急性呼吸窘迫综合征肺泡塌陷与肺复张的意义

大量肺泡塌陷是急性呼吸窘迫综合征(ARDS)病理生理改变的基础,可导致顽固性低氧血症、肺泡表面活性物质丢失、呼气气流受限、去复张性肺损伤、肺部感染和生物性肺损伤。积极的实施肺开放策略,实现塌陷肺泡的复张具有重要的临床意义。肺复张导致肺泡过度膨胀、循环干扰,以及肺泡难以复张因素的存在,使肺泡完全复张可能并不必要。在避免肺泡塌陷危害与肺复张的局限性之间寻求平衡,才能使肺复张确立其在ARDS治疗中的恰当地位。     

Changes in cry acoustics and distress ratings while the infant is crying

Acoustics and distress ratings were examined during four minutes of naturally occurring crying from 20 healthy, 1‐month‐old infants. Two listeners made continuous judgements of infant distress during every 10‐s segment of each cry sample. Dysphonation, number of wails, and pause duration were related to distress ratings across the 4 min of crying. Means and variances of ratings and acoustics, and the predictive value of each acoustic variable to ratings, differed in the first and second halves of the samples. Differences in the pattern of results occurred for individual infants. The results highlight the importance of studying the cry as a dynamic acoustic signal that may provide unique information about an individual infant's level of distress. Copyright © 2009 John Wiley & Sons, Ltd.     

An implicit measure of anti-gay attitudes: Prospective associations with emotion regulation strategies and psychological distress

Members of stigmatized groups are at increased risk for mental health problems, and recent research has suggested that emotion dysregulation may be one mechanism explaining the stigma-distress association. However, little is known regarding characteristics that predict vulnerabilities to emotion dysregulation and subsequent distress. We examined whether anti-gay attitudes would predict poorer emotion regulation and greater psychological distress in 31 lesbian, gay, and bisexual (LGB) respondents. Respondents completed implicit and explicit attitude measures at baseline, and participated in an experience sampling study examining stigma-related stressors, emotion regulation strategies, and mood over the course of ten days. Implicit and explicit attitude measures were not correlated. LGB respondents with greater implicit anti-gay attitudes engaged in significantly more rumination and suppression and reported more psychological distress. Rumination fully mediated the prospective association between implicit prejudicial attitudes and psychological distress, and suppression was a marginally significant mediator.     

Self,other and individuation: resolving narcissism through the lunar and solar paths of the Rosarium

This paper describes narcissism as our natural, infant-like behaviour, and specifies three characteristics relating to the evacuation and avoidance of distress, to control, and to distancing from relationship. It suggests that the processes of incarnation and individuation represent the development of the early ego and the ‘resolution’ of these narcissistic ways of being, including escape from the ‘mirror trap’. The development of the early, controlling ‘homunculus-ego’ entails the loosening and broadening of ego-identifications and the ego becoming subject to the Self. This is an embodied-relational-social-spiritual process outlined in detail by the full 20 woodcuts of the Rosarium Philosophorum, and specifically the lunar (relational) and solar (self-expressive) paths, which are explored herein. These processes are illustrated with respect to the interaction between infant and caregiver, clinical vignettes and examples from the political sphere.     

The Psychological Cost of Racial Discrimination: What is the Role of Residential Segregation?

Racial discrimination is known to harm health, but to what extent the health burden of racial discrimination is contingent on residential contexts is understudied. This study examines the moderating role of racial residential segregation in the relationship between racial discrimination and psychological distress. Nationally representative data from the 2002–2003 National Latino and Asian American Study were merged with metropolitan-level data from the U.S. Census. Logistic regression models were used to test the independent and joint contributions of racial discrimination and residential segregation to psychological distress among Asians and Latinxs, stratified by nativity status. Higher residential segregation (measured by the interaction index) is associated with lower odds of distress among U.S.-born Asians but not among other groups. As for the moderating effect, residential segregation exacerbates the positive association between discrimination and distress among foreign-born Asians (measured by the dissimilarity index) and foreign-born Latinxs (measured by the interaction index), but not among their respective U.S.-born counterparts. Taken together, the present study highlights that strategies to mitigate the psychological burden of racial discrimination need to move beyond individual-level efforts to incorporate neighborhood-based approaches. In particular, results provide empirical support for efforts to reduce residential segregation, particularly among immigrants who are discriminated against.     

Marginalized Identities,Trump-Related Distress,and the Mental Health of Underrepresented College Students

The current study sought to determine whether holding targeted marginalized identities was associated with greater experiences of distress related to Trump's presidency and whether participants’ level of Trump-related distress predicted decrements in mental health. Participants in the current longitudinal study included 338 underrepresented college students attending a predominantly White institution. Results indicated that individuals who held targeted marginalized identities reported greater Trump-related distress compared to their non-targeted counterparts, and that holding multiple targeted marginalized identities was associated with greater levels of Trump-related distress. Findings also indicated that Trump-related distress was associated with increases (relative to previous trajectories) in anxious but not depressive symptoms. Overall, our results suggest that a shift in sociopolitical circumstances that promulgates bigotry may be harmful to those who possess targeted marginalized identities.     

Race-Based Stress in White Adults: Exploring the Role of White Racial Identity Status Attitudes and Type of Racial Events

The impact of racial experiences on Whites has been underresearched and has rarely been considered traumatic. To understand these experiences, it is important to consider variation in one's orientation to their racial group (i.e., racial identity) and the type of racial encounter. Using a White adult sample and hierarchical cluster analysis, the authors found that reactions to race-based encounters were associated with varying levels of psychological distress and well-being and racial identity statuses. Clinical implications are discussed. El impacto de las experiencias raciales en personas blancas no ha sido suficientemente investigado y en raras ocasiones ha sido considerado traumático. Para comprender estas experiencias, es importante considerar la variación en la orientación de cada individuo hacia su grupo racial (es decir, la identidad racial) y el tipo de encuentro racial. Usando una muestra de personas adultas blancas y un análisis jerárquico de clústeres, los autores hallaron que las reacciones a los encuentros raciales estaban asociadas a niveles variables de malestar psicológico, así como de estados de bienestar e identidad racial.     

Spanish adaptation of the Personal Meaning Profile-Brief: Meaning in life,psychological well-being,and distress

Background/ObjectiveThis study aimed to adapt the Personal Meaning Profile-Brief (PMP-B) to the Spanish-speaking population and investigate its psychometric properties. The PMP-B is a 21-item instrument that assesses meaning in life through seven sources: relationship, intimacy, achievement, self-acceptance, self-transcendence, fair treatment, and religion.MethodParticipants were 546 Spanish adults comprised of a community sample (n = 171) and university students (n = 375). The PMP-B, the Ryff's Scales of Psychological Well-Being, and the Depression Anxiety Stress Scale were administrated.ResultsThe PMP-B showed a bifactor structure with one general factor and seven subfactors. Measurement invariance was found across age, gender, and samples. Internal consistency and test-retest reliability were generally good. Older people showed higher PMP-B scores than younger people. The PMP-B scores, especially relational sources of meaning, were positively associated with psychological well-being and negatively related to psychological distress, mainly to depression.ConclusionsThe validity evidence gathered in this study supports the reliable use of the PMP-B to measure meaning in life. The PMP-B can be a noteworthy contribution to the meaning-centered research.     

Factor structure and measurement invariance of the Brief Symptom Inventory (BSI-18) in cancer patients

Background/Objective: The purpose of this study was to assess psychometric properties of the Brief Symptom Inventory (BSI-18), evaluate the measurement invariance with respect to sex, age, and tumor location, and to analyze associations between social support and sociodemographic and clinical variables among individuals with resected, non-advanced cancer. Method: A confirmatory factor analysis was conducted to explore the dimensionality of the scale and test invariance across sex, age, and tumor localization in a prospective, multicenter cohort of 877 patients who completed the BSI-18 and Multidimensional Scale of Perceived Social Support (MSPSS). Results: The results show that 3-factor and 1-factor measurement models provided a good fit to the data; however, a three-factor, second-order model was deemed more appropriate and parsimonious in this population. Alpha coefficients ranged between .75 and .88. Test of measurement invariance showed strong invariance results for sex, age, and tumor location; strong invariance over time was likewise assumed. Less perceived social support appears to correlate with all BSI factors. Conclusions: The study confirmed the tridimensional structure of the BSI-18 and invariance across age, sex, and tumor localization. We recommend using this instrument to measure anxiety, depression, and somatization in epidemiological research and clinical practice.     

Empathy in adolescence: Relations with emotion awareness and social roles

In this study, we aimed at gaining a better understanding of the individual differences contributing to feelings of empathy in adolescents. Therefore, we examined the extent to which emotion awareness (e.g., recognizing and appreciating one's own and the emotions of others) and a tendency for certain social roles (e.g., helping or teasing peers when being bullied) are related to adolescents’ levels of empathy. The sample was comprised of 182 adolescents aged between 11 and 16. Empathy and emotion awareness were assessed using self‐report measures. Peer reports were used to indicate adolescents’ different social roles: Bullying, defending the victim, and outsider behaviour. Outcomes demonstrated that evaluating one's own and the emotions of others, and more defending nominations were associated with both affective and cognitive empathy, whereas aspects of emotion awareness which are linked with internalizing symptoms were related to empathic distress, suggesting maladaptive emotion appraisal. Furthermore, outsider behaviour was associated with empathic distress, emphasizing a self‐focused orientation. In contrast, more bullying was negatively associated with cognitive empathy. Overall, these outcomes demonstrate that, besides social roles, emotion awareness is an important factor for adaptive empathic reactions, whereas emotion dysregulation might cause distress when witnessing the negative feelings of others.