CBT技术对大学生进食障碍的个案干预

目的通过对进食障碍的认知行为治疗的个案研究,探讨认知行为治疗技术对我国患者的疗效。方法在6次会谈中使用CBT技术对患者的进食障碍进行干预。结果来访者焦虑、抑郁水平显著降低,进食行为基本得到控制,自引呕泻行为完全消失,体重增加,月经逐步恢复正常。结论用CBT技术对进食障碍进行干预可取得良好的疗效。     

Outcome of Cognitive Behavioral Therapy in Adolescents After Natural Disaster

PURPOSE: The authors evaluated the effectiveness of cognitive behavioral therapy (CBT) among adolescents exposed to the 2004 earthquake in Bam, Iran. METHODS: Four months after the earthquake, 135 adolescents as a case group and 33 adolescents as a comparison group were evaluated with the Impact of Event Scale Revised (IES-R). Two therapists were trained in CBT in 3-day classes according to a manual provided by mental health services. After conducting CBT in the case group, both groups were evaluated again with IES-R. RESULTS: The severity of posttraumatic stress symptoms significantly decreased among the subjects given CBT in the case group. The improvement in posttraumatic stress symptoms was attributable to improvement in each of three-symptom categories (intrusion, avoidance, and arousal) and in the total score of posttraumatic stress disorder (p < .05). CONCLUSIONS: The findings demonstrate the efficacy of CBT in alleviating posttraumatic stress symptoms among adolescents after a catastrophic disaster.     

26例颈动脉体瘤的外科治疗体会

目的：探讨颈动脉体瘤(Carotid body tumor,CBT)的诊断和治疗经验。方法：26例患者，分别血管多普勒B超检测及单侧血管造影术或数字减影血管造影术(Digital subtrasound angiography，DSA)，明确诊断。术前均行颈动脉压迫试验。手术治疗，其中瘤体剥离式切除9例；颈外动脉同时切除15例；颈内动脉部分切除，颈总、颈内人造血管搭桥术1例；颈总动脉分叉处切除、颈内外动脉吻合1例。结果：除2例合并脑部并发症并治愈，无1例死亡。结论：DSA对CBT的诊断最具权威性，术前颈动脉压迫训练，正确的术式选择是减少脑部并发症保证手术成功的关键。     

颈动脉体瘤诊断与治疗进展

颈动脉体瘤属于化学感受器肿瘤，具有家族遗传倾向颈动脉体瘤的发生与SDH基因的突变有关，多数为良性，恶性率不超过10％，诊断恶性的标准为局部淋巴结或远处转移应根据仔细的临床检查和特征性影像学结果做出诊断，影像学检查包括B超（多普勒）、CT、MRI／MRA及DSADSA检查可作为诊断颈动脉体瘤的金标准，一旦诊断颈动脉体瘤，应积极采取手术治疗目前，放射治疗亦可作为治疗颈动咏体瘤的有效手段，本文对颈动咏体瘤的诊断及治疗进展作一简要综述     

Treatments for chronic fatigue syndrome

AIMS: To review studies evaluating the treatment of chronic fatigue and chronic fatigue syndrome, to describe predictors of response to treatment and to discuss the role of the occupational health physician. METHODS: A literature search was carried out using Medline and PsychInfo. RESULTS: Studies evaluating cognitive behaviour therapy, graded exercise therapy, pharmacological interventions (e.g. antidepressants and corticosteroids), immunological interventions and nutritional supplements were reviewed. The most promising results have been found with cognitive behaviour therapy and graded exercise therapy, and some predictors of outcome have been identified. Most of the other interventions were evaluated in just one or two studies and therefore evidence is insufficient to draw firm conclusions. CONCLUSIONS: By applying the models of fatigue that form the bases for cognitive behaviour therapy and graded exercise therapy, occupational health physicians may play an important role in helping the patients with chronic fatigue syndrome to reduce their symptoms, improve their functioning and return to work.     

Within and between associations of nonverbal synchrony in relation to Grawe's general mechanisms of change

The examination of nonverbal synchrony has become a promising line of psychotherapy research. Although several studies have found between-dyad associations between nonverbal synchrony and multidimensional outcomes, the findings remain heterogeneous, and within-dyad effects remain to be investigated. The present study examines within and between effects of nonverbal synchrony on mastery, resource activation, problem actuation, and motivational clarification (Grawe's general mechanisms of change). Four-hundred and twenty-three videotaped sessions of 175 patients were analysed using motion energy analysis (MEA), providing values to quantify nonverbal synchrony in the patient–therapist dyad. Grawe's general mechanisms of change in psychotherapy were rated using the Inventory of Therapeutic Interventions and Skills (ITIS). On average, patient–therapist nonverbal synchrony was greater than chance. Hierarchical linear modelling revealed that nonverbal synchrony was significantly associated with higher mastery and less resource activation on the within-dyad level. Nonverbal synchrony was not associated with problem actuation or motivational clarification, and in general, no associations were found on the between-dyad level. The results demonstrate the importance of disentangling within and between effects of nonverbal synchrony and provide initial evidence that nonverbal synchrony is tied to the specific therapeutic strategies observed in psychotherapy sessions.