Identifying environmental contributions to autism: provocative clues and false leads

The potential role of environmental factors in autism spectrum disorders (ASD) is an area of emerging interest within the public and scientific communities. The high degree of heritability of ASD suggests that environmental influences are likely to operate through their interaction with genetic susceptibility during vulnerable periods of development. Evaluation of the plausibility of specific neurotoxicants as etiological agents in ASD should be guided by toxicological principles, including dose-effect dependency and pharmacokinetic parameters. Clinical and epidemiological investigations require the use of sufficiently powered study designs with appropriate control groups and unbiased case ascertainment and exposure assessment. Although much of the existing data that have been used to implicate environmental agents in ASD are limited by methodological shortcomings, a number of efforts are underway that will allow more rigorous evaluation of the role of environmental exposures in the etiology and/or phenotypic expression of the disorder. Surveillance systems are now in place that will provide reliable prevalence estimates going forward in time. Anticipated discoveries in genetics, brain pathology, and the molecular/cellular basis of functional impairment in ASD are likely to provide new opportunities to explore environmental aspects of this disorder.     

THE SECOND SPHERE AND THE STORY OF NO STORY

The author discusses Roy Schafer's ideas of the second self and second reality, as well as his consistent theme of storyteller and story. The latter theme is also explored in the context of more recent psychoanalytic influences, such as Bionian thought, trauma theory, the French approach, and the interpersonal perspective. To illustrate the idea of the nonstory in today's clinical encounters, the author presents two clinical vignettes.     

Counselor Competency in the Courtroom

This article outlines general courtroom procedures and offers systematic practical advice for the counselor testifying as an expert witness. Major topics include the counselor role in court, preparing for testimony, answering questions, and dealing with the cross-examination.     

The role of sincere amends and perceived partner responsiveness in forgiveness

In a sample of 188 people currently in a romantic relationship, the authors examined the extent to which perceiving a partner as responsive and sincere in making amends relates to participants' forgiveness of a partner after a real‐life hurtful event. Specifically, it was predicted that sincere amends would be associated with greater forgiveness because it conveys that one's partner has understood and validated one's experience of the hurtful event. Results supported this mediational model. Further, exploratory analyses suggested that this meditational model is moderated by event severity and relationship satisfaction. Discussion focuses on understanding how this work might help to inform the dynamic process of forgiveness in couples.     

自然分娩与剖宫产的比较研究

剖宫产不是一种分娩方式,而是解决难产的手段.日益增高的剖宫产率成为人们关注的热点话题,自然分娩和剖宫产对母婴的健康和卫生资源的影响,有很多的研究和争议,对于没有医学指征要求剖宫产目前倾向于在知情同意的情况下尊重患者的自主权和选择权,但控制剖宫产率在一个理性的范围之内,是一个系统工程,值得全社会的关注.