认知行为治疗对抑郁症患者外显、内隐自杀态度的影响

目的:本文探讨抑郁症患者的外显、内隐自杀态度与自杀倾向的关系,以及认知行为治疗(CBT)对内隐、外显自杀态度的影响。方法:将伴有自杀意念的66例抑郁症患者随机分为实验组34例(药物治疗联合CBT治疗)和对照组32例(单一药物治疗),12周末测量CBT对被试的外显、内隐自杀态度的影响。结果:内隐自杀态度和外显自杀态度均能预测自杀倾向,内隐态度的预测作用略强于外显态度,标准回归系数分别为-0.44和-0.32。12周的CBT治疗对外显自杀态度的改变明显,主效应显著(P<0.05);对内隐自杀态度有影响,主效应不显著(P=0.561),但与时间变量的交互效应显著(P=0.018),存在辅助效应。结论:内隐态度比外显态度对自杀倾向的预测作用更加良好。CBT能影响被试对自杀行为的内隐态度。     

An Investigation of Nursing Staff Attitudes and Emotional Reactions Towards Patients with Intellectual Disability in a General Hospital Setting

Background It has been suggested that inequalities in health care for people with intellectual disabilities may be partly explained by negative attitudes of health professionals. This study aimed to investigate the attitudes and emotional reactions reported by nursing staff working in general hospitals towards caring for patients with intellectual disabilities. Method Attitudes and emotional reactions were measured using a self‐report, vignette style questionnaire, tested for validity and reliability. Attitudes towards patients with physical disabilities were also assessed to act as a comparison. Results Nursing staff reported less positive attitudes, more negative emotions and fewer positive emotions, in response to caring for a patient with an intellectual disability compared to a patient with a physical disability. Occupational status (registered general nurse, student nurse, nursing assistant) had no effect upon respondents reported attitudes or emotions. Finally, attitudinal and emotional variables were significantly correlated, with positive emotions being associated with more favourable attitudes. Conclusions Although caution needs to be exercised when inferring actual behaviour from attitudes expressed, it is suggested that the presence of less positive attitudes and feelings amongst nursing staff towards patients with intellectual disabilities may affect the quality of care. Recommendations for future research and service development includes: the need to focus upon improving attitudes of nursing staff through training, and increased joint working between acute care services and Community Intellectual Disability Teams.     

Public Attitudes towards People with Intellectual Disabilities: A Qualitative Comparison of White British & South Asian People

Background National and international polices promote the acceptance, integration and inclusion of people with intellectual disabilities into mainstream society. However, there is little systematic research into general population attitudes towards people with intellectual disabilities, and even less research, which considers the impact of culture on attitudes. The aim of this study was to explore how young people from White British and South Asian backgrounds differ in their attitudes towards people with intellectual disabilities and above all, how they arrive at their beliefs. Materials and Method A qualitative design utilizing focus groups and individual interviews with White British and South Asian adolescents aged 16–19 years (N = 61) was employed. Questionnaire data were collected to compare this sample to findings from a larger study run concurrently (Attitudes to people with intellectual disabilities: a cross cultural study. Thesis, University College London). Interview and focus group data were analysed using thematic analysis. Results Thematic analysis yielded five themes and pointed to widespread confusion about the concept of ‘intellectual disability’, not helped by the continuing invisibility of people with intellectual disabilities in the media. Participants expressed many positive beliefs, yet closer analysis revealed that underlying these may be more ambivalent or even hostile attitudes. Key differences between the two cultural groups are discussed. Conclusions The findings highlight the need for raising public awareness and the importance of culturally sensitive support.     

Attitudes of Social Service Providers towards the Sexuality of Individuals with Intellectual Disability

Background The sexual lives of people with intellectual disability is made complex by the involvement and influence of social service providers, whose beliefs and values have a great impact on the support they provide. We hypothesized that social service providers’ role, educational level and service in which they worked could affect attitudes towards the sexual behaviour of individuals with intellectual disability. Materials and methods The current study describes attitudes of social service providers towards the sexuality of individuals with disability measured by 20 items of Sexuality and Mental Retardation Attitudes Inventory (SMRAI). This instrument was devised by Brantlinger [Mental Retardation (1983) Vol. 21, pp. 17–22] to assess the attitudes of the staff employed by organizations that supplied services to individuals with intellectual disability. Specifically, analysis of variance (type of service × professional role × education) was performed on participants’ scores. Results Results suggested that the social service providers participating in this research study tended to have moderately liberal attitudes. Educational level and role carried out did not produce differences in their attitudes. A significant difference emerged between those who operated in different services. It was especially the staff of the outpatient treatment services who revealed the most liberal and positive attitudes towards the sexuality of individuals with intellectual disability. Conclusions The data reported in the present study seem to underline some differences between the data collected from the Italian and the Anglo‐Saxon social service providers. Failure to record influences associated with the role carried out and previous training could be related to the different contextual differences. Results suggest that particular attention should be paid to the training of those who hold managerial posts in Italian residential services.     

Teachers' Personal Concerns About Including Children with a Disability in Regular Classrooms

Regular class teachers are increasingly being asked to accommodate children with intellectual and physical disabilities in their regular classrooms. This research in Western Australia considers the personal concerns that regular class and special education teachers entertain regarding inclusive educational practices. It is proposed that an increased understanding of teachers' concerns regarding inclusive practices will provide a substantial base upon which to implement new methodologies for inclusion and improve the likelihood of the effectiveness of such practices.     

Community Hospital Physician and Nurse Attitudes About Pain Management

An interdisciplinary committee was established and charged with examining pain management and developing interventions at a 148 bed community hospital. To examine strategies on managing pain from both healthcare provider and patient perspectives, the committee surveyed the attitudes of physicians and nurses toward pain management and patients' opinions about the pain management they received in the hospital. A separate survey instrument was developed for physicians, nursing staff and patients. Physicians and nursing staff from all departments were asked to complete the survey during departmental meetings in Autumn 2000, and all patients for whom pain medication were ordered during the month of May 2000 were asked to participate. A total of 45 physicians, 142 nurses and 169 patients responded. Results showed that the majority of physicians (88.9%, n = 40) and nurses (83.0%, n = 118) were satisfied with the pain management outcomes in their patients, andthat91.1% of physicians and 90.2% of nurses included their patients in the pain management decision-making process. Nearly all patients believed their pain was adequately managed, but the results indicated a need to improve the use of pain assessment scales by the hospital staff and a need to educate and involve all patients in their pain management options. Survey data also showed a desire for staff education on pain management.     

Public Attitudes Towards Individuals with Intellectual Disabilities as Measured by the Concept of Social Distance

Background While current practices strive to include individuals with intellectual disabilities in community opportunities, stigmatizing attitudes held by the public can be a barrier to achieving true social inclusion. Methods A sample of 625 community members completed the Social Distance Subscale of the Multidimensional Attitude Scale on Mental Retardation. Results Older and less educated participants held attitudes that reflected greater social distance. Participants who had a close family member with an intellectual disability and those who perceived the average level of disability to be ‘mild’ expressed less social distance. The limited variability in scores leads us to question our overall finding of very favourable attitudes towards social interaction with persons with intellectual disabilities. Conclusions This study demonstrates that although certain demographic variables are still relevant in identifying social distance attitudes, the measurement of this construct requires revision to ensure a valid and sensitive reflection of the public’s attitudes.     

Attitudes Toward Disability

The work of health rofessionals is directly influenced by somatopsychological attitudes. Expectations from the disabled person, from health professionals, and from society play an important part in adjustment to disability. Role theory has helped us look at the "sick role" versus the disabled role and we now realize that role confusion often interferes with the adjustment process. It is important that students be made aware of these different theories to help them get in touch with their own feelings about disability and develop an understanding of attitudes which will facilitate the adjustment process. An instrument measuring attitudes toward the disabled was administered to two successive junior occupational therapy classes, at the beginning and the end of the school year. Change in attitudes was analyzed and positive significant results were discussed in relation to implications for education and practice.     

医学生对残疾人态度研究的系统综述

目的系统综述医学生对残疾人态度的现状,为开展改善医学生对残疾人态度的课程改革奠定基础。方法计算机检索Ovid数据库集合、PubMed数据库、Web of Science数据库、中国期刊全文数据库、万方全文期刊数据库,检索时限从数据库收录起始时间至2014年11月30日,根据纳入和排除标准筛选文献、提取资料、系统分析。结果共纳入17篇文献,医学专业的学生对残疾人的态度处于中等或偏下水平,年龄、性别、不同专业、不同地区、曾与残疾人接触的经验等都是对残疾人态度的影响因素。结论医学生对残疾人态度各不相同,开展课程设置改革或干预前,应先了解目标学生群体的态度现状,从而有针对性地开展有效干预。     

Dysfunctional Attitudes in endogenous and nonendogenous depressed inpatients

Sixty-two depressed inpatients completed the Dysfunctional Attitudes Scales (DAS) during their first week of hospitalization. They also received a dexamethasone suppression test (DST) and were diagnosed melancholic or nonmelancholic according to DSM-III criteria. DAS scores were not related to the diagnosis of melancholia. Patients with abnormal results on the DST scored significantly lower on the DAS than depressives with a normal DST. The results suggest that dysfunctional attitudes are less pervasive in endogeneously depressed inpatients.The authors thank Caryn Corenthal and Dalene Stangl for assistance in collecting the data, and Bruce Pfohl for assistance in diagnosis.     

第二次全国残疾人抽样调查言语残疾标准研究

本文介绍了用于我国第二次全国残疾人抽样调查言语残疾调查的标准,包括进行调查的言语障碍类型、言语残疾的分级标准、筛查方法、言语残疾调查工具、言语残疾的诊断方法、病因分析以及康复建议。     

WAIS-RC简式测验校正后常模在智力残疾鉴定中的应用

目的探讨韦氏成人智力量表(WAIS-RC)简式测验校正后常模在智力残疾鉴定中的应用效度。方法随机取128例作智力残疾鉴定的精神发育迟滞(MR)患者,测得其标准全式总智商(FIQ),再根据原标准化常模以及校正后的新常模,分别以Tellegen法计算其四合一简式FIQ,并进行比较分析。结果原常模和新常模简式FIQ与全式之间均呈显著正相关(P＜0.01);均值比较原常模简式FIQ高于全式(P＜0.01),新常模简式FIQ与全式之间差异无统计学意义(P＞0.05);按全式智商重度缺损组其新常模简式的等级划分符合率与原常模一样均为0.00%;中度和轻度缺损组比原常模要高(P＜0.01)。结论校正后的WAIS-RC简式测验效度优于原常模简式,但对重度缺损者不适用。     

Implicit and Explicit Attitudes Toward Spiders: Sensitivity to Treatment and Predictive Value for Generalization of Treatment Effects

This study tested whether high spider fearful individuals’ implicit and explicit attitudes toward spiders are sensitive to exposure treatment, and whether post-treatment implicit and/or explicit attitudes are related to the generalization of treatment effects. Self-reported explicit and implicit attitudes (indexed with a pictorial Extrinsic Affective Simon Task) were assessed in high spider fearful, treatment-seeking individuals (n = 60) before and after a one-session exposure in vivo treatment and at 2-month follow-up. A group of non-fearful participants (n = 30) completed the same assessments once. Results show that implicit attitudes did not change following treatment over and above test–retest effects. In contrast, explicit attitudes did change favorably following treatment, but negative explicit attitudes at post-treatment were associated with less pronounced overt approach behavior at follow-up. These findings support the idea that residual negative explicit attitudes interfere with the generalization of treatment effects.

World Health Organisation Disability Assessment Schedule II: Contribution to the Italian validation

Introduction.?The World Health Organisation Disability Assessment Schedule II (WHODAS II) is an instrument developed by the World Health Organisation in order to assess behavioural limitations and restrictions to participation experienced by an individual, independently from a medical diagnosis. The conceptual frame of reference of this instrument is the International Classification of Functioning, Disability and Health: ICF. Specifically, the instrument is designed to evaluate the functioning of the individual in six activity domains: Understanding and communicating, Getting around, Self-care, Getting along with people, Life activities, Participation in society.

Purposes.?Considering the widespread consent about the usefulness of the WHODAS II, the general aim of the present study is to provide a contribution to the validation of the Italian version.

Method.?The WHODAS II Italian version has been administered to a sample of 500 participants subdivided in two groups: 271 normal adults and 229 disabled adults. The disabled participants group has been subdivided in three sub-groups, according to their disability: 111 motor disabled, 45 mental disabled, 73 sensory disabled.

Results.?The mean Total score of the WHODAS II is 12.95 for the normal adults and 22.93 for the disabled group. Either group obtains the least impairment in the Self-care domain. This could be probably due to the presence of social-health workers in everyday life for all Italian disabled people. For the three disabled participant groups separately computed the mean Total score is: 28.66 for the motor disabled, 24.60 for the mental disabled, and 14.97 for the sensory disabled, confirming that sensory disabled do not perceive their disability as a personal functioning problem but a socially constructed one. Some subscales of WHODAS II show relatively strong floor effects. The Cronbach's Alpha calculated for each of the subscales is found to be high. The correlations of the subscales show strong correlations in all subscales.

Conclusions.?The WHODAS II is a useful instrument for measuring disability and functioning in normal and disabled people. It shows high reliability and a stable factor structure; although an additional psychometric evaluation of a representative sample of Italian disabled should be carried out in order to reach standard scores for each macro-category of disability.     

Implicit Attitudes and Explicit Ratings of Romantic Attraction of College Students Toward Opposite-Sex Peers with Physical Disabilities

This is a replication and extension of a study by Man et al. in Journal of Developmental and Physical Disabilities 18:35–44, 2006, who found that college students rated the romantic attractiveness of opposite-sex peers as equal, regardless of the presence or absence of a physical disability. Based on photographs with brief biographical vignettes 41 college students rated attractiveness of young adults with the Romantic Attraction Scale (RAS; Campbell in Journal of Personality and Social Psychology 77:1254–1270, 1999) and then completed the Implicit Association Test (IAT; Nosek et al. in Personality and Social Psychology Bulletin 31:166–180, 2005) to assess their implicit attitudes toward disabilities. Self-reported romantic attractiveness was unaffected by the presence of a physical disability. However, the IAT revealed a clear preference for physical health over physical disabilities. The discrepancy between the explicit attractiveness ratings and the implicit attitudes toward physical disabilities suggests that the former were biased by social desirability. Alternative explanations of the inconsistencies between the explicit and implicit data are discussed.

Mainstream Students’ Attitudes to Possible Inclusion in Unified Sports with Students who have an Intellectual Disability

Background Schools in New Zealand do not normally include students with intellectual disability in their sports programmes. This study examined regular students’ attitudes towards the possible inclusion of students with an intellectual disability in an integrated sports programme within their school. Materials and Methods A total of 170 school students at year 6 (10 years) and year 12 (16 years) at four Auckland schools completed an attitude scale assessing their acceptance of a possible unified sports programme at their school, a test of their knowledge about Special Olympics, and wrote open‐ended comments about unified sports; a subsample at each age level was interviewed. Results Students had positive attitudes towards possible involvement alongside students with an intellectual disability in unified sports. These attitudes were moderated by age and gender, but not knowledge about Special Olympics. Conclusions The strengthening of inclusion and normalization through unified sports would likely have positive peer social acceptance by typical students in New Zealand.