中学生自尊、社会支持与手机游戏沉迷关系

目的 探讨中学生自尊、社会支持与手机游戏沉迷的现状,并检验社会支持的中介作用,为降低中学生手机游戏沉迷程度提供参考。方法 整群随机抽取2 307名中学生为研究对象,采用自尊量表（SES）、青少年社会支持量表与手机游戏沉迷量表进行调查,并运用描述统计、相关分析、回归分析、结构方程模型检验进行分析。结果 中学生自尊、社会支持与手机游戏沉迷的评分分别为（29.01±5.74）分、（63.75±11.89）分、（61.01±19.84）分;其中,手机游戏重度沉迷、中度沉迷、轻度沉迷或不沉迷所占比例分别为8.50%、62.72%、28.78%。中学生自尊与手机游戏沉迷各维度及总评分均呈负相关（r=-0.33~-0.21,P均<0.01）;除了参与时长、参与习惯外,社会支持各维度及总评分与手机游戏沉迷其他维度及总评分均呈负相关（r=-0.28~-0.12,P<0.05或0.01）;自尊与社会支持各维度及总评分均呈正相关（r=0.11~0.26,P均<0.01）。自尊、社会支持各维度与总评分均能负向预测手机游戏沉迷（β=-1.49~-0.21,t=-10.10~-2.36,P<0.05或0.01）,自尊能正向预测社会支持（β=0.19,t=3.20,P<0.01）;中学生社会支持在自尊与手机游戏沉迷之间存在部分中介效应,检验模型的参数如下：χ²/df=4.36,GFI=0.89,AGFI=0.90,NFI=0.91,CFI=0.93,IFI=0.86,RMSEA=0.078。结论 中学生自尊与社会支持均处于中等偏上水平;手机游戏沉迷各程度分布不均匀,中度沉迷者占大多数。中学生自尊水平越高,社会支持状况越好,则手机游戏沉迷程度越轻。中学生自尊水平既可以直接影响手机游戏沉迷,也可以通过社会支持间接影响手机游戏沉迷。     

中学生一般自我效能感与手机游戏沉迷：时间管理倾向的中介作用

目的 探讨中学生一般自我效能感和手机游戏沉迷之间的关系以及时间管理倾向在其中的中介效应。方法 于2020年11月-2021年2月采用整群抽样法选取江西省和四川省共三所中学的667名中学生为研究对象,采用一般自我效能感量表（GSES）、手机游戏沉迷量表以及青少年时间管理倾向量表（ATMD）对其进行问卷调查。使用Bootstrap方法进行中介效应检验。结果 ①手机游戏沉迷量表总评分与GSES和ATMD总评分均呈负相关（r=-0.122、-0.333,P均<0.01）,ATMD总评分与GSES总评分呈正相关（r=0.536,P<0.01）。②一般自我效能感和时间管理倾向均能负向预测手机游戏沉迷（β=-0.333、-0.122,P均<0.01）,一般自我效能感能够正向预测时间管理倾向（β=0.536,P<0.01）。③时间管理倾向在一般自我效能感和手机游戏沉迷之间起完全中介作用,中介效应量为-0.159（95% CI：-0.213~-0.112,P<0.01）,中介效应占总效应的70.38%。结论 一般自我效能感通过时间管理倾向间接影响手机游戏沉迷。     

中职生未来时间洞察力与学业拖延的关系：自我控制的中介作用

目的 探讨中职生未来时间洞察力对学业拖延的影响及自我控制的作用,为中职生心理健康教育提供参考。方法 于2022年6月选取安徽省黄山市2所中职院校的1 419名中职生为研究对象,采用青少年未来时间洞察力问卷、中学生学业拖延问卷和自我控制量表（SCS）分别评定中职生的未来时间洞察力、学业拖延和自我控制能力情况,使用PROCESS中介效应检验分析自我控制在未来时间洞察力和学业拖延之间的中介作用。结果 (1)青少年未来时间洞察力问卷总评分、SCS总评分与中学生学业拖延问卷总评分均呈正相关（r=0.558、0.470,P均<0.01）;(2)未来时间洞察力和自我控制均能正向预测学业拖延（β=0.463、0.218,P均<0.01）,未来时间洞察力能够正向预测自我控制（β=0.348,P<0.01）;(3)自我控制在未来时间洞察力和学业拖延之间起部分中介作用[间接效应=0.076(95%CI:0.052～0.101,P<0.01),间接效应占总效应的16.41%]。结论 中职生未来时间洞察力可以直接影响学业拖延,也可以通过自我控制间接影响学业拖延,自我控制在未来时间洞察力与...     

中学生童年期虐待与失眠之间的关系：一个有调节的中介模型

目的 分析中学生童年期虐待与失眠之间的关系,探讨创伤后应激障碍（PTSD）症状在二者关系中的中介作用以及心理韧性的调节作用。方法 于2021年4月-5月,采用方便抽样法,从中国西部某市3所中学共抽取3 412名学生,完成了童年期创伤问卷（CTQ）、创伤后应激障碍量表（PCL）、失眠严重程度指数量表（ISI）和心理韧性量表评定,使用Process 3.4进行有调节的中介效应检验。结果 中学生CTQ评分与PCL和ISI评分均呈正相关（r=0.540、0.320,P均<0.05）,CTQ、PCL和ISI评分与心理韧性量表评分均呈负相关（r=-0.049、-0.193、-0.132,P均<0.05）。PTSD症状在童年期虐待和失眠之间起部分中介作用（β=0.161,P<0.05）,中介效应占总效应的80.5%。心理韧性在童年期虐待与PTSD症状的前半路径起调节作用（β=-0.008,P<0.01）。结论 在中学生中,PTSD症状在童年期虐待与失眠症状中起部分中介作用,且心理韧性在儿童期虐待与PTSD症状中起调节作用。     

高中生基本心理需求满足与手机成瘾：孤独感和社交焦虑的中介作用

目的 探讨孤独感和社交焦虑在高中生基本心理需求满足与手机成瘾之间的中介作用,为高中生手机成瘾的干预提供参考。方法 于2022年4月,采用随机抽样方法,纳入四川省某县5所中学共14 666名高中生为研究对象。采用基本心理需求满足量表（BPNS）、UCLA孤独量表第三版（UCLA-3）、交往焦虑量表（IAS）以及手机成瘾指数量表（MPAI）进行横断面调查。使用Bootstrap法进行孤独感和社交焦虑在基本心理需求满足与手机成瘾间的中介作用分析。结果 (1)共回收有效问卷14 036份,检出1 752名（12.48%,95%CI:0.114～0.136）高中生存在手机成瘾。BPNS总评分与UCLA-3总评分、IAS总评分、MPAI总评分均呈负相关（r=-0.771、-0.486、-0.417,P均<0.01）,MPAI总评分与IAS总评分、UCLA-3总评分均呈正相关（r=0.403、0.424,P均<0.01）,IAS总评分与UCLA-3总评分呈正相关（r=0.458,P<0.01）;(2)高中生基本心理需求满足程度可以直接负向预测手机成瘾（β=-0.383,P<0...     

重大公共危机事件下四川省在校学生安全感与焦虑状况

目的 以新型冠状病毒肺炎（COVID-19）疫情为例,了解四川省在校学生群体在重大公共危机事件下的安全感与焦虑状况,为疫情防控常态化阶段的心理教育与心理干预提供参考。方法 于2020年6月选取四川省高校、中学及小学共7 319名在校学生为研究对象,通过问卷星网络平台,采用马斯洛安全感-不安全感问卷（S-I）和焦虑自评量表（SAS）进行问卷调查。结果 四川省在校学生SAS评分为（41.52±9.90）分,S-I总评分为（29.88±11.60）分;男生S-I总评分高于女生,SAS评分低于女生,差异均有统计学意义（t=5.961、-2.430,P均<0.01）;不同学段的学生S-I和SAS总评分差异均有统计学意义（F=122.579、60.950,P均<0.01）;S-I总评分及各维度评分与SAS评分均呈负相关（r=-0.553～-0.471,P均<0.01）。线性回归分析显示,回归模型拟合较好（调整后R2=0.274）,模型具有统计学意义（F=40.802,P<0.01）,情绪安全感对焦虑具有负向预测作用（β=-0.441,P<0.01）。结论 重大公共危机...     

神经质人格对护理本科生手机成瘾倾向的影响：压力知觉和自我控制的链式中介作用

背景 手机成瘾对大学生产生许多不利影响,如抑郁、焦虑、注意力涣散、认知障碍和睡眠障碍等。护理本科生是临床护理工作的重要后备力量,其不良的心理健康状况对未来的护理工作质量和护患关系具有重要影响。目的 探究神经质人格与护理本科生手机成瘾倾向的关系,通过构建链式中介模型,考查压力知觉和自我控制在神经质人格与手机成瘾倾向之间的作用路径。方法 于2023年2月―3月,采用方便抽样法,选取陕西省西安市10所高校共900名护理本科生为研究对象。采用艾森克人格问卷简式量表中国版（EPQ-RSC）中的神经质分量表、压力知觉量表（PSS）、自我控制量表（SCS）以及手机成瘾倾向量表（MPATS）分别评定护理本科生的神经质人格、主观压力、自我控制能力和手机成瘾倾向。运用SPSS宏程序Process 4.1中的model 6检验压力知觉和自我控制在护理本科生神经质人格与手机成瘾倾向之间的中介作用。结果 (1)在900名护理本科生中,检出存在手机成瘾倾向者314人（34.89%）。(2)护理本科生EPQ-RSC神经质分量表评分与PSS总评分和MPATS总评分均呈正相关（r=0.400、0.287,P均<...     

中学生抑郁情绪及其影响因素研究

目的调查中学生群体的抑郁情绪及其影响因素,为改善其心理健康水平提供参考。方法于2017年2月-5月采用整群抽样方法抽取山东省日照市3所中学的初中生为研究对象,采用Kutcher青少年抑郁量表11项版(KADS-11)和青少年生活事件量表(ASLEC)评定初中生的抑郁情绪和生活事件,采用自制一般情况问卷调查中学生的父母关系及受照料情况。结果共发放问卷1 300份,回收有效问卷1 231份。中学生KADS-11评分为(7.97±4.25)分,KADS-11评分≥9分者有521人(42.32%)。不同父母关系的中学生焦虑不安因子评分比较差异有统计学意义(P0.01);逐步回归分析显示,学习因子和人际关系因子评分对KADS-11总评分有正向预测作用(β=0.23、0.11),受罚因子评分对KADS-11总评分有负向预测作用(β=0.06)。结论山东日照地区在校中学生的负性情绪较普遍,经历的生活事件主要与学习相关,父母关系、学习压力和人际关系是其心理健康的影响因素。     

公安院校学生孤独感对网络偏差行为的影响：一个有调节的中介模型

目的 探讨公安院校学生孤独感、网络成瘾和网络偏差行为之间的关系及其作用机制。方法 于2020年3月,采用整群抽样法抽取四川省某公安院校766名学生为研究对象,采用UCLA孤独感量表（UCLA-LS）、网络依赖诊断量表（DSFIAD）与大学生网络偏差行为问卷进行调查,通过SPSS 20.0进行统计分析,并采用Mplus 8.0进行中介与调节效应检验。结果 (1)公安院校男性大学生网络偏差行为问卷评分高于女性（t=7.560,P<0.01）;(2)公安院校学生UCLA-LS评分与DSFIAD评分呈正相关（r=0.406,P<0.01）,网络偏差行为问卷评分与UCLA-LS和DSFIAD评分均呈正相关（r=0.279、0.592,P均<0.01）;(3)孤独感可以正向预测网络偏差行为（β=0.279,t=9.041,P<0.01）;(4)网络成瘾在孤独感与网络偏差行为之间起完全中介作用[间接效应=0.233(95%CI:0.190～0.279,P<0.01),间接效应占总效应的83.51%];(5)“孤独感→网络成瘾→网络偏差行为”这一中介效应的后半段路径（网络...     

青少年压力感知对执行功能的影响：自我厌恶和负性情绪的作用路径

背景 青少年执行功能的发展受诸多环境因素的影响。压力感知与执行功能密切相关,但其对青少年执行功能影响的路径尚不明确。目的 探究负性情绪和自我厌恶在青少年压力感知与执行功能之间的作用路径,以期为改善青少年的执行功能提供参考。方法 于2022年5月1日—30日,选取山东省日照市5所高中和5所初中的7 734名青少年进行问卷调查。使用自编调查表收集青少年的一般资料,采用压力感知量表（PSS）、执行功能行为评定量表自评版（BRIEF-SR）、患者健康问卷（PHQ-4）和自我厌恶量表（SHS）分别评定青少年的压力感知水平、执行功能、负性情绪以及自我厌恶水平。采用Spearman相关分析考查各量表评分之间的相关性。采用Bootstrap方法检验自我厌恶和负性情绪在青少年压力感知与执行功能之间的中介效应。结果 共回收有效问卷7 012份（90.66%）。青少年BRIEF-SR评分与PSS、PHQ-4、SHS评分均呈正相关（r=0.564、0.653、0.597,P均<0.01）,PSS评分与PHQ-4和SHS评分均呈正相关（r=0.615、0.531,P均<0.01）,PHQ-4评分与...     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.