冲动性和攻击性对大学生自杀未遂行为的影响

目的 了解冲动性及攻击性对大学生自杀未遂行为的影响.方法 采用<自杀态度与心理健康状况问卷(大学版-Ⅳ)>对重庆市随机抽取的11所大学的12000名大学生进行调查.比较有无自杀未遂大学生中文版Barratt冲动行为量表与Buss和Perry攻击问卷的评估结果,分析冲动性及攻击性人格对大学生发生自杀行为的影响.结果 收集有效问卷9808份,大学生自杀未遂的报告率为1.7%(169/9808).自杀未遂组的冲动行为量表中的非计划性、行动冲动性和认知冲动性及总分均高于无自杀未遂组(P<0.001).自杀未遂组Buss和Perry攻击问卷的总分及身体攻击、言语攻击、愤怒、敌意、指向自我的攻击等各因子分均高于无自杀未遂组(P<0.01).多因素条件logistic回归分析显示,与自杀未遂最密切有关的独立危险因素排列为:攻击性总分高(OR=20.81,95%CI:12.36～35.03,P<0.01),行动冲动性分高(OR=4.32,95%CI:2.33～8.01,P<0.01).冲动性总分高(OR=3.37,95%CI:1.65～8.42,P<0.01),非计划性分值高(OR=3.12,95%CI:1.75～5.56,P<0.01),自杀意念强(OR=2.54,95%CI:1.75～3.70,P<0.01),已发生过性行为(3.12,95%CI:1.75～5.56,P<0.01),女性(OR=2.15,95%CI:1.48～3.14,P<0.01),指向自我的攻击分值高(OR=1.89,95%CI:1.24～2.88,P<0.01).结论 有自杀未遂的大学生更多体现出冲动性及攻击性人格,对大学生冲动性自杀行为应采取不一样的干预方案.     

自杀意念自评量表的初步制定

目的：编制适合我国国情的自杀意念自评量表（SIOSS）以利于早期发现和干预。方法：参考相关文献并结合经验选编条目池形成初稿，再以216名受试者的测试结果，对初稿进一步检验与筛选，形成最终量表，同时进行信度和效度检验。结果：SIOSS共26条，绝望、乐观、睡眠、掩饰4个因子。除掩饰因子外，余各因子及条目与精神症状自评量表（SCL-90）总分及抑郁因子聚合度良好。抑郁症组（患者组）量表总分和各因子分均高于对照组，且患者组自杀意念的发生率（42.3%）明显高于对照组（5.4%）。量表参考划界点为12分。结论：自杀意念自评量表的信度与效度均达到统计要求，可作为筛查自杀意念的有效测量工具。     

山东农村居民自杀意念的发生率及其危险因素研究

目的 了解农村居民自杀意念的发生率及其危险因素,为自杀干预提供依据.方法 采用包括一般健康状况问卷、冲动性和攻击性量表、社会支持量表、家庭亲密度与适应性量表等对山东滕州市东郭镇19个村≥15岁的5039例农村居民进行自杀意念及其相关因素的调查,以多因素logistic模型分析自杀意念的危险因素.结果 在农村居民中,9.33%(470/5039)在过去任何时候有过自杀意念(95%CI:8.52%～10.13%),5.39%(299/5039,95%CI:5.28%～6.59%)近1年有过自杀意念.近1年自杀意念的危险因素排列为:近1年慢性压力大(OR=5.61,95%CI:4.04～7.78),攻击性高(OR=2.54,95%CI:1.93～3.35),非现婚状态(OR=2.04,95%CI:1.52～2.76),生命质量低(OR=1.86,95%CI:1.40～2.48),女性(OR=1.76,95%CI:1.34～2.32),自我感觉经济状况差(OR=1.70,95%CI:1.29～2.25),认识的人中有自杀(OR=1.53,95%CI:1.17～1.99),家庭亲密度低(OR=1.38,95%CI:1.06～1.80).结论 农村居民自杀意念发生率处于较高水平.慢性压力大、攻击性高、非现婚状态是近1年自杀意念最主要的危险因素.应根据其危险因素制订有针对性的干预计划.     

大中学生自杀意念及相关心理变量研究

目的:探讨大中学生自杀意念与相关心理变量的关系。方法:采用分层取样法,对某市初二到硕士研究生一年级828名被试进行自杀意念量表(SSI)等量表测试。结果:①随年龄增长,大中学生自杀意念、企图呈下降趋势。女生自杀意念比男生多,而男生自杀行为能力比女生强;②有无自杀意念者在临床症状、人格因素、应对风格及生活满意度上差异均有统计学意义;③自杀意念与症状自评量表(SCL-90)各分量表、艾森克个性问卷(EPQ)神经质、精神质、应对检查表(COPE)诸多应对风格显著相关。结论:大中学生自杀意念与临床症状、应对方式、人格和生活满意度存在相关。     

有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激的比较研究

目的:探讨有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激性生活事件的差异。方法:对143例抑郁症患者进行自编一般情况问卷、Beck抑郁自评量表(BDI)、认知情绪调节问卷中文版(CERQ-C)评定。结果:有自杀意念抑郁症发作患者BDI总分、婚姻家庭应激及社会生活应激分及CERQ-C适应性策略与不适应性策略总分显著高于无自杀意念抑郁症患者(P<0.05或P<0.01)。有自杀意念抑郁症患者抑郁总分与工作学习应激、婚姻家庭应激、社会生活应激及CERQ-C不适应性策略分呈显著正相关(r=0.569,0.470,0.341,0.303,P<0.05或P<0.01);无自杀意念抑郁症患者抑郁总分仅与婚姻家庭应激呈显著正相关(r=0.361,P<0.01)。结论:有自杀意念较无自杀意念抑郁症患者经历更多的负性生活事件,存在更严重的抑郁情绪,较多地采用认知应对策略。     

儿童焦虑性情绪障碍筛查量表的临床应用

目的研究儿童焦虑性情绪障碍筛查量表SCARED在儿童及青少年情绪障碍中的应用。方法随机抽取上海市精神卫生中心儿童心理门诊符合CCMD-3诊断标准的焦虑症患儿35例,多动障碍患儿31例,随机抽取上海市某中小学45例健康儿童为对照组。研究组患儿及父母均填写SCARED量表,对照组填写SCARED量表并在一周后重测,多动症组评估SCARED量表。结果研究组SCARED量表总分及各因子分均分别显著高于对照组、多动症组。患儿自评与父母评定的相关系数在0．618至0．839之间。重测信度在0．451～0．872之间,各因子分与总分相关系数在0．331～0．852之间,Cronbach‘s a系数在0．2331至0．8032之间。SCARED量表总分与焦虑自评量表总分相关系数为0．661。结论SCARED量表信、效度良好,可作为临床辅助诊断及科研的筛查工具。     

伴有自杀意念抑郁症患者人格与应对方式的研究

目的:探讨伴自杀意念的抑郁症患者人格与应对方式及两者的相关性。方法:采用一般情况调查表和汉密尔顿抑郁量表(HRSD)、自杀意念自评量表(SIOSS)、艾森克人格问卷(EPQ)及简易应对方式问卷(SCSQ)对93例抑郁症患者进行调查和评估。结果:根据SIOSS评分93例抑郁症患者分为自杀意念组(SIOSS≥12分,57例)和非自杀意念组(SIOSS12分,36例);自杀意念组EPQ精神质(P)、神经质(N)分显著高于非自杀意念组(P均0.05);外向-内向(E)、掩饰因子(L)分显著低于非自杀意念组(P均0.05);SCSQ积极应对分显著低于非自杀意念组(P0.05)。EPQ-P、N与SCSQ-积极应对评分呈负相关;EPQ-E与积极应对评分呈正相关(P均0.05)。结论:伴自杀意念的抑郁症患者人格特征为情绪不稳定,性格内向,积极应对方式较少,这可能影响他们采取极端方式解决问题。     

青少年人格冲动性与攻击性的关系：同胞关系的作用路径

背景 我国正从独生子女家庭进入多子女家庭,探索同胞关系在青少年人格冲动性与攻击性之间的作用机制,对促进青少年心理健康以及维护社会和谐稳定有着重要意义。目的 探讨同胞关系在青少年人格冲动性与攻击性之间的作用路径,为青少年暴力攻击行为的预防提供参考。方法 于2023年2月—4月,采用随机抽样方法选取四川省某县12所中小学共986名有同胞关系的学生作为研究对象。采用Barratt冲动性量表（BIS-11）、Buss和Perry攻击问卷中文版（AQ-CV）以及同胞关系问卷（SRQ）进行横断面调查。采用Pearson相关分析考查各量表评分的相关性。使用Bootstrap法检验同胞关系在人格冲动性与攻击性之间的作用路径。结果 BIS-11总评分与AQ-CV总评分、SRQ中的冲突维度评分、争宠维度评分均呈正相关（r=0.485、0.276、0.280,P均<0.01）,与SRQ温暖/亲密维度评分呈负相关（r=-0.383,P<0.01）;AQ-CV总评分与SRQ冲突维度评分、争宠维度评分均呈正相关（r=0.387、0.340,P均<0.01）,与温暖/亲密维度评分呈负相关（r=-...     

自我效能量表的信度及效度研究

目的评价自我效能量表(SES)的信度和效度.方法由专业医生对45例心身科门诊心理咨询者评定SES和症状自评量表(SCL-90),一周后重测SES.对量表的内部一致性、重测信度及平行效度进行分析.结果SES的Cronbach'sα系数为0.7984,重测后各项目的相关系数均在0.672～0.932之间.SES的总分与SCL-90总分间的相关系数为0.454,且半数以上的项目与SCL-90总分呈明显相关.结论SES具有较好的信度和效度.     

重性抑郁障碍患者血清胆固醇水平与抑郁、自杀意念的相关分析

目的:探讨重性抑郁障碍(MDD)患者血清总胆固醇(TC)水平与抑郁、自杀意念的相关性。方法:收集108例MDD患者的一般及临床资料,检测其血清TC水平,并据此分为TC异常组和TC正常组,采用汉密尔顿抑郁量表-17项(HAMD-17)、自杀意念自评量表(SIOSS)对两组患者进行评定;采用Logistic回归方法对各相关因素进行分析。结果:入组的MDD患者中,44例(40. 7%)入TC异常组,64例入TC正常组; TC异常组HAMD-17总分及其中焦虑/躯体化、认知障碍、睡眠障碍因子分、以及SIOSS总分显著高于TC正常组(P均0. 01);以血清TC水平为因变量的Logistic回归分析显示,HAMD中的焦虑/躯体化因子和SIOSS总分纳入方程(P 0. 05或P 0. 01)。结论:MDD患者血清TC水平越高,其焦虑/躯体化症状和自杀意念越重。     

Psychiatric resident dismissal: a national survey of training programs

The authors report on a nationwide survey of psychiatric residency training directors who responded to a questionnaire designed to elicit information on the magnitude of the problem of unacceptable performance by residents. One hundred six program directors reported on 5,591 internship or residency positions from 1981 to 1985. A total of 184 residents (3.3%) were prematurely terminated or persuaded to resign; departmental deliberations were held on an additional 139 residents (2.5%). Reasons for dismissal and indications during the selection process that a trainee might prove problematic are discussed. A provocative finding was that 37% of terminated residents were accepted into other psychiatry training programs.     

Personal health care of residents: preferences for care outside of the training institution

OBJECTIVE: The personal health care issues of residents are important but have received minimal study. Available evidence suggests that residents experience difficulties obtaining care, partly related to both the demands of medical training and concerns about confidentiality and privacy. METHODS: A self-report survey was distributed in 2000-2001 to advanced residents at the University of New Mexico Health Sciences Center. Questions related to personal health and health care attitudes, behaviors, preferences, and experiences, and vignettes related to personal illness and treatment. Here the authors report findings regarding preferences for obtaining health care "at" versus "outside" of one's training institution. RESULTS: Data from 141 residents are presented. A substantial minority of residents had obtained care outside of their institution in the preceding year. Residents expressed concerns about their medical privacy and confidentiality related to obtaining care within their own institution, including concerns about being seen by other residents or by past or future attendings. Women expressed more concern than did men on numerous issues, as did residents in primary care versus specialty training. Residents expressed a preference for care outside the training institution when taking into account confidentiality and prevention of embarrassment; care at their own institution was preferred when considering expense and scheduling. Outside care was more strongly preferred for more stigmatizing illnesses (e.g., mental health-related). Most residents felt poorly informed regarding their personal health care confidentiality rights and did not know whether their institution had confidentiality policies regarding residents who develop physical or mental health problems. CONCLUSION: Residents worry about confidentiality and privacy when deciding where to obtain personal medical care. Trainees' concerns are relevant to crafting policies on resident health care. Programs should strive to inform residents thoroughly about policies and rights pertaining to personal health care.     

Traumatic stress and ways of coping of community residents exposed to a train disaster

OBJECTIVES: The aims of this study were to examine the degree of traumatic stress and the coping strategies employed by community residents who lived on both sides of a rail track where a train collision occurred in 1996 in Stafford, UK. The hypothesis was that there would be a high level of traumatic stress and that emotion-focused coping would be the predictor to distress. METHOD: This was a cross-sectional survey with a retrospective design in which 66 community residents, who lived between 30 and 100 feet away from the crash site, were interviewed. The study began approximately 7 months after the disaster. The Impact of Event Scale (IES), the General Health Questionnaire (GHQ-28) and the Ways of Coping Checklists (WOC) were administered to the residents. RESULTS: On the whole, the results did not entirely support the hypothesis. The residents were found to have experienced some intrusive thoughts and avoidance behaviour but their mean scores were significantly lower than those of standardized samples. Thirty-five per cent scored at 4 or above on the GHQ-28. Traumatic stress was predicted by both emotion-focused and problem-focused coping strategies. CONCLUSION: Although community residents were not on the train or related to the dead or injured in any way, they could, after being exposed to a train disaster, manifest traumatic stress symptoms which had long-lasting effects. Such traumatic stress was found to be associated with coping strategies of community residents characterized by their efforts to manage or alter the source of stress, and by their efforts to regulate stressful emotions.     

Behavioural problems in Sydney nursing homes

The prevalence of significant behavioural disturbance in 46 Sydney nursing homes was examined. All 2445 residents were rated on a brief screening questionnaire by senior nurses, who decided that 704 (29%) displayed at least one problem behaviour for much of the time. Primary care nurses (PCNs) then rated these ‘screen-positive’ residents using the Cohen-Mansfield Agitation Inventory (CMAI). In one nursing home the PCNs rated all 100 residents on the CMAI and found that 24 of 58 ‘screen-negative’ residents displayed CMAI behaviours once daily or more. Of CMAI behaviours rated as occurring daily or more often, 30% were manifested by ‘screen-negative’ residents. Prevalence figures based on ‘screen-positive’ residents are underestimates. Interrater reliability between PCNs was good. We report that at least 3.3% of residnets paced and 0.45% screamed several times an hour. Each of the following behaviours was manifested daily or more often by 10– 15% of the residents: restlessness, pacing, repetitive sentences, constant calls for help, cursing/verbal aggression and complaining. Aggressive behaviours (eg hitting, kicking, biting) were less common, and a relationship to cognitive impairment was demonstrated. Increased research on assessment and management of these behaviours is needed.     

Innovative dementia care: functional status over time of persons with Alzheimer disease in a residential care centre compared to special care units.

Residential care centres (RCCs) for persons with Alzheimer disease are increasing worldwide, but there are few studies that compare the functional outcomes of RCC residents to residents of other types of continuing care settings. This study compared residents of the first Canadian RCC on physical, cognitive, behavioural and emotional functioning 6, 12 and 18 months after admission to residents of special care units (SCUs) operated by the same continuing care provider. SCU residents were initially functioning lower than RCC residents on most outcome measures and these differences persisted over time. Resident functioning declined over time regardless of care setting and, when the initial status was controlled for, the rates of decline were similar. However, RCC residents experienced greater independence/freedom of choice, fewer physical or psychotropic medication restraints and were more active, which may have enhanced their quality of life.     

A Study of Common Carotid Arterial Blood Flow Volume of Nursing Home Residents

Abstract: Ninety-seven nursing home residents were divided into 2 groups according to whether they had had an episode of stroke or not. Each group was classifled into 3 subgroups: prolonged bed rest, walking with aids or walking by themselves. They were investigated for both the carotid blood flow volume and the modifled Stockton geriatric rating scale (SGRS), In chronic stroke residents, the total blood flow volume of prolonged bed rest residents was lower than that who can walk by themselves. In residents without stroke, the total blood flow volume of prolonged bed rest residents was lower than the other 2 subgroups. The total blood flow volume was significantly correlated with the scores of 3 : factors of the modifled SGRS.     

Are Female Psychiatry Residents Better to Propose in Emergency a Voluntary Hospitalization?

This study analyses assessment, intervention and admission decisions made by emergency psychiatry residents, to determine whether these differ depending on the gender of the resident. Data from all patients presenting to a psychiatric emergency room were collected prospectively for a 3 months period as part of a local quality check project. A questionnaire was used to collect patient demographic data, diagnosis, treatment decisions and the personal and professional characteristics of the residents who performed the assessments. During the 3 months of the study period we obtained data on all 251 emergency assessments carried out by all six residents working in the service. These were 3 female and 3 male 3rd year residents in psychiatry. There was no difference between male and female residents concerning ICD-10 diagnostic assessment, adherence to local hospitalization criteria guidelines, psychotherapeutical and pharmacological treatments administered. A similar distribution between male and female residents was found for diagnoses. No difference was found in the rate of hospitalization decisions between male and female residents. However, surprisingly, there were more voluntary hospitalizations by the women residents (P = 0.035; χ² = 4.443) and more involuntary admissions by the men residents (P = 0.005; χ² = 7.643). There was no correlation between the gender of the patient and the assessment or hospitalization decision of either male or female residents. Although this study has methodological limitations, it suggests that female emergency psychiatry residents are more likely to propose voluntary hospitalizations.     

Some correlates of language deterioration in severely and profoundly retarded long-term institutionalized residents.

Progress or deterioration in language use was observed in two samples of retarded institutionalized residents. One sample was observed twice, and the other three times, at 5-year intervals. We coded change in language use as noncommunicating, regressed irregular, stable, or progressed. Change in language use was found to be related to two indicators of intellectual capacity. Central nervous system involvement may play a part in irregular or totally absent communication. Institutional policies regarding transfer of residents also affect the apparent language deficit in longer-term residents.     

Clinical characteristics and service use of persons with mental illness living in an intermediate care facility.

OBJECTIVE: The study examined the characteristics of residents living in a 450-bed intermediate care facility for persons with severe mental illness in Illinois and sought to determine the factors predicting their utilization of mental health services. METHODS: Data on 100 randomly selected residents with a chart diagnosis of schizophrenia were collected using chart review and interviews. Data for 78 residents whose diagnosis of schizophrenia or schizoaffective disorder was confirmed using the Structured Clinical Interview for DSM-IV were included in the analyses. RESULTS: Fifty-three percent of the residents used facility-based specialty mental health services beyond medication management, such as group therapy or a day program. Persons with the least severe psychiatric illnesses and with higher levels of motivation for overall care used the most mental health services. Thirty-five percent of the residents had been discharged to an inpatient psychiatric unit during the previous year. Residents most likely to be discharged to those settings were young men with a history of homelessness who refused facility-based health services. CONCLUSIONS: Despite recent policy-driven efforts to improve care in this intermediate care facility for persons with mental illness, the facility continues to have problems addressing the mental health needs of the residents.