康复期精神分裂症患者社会功能与家庭亲密度和适应性的相关研究

目的探讨康复期精神分裂症患者的社会功能与家庭亲密度和适应性的相关性。方法选取在自贡市精神卫生中心住院治疗后出院的康复期精神分裂症患者100例为研究对象。采用家庭亲密度与适应性量表中文版(FACESⅡ-CV)和Morningside康复状态量表(MRSS)对患者进行评定。结果理想亲密度评分与社交量表评分呈负相关(r=-0.525,P0.05);实际适应性及实际亲密度评分分别与活动能力缺乏量表、依赖量表、社交量表评分及MRSS总评分呈负相关(r=-0.198,-0.078,-0.372,-0.225,P0.01;r=-0.092,-0.043,-0.204,-0.105,P0.01);不满意亲密度评分与依赖量表、活动能力缺乏量表评分及MRSS总评分呈正相关(r=-0.531,-0.401,-0.395,P0.05或0.01);不满意适应性评分与依赖量表评分呈正相关(r=0.402,P0.01)。结论临床中应加强对康复期精神分裂症患者的家庭干预,有意识地引导其家庭亲密度和适应性提高,以改善患者的社会功能。     

家庭干预对首发精神分裂症患者辅助治疗的随访研究

目的:探讨家庭干预对首发精神分裂症患者预后的影响。方法:将90例首发精神分裂症患者随机分为抗精神病药物合并家庭干预组(干预组,45例)及单用抗精神病药物组(对照组,45例),进行为期1年的随访研究。采用家庭亲密度和适应性量表(FACESⅡ-CV)、家庭功能量表(FAD)、简明精神病评定量表(BPRS)、阳性症状评定量表(SAPS)及阴性症状评定量表(SANS)评估患者家庭状况和精神症状。结果:随访结束后,干预组家庭亲密度和适应性及家庭功能改善明显(P<0.01);干预组FACESⅡ-CV中的实际亲密度、理想亲密度因子评分显著高于对照组[(66.7±12.2)分、(57.7±10.4)分、(68.4±10.6)分、(55.8±9.7)分,P均<0.01],干预组FAD中的沟通、角色、情感反应、情感介入、行为控制及总的功能因子评分显著低于对照组(P均<0.05);两组BPRS、SAPS及SANS评分均较入组时有明显下降(P均<0.01),随访期干预组BPRS和SANS评分显著低于对照组[(19.6±10.7)分、(21.8±12.5)分、(16.7±6.4)分、(18.8±7.2)分,P均<0.01];多元逐步回归分析显示患者精神症状预后与基线期精神症状严重程度呈正相关,与基线期家庭功能及发病年龄呈负相关(t=2.65,-2.49,-2.79,P均<0.05)。结论:对精神分裂症患者进行家庭干预,可增加患者家庭亲密度和适应性,提高家庭功能,改善疾病预后。     

维持治疗期精神分裂症患者认知功能与家庭功能的关系

目的探讨维持期精神分裂症病人认知功能、家庭功能及家庭亲密度/适应性的关系。方法入组42例维持期治疗的精神分裂症病人及42例正常对照者,分别对病人组和对照组进行家庭功能量表、家庭亲密度及适应性量表评估,用威斯康星卡片分类测验(WSCT)、Stroop色词测验来评估认知功能,并分析它们之间的关系。结果与正常对照相比,精神分裂症组在家庭功能量表、家庭亲密度及适应性量表中指标明显下降(除理论亲密度、实际适应度、理论适应度外)(t=-12.75～1.95,P0.05);认知功能方面,病人组在所测量各指标明显下降,(t=-3.27～10.62,P0.05);同时发现:概念化水平与情感反应、正确应答数与亲密不满度、非持续错误数与情感介入分值显著相关(r=0.36～0.50,P0.05)。结论精神分裂症病人在家庭亲密度、家庭功能感受方面及注意力、认知灵活性、抽象概括方面功能受损,维持期精神分裂症部分认知功能与家庭功能显著相关。     

精神分裂症患者家庭环境、父母教养方式以及亲密度和适应性的调查分析

目的　探索精神分裂症患者的家庭环境、父母教养方式以及亲密度和适应性的特点。方法　采用家庭环境量表 (中文版 ) ) (FES -CV)、父母教养方式评价量表 (EMBU)及家庭亲密度和适应性量表 (中文版 ) (FACESII-CV)对 110例精神分裂症患者 (研究组 )进行评定 ,并与 110例正常受试者 (对照组 )加以比较。结果　①同正常对照组相比 ,患者家庭表现为低亲密度、低情感表达、低成功性、低组织性以及高矛盾性和控制性差 (P <0 0 5或P<0 0 1)。②在教养方式上 ,患者父亲表现为低情感温暖、高惩罚严厉、过分干涉和拒绝否认 (P <0 0 1) ;而母亲表现为低情感温暖、高拒绝否认、惩罚严厉和偏爱被试 (P <0 0 5和P <0 0 1)。③在亲密度和适应性方面 ,患者家庭的实际亲密度、实际适应性、理想亲密度和理想适应性均较对照组为差 (P <0 0 1)。结论　患者的家庭环境、父母教养方式以及亲密度和适应性方面均存在着诸多方面的问题 ,可能对精神分裂症的发病起重要作用。     

青少年精神分裂症患者家庭因素的研究

目的:探讨青少年精神分裂症患者的发病和家庭因素的相关性.方法:采用父母养育方式评价量表(EMBU)及家庭环境量表中文版(FES-CV)对60名青少年精神分裂症患者进行测评并与60名健康青少年进行对照及相关分析.结果:青少年精神分裂症患者父母养育方式与正常组对照显示:其父亲惩罚严厉、拒绝否认因子分显著高于对照组,情感温暖、理解因子分显著低于对照组(P＜0.05或P＜0.01);其母亲过分干涉过度保护、偏爱被试因子分显著高于对照组;母亲的情感温暖理解、过度保护、偏爱被试因子分高于父亲(P＜0.05或P＜0.01).家庭环境的亲密度、情感表达、文化性、娱乐性的因子分低于对照组,矛盾性和控制性均高于对照组(P＜0.05或P＜0.01).相关分析显示:父亲过度保护与母亲拒绝否认,及母亲过度保护与父亲拒绝否认因子之间呈负相关(r≥0.8);父亲与母亲EMBU相同因子得分具有相关关系(r≥0.6).结论:不良的家庭环境和父母养育方式对青少年精神分裂症的发病起一定作用,具有相关性.     

精神分裂症患者直系子女早期人格特征及家庭环境的相关性研究

目的 探讨精神分裂症患者直系子女的人格特征、家庭环境模式以及家庭环境因素对其人格特征的影响.方法 采用艾森克个性问卷(幼年版)(EPQ)及家庭环境量表中文版(FES-CV)评估35例精神分裂症患者直系子女(研究组)和35例正常对照(对照组)的人格特征及家庭环境模式.结果 (1)研究组的精神质、神经质两个维度评分显著高于对照组(P ＜0.05,P＜0.01),内-外向维度评分显著低于对照组(P＜0.05).(2)研究组亲密度、成功性、娱乐性3个因子评分显著低于对照组(P＜0.01),矛盾性、独立性及控制性3个因子评分显著高于对照组(P＜0.05).(3)研究组精神质与亲密度、娱乐性呈显著负相关(P ＜0.05,P＜0.01),与矛盾性、控制性呈显著正相关(P＜0.05);内外向与亲密度、成功性、娱乐性呈显著正相关(P ＜0.05,P＜0.01);神经质与亲密度、娱乐性呈显著负相关(P＜0.05),与控制性呈显著正相关(P＜0.05).结论 家庭环境对精神分裂症患者直系子女发育早期的人格特征可能产生不利影响.     

注意缺陷多动障碍不同亚型男性患儿家庭亲密度及适应性与养育方式调查

目的 了解不同亚型注意缺陷多动障碍(ADHD)患儿的家庭亲密度及适应性与养育方式特点.方法 对湖南省9495名儿童及其家长采用二阶段流行病学调查方法进行问卷调查,对其中部分符合美国精神障碍诊断与统计手册第4版ADHD诊断标准的患儿采用家庭亲密度及适应性量表(注意缺陷型40例,多动冲动型52例,混合型39例;对照组58例)和父母教养方式评价量表(注意缺陷型48例,多动冲动型42例,混合型56例;对照组6例)进行调查.结果 (1)ADHD 3个亚型的现实亲密度、亲密满意度、适应满意度评分与对照组的差异均无统计学意义(F检验,P均＞0.05);理想亲密度、现实适应性和理想适应性各分项与对照组的差异均有统计学意义[事后(Post Hoc)检验,P均＜0.05],尤以多动冲动型更为明显.(2)ADHD 3个亚型父亲情感温暖评分与对照组的差异均有统计学意义(Post Hoc检验,P均＜0.05);注意缺陷型父亲惩罚评分与对照组的差异有统计学意义(Post Hoc检验,P=0.011);ADHD 3个亚型母亲惩罚评分与对照组的差异均有统计学意义(Post Hoc检验,P均＜0.05);注意缺陷型和混合型母亲情感温暖评分与对照组的差异有统计学意义(Post Hoc检验,P均＜0.05).结论 ADHD男性患儿不同亚型在家庭亲密度及适应性和养育方式特点不尽一致,应针对性地进行家庭干预.     

精神分裂症发病及预后的相关影响因素分析

目的研究影响精神分裂症患者发病及预后的相关因素。方法 1.随机收集住院精神分裂症患者50例,社区康复精神分裂症患者51例,采用自编一般情况表收集患者背景资料。2.使用"阳性与阴性症状量表(PANSS)"、"家庭亲密度和适应性量表中文版(FACESⅡ-CV)"测评精神分裂症患者的症状及家庭功能。结果 1.社区康复组患者疾病发作次数、住院次数少于住院组(P0.05)。2.社区康复组患者的PANSS粗分、阳性总分、阴性总分、一般精神病理学量表分以及反应缺乏、思维障碍、偏执得分三项症状群评分都要低于住院组(P0.05)。3.家庭亲密度和适应性测评,在实际适应性上,社区康复组家庭的适应性要优于住院组(P0.05)。结论 1、与既往研究结果一致的结论 :(1)精神分裂症患者的婚姻关系支持不足。(2)住院组精神分裂症患者的精神症状严重程度、发作、住院频率普遍都比社区康复组患者严重。(3)相对较好的家庭功能对精神分裂症患者的康复是一种保护性因素。2、本研究新观点:从心理、社会综合角度看精神分裂症患者的发病,更可能和"个体内在需求与个体的内外环境供给"不匹配让个体主观体验到的压力程度(简称"供需冲突张力")有关。     

网络成瘾者家庭亲密度、适应性的类型特点及其与应付方式的相关性

目的了解网络成瘾(Internet Addiction Disorder,IAD)者家庭教养方式、家庭亲密度、适应性的特点、类型及其与应付方式之间的相关性,为IAD者的家庭治疗提供理论基础。方法对111例网络成瘾住院患者(IAD组)和120例健康对照者(对照组)进行家庭亲密度和适应性、应付方式和父母教养方式的问卷调查,应用SPSS13.0统计软件进行t检验和相关分析。结果 (1)IAD组非民主平等型家长管教方式(包括暴力型、溺爱型、冷落型)显著高于对照组(76.6%∶6.7%;χ2=76.27,P=0.000);其家庭亲密度和适应性类型以松散型和僵硬型为主(58.6%,87.4%)。(2)IAD组FACES家庭亲密度因子中的实际亲密度评分、理想亲密度评分和适应性因子中的实际适应性评分、理想适应性评分均低于对照组(P<0.05,P<0.01),两个因子评分的不满程度评分均高于对照组(P<0.01)。(3)实际家庭亲密度和实际家庭适应性评分与解决问题、求助2个因子评分均呈正相关(P<0.01),与自责、幻想、逃避、合理化4个因子评分均呈负相关(P<0.01);家庭亲密度不满程度和适应性不满程度评分与解决问题、求助均呈负相关(P<0.01),与自责、幻想、逃避、合理化均呈正相关(P<0.01)。结论IAD青少年父母教育以非民主型管教为主,家庭亲密度及适应性较低,对家庭教育方式不满意程度较高,且与其不良的应付方式显著相关。改变父母教养方式和改善家庭功能可以防治青少年IAD。     

家庭护理干预对精神分裂症患者康复的影响

目的 探讨家庭护理干预对精神分裂症患者康复的影响.方法 将163例精神分裂症患者随机分为2组,均于干预前和8周末采用简明精神病症状量表(BPRS)、自知力与治疗态度问卷(ITAQ)、社会功能筛选量表(SDSS)进行评价比较.结果 2组入组时各量表评分比较差异无统计学意义(P＞0.05).干预8周末研究组BPRS总分及焦虑抑郁和缺乏活力因子分均明显低于对照组,差异有统计学意义(P＜0.05);ITAQ评分研究组为(17.24±0.48),对照组为(9.56±0.42),2组差异有统计学意义(P＜0.01);SDSS总分及各因子分均明显高于对照组,2组差异有统计学意义(P＜0.01).结论 家庭护理可有效促进精神分裂症患者康复.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Serious emotional and behavioral problems and mental health contacts in American and British children and adolescents

OBJECTIVE: To compare prevalence of serious emotional and behavioral problems and mental health contacts for these problems among American and British children and adolescents. METHOD: Data on children and adolescents ages 5 to 16 years were drawn from the 2004 U.S. National Health Interview Survey (response rate = 79.4%) and the 2004 survey of Mental Health of Children and Young People in Great Britain (response rate = 76.0%). Emotional problems, hyperactivity/inattention, and conduct problems were assessed using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Psychometric properties of SDQ scales were compared across countries. RESULTS: The SDQ has similar psychometric properties across countries. More British than American children met the criteria for emotional and conduct problems, but not hyperactivity/inattention. Prevalence was higher for all problems in 5- to 8-year-old British boys and for emotional problems in 13- to 16-year-old British girls. American children with serious emotional and behavioral problems had a higher prevalence of mental health contacts overall and with mental health providers but not with general medical providers. CONCLUSIONS: British children have a higher prevalence of parent-reported serious emotional and behavioral problems than American children. However, British children with these problems are less likely than American children to receive mental health care.     

Spatial attention and conscious perception: interactions and dissociations between and within endogenous and exogenous processes

A current controversy exists about the relationship between spatial attention and conscious perception. While some authors propose that these phenomena are intimately related (Bartolomeo, 2008, Chun and Marois, 2002, O’Regan and Noë, 2001, Posner, 1994), others report dissociations between them (Kentridge et al., 1999, Koch and Tsuchiya, 2007, Wyart and Tallon-Baudry, 2008). However, spatial attention is not a unitary mechanism, and it is possible that not all forms of attention dissociate from conscious perception. In the present study we used a paradigm in which endogenous and exogenous forms of attention are orthogonally manipulated in order to investigate their relation with conscious perception within the same design. By analyzing two different cue-related components, our results demonstrated that while endogenous attention was electrophysiologically dissociated from conscious perception, exogenous attention was not, consistent with the hypothesis that exogenous attention is an important antecedent of our conscious experience. Our results support previous claims of dissociations between some forms of spatial attention and conscious perception, but also highlight the importance of exogenous orienting on the selection of information for conscious access.