大学生羞耻感和心理健康以及自我效能,自尊的相关研究

目的： 了解大学生羞耻感与心理健康的关系, 以及它们和自我效能、自尊之间的关系。方法： １９１ 名北京大学本科生参加了本研究, 其中男生１１１人, 女生８０ 人, 平均年龄为２０．４岁。所有的被试填写了羞耻量表、症状自评量表 （ＳＣＬ－ ９０）、自我判断调查表（ＳＥＩ） （测查自我效能感） 和自尊量表（ＳＥＳ）。结果： 羞耻和ＳＣＬ－９０ 各因子得分均呈显著的正相关（ｐ 均小于０．０１）;自我效能、自尊与羞耻得分之间有显著的负相关（ｐ 均小于０．０１）。考察ＳＣＬ－９０ 各因子和自我效能、自尊的相关情况发现, ＳＣＬ－９０各因子和自我效能、自尊得分之间呈显著的负相关 （ｐ 均小于０．０１）。表明羞耻体验可引起自我效能、自尊水平的下降, 同时自我效能和自尊水平的降低可能反过来加强了羞耻的体验, 并最终影响到心理健康。     

Don't Mourn: Organize. Reviving Mental Health Services Research for Healthcare Quality Improvement

The structure, organization, management, and design of the mental health system are changing profoundly as new healthcare policies reshape its configurations. This special issue is a call to action for the mental health services research field. The articles represent an important attempt to identify specific concepts, constructs, and findings from psychosocial treatment research about fidelity and integrity of treatment and align them with healthcare quality. However, the current structure and processes for deriving quality indicators place other demands on the extant research base. These will challenge this migration unless changes are made in leadership around consistent measurement strategies, payment mechanisms to support quality, and attention to technological infrastructure development. The mental health services research field should be proactive. Pediatric issues need special attention, especially as applied to community‐based services for children and their families.     

Mental health diagnosis by nurses using the Global Mental Health Assessment Tool: a validity and feasibility study.

BACKGROUND: The Global Mental Health Assessment Tool-Primary Care Version (GMHAT/PC) has been developed to assist health professionals to make a quick and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in a previous study involving GPs. Its use by other health professionals may help in detecting and managing mental disorders in primary care and general health settings. AIM: To assess the feasibility of using a computer-assisted diagnostic interview by nurses and to examine the level of agreement between the GMHAT/PC diagnosis and psychiatrists' clinical diagnosis. DESIGN OF STUDY: Cross-sectional validation study. SETTING: Primary care, general healthcare (cardiac rehabilitation clinic), and community mental healthcare settings. METHOD: A total of 215 patients between the ages of 16 and 75 years were assessed by nurses and psychiatrists in various settings: primary care centre (n = 54), cardiac rehabilitation centre (n = 98), and community mental health clinic (n = 63). The time taken for the interview, and feedback from patients and interviewers were indicators of feasibility, and the kappa coefficient (kappa), sensitivity, and specificity of the GMHAT/PC diagnosis were measures of validity. RESULTS: Mean duration of interview was under 15 minutes. The agreement between nurses' GMHAT/PC interview-based diagnosis and psychiatrists' International Classification of Diseases (ICD)-10 criteria-based clinical diagnosis was 80% (kappa = 0.76, sensitivity = 0.84, specificity = 0.92). CONCLUSION: The GMHAT/PC can assist nurses to make accurate mental health assessment and diagnosis in various healthcare settings and it is acceptable to patients.     

Mental Health Services and Sexual Abuse: The Need for Staff Training

ABSTRACT

Identification of child abuse by mental health services is important for formulation of the causes of presenting problems and for development of comprehensive treatment plans. A small but growing number of studies suggest, however, that the majority of child sexual abuse cases are not identified by mental health services. A similarly small literature also suggests that abuse survivors are extremely reluctant to spontaneously tell anyone about the abuse, indicating that professionals have a responsibility to ask rather than wait for spontaneous disclosures. The purpose of this study, therefore, was to add to these two bodies of literature with a New Zealand sample. A postal questionnaire was completed by 191 women who had received counselling for childhood sexual abuse. The average amount of time taken to tell anyone about the abuse was 16 years. Only 22% of those who had been in contact with public mental health services had ever been asked about abuse by those services. It was concluded that New Zealand women are reluctant to disclose abuse and that mental health services are, as is the case elsewhere, failing to assist them with this process. The need for staff training is discussed, and an example described.     

Practice Research Networks: Promises and Pitfalls

Networks that incorporate community settings and populations are essential if we want to understand how well interventions work in the community and how to ensure that they are used in community practice. The challenges in setting up such networks are deciding what type of network is best, what questions are most important to address in them, and how to ensure that they are feasible in the long run. The paper by Borkovec and colleagues offers an opportunity to discuss the promises and pitfalls of practice research networks.     

洛阳地区儿童精神卫生调查

作者根据美国ＤＳＭ－Ⅲ诊断标准和南京神经精神病防治院制订的儿童精神卫生调查表及儿童智力筛选表，随机抽样调查了我区２２所小学，４所幼儿园，２所城市中学１０１４０名儿童（３－６岁１７６０人，７－１２岁７２５５人，１３－１４岁１１２４人）。调查结果：（１）轻微脑功能障碍（ＭＢＤ）５３人，患病率为５．２２％－（３－６岁１人，７－１２岁４７人，１３－１４岁４人），以学龄初期居多。（２）智力发育迟滞１１０人，     

专业心理健康服务感知风险结构研究

目的:探讨专业心理健康服务感知风险的结构。方法 :对天津地区555名在校大学生和全国13个省区的557名社区居民进行了问卷调查。结果:探索性和验证性因素分析证实,专业心理健康服务感知风险包括四个维度,分别为心理风险、服务质量风险、功能价值风险和社会风险,其中,人们对服务质量风险和功能价值风险的感知最强。自编感知风险问卷具有良好的信度和效度。结论:对于专业心理健康服务这一特殊的服务产品,人们感知风险的多维结构体现出服务自身的特点。专业心理健康服务现阶段的发展可着重于规范服务体系和宣传功能价值。     

Conceptualizing Mental Health Care Utilization Using the Health Belief Model

This article uses the Health Belief Model (HBM; Health Education Monographs , 1974, 2:409) as a framework for explaining what factors might encourage or inhibit an individual from utilizing mental health services. The HBM is a socio-cognitive approach that proposes that people are likely to engage in a given health-related behavior when they believe the problem could have serious consequences for daily living activities, when they believe the intervention will be effective, and when they perceive few barriers to taking action. When applied to mental health utilization, this model provides a structure for developing and evaluating programs designed to increase mental health awareness and appropriate utilization.     

Ethical Challenges in Practice-Based Mental Health Services Research: Examples From Research With Children and Families

Researchers have been encouraged to improve the practical relevance and utility of their work by conducting research based on "real-world" service settings and collaborating with other stakeholders, such as service providers and consumers. Practice-based research presents multiple ethical challenges, not well addressed in the literature. We discuss ethical challenges in three general categories, derived from our experience in practice-based research on child and family services: (a) multiple roles and potentially competing demands of research and clinical care, (b) multiple potential uses of research data, and (c) policy and fiscal challenges. Suggested directions for future work are also proposed.     

A Reason for Optimism in Rural Mental Health Care: Emerging Solutions and Models of Service Delivery

This invited commentary responds to Jameson and Blank's literature review (2007) and utilizes different source materials, such as personal communications among clinicians and policymakers, Internet-based information, and direct professional experience. An update is provided regarding new graduate programs training clinicians for rural service. In addition, perceived barriers to treatment are challenged, because they are drawn from research results that could be interpreted in different ways, given the cultural heritage of southern and central Appalachian people. Lastly, the efforts of the Veterans Affairs Health Care System to reach rural citizens for mental health treatment are summarized. Some of these federal processes could be replicated at the state level, if sociopolitical and economic factors were more directly addressed. The commentary concludes, from the perspective of a professional providing clinical services in a rural setting, that a more optimistic outlook on the state of rural mental health care may be warranted.     

小组心理干预对新兵心理健康水平的影响

目的：探讨小组心理干预对新兵心理健康水平的影响。方法：采用症状自评量表（SCL－90）和特质应对方式问卷（TCSQ）对512名新兵进行心理测试，将检测出的64名有心理问题的分为两组，A组（31人）为小组心理干预，B组（33人）为对照组。在集体讲授心理卫生课的基础上，对A组采取小组心理干预。结果：经过4周小组心理干预后，A组有效率为61．29％，B组有效率为33．33％，两组比较有显著性差异（P＜0．01）。SCL－90结果：干预后A组中除恐怖因子分没有变化外，其它各项因子得分明显下降（P＜0．01）。A组的SCL－90总分、阳性项目数、躯体化、强迫、人际关系、忧郁、精神病性因子分与B组相比较有明显低（P＜0．05－0．01）。TCSQ结果：A组中的消极应对得分明显降低（P＜0．01），而B组消极应对得分没有变化。结论：小组心理干预在短期内不仅能有效改善新兵的躯体化、强迫、抑郁、人际关系敏感等常见心理问题，还能促进成功应对方式的形成，掌握自我调节方法，对提高新兵的心身健康水平及我军整体素质提高大有裨益，可推广试用。     

大学特困生心理健康状况研究

大学特困生心理健康状况密切关系到他们的人格塑造和健康成长。本文采用ＳＣＬ－９０症状自评量表,对４０例特困生和４０名经济条件中等以上的学生进行测量研究,表明特困生在躯体化、强迫、人际关系、抑郁、焦虑、敌对性、恐怖等方面的症状,显著高于经济条件正常的学生,说明经济贫困会影响健康。     

大学生羞耻感、人格与心理健康的结构模型初步研究

目的：探讨大学生羞耻感与人格，心理健康的关系。建立大学生羞耻感，人格与心理健康的结构模型。方法：178名大学生参加了本研究，其中男生86人，女生92人，平均年龄21岁。所有被试填写了羞耻量表，艾森克人格问卷简式量表和症状自评量表，运用结构方程模型对数据进行拟合，结果：初步建立了人格，羞耻感与心理健康的理论关系模型。同时通过模型比较确定了羞耻感在人格和心理健康关系模型中的部分中介地位。     

Mental health aspects of emergency medical services for children: summary of a consensus conference.

OBJECTIVE: To address the mental health needs of children involved in emergency medical services (EMS). METHODS: A multidisciplinary consensus conference convened to identify mental health needs of children and their families related to pediatric medical emergencies, to examine the impact of psychological aspects of emergencies on recovery and satisfaction with care, and to delineate research questions related to mental health aspects of medical emergencies involving children. RESULTS: The consensus group found that psychological and behavioral factors affect physical as well as emotional recovery after medical emergencies. Children's reactions are critically affected by age and developmental level, characteristics of the emergency medical event, and parent reactions. As frontline health care providers, EMS staff members are in a pivotal position to recognize and effectively manage the mental health needs of patients and their families. CONCLUSIONS: Ecological changes in emergency departments, such as linkages to mental health follow-up services, training of EMS providers and mental health professionals, and focused research that provides an empirical basis for practice, are necessary components for improving current standards of health care.     

疗养空勤人员身心健康调查报告

目的评估疗养空勤人员的身心健康状况,为空勤人员体检鉴定提供依据。方法采用症状自评量表(SCL-90)进行心理测评,依据空勤人员年度健康大体检标准进行体检。结果空勤人员在SCL-90各因子分均低于全国常模,其中躯体化(t=2.925,P<0.01),有显著统计学意义;精神病性、焦虑、抑郁、人际敏感等各项因子(t=2.586～11.567,P<0.001),有非常显著统计学意义。躯体方面在高脂血症(17.80%)、脂肪肝(9.60%)等检出率较高。结论疗养空勤人员心理健康状况好于一般正常人,具有良好的心理素质。躯体方面部分疾病检出率较高。     

农村留守儿童心理健康状况调查研究

目的调查初中阶段农村留守儿童心理健康状况及特点,为有针对性的展开留守儿童心理健康教育提供参考。方法采用王极盛的《中国中学生心理健康量表》对湖南省3个地区6所学校的670名留守初中生的心理健康状况进行测查。结果 1留守儿童的心理健康总检出率为57.14%;2留守儿童男生与女生在敌对和心理不平衡上差异显著(t=2.17,2.71,P0.05);3监护人为母亲的儿童在抑郁上的得分要低于监护人为父亲、祖父母的且差异显著(F=2.90,P0.05);4父母的打工年限会对留守儿童的人际关系紧张与敏感、焦虑等产生影响(F=3.09,2.94,P0.05)。结论留守儿童心理健康状况不容乐观,必须重视留守儿童的心理健康教育。     

陕北地区农村留守儿童的心理状况调查

目的:探讨陕北地区农村留守儿童的心理状况及特点。方法:选择陕北地区2~6年级农村小学生为研究对象,采用多阶段抽样方法,采用心理健康诊断测验分别对延安地区和榆林地区农村留守儿童进行调查。结果:77.88%的留守儿童存在各种心理焦虑,各因子得分的均分为3.20~8.89,最高为学习焦虑,留守儿童和非留守儿童得分在对人焦虑上有差异(t=-2.147,P0.05);8个因子中,≥8分的检出率范围为2.97%~67.84%,检出率最低为孤独倾向,最高为学习焦虑,留守儿童和非留守儿童在对人焦虑(χ2=6.624,P=0.01)和孤独倾向(χ2=4.907,P=0.027)上有差异;男生心理问题检出率的范围在2.27%~64.39%,女生心理问题检出率范围在3.65%~71.17%,女生的自责和恐怖倾向检出率高于男生(P0.05),延安地区农村留守儿童心理焦虑检出率高于榆林地区。结论:陕北地区农村留守儿童具有较多的心理焦虑,尤其是学习焦虑,需要全社会共同参与和努力来改善。