高三学生考试焦虑与家庭亲密度和适应性的研究

目的探讨高三学生考试焦虑状况及与家庭亲密度和适应性之间的关系。方法采用整群抽样方法抽取合肥市3所高级中学中参加2013年高考的应届高三学生334人,应用状态-特质焦虑问卷(STAI)、症状自评量表(SCL-90)、家庭亲密度和适应性量表中文版(FACESⅡ-CV)进行调查。结果是否是独生子女以及不同性别之间在焦虑状态、焦虑特质、亲密度及适应性评分差异均无统计学意义(P0.05);亲密度和躯体化、强迫、焦虑状态和焦虑特质呈负相关(r=-0.314~-0.143,P0.01);适应性和焦虑状态、焦虑特质呈负相关(r=-0.265~-0.214,P0.01)。结论良好的家庭亲密度和适应性有利于减轻高三学生的考试焦虑。     

青少年精神分裂症家庭功能及有关情况

目的:探讨青少年精神分裂症患者的家庭功能以及亲密度和适应性特点.方法:采用家庭功能量表(FAD)以及家庭亲密度和适应性量表(FACES Ⅱ-CV)对52例青少年精神分裂症患者(患者组)和60名健康志愿者(对照组)进行调查,并比较结果.结果:患者组在沟通、情感反应、情感介入、行为控制以及总的功能等方面的评分显著高于正常对照组(P＜0.05或P＜0.01);患者组的家庭亲密度和家庭适应性各因子评分明显低于正常对照组(P＜0.05或P＜0.01).结论:青少年精神分裂症患者家庭支持系统不良,应针对其家庭特点开展家庭干预.     

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。     

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。     

精神分裂症患者病耻感与生活质量的关系

目的:探讨精神分裂症患者病耻感与生活质量的关系。方法:采用一般情况调查表、贬低-歧视感知量表及精神分裂症患者生活质量量表对95例住院及152例社区精神分裂症患者进行问卷调查。结果:住院患者的贬低-歧视感知量表评分与生活质量量表总分分别为(29.53±4.57)分、(26.02±14.16)分;社区患者分别为(28.03±3.48)分、(37.44±13.44)分;住院患者的贬低-歧视感知量表评分与生活质量总分(r=0.214)、动力与精力因子分(r=0.024)呈正相关(均P<0.05);社区患者贬低-歧视感知量表评分与生活质量总分(r=-0.255)、动力与精力因子分(r=-0.349)呈负相关(P均<0.01)。结论:生活质量越差,住院精神分裂症患者病耻感越强;社区精神分裂症患者生活质量越差,病耻感越少。     

酒依赖患者应对方式与家庭环境的关系

目的:探讨酒依赖患者应对方式与家庭环境的相关性。方法:对58例酒依赖患者(研究组)和60名无嗜酒史的当地市民(对照组)进行应对方式问卷(CSQ)和中文版的家庭环境量表(FES)调查,分析酒依赖患者应对方式与家庭环境因素的关系。结果:研究组CSQ中退避、幻想和自责因子分显著高于对照组(t=2.41,t=3.22,t=4.15;P0.05或P0.01);FES中亲密度、情感表达、娱乐性、道德宗教观、组织性评分显著低于对照组,矛盾性和控制性评分显著高于对照组(P0.05或P0.01)。研究组FES中亲密度、情感表达、独立性、成功性评分与CSQ解决问题评分呈正相关,情感表达评分与求助评分呈正相关,娱乐性评分与自责评分呈负相关(P0.05或P0.01)。结论:酒依赖患者应用不成熟的应对方式,不良家庭环境是其影响因素。     

精神分裂症急性期患者5-羟色胺转运体mRNA表达相关因素分析

目的:探讨精神分裂症急性期患者5-羟色胺转运体(SERT)mRNA表达水平及其与临床因素的关系。方法:收集44例未经治疗的精神分裂症急性期患者的临床资料,给予阳性与阴性症状量表(PANSS)评估;采用逆转录聚合酶链反应(RT-PCR)方法测定外周血SERT mRNA表达。结果:有攻击行为患者(26例)SERT mRNA表达明显高于无攻击行为患者(18例)(F=9.75,P0.01)。SERT mRNA表达与患者发病年龄无相关(r=0.056,P=0.722);与病程呈正相关(r=0.418,P0.01);与PANSS的阴性症状分呈负相关(r=-0.335,P0.05);与PANSS总分、阳性症状分及一般精神病理分无相关性(r=-0.156,P=0.317;r=0.115,P=0.465;r=-0.097,P=0.538)。结论:精神分裂症急性期患者SERT mRNA高表达与其病程长、伴有攻击行为以及阴性症状量表评分低有关。     

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。     

精神分裂症患者述情障碍与应付方式的相关性

目的探讨精神分裂症患者述情障碍与应付方式特征及其相关性。方法本研究为单纯随机对照研究。将62例符合《国际疾病分类(第10版)》(ICD-10)诊断标准的精神分裂症患者作为研究组,选取70名正常健康者为对照组。采用多伦多述情障碍量表(TAS-20)和应付方式问卷(CSQ)对两组进行测评。结果研究组TAS-20各项因子评分高于对照组(P0.05或0.01),研究组CSQ的退避、幻想、自责因子评分高于对照组(P0.01),合理化和解决问题因子评分低于对照组(P0.01)。相关分析显示,研究组TAS-20的P1因子与CSQ的幻想、自责、合理化因子呈正相关(r=0.352~0.488,P0.05),与解决问题因子呈负相关(r=-0.327,P0.05);P2因子与CSQ的合理化因子呈正相关(r=0.256,P0.05),与解决问题因子呈负相关(r=-0.349,P0.05)。结论精神分裂症患者存在述情障碍和消极的应付方式,且述情障碍与应付方式存在一定的相关性。     

个案管理对社区精神分裂症患者康复作用——18个月随访研究

目的:探讨个案管理对社区精神分裂症患者的康复作用。方法:对在专科医院就诊的康复期精神分裂症患者(个案组,46例)实施18个月个体化康复方案(规范化治疗、康复训练、健康教育);干预前、干预6、12、18个月分别进行阳性和阴性症状量表(PANSS)、康复状态量表(MRSS)、自知力与治疗态度问卷(ITAQ)和日常生活能力量表(ADL)评估,结果与在社区接受精神卫生服务的康复期精神分裂症患者(社区组,48例)比较。结果:两组PANSS总分和阴性症状分不同时间点差异有统计学意义,组别与时间有交互作用(P均0.01);阳性症状分、一般病理分两组不同时间点差异有统计学意义(P均0.05)。MRSS总分、活动能力缺乏、社交能力、目前症状与异常行为评分两组不同时间点差异有统计学意义(P均0.01);MRSS总分、依赖性、活动能力缺乏、社交能力分具有组别与时间交互作用(P0.05或P0.01)。两组ITAQ中自知力与治疗态度评分具有交互作用(P均0.05)。两组ADL评分不同时间点差异有统计学意义,组别与时间有交互作用(P均0.01)。干预18个月时两组服药时间和依从性差异有统计学意义(P均0.05)。结论:个案管理对改善康复期精神分裂症患者的病情、自知力、治疗态度以及日常生活能力方面均优于常规社区精神卫生服务。     

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.     

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.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.