德国卫生保健体系改革及相关伦理问题简析

从德国现有卫生保健及医疗保险体系在保障其社会稳定的重要作用角度出发,介绍了德国的原有整体医疗卫生保障体系的背景,指出政府的指导、政策稳定、完善的津贴体系保障了整体国民健康和卫生保健的公平分配,高素质,医术高超的医生队伍起到了核心作用。同时指出由于意识形态和经济原因,德国卫生保健体系改革所引发的问题。     

Is there an optimal factor structure of the Positive and Negative Syndrome Scale in patients with first‐episode psychosis?

The Positive and Negative Syndrome Scale (PANSS) is the most widely used scale to assess a variety of symptoms in patients with schizophrenia and other psychoses. The factor structure of the PANSS has been examined with confirmatory factor analyses in several studies, but not in a well‐defined first‐episode psychosis sample. The aim of this paper is to examine the statistical fit of five different PANSS models in a first‐episode, non‐affective psychosis sample. Confirmatory factor analyses were performed on PANSS data (n = 588). A main criterion for best fit was defined as the Expected Cross Validation Index (ECVI). No tested model revealed an optimally satisfactory model fit index. The Wallwork/Fortgang five‐factor model demonstrated the most optimal psychometric properties. The corresponding subscales of all evaluated five‐factor models were strongly intercorrelated. The Wallwork/Fortgang five‐factor model was found to be statistically and clinically ideal among patients with first‐episode psychosis. Therefore, we recommend this model in forthcoming studies among patients with first‐episode psychosis. However, to prevent the loss of clinically valuable information on an item level, we do not recommend removing any items from the original form. Our study also implies that the specific choice of model will not have a substantial effect on outcome results in studies on the course and outcome in first‐episode psychosis.     

Assessment of visual acuity in preschool children

Abstract.— Problems in testing visual acuity of preschool children were discussed with regard to choice of optotype and test distance, illumination, instruction and response indicator, and the motivational aspect of the test situation. A test situation conforming to these requirements for measuring visual acuity was arranged for testing of preschool children, using a discrimination learning paradigm with simultaneous presentation of the cues. The test figures were two Landolt Cs of equal size but one with the gap filled in, thus forming a circle. Small toys were used as rewards for choosing the Landolt C. Of 27 children, 2–6 years of age, 25 achieved a visual acuity level corresponding to a Snellen value of 20/20. The results thus indicate a better visual acuity for preschool children than is commonly believed.     

Sex-role related personality traits and irrationality

Among undergraduate psychology students, masculinity and femininity scores on the Personal Attributes Questionnaire were correlated with a measure of irrational value orientation. Both for women and men significant negative correlations between masculinity and irrationality were found. Feminity and irrationality proved to be unrelated in both sex groups. Finally, no interaction effect of masculinity and feminity on irrationality was obtained.     

Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder

Hellvin, T., Sundet, K.,Vaskinn, A., Simonsen, C.,Ueland, T., Andreassen, O.A. & Melle, I. (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology 51, 525–533. Studies of social functioning in severe mental disorders are disadvantaged by the multitude of different assessment instruments in use. The present study aims to establish reliability and validity of the Norwegian version of the Social Functioning Scale (SFS) and to examine social functioning in bipolar disorder (BD) compared to schizophrenia (SZ) and healthy controls (HC). SFS, a 76 item questionnaire divided into seven subscales measuring various aspects of daily life functioning, was administered to samples diagnosed with BD (n = 100) or SZ (n = 100) and to HC (n = 100), recruited from the ongoing Tematic Organized Psychosis (TOP) study. Reliability analyses prove adequate psychometric properties both for the composite full scale score (α: 0.81) as well as for the seven subscale scores (α: 0.60–0.88). Principal component analysis of the subscales confirms a one‐component structure, explaining 59% of the variance. Although significantly correlated with the Global Assessment of Functioning, our results indicate that the SFS measures different aspects of social functioning, is less influenced by demographic and clinical characteristics, but differentiates at the same time significantly BD from SZ. Thus, SFS adds valuable information as a supplement to standard clinician‐rated assessment tools of social functioning, suited both for research and clinical work.     

Normative data for eight neuropsychological tests based on a Danish sample

Normative neuropsychological data have been provided using a sample of 101 persons aged 20 to 54 years. Eighty-seven of the subjects were recruited among patients who had undergone minor surgery, and 14 subjects were volunteers from the staff at the hospital laundry. The measures consisted of seven subjects from the WAIS-R, the trail-making test, symbol digit modalities test, auditory-verbal learning test, story recall test, visual gestalt test, recurring figures test, verbal fluency, and Purdue pegboard test. These measures were selected because of suitability in regard to time taken for testing each subject and their sensitivity to subtle changes in neuropsychological functioning. The sample was arbitrarily divided into three age groups, and for each of the three samples, mean, standard deviation, and range were calculated for each test. The results of the Information and Vocabulary subtests from the WAIS-R, education, and social status were applied as independent variables in linear regression analyses where each of the neuropsychological tests, in turn, was the dependent variable. For the oldest age group, age in addition was used as an independent variable. Significant linear relationships, which accounted for an optimal part of the variance, were selected for clinical application.     

Dialectical and hermeneutical psychology

Dialectical and hermeneutical contributions to psychology are reviewed separately for the countries Denmark, Finland, Norway, and Sweden. Then, selected contributions are presented more extensively from the areas of family, socialization, and therapy; behavior therapy; educational psychology; research methods; and general psychology. Particularly in the area of family and socialization, dialectical and hermeneutical approaches have contributed to the application of, and reflection upon, therapy as a research method. The impact of dialectical and hermeneutical thought on Scandinvian psychology is too diverse to talk about any specific school, in either of the two traditions. Some main points of emphasis are, though: the qualitative study of individual cases, particularly through therapy; the focus on the internal unity of individual acts with the historical and material context of the act; the impact of the dominating mode of production upon every sphere of human life; the focus on issues of interpretation, particularly the relation of appearance and essence; and the conception of the object of psychology as a developing individual in a historical world.     

Embedded Figures Test compared with clinical tests of abstraction and memory in intellectual impairment

Results on a batter of memory and concept formation tests were compared with performance on the Embedded Figures Test (EFT) and the Visual Gestalts Test for 50 psychiatric patients with intellectual impairment (35 males and 15 females, aged 25–69 years). The EFT only correlated with the concept formation tests and the Visual Gestalts Test. Furthermore, an interrelationship between the EFT results and the degree of intellectual impairment was found. Also, the patients' performance on the EFT was significantly impairment was found. Also, the patients' performance on the EFT was significantly poorer than that of normal individuals. Thus it was concluded that the EFT should be considered as a visuo-spatial test of abstraction, sensitive to intellectual impairment.     

KNOWLEDGE AND IMAGINATION IN FICTION AND AUTOBIOGRAPHY

Abstract: Autobiographies are particularly interesting in the context of moral philosophy because they offer us rare and extended examples of how other people think, feel and reflect, which is of crucial importance in the development of phronesis (practical wisdom). In this article, Martha Nussbaum's use of fictional literature is shown to be of limited interest, and her arguments in Poetic Justice against the use of personal narratives in moral philosophy are shown to be unfounded. An analysis of Aristotle's concept of mimesis shows that Nussbaum's claims for fictional literature also apply to personal narratives. A case is then made for the importance of personal narratives in developing practical wisdom, and three sub‐genres of autobiography are discussed: (1) the confession, (2) the apology and (3) the testimonial. These sub‐genres exemplify some of the unique features of personal narratives.