but women did indicate less perceived support from the organization, fewer EM leadership positions, less perceived control over their work situation and less organizational support than did men.     

新编大学生性别角色量表揭示性别角色变迁

性别角色代表个人的社会性别, 对个人乃至整个民族素质的发展有重要意义。随着时代的变化, 当代大学生的性别角色观与性别角色也发生着变化。由于已有的性别角色测量工具多年来没有修订, 因此, 对当代大学生性别角色的测量亟需一个对发展变化敏感的有效测量工具。本研究根据性别角色研究的通行原则, 基于1700个相关词汇, 筛选出男女正性词各35个, 中性词20个。在386名大学生中初测结果显示, 男性化量表(16个题目)含领导力、男子气、理性、大度四个因子, 体现出男性的“工具性”特质; 女性化量表(16个题目)含同理心、女子气、勤俭心细三个因子, 反映出女性的“表达性”特质; 中性化量表则有18个题目。之后在全国5008名大学生中的复测表明, 该男性化量表内部一致性系数为0.89, 女性化量表为0.84; 两个量表的重测信度分别为0.82和0.80; 验证性因素分析显示该量表的结构效度良好, 他评效度和专家效度较高。与已有性别角色量表比较, 构成本量表的词汇有较大变化：男性化词汇体现的“理性化”特质反映出当代中国男性的特点; 女性化词汇虽仍以“表达性”特质为主, 但也体现了中国传统“勤俭心细”的特征。大样本调查发现, 当代大学生性别角色双性化、未分化和单性化群体数量各占约三分之一; 传统占优势的单性化已让位于非单性化; 理想的双性化与最差的未分化同步增长; 男性化比例男性高于女性, 女性化比例女性高于男性, 传统性别角色的影响减弱但依然存在。     

Determinants of the magnitude of willingness to accept relative to willingness to pay

In this paper we test two hypotheses that stem from the work of Mellers, Chang, Birnbaum and Ordonez ( 1992 ). The first hypothesis is that in a binary gamble, the ratio of WTA to WTP is decreasing in the probability attached to a nonzero event. The second hypothesis is that this ratio is independent of the size of stakes. We find support for the first hypothesis, but mixed support for the second. The second hypothesis holds in the case of gains, but not in the case of losses. Copyright © 2001 John Wiley & Sons, Ltd.     

Continuity in Problems of Social Functioning in Adulthood: A Cumulative Perspective

Based on an ongoing longitudinal study involving 145 women and 152 men, this study analyzed the continuity in and accumulation of problems of social functioning from age 27 (year 1986) to age 36 (year 1995), and studied sex differences in these processes. The accumulation of problems of social functioning (e.g., poor financial standing, poor intimate relationships, and drinking problems) was more common in men than in women at both ages. Sex differences, however, narrowed because problems increased only among women during the follow-up period. Continuity, both in accumulated problems and in good social functioning, was stronger than continuity in single problems, as assumed on the basis of the theory of problem gravitation. The proportion of individuals with either accumulated problems or with good social functioning did not, however, increase relative to individuals with single problems, as the theory of problem gravitation has suggested. Continuity in problems of social functioning was partly mediated by career instability among both sexes. There was also a tendency for the quality of partner to moderate the relation between problems of social functioning between the two ages; in particular, a problematic partner was likely to add to women's problems.     

Holocaust Survival Stories: Change Over Time

Those Holocaust survivors who have found it impossible to discuss their experiences often face a bleak old age (Krystal, 1990). Some of those who have reached an audience, however, have been changed by the experience of writing. This paper analyzes the differences between those writers whose stories remain static, like Jerzy Kosinski, and others like Elie Wiesel, Gerda Weissmann Klein, and Aharon Appelfeld, whose accounts have become more complex as they aged.     

医疗费用在医疗制度改革中的变化趋势及政策取向

医疗费用的水准及其变化过程主要取决于一个国家的经济发展水平。我们预测其变化趋势可能经历三个新阶段。因此,在宏观管理上要注意四个方面的政策取向：重效率轻收入、重效果轻价格、重科学管理轻粗放经营、重长远利益轻眼前利益。