高中学生考试焦虑与家庭因素的关系分析

目的研究高中生考试焦虑的现状及其家庭相关因素。方法应用考试焦虑量表(TAS)、家庭环境量表中文版(FESCV)和父母养育方式评价量表(EMBU)对山东省某中学高一年级538名学生进行调查。结果高中生考试焦虑的检出率为65.20%。有考试焦虑者家庭环境量表的亲密度、情感表达因子分显著低于无考试焦虑者(P<0.05),而其矛盾性、成功性因子分显著高于无考试焦虑者(P<0.05)。有考试焦虑者父母养育方式评价量表的父亲过分干涉、父亲拒绝否认、父亲过度保护、母亲过分干涉过分保护、母亲拒绝否认、母亲惩罚严厉因子分非常显著高于无考试焦虑者(P<0.01),而其母亲情感温暖理解因子分极显著低于无考试焦虑者(P<0.001)。结论高中生考试焦虑检出率较高。高中生考试焦虑与家庭环境和父母养育方式密切相关。     

心因性非癫痫性发作儿童自我意识、家庭环境及父母养育方式的对照研究

目的探讨心因性非癫痫性发作（PNES）儿童自我意识、家庭环境和父母养育方式的特征及其与正常儿童的区别。方法采用Piers-Harris儿童自我意识量表（CSS）、家庭环境量表中文版（FES-CV）、父母养育方式问卷（EMBU）对43例PNES儿童和43名正常对照组儿童进行了评估。结果 PNES儿童CSS总分及焦虑、合群、幸福与满足分量表得分低于对照组儿童;FES-CV中的知识性分量表得分低于对照组儿童;EMBU中父亲的情感温暖与理解因子得分低于对照组儿童,父亲的惩罚严厉因子、母亲的过分干涉与过度保护因子、父母亲的拒绝否认因子得分高于对照组儿童。结论心因性非癫痫性发作儿童存在不良的自我意识、家庭环境及父母养育方式。     

民办高校大学生人格特征与父母养育方式的关系研究

目的 探讨高职大学生人格特征与父母养育方式的关系,为高校开展心理健康教育工作提供科学依据.方法 用父母养育方式量表（EMBU）和艾森克人格问卷（EPQ）对273名大学生生进行问卷调查.结果 EPQ测量结果显示文科生在精神质（P）维度得分显著低于理科生（P＜0.01）男生精神质（P）维度得分显著高于女生（P＜0.01）,大二学生在神经质（N）得分显著高于大一学生（P＜0.01）.内外向（E）维度与父亲情感温暖与理解（f1）、母亲情感温暖与理解（m1）、母亲偏爱被试（m5）呈正相关（P＜0.01）;精神质（P）与父亲情感温暖与理解（f1）、母亲情感温暖与理解（m1）呈负相关（P＜0.01）,与父亲惩罚严厉（f2）、父亲过分干涉（f3）、父亲拒绝否认（f5）、母亲拒绝否认（m3）、母亲严厉惩罚（m4）呈正相关（P＜0.05）;神经质（N）与父亲情感温暖与理解（f1）、母亲情感温暖与理解（m1）呈负相关（P＜0.01）,与父亲过度保护（f6）、母亲过分干涉及过度保护（m2）、母亲惩罚严厉（m4）呈正相关（P＜0.05）.父亲惩罚、严厉（f2）、母亲惩罚、严厉（m4）进入精神质（P）回归方程;母亲情感温暖与理解（m1）进入内外向（E）回归方程;父亲情感温暖与理解（f1）,母亲过度干涉、过度保护（m2）进入神经质（N）回归方程.结论 大学生父母养育方式对其人格形成有显著影响.     

社交焦虑障碍患者父母养育方式分析

目的：探讨社交焦虑障碍（SAD）患者的发病与父母养育方式的关系。方法：采用自编社会人口学资料调查表、父母养育方式量表（EMBU）对30例SAD患者（患者组）和30名正常人（对照组）进行评估;以Liebowitz社交焦虑量表（LSAS）≥38分为界,评估SAD的严重程度。结果：患者组LSAS评分平均（78.0±27.8）分显著高于对照组的（22.2±9.0）分,两组比较差异有统计学意义（χ2=10.477,P〈0.01）。患者组EMBU中父亲的拒绝、否认因子分和过度保护因子分平均（11.10±3.93）分和（10.77±2.57）分显著高于对照组的（8.67±1.97）分和（9.30±1.77）分（t=3.035、2.578,P〈0.01或P〈0.05）;父亲的情感温暖、理解因子分和偏爱被试因子分平均（43.30±11.45）分和（10.50±2.91）分显著低于对照组的（51.20±8.10）分和（12.87±5.43）分（t=3.085、2.104,P〈0.01或P〈0.05）。母亲的拒绝、否认因子分平均（13.93±5.34）分显著高于对照组的（11.33±2.26）分（t=2.457,P〈0.05）,母亲的情感温暖、理解因子分和偏爱被试因子分平均为（43.07±12.07）分和（10.50±2.91）分显著低于对照组的（51.53±8.26）分和（12.87±5.43）分（t=3.170、2.104,P〈0.01或P〈0.05）。结论：SAD的发生与父母养育方式有关,不良的父母养育方式可能是SAD的发病原因之一。     

独生子女情感障碍患者人格与父母教养方式的相关性

目的:探讨独生子女情感障碍患者人格与父母教养方式的相关性. 方法:采用艾森克个性问卷(EPQ)、人格诊断问卷(PDQ-4+)、父母教养方式评价量表(EMBU)对情感障碍独生子女患者90例(研究组)和正常独生子女90名(正常对照组)进行测评,其中研究组患者在自知力恢复以后测评.结果:研究组EPQ评分精神质、神经质、内外倾性显著高于正常对照组(t=5.63,6.11,11.13;P均＜0.01).研究组人格障碍的阳性率(44.44％)高于正常对照组(28.89％)(x2=4.69,P＜0.05).研究组EMBU评分父母惩罚、父母拒绝、父亲保护、母亲干涉因子分高于正常对照组(t=3.03 ～8.20,P均＜0.01),而父亲温暖因子低于正常对照组(t=4.46,P＜0.01). 结论:不良的父母教养方式可能造成独生子女人格障碍,人格障碍与情感障碍的发病有关.     

南通市青少年网络成瘾现状及与父母教养方式的关系

目的 了解南通市青少年网络成瘾现状及与父母教养方式之间的关系,为预防和干预青少年网瘾提供理论依据.方法 采用自制一般情况调查表、Young网络成瘾问卷(IAII)、父母养育方式评价量表(EMBU),对分层、随机抽样收集的3400例中小学生进行调查,小学生、初中生、高中生实际人数比为3∶2∶1.结果 (1)南通市青少年上网率92.14％,男生高于女生(P＜0.05);(2)网络成瘾现患率3.29％,男生高于女生(P＜0.01);(3)初中生和高中生网络成瘾的现患率明显高于小学生 (P＜0.01);(4)学习成绩差的网瘾率明显高于成绩较好和成绩中等者(P＜0.01);(5)成瘾组的EM-BU父母严厉惩罚、过分干涉、拒绝否认、过度保护因子分均显著高于非成瘾组(P＜0.01),而父母的情感温暖因子分非成瘾组显著高于成瘾组(P＜0.01).结论 南通市青少年网络成瘾与父母教养方式密切相关,须引起重视.     

父母养育方式与大学生焦虑水平的关系

目的了解父母养育方式与大学生焦虑水平的关系。方法采用父母养育方式评价量表（EMBU）和焦虑自评量表（SAS）对300名大学生进行调查。结果（1）父母亲养育方式中的“拒绝否认”和父亲的“过度保护”因子存在性别差异；母亲的“过度保护”因子有城乡差异。（2）大学生焦虑水平与父母亲的“情感温暖”因子有显著负相关，与父母亲的“拒绝否认”因子和父亲的“严厉惩罚”、“过度保护”因子有显著正相关。（3）回归分析发现，父亲的“严厉惩罚”固子、“过度保护”因子和母亲的“情感温暖”、“过分干涉保护”因子对大学生的焦虑水平有预测作用。结论父母养育方式与大学生焦虑水平关系密切。     

抑郁障碍患者人格特征与父母教养方式、自身防御方式的相关性

目的 探讨抑郁障碍患者人格特征与父母教养方式、自身防御方式的关系。方法 将徐州市 东方人民医院 2016 年 8 月至 2019 年 7 月收治的 60 例抑郁障碍患者作为观察组，并选择 60 名健康志愿者 为对照组，向两组受试者发放明尼苏达多项个性调查表（MMPI）、父母教养方式评价量表（EMBU）、防御 方式问卷（DSQ），分析抑郁障碍患者人格特征与父母教养方式、自身防御方式的关系。结果 MMPI 量 表评分中，观察组疑病、抑郁、癔症、精神病态、妄想狂、精神衰弱评分均高于对照组（t=12.949、15.893、 20.349、7.188、6.863、5.391，P＜ 0.05）；EMBU 量表评分中，观察组父母情感温暖与理解因子分低于对 照组（t=3.126、3.096，P＜ 0.05），父母惩罚与严厉因子分、拒绝与否认因子分、父亲过度保护因子分、母 亲过分干涉与保护因子分均高于对照组（t=3.256、3.661、4.622、3.744、4.225、2.832，P＜ 0.05）；DSQ 评分 中，观察组不成熟防御机制评分高于对照组（t=4.938，P＜ 0.05），成熟防御机制评分低于对照组（t=3.423， P＜ 0.05）。相关性分析显示，抑郁障碍患者抑郁、精神病态、精神衰弱与其父母惩罚与严厉因子分、 拒绝与否认因子分、父亲过度保护因子分、母亲过分干涉与保护因子分呈正相关（r=0.304～0.348， P＜ 0.05），疑病、抑郁与父母情感温暖与理解因子分呈负相关（r=-0.322～-0.344，P＜ 0.05）；抑郁障碍患 者抑郁、精神病态、妄想狂、精神衰弱与其不成熟防御机制评分呈正相关（r=0.303～0.334，P＜ 0.05），疑 病、抑郁、癔症与其成熟防御机制评分呈负相关（r=-0.305～-0.309，P＜ 0.05）；抑郁障碍患者父母惩罚 与严厉因子分、拒绝与否认因子分、父亲过度保护因子分、母亲过分干涉与保护因子分与其不成熟防御 机制呈正相关（r=0.393～0.418，P＜ 0.05），与其成熟防御机制呈负相关（r=-0.385～-0.407，P＜ 0.05）；父 母情感温暖与理解与其不成熟防御机制呈负相关（r=-0.404、-0.416，P＜ 0.05），与其成熟防御机制呈正 相关（r=0.412、0.422，P＜ 0.05）。结论 抑郁障碍患者人格特征与父母教养方式（父母情感温暖与理解、 惩罚与严厉、拒绝与否认、父亲过度保护、母亲过分干涉与保护）、自身防御方式（不成熟防御机制）具有 相关性。     

首发青少年抑郁症与父母养育方式和自我接纳的关系研究

目的了解父母养育方式和自我接纳与首次发病青少年抑郁症的关系。方法对52例首次抑郁发作的青少年患者和214例正常对照者进行一般社会人口学资料表、父母养育方式评价量表(EMBU)和自我接纳问卷(SAQ)测评。结果与正常对照组相比,青少年抑郁症患者的父母更少情感温暖、理解(P<0.01),母亲有更多的拒绝、否认和更少偏爱被试(P<0.05);逐步判别分析显示,母亲的温暖、理解具有统计学判别意义(P<0.01);抑郁症青少年的自我接纳和自我评价显著低于正常青少年(P<0.01)。结论父母养育方式和自我接纳程度低与青少年抑郁发病相关;母亲的情感温暖、理解对青少年抑郁症的影响最大。     

品行障碍患儿父母养育方式及应付方式的研究

目的:探讨父母养育方式对品行障碍患儿的应付方式的影响。方法:采用父母养育方式评价量表(EMBU)及应付方式问卷(CSQ)对46例品行障碍患儿和46名正常儿童为对照进行评估,并对父母养育方式与应付方式作相关分析。结果:品行障碍组患儿父母的情感温暖因子分明显低于对照组,而其他各项因子分(除父母的偏爱被试及父亲的过分干涉、过度保护外)则均明显高于对照组(P<0.05或P<0.01);品行障碍组解决问题评分明显低于对照组,而自责、求助、幻想、退避因子分则明显高于对照组(P<0.01);品行障碍组解决问题、求助与父母的情感温暖因子呈正相关,而与其他各项因子呈负相关;自责、退避与父母的情感温暖因子呈负相关,而与其他各项因子呈正相关。结论:品行障碍患儿多采用消极的应付方式,与父母的养育方式明显相关。     

Treatment Considerations in Anticonvulsant Monotherapy

Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.     

Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity

Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.     

Pediatric Epilepsy Surgery

Summary: The use of implantable arrays of epidural electrodes has made it possible to carry out extraoperative electrocorticography (ECoG) and functional localization in the awake child. This has permitted cortical excisions that are determined by criteria similar to those obtained during surgical procedures performed under local anesthesia in adults. In addition, the method also permits simultaneous ECoG and video monitoring during the child's symptomatic seizures, providing additional important localizing information that is impractical to obtain in operations under local anesthesia. We report our experience with 75 children, ages 5 months to 15 years, whom we have managed with epidural electrode arrays. The method of extraoperative ECoG is described and illustrative cases are presented to demonstrate its feasibility and utility in children. In addition, we call attention to gliomas as a common cause of chronic focal seizures in children. Of 49 children undergoing resection and followed for from 1 to 14 years (mean of 5.8 years), 32 (65%) are either seizure free or have had a significant reduction in seizure frequency that has unambiguously improved their quality of life. The results are analyzed further by relating the surgical outcome to each of the pathologic entities that caused the seizures. This analysis reveals the variety of neurological conditions that commonly cause intractable focal seizure disorder in children and distinguishes those pathologic entities in which the seizure disorder is apt to respond to surgical intervention from those that will not.     

Un nouveau cadre conceptuel de travail pour une psychiatrie revisitée ? Introduction à deux articles de E. Kandel

In two articles which appeared in the American Journal of Psychiatry and that were subsequently translated for Évolution Psychiatrique, E. Kandel examines the bases for a reinterpreted psychiatry that is prepared to confront the major challenge of the 3rd millenium: that of insight into the mind and brain. This requires a major reorganization of the discipline, which involves a reinvestment of the scientific approach and a critical  assessment of the data provided by psychoanalytical psychiatry and cognitive neurosciences. Seven concepts have therefore been proposed for interactive re-examination: consciousness, the unconscious, memory, emotion, development, desire, impulse. The dynamic relations existing between genetics and the environment allow one to see how evolutions are possible from actions at different levels, both psychotherapeutic and pharmacological. Imaging and other techniques provide additional objective information to the process of human interaction which remains the basis of psychiatry. A common framework for psychiatry and the neurosciences, a reconsideration and renewal of the psychoanalytical approach are both possible and necessary.     

Opioids and the developing organism: A comprehensive bibliography, 1984–1988

A comprehensive bibliography of the literature concerned with opioids and the developing organism for 1984-1988 is presented. Utilized with companion papers (Neurosci. Biobehav. Rev. 6:439-479; 1982; 8:387-403; 1984), these articles cover the clinical and laboratory references beginning in 1875. For the years 1984, 1985, 1986, 1987, and 1988, a total of 877 citations were recorded. A series of indexes accompanies the citations in order to make the literature more accessible. These indexes are divided into clinical and laboratory topics, and subdivided into such topics as the type of opioid explored and the general area of biological interest (e.g., physiology).     

La biologie et le futur de la psychanalyse : un nouveau cadre conceptuel de travail pour une psychiatrie revisitée

The American Journal of Psychiatry has received a number of letters in response to my earlier “Framework” article (1). Some of these are reprinted elsewhere in this issue, and I have answered them briefly there. However, one issue raised by some letters deserves a more detailed answer, and that relates to whether biology is at all relevant to psychoanalysis. To my mind, this issue is so central to the future of psychoanalysis that it cannot be addressed with a brief comment. I therefore have written this article in an attempt to outline the importance of biology for the future of psychoanalysis.     

Facteurs de risque environnementaux à la schizophrénie

Schizophrenia is currently a major concern, its prevalence being estimated at around 1% and its social consequences being severe. The elucidation of the pathophysiology of the disease is difficult due to the great variability of clinical expressions, the instability of the clinical symptoms during the evolution and the absence of reliable biological markers. The existence of a familial aggregation in schizophrenia is well known, the risk of presenting the disease for first-degree relatives of patients being 5 to 10 times higher than the risk observed in the general population. The genetic component was further confirmed by twin and adoption studies. Although the concordance for the disease is higher (40 to 70%) among monozygotic twins as compared with dizygotic twins (15%) it does not reach 100%, which implies that environmental factors modulate the effects of the genotype. However, the role of these factors and especially their interaction with genetic factors remain unclear but the implications of some specific environmental factors are well documented by recent research data. The current literature on sex differences in schizophrenia is consistent. Several studies have suggested that male and female patients may differ in age at the onset and expression of clinical symptoms. Complications during pregnancy or birth-giving may increase the risk of developing schizophrenia later in life. The major complications are oxygen deprivation during pregnancy, bleeding, maternal malnutrition or infection (exposure to influenza, for example). A low birth weight is associated with an increased risk of schizophrenia. Psychoses are more common among people living in an urban environment and among those born during winter months. Schizophrenia is probably more prevalent in people who are living promiscuously, are subject to toxic abuse, poor nutrition and stress but here more precise data are needed. Moreover, immigrants have a higher risk of developing psychotic disorders. In addition, head traumas are associated with an increased risk of schizophrenia. Though they are contentious, some studies suggest that substance abuse (cannabis use in European countries) is related to the development of schizophrenia, especially in people with genetic vulnerability. Moreover, substance misuse may worsen the symptoms. If the environment is sufficiently stressful, people with a high genetic vulnerability will develop some degree of mental illness, including schizophrenia. Conversely, a less stressful or a protective environment may decrease the risk of its onset in persons with a predisposition to schizophrenia.     

Introduction: Goals

Summary: Epilepsy is characterized by recurrent seizures. Many epilepsies with focal seizures as well as convulsive generalized seizures respond satisfactorily to antiepileptic drugs (AEDs) that reduce repetitive firing (e.g., phenytoin, carbamazepine, and valproate) or that augment GABA_A-mediated inhibition (e.g., phenobarbital and benzodiazepines). A number of drugs presently under development, such as NMDA receptor antagonists, loreclezole, losigamone, meth-ysticine, and dextromethorphan, are promising in acute animal models of otherwise drug-resistant convulsant activity. As a result of recent studies in both experimental models and surgically resected human epileptic brain, the prospects for development of AEDs have significantly improved. Several new AEDs recently have reached the commercial market or are in experimental or clinical trials. A comparative presentation of the standing of the new AEDs with respect to their efficacy and side effects is necessary, but still very difficult. Because initial experience with new AEDs is restricted to populations with severe drug-resistant epilepsy, the crucial question whether potential new AEDs can alter prognosis is not yet definitively answered. There is a clear need to compare the effects of standard AEDs and new AEDs in naive patients and over longer follow-up periods. Moreover, because of the strong desire to develop antiepileptic therapy that directly treats the primary etiology of a given epileptic syndrome , or modifies the neurobiological processes that cause recurrent seizures, better experimental epilepsy models for chronic epilepsy and further clinical studies are necessary to increase the knowledge on the pathophysiology of distinct epileptic syndromes. In this respect, studies on the differences between responders and nonresponders to a given AED treatment are extremely valuable.