拯救肢体畸残患者的“菩萨”——秦泗河从事儿麻后遗症矫治30年的纪念

秦泗河医生30年来坚守于基层乡、区级医院,毕生心血奉献于小儿麻痹后遗症——肢体畸残矫治事业,开创了肢残矫治“前无古人,后无来者”的秦泗河畸代,值得珍惜、尊重和纪念,更是为了记住历史,给这样的事业以应有的地位和尊重。其多重意义,将为医学界带来激励和启迪。     

Paranoid delusions and threatening hallucinations: a prospective study of sleep paralysis experiences

Previously we reported a three-factor structure for hallucinations accompanying sleep paralysis (SP). These earlier analyses were, however, based on retrospective accounts. In a prospective study, 383 individuals reported individual episodes online providing further evidence for the three-factor structure as well as clearer conceptually meaningful relations among factors than retrospective studies. In addition, reports of individual episodes permitted a more fine-grained analysis of the internal structure of factors to assess predictions based on the hypothesis that a sensed or felt presence (FP) is a core experience affecting other SP hallucinations. Results were generally consistent with this hypothesis. In particular, associations among, and temporal stability of, sensory hallucinations were largely explained by their common association with FP. The findings are consistent with REM initiation of a threat activated vigilance system with pervasive effects on the SP experience and suggest a potential model for the thematic organization of nightmares and dreams more generally.     

Felt presence: paranoid delusion or hallucinatory social imagery?

Cheyne and Girard characterize felt presence (FP) during sleep paralysis attacks as a pre-hallucinatory expression of a threat-activated vigilance system. While their results may be consistent with this interpretation, they are nonetheless correlational and do not address a parsimonious alternative explanation. This alternative stipulates that FP is a purely spatial, hallucinatory form of a common cognitive phenomenon—social imagery—that is often, but not necessarily, linked with threat and fear and that may induce distress among susceptible individuals. The occurrence of both fearful and non-fearful FPs in a multiplicity of situations other than sleep paralysis attacks supports the notion that FPs are hallucinatory variants of social imagery and that they are not necessarily bound to threat-activated vigilance. Evidence linking FPs with anxiety disorders supports the notion that the distress they evoke may be mediated by a more general affective distress personality factor. To illustrate the predominantly spatial character of FP hallucinations, similarities between FP and phantom limbs are summarized and the possibility that these two phenomena are parallel expressions (self- vs. other-presence) of a mirror neuron system is considered.     

The nature and varieties of felt presence experiences: A reply to Nielsen

Nielsen [Nielsen, T. (2007). Felt presence: Paranoid delusion or hallucinatory social imagery? Consciousness and Cognition, 16(4), 975–983.] raises a number of issues and presents several provocative arguments worthy of discussion regarding the experience of the felt presence (FP) during sleep paralysis (SP). We consider these issues beginning with the nature of FP and its relation to affective-motivational systems and provide an alternative to Nielsen’s reduction of FP to a purely spatial hallucination. We then consider implications of the “normal social imagery” model. We can find only one specific empirical hypothesis articulated within this framework and it turns out to be one that we explicitly addressed in our original paper. We also review our position regarding the possible relation of FP during SP to a number of related anomalous experiences and contrast FP to anomalous vestibular-motor (V-M) phenomena. We review our position that the neuromatrix concept, in the light of available evidence, is more appropriately applied to V-M experiences than FP. Finally, we pursue speculations, raised in Nielsen’s commentary, on the wider implications of FP.     

19世纪帕金森病的研究历史

1817年Parkinson首先描述了震颤麻痹,此后的45年中陆续出现了一些相关报道,但并未增加有价值的临床信息。1861年以后,Charcot对此病进行了深入的研究,认识到动作缓慢是本病的核心症状之一,并将其与肌强直鉴别开。他细致地描述了面具脸等症状,认为震颤并非诊断的必要因素,在命名上建议用帕金森病来取代震颤麻痹。     

Associations between sleep variables and ostensibly paranormal experiences and paranormal beliefs: A scoping review

Night-time is a period of great significance for many people who report paranormal experiences. However, there is limited understanding of the associations between sleep variables and seemingly paranormal experiences and/or beliefs. The aim of this review is to improve our understanding of these associations while unifying a currently fragmented literature-base into a structured, practical review. In this pre-registered scoping review, we searched for relevant studies in MEDLINE (PubMed), PsycINFO (EBSCO), Web of Science and EMBASE using terms related to sleep and ostensibly paranormal experiences and beliefs. Forty-four studies met all inclusion criteria. All were cross-sectional and most investigated sleep paralysis and/or lucid dreaming in relation to ostensibly paranormal experiences and paranormal beliefs. Overall, there were positive associations between many sleep variables (including sleep paralysis, lucid dreams, nightmares, and hypnagogic hallucinations) and ostensibly paranormal experiences and paranormal beliefs (including those of ghosts, spirits, and near-death experiences). The findings of this review have potential clinical implications such as reducing misdiagnosis and treatment development and provide foundations for further research. Our findings also highlight the importance of understanding why so many people report ‘things that go bump in the night’.     

Tonic immobility and childhood sexual abuse: a preliminary report evaluating the sequela of rape-induced paralysis

The present study examined tonic immobility (TI) in victims of childhood sexual abuse (CSA). Female undergraduates (n=39) and female psychiatric inpatients (n=41) who experienced CSA completed a series of questionnaires assessing aspects of their victimization history, psychological functioning, and TI symptoms. Over fifty-two percent of all participants reported TI in response to CSA. Episodes of CSA involving attempted or completed penile/vaginal penetration were more likely to be associated with an increased likelihood of experiencing TI, and report of TI was associated with greater current psychological impairment. The implications of these findings are discussed, and suggestions for future research are offered.     

针灸治疗周围性面瘫随机对照研究的文献分析

遵循循证医学评价文献的原则,在中国生物医学文献数据库、CNKI等数据库全面检索2002—2006年间的相关文献并进行计量学评价分析。共检索出文献1284篇,其中RCT文献共有169篇,按照循证医学评价文献的原则及方法,从研究对象、随机分配方法、对照措施、盲法采用情况等多个方面进行分析评价。2002—2006五年间报道的RCT数量比从建国到2000年报道的RCT数量多,但仍需进一步改善文献质量。     

创伤性截瘫患者的人文关怀

截瘫是一种严重的残疾,其中大部分是由外伤导致脊髓损伤而引起的。在目前的急救护送、诊治方法和康复治疗中仍然存在很多不足。中国的人文关怀有着深厚的传统根基,已经渗透到各个领域。本文就如何应用人文关怀的精神关爱截瘫患者,更好地构建和谐社会谈几点看法。     

‘Paralysed associations’: countertransference difficulties in recognising meaning in the treatment of children on the autistic spectrum

Children with autism can have a paralysing effect on the clinician’s capacity to associate freely: connections that seem obvious on reflection may be impossible to notice in the child’s presence. The author argues that this situation can be reached by more than one pathway, and that the degree of the child’s bodily and emotional cohesion is an important factor. Children may seek to immobilise the therapist’s thought processes through projective identification, whether to communicate their own experience of paralysis or because these thought processes are equated with a parental intercourse that produces a ‘baby’ (as described by Bion and Britton). Vignettes are offered to illustrate how the therapist may be nudged into overlooking this baby as well as a potentially growing part of the child that is identified with it, with important consequences for development. A second possible pathway appears to involve the much more primitive mechanism of adhesive identification, in which the child’s sense of continuing existence depends on sticking to the therapist’s surface and any movement can lead to a sense of bodily disintegration. In the clinical illustration, the therapist felt physically constrained and unable to recognise links in the material: it is suggested that this was in resonance with the child’s fear that movement, whether physical or mental, meant losing parts of his body and must be avoided at all costs. These levels can mask each other, and it seems essential to attend to both in order to avoid impasse or the overlooking of essential aspects of the child’s experience.