Expressed Emotion In The Narrative Context of Family Photographs

This study aims to elucidate cognitive and contextual aspects of the EE (Expressed Emotion) concept. The EE levels of both parents of two first admission psychotic patients were rated from the Five Minute Speech Sample (FMSS), and the emotional responses were further analyzed in narratives of family photographs. The attribution model was found to provide an explanatory framework for understanding relatives' expressed emotions (EE) toward a family member suffering from psychotic disturbances. Four case reports indicated that family photographs induced parents to create narratives in which emotions, attributions, and strategies for coping with stressful aspects of the illness came forward as intertwined phenomena. The method can offer more comprehensive data for intervention strategies aiming to alter the prevailing atmosphere and interaction patterns within the high EE family.     

The Experience of Time in Acute Psychosis and Schizophrenia

From the narrative point of view the plot of a story configures time. In psychosis, when experiences remain unnarrated, experience being-in-time is also missing. Once experiences are given narrative form, they can be left behind as a part of individual's personal history, thus enabling present experiences to be narrated. Unnarrated experiences do not accumulate. Narrative history contains, however, enough redundancy to invite you to restory your past in a new way if you need to. Hence, from the narrative point of view, early, family- and network-centered intervention is of special value in cases of acute psychosis.     

急性应激损伤错误监控与错误后调整

生活中, 个体会时时关注自己的行为结果并及时做出调整以适应环境的变化。但在应激下个体能否有效地监控行为并做出适应性调整依然未知。本研究招募了52名男性大学生被试, 将其随机分入应激组与控制组, 采用特里尔社会应激测试(Trier Social Stress Test, TSST)诱发个体的应激反应, 并结合错误意识任务(Error Awareness Task, EAT)探索个体急性应激下的错误监控与错误后调整过程。应激指标的结果显示应激组个体在应激任务后唾液皮质醇、心率、应激感知自我报告和负性情绪均显著高于控制组, 表明急性应激的诱发是成功的。行为结果显示应激组的错误意识正确率显著低于控制组, 错误意识反应时显著短于控制组; 进一步地, 应激组个体在意识到错误之后的试次上正确率显著低于未意识到错误之后的试次, 并且应激组个体在意识到错误之后的试次上正确率低于控制组。结果表明急性应激降低了个体对错误反应的监控水平, 即便在辨别出错误反应的情况下, 个体的行为监控与调节也更差。本研究说明急性应激会损伤行为监控系统, 导致个体的行为适应性下降。     

急性应激损害对威胁刺激的注意解除

急性应激会增强个体对威胁刺激的注意偏向, 但急性应激是增强了对威胁刺激的注意定向还是损害了对威胁刺激的注意解除还不清楚。本研究采用社会评估冷压任务和点探测任务, 结合事件相关电位技术, 考察急性应激对威胁刺激注意偏向影响的认知机制。在进行社会评估冷压任务后, 应激组个体的状态焦虑和皮质醇浓度显著升高。在注意偏向中, 应激组对威胁刺激的注意解除比控制组更慢, 应激组和控制组在对威胁刺激的注意定向上无显著差异。ERP结果上, 威胁刺激诱发应激组比控制组产生了更负的SPCN, 在N2pc上没有显著差异。应激组和控制组皮质醇增量的差异和N2pc、SPCN的组间差异均有显著正相关。这些结果说明, 急性应激增强对威胁刺激的注意偏向是因为其损害个体对威胁刺激的注意解除, 这可能是因为急性应激损害了与注意解除相关的额-顶网络的功能所致。     

Effect of Acute Psychological Stress on Motion-in-Depth Perception: An Event-Related Potential Study

The present study explored the intrinsic event-related potential (ERP) features of the effects of acute psychological stress on the processing of motion-in-depth perception using a dual-task paradigm. After a mental arithmetic task was used to induce acute psychological stress, a collision task was used to evaluate motion-in-depth perception. The error value and average amplitude of late slow waves (SW) were significantly larger for the earlier colliding spheres’ than for the later colliding spheres. The P1 peak latency in the left occipital region was significantly shorter than that of the right occipital region in the motion-in-depth perception task. Compared to the control condition, the estimated value of residual time-to-collision and error value were significantly reduced, and the N1 peak amplitude and the SW averaged amplitude were significantly increased in the stress condition. Longer motion-in-depth time improved discrimination accuracy and decreased the investment of cognitive resources. Acute psychological stress increased behavioral performance and enhanced attention resources on the motion-in-depth perception task together with greater investment of cognitive resources.     

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction--the Swedish version

When people's health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also investigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach's alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R's seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception.     

CBT/DBT-Informed Intensive Outpatient Treatment for Anxiety and Depression: A Naturalistic Treatment Outcomes Study

Anxiety and depression are highly prevalent and disabling mental health disorders, with comorbidity often posing as a barrier to successful treatment outcomes, thus creating a need for more intensive treatment options. Outpatient clinicians are more likely to refer patients with severe symptoms of anxiety and depression to inpatient hospitalizations rather than partial hospital programs (PHPs) or intensive outpatient programs (IOPs), despite evidence that inpatient hospitalization is associated with high costs and other risks following discharge. The present study reviews two case studies of patients who received cognitive-behavioral therapy/dialectical behavior therapy (CBT/DBT)-based IOP treatment in a private New York clinic. We evaluated treatment outcomes for 73 adult patients (50.7% female) with a mean age of 29.10 years (SD = 10.30). At intake, patients averaged 2.15 diagnoses (SD = 0.94, range = 4) and the majority (80.8%) were prescribed psychotropic medication. Treatment was structured and individually tailored, with patients receiving an average of 21.77 hours (SD = 15.06) of psychotherapy over 12.63 treatment sessions (SD = 9.76), across 12.21 days (SD = 9.61). We observed a clinically and statistically significant change in symptoms of anxiety (t = 6.24, p < .001), depression (t = 5.55, p < .001), and suicidality (t = 2.32, p < .05) over the course of the IOP. After completing treatment, 68.1% of participants tapered down to once-weekly treatment. The present study highlights the clinical utility of an IOP and suggests that this approach can be effective for adult patients presenting with severe symptoms of anxiety and/or depression.     

AMAs及其靶抗原在原发性胆汁性肝硬化发病中的作用

原发性胆汁性肝硬化（PBC）是一种以慢性进行性胆汁淤积为特点的自身免疫性肝病,血清中抗线粒体抗体（AMAs）,尤其AMA-M2升高是该病的特异性表现.AMAs在PBC发病过程中的作用是研究重点之一.丙酮酸脱氢酶复合物（PDC）的E2亚单位（PDC-E2）是AMAs的主要抗原.诱发AMAs靶抗原暴露和打破免疫耐受的主要诱因是感染及化学因素.后者或与靶抗原交叉反应,或通过对靶抗原的化学修饰,或是使凋亡后抗原的清除发生障碍,从而促进AMAs的产生.针对PDC-E2的细胞免疫主要参与PBC的发病.AMAs在PBC发病中的作用存在争议,更多研究认为其不参与PBC的发病.     

自身免疫性胰腺炎的诊治进展

自身免疫性胰腺炎（AIP）是一种特殊类型的慢性胰腺炎,以胰腺肿大及胰管不规则狭窄为特征.AIP分两个亚型：Ⅰ型AIP好发于亚洲老年人,为淋巴浆细胞硬化性胰腺炎;Ⅱ型AIP多见于西方人,为导管中心型胰腺炎.AIP缺乏特异性血清标志物,诊断主要依赖于其特征性改变.依据AIP诊断标准国际共识,AIP的诊断包括影像学、血清学、胰腺外器官受累、组织病理学和诊断性激素治疗5个方面.糖皮质激素是AIP的首选治疗方法,但复发率高,免疫调节剂对维持AIP的持续缓解具有一定作用.AIP总体预后良好,胰管结石和癌变是其潜在的并发症,但发生率极低.