情绪抑制和认知重评对BPD患者负性情绪的影响

目的:比较情绪抑制和认知重评两种调节方式对BPD患者负性情绪的影响.方法:以20名BPD患者为被试,采用生理心理实验法测量被试观看电影片段的主观体验变化和生理反应变化.结果:在观看负性情绪片段3期间,认知重评组的负性体验较少、生理唤起较低;在情绪恢复阶段,认知重评组的负性情绪恢复得更快.结论:认知重评能有效调节BPD患者的负性情绪.     

不同民族创伤后应激反应模式比较的质性研究——汶川地震后对羌汉幸存者的访谈分析

目的:探讨汶川地震中羌汉民族间创伤后应激反应模式的差异,并分析其原因,为有效地对灾害幸存者进行心理救助和干预提供依据。方法:以2008年5.12汶川地震的重灾区北川为例,运用目的性抽样的方法,分别对23个羌族和23个汉族幸存者进行了个案访谈,收集了他们对地震灾难的认知方式、反应模式和应对方式等方面的资料。结果:羌汉民族间在创伤后应激反应模式上具有差异,羌族幸存者倾向于更直接的表达情绪和行为;而汉族幸存者则倾向于含蓄内敛化。同时,两个民族在对灾难的归因方式及应对方式上也存在一些差异。结论:羌汉民族间创伤后应激反应模式存在差异,这种差异部分可能是由于民族文化差异造成的,同时,资源保存理论也提供了很好的解释。     

汶川地震幸存者的创伤后应激障碍及其影响因素

目的:评估汶川大地震对幸存者所带来的心理影响,以便为进行心理援助和治疗的临床工作者提供更有价值的诊断信息。方法:对安置在绵竹体育中心灾民安置点的956名地震幸存者施测了创伤暴露水平问卷,事件冲击量表(IES-R)和D型人格量表(DS-14)。结果:在地震发生之后不久,有82.6%的被试表现出创伤后应激障碍;在地震中创伤暴露水平高的被试更有可能表现出创伤后应激障碍;女性被试、中年被试、已婚被试以及拥有D型人格的被试更可能产生创伤后应激障碍;回归分析的结果表明性别、年龄、婚姻状态、创伤暴露水平以及D型人格中的负性情绪是影响被试是否表现出创伤性应激障碍的关键因素。结论:有较高比例的地震幸存者表现出创伤后应激障碍,高创伤暴露水平、女性、中年、已婚和负性情绪是幸存者表现出创伤后应激障碍的主要影响因素。     

认知倾向在大学生压力与负性情绪关系中的中介作用

目的:探讨认知倾向在大学生压力与负性情绪之间的中介作用.方法:采用压力感问卷、流调中心用抑郁问卷(CES-D)、状态焦虑问卷(STAI)和认知倾向问卷对391名大学生进行测查.结果:(1)压力与负性情绪关系密切,但存在明显的个体差异;(2)无论压力情境如何,持有乐观认知倾向的个体比持有悲观认知倾向的个体较少体验到抑郁、焦虑.其中,在较高压力情境下悲观倾向组的抑郁、焦虑体验最多,而在较低压力情境下乐观倾向组的抑郁、焦虑体验最少;(3)回归分析表明,认知倾向在压力与负性情绪的关系中发挥了显著的调节作用;(4)在较低压力情境下,认知倾向在负性情绪的性别差异中起着重要的调节作用.结论:认知倾向作为一种内在资源,在大学生压力与负性情绪关系中发挥着重要的中介作用.预防和矫治负性情绪,应重视帮助个体建构积极乐观的认知倾向.     

新冠肺炎疫情中公众风险认知和无意/有意传谣行为的关系：负性情绪的中介作用

目的:探讨新冠肺炎疫情爆发期间公众风险认知、负性情绪和无意/有意传谣行为间的关系。方法:采用风险认知量表、公共卫生事件负性情绪量表、传谣行为量表对1063名公众施测。结果:新冠肺炎风险认知、负性情绪和无意/有意传谣行为之间均呈显著正相关,负性情绪在风险认知和无意传谣行为间起部分中介作用,在风险认知和有意传谣行为间起完全中介作用。结论:风险认知会直接增加公众的无意传谣行为,也会通过增加负性情绪对无意和有意传谣行为产生影响。     

自我认知评估对羞耻认知调节策略选择的影响

目的:考察自我指向和他人指向的自我负性认知评估类型对个体选择特定羞耻情绪认知调节策略的影响。方法:采用情境故事法操纵两种能激发羞耻的负性自我认知评估以诱发个体羞耻情绪,比较两种条件下个体在认知情绪调节策略选择上的差异。结果:①自我指向的自我负性认知评估仅和能维持/扩大羞耻严重程度的消极认知策略有关,而他人指向的自我负性认知评估既和上述消极认知策略有关,又和防御型及修复型策略的选用有关。②自我指向的负性认知评估是羞耻体验中的主要负性认知评估类型,而他人指向的自我负性认知评估常伴随前者出现,并可加剧其强度。结论:自我负性认知评估类型对个体认知调节策略的选择有一定影响,但这一影响的表现是复杂的。     

羞耻和一般负性情绪的认知调节策略

目的:研究个体对羞耻与一般负性情绪的认知情绪调节的差异,以及高低特质羞耻者对羞耻与一般负性情绪的认知调节特点.方法:采用方便取样,500名大学生填写羞耻体验量表(Experience of Shame Scale,ESS)和认知情绪调节问卷(Cognitive Emotion Regulation Questionnaire,CERQ).结果:个体在羞耻情绪和一般负性情绪时使用的认知调节策略有显著差异;高羞耻和低羞耻者倾向于使用不同的认知调节策略,而且这种差异大体一致地存在于调节羞耻情绪和一般负性情绪时.结论:个体对羞耻情绪的认知调节不同于对一般负性情绪的认知调节,特质羞耻者有其独特的认知情绪调节方式.     

沙盘游戏治疗对重复梦影响的个案研究

目的:探讨沙盘游戏治疗对重复梦的影响.方法:用沙盘游戏对1例受重复梦困扰患者进行治疗.结果:治疗后患者的重复梦发生以下变化.(1)发生的频率:梦境出现的频率明显降低或消失;(2)梦的情绪体验:负性情绪越来越少,负性情绪的强烈程度也越来越轻;(3)梦的发展趋向:更为积极;(4)梦的发展速度:更为快捷,外在的干预加快梦境的发展和变化,有明显的发展阶段;(5)梦中重复的元素:朝积极的方向变化.结论:当情绪情感得到释放或所呈现的问题获得解决的时候,有关重复梦不再出现.沙盘游戏对重复梦的干预可能是有效的.     

自杀未遂住院的抑郁症患者自杀前心理体验的定性研究

目的:了解抑郁症患者自杀前2周的主观体验,探究患者自杀前的主观体验和认知特点,为抑郁症患者自杀风险的评估和干预提供依据。方法:选取某三级甲等精神专科医院收治的2周内有自杀未遂史的抑郁症患者22例,对其自杀前的主观体验及自我评价、死亡态度、疾病认知进行深入访谈,运用Colaizzi 7步分析法进行资料分析。结果:抑郁症患者自杀前的负性感受增强、社会联结感降低,对自我、死亡和疾病的认知普遍存在认知歪曲,其中极端化认知歪曲突出。结论:临床上应特别关注负性感受强烈、极端化的认知歪曲突出和社会联结感低的抑郁症患者,并制定有针对性的心理干预措施,以降低此类患者的自杀危险性。     

华北煤炭医学院已经派遣20名心理援助志愿者奔赴四川灾区

2008年5月12日下午2时28分,四川省汶川县发生8级强烈地震灾害。这场突如其来的巨大灾害,不仅给灾区同胞造成了重大的人员伤亡和巨大的经济损失,而且给灾区人民的心理造成了严重创伤。救援灾民不仅需要及时的、充足的医疗和生活物质的援助,更需要科学有效的心理的援助!为使地震给人们带来的心理伤害减轻到最低限度,我院积极响应党和国家的号召,迅速派遣20名心理援助志愿者分4批奔赴抗震救灾一线实施“心理救助”工作。临行前,中国心理卫生协会煤炭分会理事长、学院党委书记李卫中,中国健康心理学杂志主编、院长袁聚祥,中国心理卫生协会常务理事、中国健康心理学杂志执行主编、心理学系主任李建明教授,学院办公室主任王胜本等亲自为志愿者们送行,并且殷殷嘱托:他们希望志愿者们想灾民之所想,急灾民之所急,弘扬唐山抗震精神,把温暖送到灾区人的心坎上;同时,注意劳逸结合,保重身体,圆满完成光荣使命。华北煤炭医学院已经派遣20名心理援助志愿者奔赴四川灾区@朱小茼$华北煤炭医学院心理学系 @张立祥     

汶川地震亲历者心理健康状况调查

目的:研究汶川地震后受灾群众的心理健康状况及影响因素。方法:采用事件影响量表修订版(IES-R)等测量工具,对灾后一月内四川省什邡地区及转入本院的受灾群众共342人进行评估。结果:灾后一月内PTSD症状的发生率为45.9%,女性明显高于男性;两个群体PTSD症状的发生率差异不明显,但什邡地区症状程度较重,消极应对、脱离灾后环境等因素是PTSD症状的影响因素。结论:地震后受灾人群,PTSD症状发生率较高,其中女性群体应受到更多的关注。     

Risk factors for physical symptoms after a disaster: a longitudinal study

BACKGROUND: Although symptoms such as fatigue, headache and pain in bones and muscles are common after disasters, risk factors for these symptoms among disaster survivors have rarely been studied. We examined predisposing, precipitating and perpetuating factors for these physical symptoms among survivors of a man-made disaster. In addition, we examined whether risk factors for physical symptoms differ between survivors and controls.METHOD: Survivors completed a questionnaire 3 weeks (n=1567), 18 months and 4 years after the disaster. Symptoms and risk factors were measured using validated questionnaires. A comparison group was included at waves 2 and 3 (n=821). Random coefficient analysis (RCA) was used to study risk factors for symptoms. RESULTS: Female gender [beta (beta)=1.0, 95% confidence interval (CI) 0.6-1.4], immigrant status (beta=1.0, 95% CI 0.6-1.4) and pre-disaster psychological problems (beta=0.8, 95% CI 0.1-1.4) were predisposing factors for symptoms. Although disaster-related factors were predictors, the relationship between symptoms and disaster-related factors was not very strong and the magnitude of this association was reduced when perpetuating factors were added. Intrusions and avoidance, depression, anxiety and sleeping problems were important perpetuating factors for physical symptoms among survivors and mediated the association between traumatic stress and physical symptoms. Risk factors for symptoms were comparable between survivors and controls. CONCLUSIONS: The results indicate that health-care workers should be alert for physical symptoms among female survivors, immigrant survivors and individuals with a high level of psychological problems both before and after a disaster.     

特大爆炸事故幸存者创伤后应激障碍的初步研究

目的 :了解特大意外爆炸事故对幸存者心理健康水平、PTSD的发生、PTSD的临床特征及其相关因素的影响。方法 :在爆炸事故后 3 -5个月期间 ,调查事故幸存者 ( 2 8例 ,研究组 )的一般情况、创伤经历、受伤程度及对善后处理的满意程度 ,采用创伤后应激反应症状清单、事件影响量表 (IES)、SCL -90、康奈尔医学指数 (CMI)、SDS、SAS评定 ,并与对照 ( 3 0例 )进行比较 ,分析PTSD诊断的相关因素。结果 :研究组IES、SDS、SAS、CMI、总分、CMIMR和SCL -90各统计指标与对照组的差异极其显著 (P <0 0 1)。诊断为PTSD者 78 6% ,PTSD的诊断与IES总分、现场暴露程度和对善后处理的满意程度相关。结论 :特大爆炸事故可导致暴露者出现不同程度的心理痛苦 ,PTSD的发生与创伤事件的暴露程度和对善后处理的满意程度相关。     

Depletion of ovarian reserve in young women after treatment for cancer in childhood: detection by anti-Müllerian hormone, inhibin B and ovarian ultrasound

BACKGROUND: Treatment of cancer during childhood may result in loss of primordial follicles from the ovary. METHODS: Ten cancer survivors and 11 controls with regular menstrual cycles, in addition to 10 cancer survivors and 10 controls taking the combined oral contraceptive pill (COCP) were recruited. Subjects were investigated on days 3-5 of a menstrual cycle, or week 3 of COCP administration before and 24 h after administration of 225 IU FSH. RESULTS: Serum FSH levels were elevated in cancer survivors with regular menstrual cycles (7.5 +/- 1.4 versus 4.2 +/- 0.3 IU/l; P = 0.02), while anti-Müllerian hormone (AMH) levels were lower (13.0 +/- 3.0 versus 21.0 +/- 3.4 pmol/l; P < 0.05). Other hormone levels were unchanged. Ovarian volume was smaller in cancer survivors than controls (3.0 +/- 0.5 versus 5.0 +/- 0.8 ml; P < 0.05), but antral follicle count (AFC) was similar. During COCP administration, inhibin B remained undetectable in six cancer survivors after FSH administration, whereas all controls showed a rise in inhibin B levels. The AFC was lower in cancer survivors than in controls (4.2 +/- 0.8 versus 7.2 +/- 0.8; P = 0.02). Ovarian volume was low in both groups, but did not differ between them. CONCLUSIONS: The study results demonstrate both hormonal and biophysical evidence of partial loss of the ovarian reserve in young cancer survivors. This was detected both in women with normal menstrual cycles and during COCP administration.     

Brief report: post-traumatic stress during emerging adulthood in survivors of pediatric cancer

OBJECTIVE: To examine post-traumatic stress symptoms (PTSS) and disorder (PTSD) among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. METHOD: From elementary and middle school, we prospectively followed a cohort of 56 cancer survivors, 60 comparison peers, and their parents. Assessments were completed after the youth's 18th birthday using questionnaires and a semi-structured psychiatric interview. Healthcare providers rated treatment severity and late effects. RESULTS: Survivors and comparison peers did not differ on rates of PTSS or PTSD, but comparison peers reported more dissociative experiences than survivors. Late effects were associated with a greater number of past PTSS. Of the 16 cancer survivors who reported a traumatic event, five (31%) were cancer-related. CONCLUSIONS: Levels of PTSS were similar for survivors and comparison peers. Research with other potentially traumatic diseases or treatments (e.g., amputations, brain tumors) is needed. The role of methodology and contextual factors in the assessment of PTSS/PTSD is discussed.     

汶川大地震幸存者地震前后生理指标变化

目的:对比汶川大地震前后幸存者的生理指标变化,评估汶川大地震给幸存者带来的生理影响。方法:在地震发生2个月后对1379名地震幸存者进行了全面的身体检查,并将本次检查结果与地震发生之前一年幸存者的身体检查结果做比较。结果:地震后的2个月,幸存者的体重、BP、HR、WBC、RBC、PLT、GLU、HDL、LDL与地震前一年相比,差异均具有统计学意义;体重、收缩压、心率、RBC、GLU的变化量存在年龄差异;收缩压、RBC、HDL、LDL的变化在性别上存在差异。结论:创伤应激可以引起体重、血压、血常规、血糖、血脂等多项生理指标的改变。     

Sexual functioning of cervical cancer survivors: a review with a female perspective

Objective

Sex is an important, often deteriorated, dimension of quality of life after cancer treatment. We conducted a systematic review on sexual functioning of cervical cancer survivors.

Methods

Studies between January 1988 and April 2010 were rated on their internal validity. Results were analyzed focusing on four major categories of sexual functioning: desire, arousal, orgasm, pain. Comparisons were made between healthy controls versus cervical cancer survivors, survivors before versus after treatment and between different treatment modalities.

Results

Twenty studies were included. Most studies showed no differences in the ability to achieve an orgasm. Cervical cancer survivors reported more dyspareunia than healthy controls and dyspareunia was more frequent and lasted longer after radiotherapy. Lack of lubrication was more frequent in cervical cancer survivors and a significant decrease in sexual interest and activity after treatment was found.

Conclusion

Cervical cancer survivors are at risk for sexual pain disorders, while sexual satisfaction (orgasm) is not impaired and radiotherapy negatively influenced sexual pain disorders. Health care providers should inform cervical cancer survivors about the possible risk of developing sexual pain disorders after cervical cancer treatment, especially after radiotherapy. As sexual satisfaction per se is not impaired, we suggest that prevention and treatment of sexual dysfunction should focus on painless and satisfactory sex instead of on resuming intercourse.     

Interrelation between factor VII, prekallikrein, and hyperfibrinolysis in advanced cirrhosis.

Factor VII and prekallikrein activities were studied in 37 patients with liver cirrhosis who were in a decompensated state. Sixteen of them died 30-70 days after admission; 21 survived and were discharged after 30-80 days. Seven who died and six survivors had signs of hyperfibrinolysis: factor VII activity differentiated the two groups independently of the presence of hyperfibrinolysis. The presence of hyperfibrinolysis significantly reduced prekallikrein activity, which did not differentiate clearly survivors from non-survivors. Long term follow up of survivors showed a good correlation between factor VII and prekallikrein activities with long term survival. Hyperfibrinolysis seemed to influence the clinical course of patients: 87% of patients with hyperfibrinolysis who died had fatal haemorrhagic episodes. Low factor VII activity may be a precursor of terminal liver insufficiency.     

Long-term endocrine side effects of childhood Hodgkin's lymphoma treatment: a review

BACKGROUND Since childhood cancer survival has increased, long-term effects of treatment have gained interest. Childhood Hodgkin's lymphoma has been treated successfully for decades now. We provide an overview of the literature on long-term endocrine side effects, such as gonadal dysfunction and growth retardation, as a result of childhood Hodgkin's lymphoma treatment. METHODS A comprehensive search of the Pubmed database was performed. RESULTS We identified 16 studies (10 studies: 298 male survivors and 6 studies: 230 female survivors) about gonadal dysfunction. In survivors treated with alkylating agents or pelvic radiotherapy, severe gonadal damage is described. Recovery was rarely described. Seven studies (481 survivors) about bone mineral density (BMD) and growth were identified. The effects on BMD appear to be small. Data on growth are scarce, but show that radiotherapy in a dose of >30 Gy including the spine, especially in pre-pubertal children, results in reduced height. We included 10 studies (4012 survivors) about thyroid complications. Hypothyroidism is the most common thyroid disorder after radiotherapy. There is also a significant incidence in thyroid carcinoma after low-dose radiation. In survivors treated with chemotherapy only, hypothyroidism and thyroid cancer have not been reported. CONCLUSIONS The severity of endocrine toxicity after childhood Hodgkin's lymphoma depends on the type of treatment. Gonadal dysfunction seems to be the most severe endocrine long-term effect, especially after treatment with alkylating agents or pelvic radiotherapy. The knowledge obtained in specific follow-up programmes for paediatric cancer survivors will help to find the optimal balance between curability and long-term side effects.