儿童心理虐待与情绪行为问题:社会支持的中介效应

目的:探讨社会支持在儿童心理虐待与情绪行为问题之间的中介作用。方法:采用方便抽样的方法,对1605名中小学生采用儿童心理虐待量表、中小学生心理虐待自评量表、领悟社会支持量表以及长处和困难量表进行测量。结果:中介效应检验结果表明,儿童心理虐待对情绪行为问题既有直接效应又有间接效应,且以直接效应为主。结论:儿童心理虐待不仅直接影响个体的心理健康,同时还通过社会支持间接影响心理健康。     

医学新生儿童期心理虐待与创造力、认知偏差的调查分析

目的:了解海南医学新生的儿童心理虐待状况;比较不同创造力、认知偏差类型的学生的儿童期心理虐待差异。方法:方便取样,采用儿童心理虐待量表、卡特尔多项人格量表-创造力、认知偏差问卷对365名自愿参与的海南省某医学院临床医学专业2014级新生进行测量,对数据进行t检验和方差分析。结果:男生的恐吓、贬损、干涉、纵容维度得分高于女生(t=2.38,2.17,2.40,2.72;P均0.05);独生子女医学新生的忽视维度得分低于非独生子女者,而干涉维度得分高于后者(t=-3.82,2.17;P均0.05);单亲家庭医学新生的忽视和贬损维度得分高于非单亲学生(t=2.80,3.24;P均0.05)。不同创造力等级的医学新生在儿童心理虐待得分上的差异无统计学意义。不同认知偏差类型的医学新生在贬损、干涉维度得分上的差异均有统计学意义(F=10.92,13.54;P均0.001)。结论:不同性别、是否独生、是否单亲的医学新生在儿童期遭受的心理虐待不一样;不同创造力的医学新生在儿童期遭受的心理虐待无差异;不同认知偏差类型的医学新生在童年期遭受的贬损和干涉高于其他类型者。     

大学生自尊与主观幸福感的关系:应对方式的中介作用

目的探讨应对方式在大学生自尊与主观幸福感之间所起的潜在中介作用,为大学生心理健康教育工作提供科学依据和指导。方法采用生活满意度量表、积极消极情感量表、Rosenberg自尊量表和简易应对方式问卷对286名大学生进行问卷调查,并运用结构方程模型技术探讨应对方式在自尊与主观幸福感之间所起的中介作用。结果相关分析发现自尊和积极应对与生活满意度和积极情绪显著正相关(r=0.15~0.42,P0.05);自尊与消极情绪显著负相关(r=0.48,P0.001);消极应对方式与消极情绪显著正相关(r=0.30,P0.001);自尊与积极应对方式显著正相关(r=0.27,P0.001),与消极应对方式显著负相关(r=-0.23,P0.001)。中介效应分析发现,消极应对在自尊与主观幸福感之间的关系中起部分中介作用(β=0.08,P0.05)。结论自尊既可以直接影响主观幸福感,也可以通过消极应对的中介作用间接影响主观幸福感。     

大学生情绪调节自我效能感在虐待与抑郁间的中介作用

目的:探讨大学生情绪调节自我效能感与儿童期虐待经历的关系,以及情绪调节自我效能感在虐待与抑郁间的中介作用。方法:从哈尔滨市4所高校选取475名大学生,采用情绪调节自我效能感量表(RES)的中文版、儿童期虐待问卷(CTQ)、流调中心用抑郁量表(CES-D)进行测查,其中CTQ采用回顾性调查。结果:躯体忽视和躯体虐待负向预测调节积极情绪效能感(POS)(β=-0.38、-0.52);情感忽视和性虐待负向预测调节沮丧/痛苦情绪效能感(DES)(β=-0.35、-0.31);躯体忽视负向预测调节生气/愤怒情绪效能感(ANG)(β=-0.23);躯体忽视和躯体虐待正向预测抑郁(β=0.78、3.20)。POS在情感忽视、躯体忽视、性虐待与抑郁之间具有中介作用(中介效应介于0.021~0.029);DES在情感忽视、躯体忽视、躯体虐待、性虐待与抑郁之间起着中介作用(中介效应介于0.017~0.040);ANG在情感忽视、躯体忽视与抑郁之间存在中介作用(中介效应介于0.016~0.019)。结论:低情绪调节自我效能感可能与儿童期虐待经历有关,情绪调节自我效能感在虐待与抑郁之间具有中介作用。     

儿童期虐待、大五人格对医学生自尊水平影响的路径分析

目的考察医学生儿童期虐待、大五人格与自尊水平的关系,为大学生心理障碍的干预提供依据。方法采用整群抽样法,对某医学院262名医学生进行调查,使用儿童期虐待史自评量表(PRCA)、自尊量表(SES)、简式大五人格问卷(NEO-FFI-R)等问卷进行现场测试,用结构方程模型分析软件Amos7.0作路径分析。结果儿童期虐待对神经质有直接正向影响(β=0.255,P<0.01),对外向性、友善性和谨慎性有直接负向影响(β=-0.251,-0.224,-0.166,P<0.01);神经质对自尊有直接负向影响(β=-0.278,P<0.01),外向性对自尊有直接正向影响(β=0.190,P<0.01);儿童期虐待对自尊没有直接影响(P>0.05)。神经质和外向性作为中介变量全部中介着儿童期虐待对自尊的影响。结论儿童期虐待对医学生自尊水平具有间接影响,而无直接影响,大五人格在儿童期虐待和自尊之间起完全中介作用。     

社会情绪能力对初中生社会适应能力的影响:同伴关系与自尊的链式中介作用

目的:探讨社会情绪能力对初中生社会适应能力影响的作用机制.方法:采用社会情绪能力量表、同伴关系量表、自尊量表和社会适应能力量表对988名初中生进行调查.结果:①社会适应能力与社会情绪能力和自尊呈现正相关(r = 0.33,0.50,P＜0.001),与同伴关系呈现负相关(r=-0.47,P＜0.001);②社会情绪能力可以正向预测初中生社会适应能力(y=0.37,P＜0.001);③同伴关系和自尊在社会情绪能力和初中生社会适应能力之间起部分中介作用.且该中介作用包含3条路径:一是同伴关系的单独中介作用;二是自尊的单独中介作用;三是同伴关系和自尊的链式中介作用(25.83％、35.07％和11.25％).结论:社会情绪能力不仅直接影响初中生社会适应能力,还通过同伴关系和自尊间接影响初中生社会适应能力.     

大学生完美主义与抑郁:自我效能感的中介作用和自尊的调节作用

目的:探讨自我效能感和自尊在大学生完美主义与抑郁之间的中介作用和调节作用。方法:采用近乎完美主义量表、抑郁问卷、一般自我效能感量表以及自尊量表对389名大学生进行测量。结果:1消极完美主义与抑郁之间呈现出显著的正相关(r=0.208,P0.001),与自我效能感之间呈现出显著的负相关(r=-0.194,P0.001);积极完美主义与抑郁之间呈现出显著的负相关(r=-0.307,P0.001);自我效能感和自尊均与抑郁呈现出显著的负相关(r=-0.585,-0.236;P0.001);2自我效能感在消极完美主义与抑郁之间起完全中介的作用(β=-0.557,P0.001);3自尊在积极完美主义与抑郁之间起调节作用(β=1.127,P0.05)。结论:完美主义对大学生心理健康可以产生积极的影响也可以产生消极的影响,其中消极完美主义通过影响自我效能感进而对抑郁产生促进作用,积极完美主义则在自尊的共同影响下对抑郁产生抑制作用。     

农村青少年的心理健康与网络行为

目的:研究四川农村青少年心理健康和网络行为的现况及影响因素,以及二者相互影响关系。方法:抽取2所农村中学的2745例初一和高一学生,采用中学生心理健康量表(MMHI)、自尊量表(SES)和社会支持量表(SSRS)分别评估其心理健康状况、自尊和社会支持程度,问卷调查其社会人口学特征和网络行为情况,通过非递归结构方程模型分析各因素对心理健康和网络行为的效应及二者相互关系。结果:心理健康量表平均得分为(2.1±0.7)分,其中学习压力感(2.4±0.9)分、情绪不稳定(2.4±0.8)分、焦虑(2.4±1.0)分三个维度得分较高。长时间上网行为率为32.8%(899/2745)。结构方程模型分析显示,女性、年龄越大的青少年MMHI得分越高(β=0.058、0.058,P0.001),男性、年龄越大的青少年长时间上网行为越多(β=-0.171、0.149,P0.001)。SES得分和SSRS得分与MMHI得分负向关联(β=-0.300、-0.263,P0.001),并通过心理健康的中介作用间接负向影响网络行为(βi=-0.074、-0.065,P0.010)。MMHI得分正向影响长时间上网行为(β=0.246,P0.001);长时间上网行为也正向影响MMHI得分(β=0.008,P0.001),但影响力较弱。结论:农村青少年总体上心理健康问题较轻,网络行为较普遍,心理健康低水平与长时间上网行为互为危险因素。     

自尊对女大学生抑郁情绪的影响:应对方式的中介作用

目的:探索自尊对女大学生抑郁的影响,及应对方式在二者之间的中介作用。方法:采用罗森伯格自尊量表、抑郁自评量表、简易应对方式量表对322名女大学生进行了实测。结果:女大学生抑郁检出率较高;自尊、积极应对方式与抑郁显著负相关(r=-0.50,0.43;P0.001),消极应对方式与抑郁显著正相关(r=0.33,P0.001);自尊显著负向预测抑郁(β=-0.55,P0.001),积极应对和消极应对在自尊与抑郁之间起并列中介作用。结论:自尊不仅直接作用于女大学生抑郁,还通过应对方式间接影响其抑郁情绪。提升女大学生自尊,锻炼其积极应对方式有助于缓解其抑郁情绪。     

高职新生自我和谐对学校归属感的影响:人际关系的中介作用

目的:探讨高职新生自我和谐对学校归属感的影响,并验证人际关系在其中的中介作用。方法:以河北省内某职业技术学院821名2015级新生为调查对象,使用自我和谐量表(SCCS)、人际关系综合诊断量表和学校归属感量表(PSSM-CR)进行测量。结果:高职新生自我和谐与人际关系困扰呈显著正相关(r=0.565,P0.001),自我和谐、人际关系与学校归属感呈显著负相关(r=-0.458,-0.417;P0.001)。高职新生的自我和谐对人际关系困扰有显著地正向预测作用(β=0.231,P0.001);人际关系困扰在自我和谐和学校归属感间具有部分中介作用,中介效应比为28.6%。结论:自我和谐不仅能直接影响高职新生的学校归属感,还能通过人际关系困扰间接影响其学校归属感。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.