注意缺陷多动障碍儿童的情绪管理

情绪问题的发生率在注意缺陷多动障碍(ADHD)儿童中居高,包括从轻度普通的情绪问题到严重的心境障碍,增加了管理和治疗ADHD儿童的难度。因此,需要将情绪问题的管理整合进ADHD的干预方案,诊疗管理方案应是分级、跨专业、分步骤、综合性。根据情绪问题的性质和程度,不同级别和领域的临床专业人员进行适合其自身能力的管理方案,采取有依据的干预和治疗方法。通常优先重点治疗损害最大的疾病,或共同治疗。本文重点介绍了情绪问题或障碍的评估方法包括警示性症状、筛查、结构化或半结构化访谈、诊断思路、相关的心理行为治疗和药物治疗。     

论视力障碍病人的情感需求及其健康教育

视力是人类重要的生理功能。人类视力活动与周围环境的关系和相互作用，以及视力障碍所产生的社会学意义及其对于人们生活质量的价值和影响应该引起医护人员的高度重视。对于视力障碍病人来说，最大的障碍莫过于心理障碍。他们对于理解和尊重的情感需求比正常人更为强烈，因此对于视力障碍者必须给予真诚的情感投入，医护入员有责任任理解他们在机体、精神和意志上的缺陷，尽量满足他们的需求，赋干他们以真诚的情感和社会责任。对于那些需要手术的眼科病人，及时进行科学的健康教育和行为指导是必不可少的。     

学龄前儿童情绪问题气质特征的研究

【目的】 了解学龄前儿童不同情绪问题的气质特征。 【方法】 采用儿童气质量表对116名情绪问题儿童(包括特殊恐怖,社交退缩,分离焦虑)与116名正常对照儿童进行测查。 【结果】 情绪问题组与对照组气质类型分布差异有统计学意义,情绪问题组中麻烦型和缓慢型的比例明显比正常对照组的高(P<0.01)。情绪问题组在趋避性和情绪本质两个维度的得分与对照组差异有统计学意义(P<0.01)。特殊恐惧、社交退缩和分离焦虑三种情绪问题在趋避性这一个维度评分与对照组差异均有统计学意义(P<0.01)。 【结论】 情绪问题儿童气质有其独特性。趋避性因子能够较好的反应行为抑制的气质特征,对情绪问题发生的有预测作用。     

折纸疗法对抑郁症患者治疗效果研究

目的探索折纸疗法对抑郁症情绪障碍干预的有效性。方法在折纸疗法中推行情景创作、引导观察、乐中体验、点拨汇总等方法,进行为期4周的干预。选择64例抑郁症患者完成整个治疗计划,采用汉密尔顿抑郁HAMD量表在各治疗时间点前后和两组间进行比较测评,包括课堂内、外的情绪、行为上的比较。结果折纸疗法总有效率达100%,HAMD量表的总量及各因子分在各治疗的时间点,两组在干预前后及自身对照均有显著性差异,有统计学意义。结论实施折纸疗法是为抑郁症患者搭建一个能获取正能量的平台,患者通过药物治疗和特殊的心理治疗能产生更好的疗效。     

中医情志护理配合穴位按摩对肺癌化疗患者睡眠质量及癌因性疲乏的影响

目的 探讨中医情志护理配合穴位按摩对肺癌化疗患者睡眠质量及癌因性疲乏的影响.方法 选取2019年7月至2021年5月我院收治的82例肺癌化疗患者,随机分为观察组(中医情志护理配合穴位按摩)与对照组(常规护理)各41例.对比两组的睡眠质量及癌因性疲乏评分.结果 干预后,观察组的睡眠质量、睡眠时间、睡眠效率、睡眠障碍评分低...     

拒绝上学儿童青少年心理健康状况分析

【目的】 探讨拒绝上学行为儿童青少年的心理健康状况。 【方法】 采用一般情况问卷,艾森克个性测验(Eysenck Personality Questionaire,EPQ),焦虑自评量表(Self-Rating Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)为工具对研究组36例和正常对照组30例进行评估。 【结果】 研究组EPQ中精神质P、神经质N差异有统计学意义(P<0.01)。内外向E、掩饰虚假L分值比较差异无统计学意义(P>0.05)。研究组SAS得分均值明显高于正常对照组,两组比较差异有统计学意义(P<0.01)。研究组与正常对照组的抑郁自评量表(SDS)得分均值比较差异无统计学意义(P>0.05)。 【结论】 拒绝上学行为儿童青少年存在精神质,情绪不稳定,焦虑等个性特征, 拒绝上学可能与转换学校,寄宿,学习压力及独生子女等因素相关。     

情绪障碍儿童的父母养育方式特征

目的 探讨情绪障碍儿童的父母养育方式特征,为情绪障碍儿童心理干预提供具体方向。方法 采用自编一般情况调查表、父母养育方式问卷对70例情绪障碍儿童及其父母和140例正常儿童及其父母进行施测。结果 两组父、母情感温暖理解、父亲偏爱被试、父亲拒绝否认因子分差异有统计学意义(P<0.05)。两组父亲情感温暖理解(19个条目)、父亲偏爱被试(3个条目)、父亲拒绝否认(1个条目)、母亲情感温暖理解(17个条目)差异有统计学意义(P<0.05)。情绪障碍组父、母部分养育因子之间存在相关性(P均<0.05)。结论 情绪障碍儿童的父母养育方式主要呈现为父母低情感温暖,高拒绝否认的特征,且具有消极互动等特点。具体体现在患儿感受不到父母的认同、宠爱、鼓励与支持等方面。     

饮食治疗的苯丙酮尿症精神行为问题

早期开始低苯丙氨酸饮食治疗的苯丙酮尿症患者仍有精神行为问题,包括认知功能,执行功能,注意力,内向性行为问题等.精神行为问题的成因一方面与脑损伤有关,表现为脑白质的改变,并受脑内Phe浓度的影响;另一方面与患者所处的社会环境因素有关,包括家长的关注和饮食限制本身带来的压力等.众多研究认为饮食治疗应尽可能维持终身,但在实施上难度比较大,现在已有研究着眼于能够有希望替代饮食治疗的新疗法,包括基因治疗,酶替代治疗,大量中性氨基酸治疗等.     

孤独症儿童混合面部表情识别及面孔性别区分能力研究

【目的】 测试孤独症儿童混合面部表情的识别能力及通过眼和嘴对面孔性别进行区分的能力。 【方法】 采用自制计算机系统对32例孤独症儿童和32例正常儿童进行测试并分析,以正确率、反应时和错误类型为分析指标,两组儿童在发展年龄上进行匹配。 【结果】 1)孤独症组儿童识别混合面部表情的平均正确率小于正常对照组〔(58.0±15.6)%和(78.4±13.5)%,t=5.4,P=0.000〕,平均反应时长于正常对照组[(9 948.3±3 116.2)ms 和(5 617.0±1 362.9)ms,t=4.7,P=0.000]。2)孤独症组儿童区分面孔性别的平均正确率小于正常对照组[眼部为(76.7 ±11.5)%和(86.6±10.9)%,嘴部为(66.2 ±12.8)%和(73.1 ±10.7)%],平均反应时长于正常对照组[眼部为(4 138.7±542.0)ms和(2 721.9±636.6)ms,嘴部为(3 807.8±710.1)ms 和(2 836.5±619.9)ms]。 【结论】 孤独症组儿童在做关于面部表情的判断时更依赖于面孔的下半部分信息;他们可以使用来自眼部的信息来加工面孔的性别信息,而与正常对照组相比他们没有显示出有使用嘴部信息来处理面孔性别信息的优势。     

The Muppet Club Project -- An alternative support service for children with emotional and behavioural disorders

Many teachers worry about their inability to provide adequate support for children with emotional and behavioural disorders (EBD). The Muppet Club Project (MCP) has demonstrated that more effective support from outside the school for such children and their teachers is not only available within existing resources, but is most successfully mobilized when schools themselves take the initiative.     

A qualitative study of the experience of caring for a person with bulimia nervosa. Part 1: The emotional impact of caring

OBJECTIVE: Family carers of individuals with mental disorders have been found to experience mental health difficulties of their own. There has been little research into the impact of caring for individuals with eating disorders. A preliminary study found that carers of individuals with anorexia nervosa experience more difficulties and distress than carers of people with psychoses (Treasure et al., [2001]. Social Psychiatry and Psychiatric Epidemiology, 36, 343-347). This is the first study to qualitatively investigate the experiences of carers of individuals with bulimia nervosa (BN). METHOD: Twenty carers of individuals with BN were interviewed using a semistructured interview. Interviews were transcribed and the texts analyzed using content analysis to identify themes. RESULTS: The principal themes to emerge were the impact of the discovery of BN on the carer, the ongoing impact of care-giving, coping strategies used by the carer, and the positive impact of the illness for both the carers and the persons in their care. DISCUSSION: BN has a potent impact on carers' lives. This has implications in terms of service provision and future research in this area.     

Support Group for Parents Coping with Children with Type 1 Diabetes

Objectives

Type 1 diabetes is one of the most common chronic diseases in childhood. Active parental involvement, parental support in the diabetes management and family functioning are associated with optimal diabetes management and glycemic control. The purpose of this study was to assess parental satisfaction with participation in the group and their perceptions of the impact of the intervention on living and coping with childrens T1D.

Methods

A sample of 34 parents of children with T1D participated in this trend study. The participants’ experience and satisfaction with support group was measured by a self- evaluation questionnaire, designed for the purpose of the present study.

Results

Quantitative data show that parents were overall satisfied with almost all measured items of the evaluation questionnaire (wellbeing in the group, feeling secure, experiencing new things, being able to talk and feeling being heard) during the 4-year period. However, parents from the second and third season, on average, found that the support group has better fulfilled their expectations than the parents from the first season (p = 0,010). The qualitative analysis of the participants’ responses to the open-ended questions was underpinned by four themes: support when confronting the diagnosis, transformation of the family dynamics, me as a parent, exchange of experience and good practice and facing the world outside the family.

Discussion

The presented parent support group showed to be a promising supportive, therapeutic and psychoeducative space where parents could strengthen their role in the upbringing of their child with T1D.     

Social support and psychological well-being in breast cancer patients

many aspects of the role of social support in psychological adaptation to illness have been investigated using different definitions of the construct. The present study focused on the role of instrumental social support and one aspect of emotional social support, namely supportive communication. In addition, the differential role of support provided in these areas by the spouse and significant others (SO) was examined. Subjects were 76 post-mastectomy breast cancer patients treated at a University Hospital in Istanbul. Patients were administered Spielberger's State-Trait Anxiety Inventory and the Beck Depression Inventory, and were interviewed using a structured interview developed by the authors. Results showed that supportive communication with the spouse, positive reaction of the spouse to mastectomy, marital satisfaction and open discussion of emotions concerning cancer were positively associated with psychological well-being. Instrumental support from the spouse or SO was not related to depression or anxiety.     

Emotional and behavioural problems in subgroups of children with chronic illness: results from a large-scale population study

Background   Children with chronic illness are known to have an increased risk of emotional and behavioural problems. In the present population-based study children with asthma, neurological disorders and other chronic illnesses were compared with children without chronic illnesses to assess differences in psychological presentation across illness groups.
Methods   A total of 537 children with parent-reported chronic illness in the Bergen Child Study were categorized into three groups: asthma, neurological disorders and other chronic illnesses. Emotional and behavioural problems were assessed by the Strengths and Difficulties Questionnaire.
Results   All three illness groups had an increased rate of emotional and behavioural problems, as well as increased probability of a psychiatric disorder compared with children without a chronic illness. Most children with asthma and other chronic illnesses did not have emotional and behavioural problems, and effect sizes were small in both groups. In children with neurological disorders the effect sizes ranged from moderate to large, with emotional problems, inattention hyperactivity and peer problems being the most frequent problems.
Conclusions   The increased rate of emotional and behavioural problems in children with chronic illness, especially neurological disorders, emphasizes the importance of early detection of mental health problems in these children.     

Relationship of anger, stress, and coping with school connectedness in fourth-grade children

BACKGROUND: High trait anger and stress, ineffective patterns of anger expression, and coping are risk factors for the development of disease and negative social behaviors in children and adults. School connectedness may be protective against negative consequences in adolescents, but less is known about this in school-aged children. The purposes of this study were to characterize relationships between trait anger, stress, patterns of anger expression, resources for coping, and school connectedness and to determine if race and gender moderate these relationships in elementary school-aged children. METHODS: Using self-report, standardized instruments, a convenience sample of 166 fourth graders in 4 elementary schools in 1 US school district was assessed in the fifth week of the school year. RESULTS: School connectedness was positively associated with social confidence and behavior control and negatively associated with trait anger, anger-out, and stress. In multiple regression analyses to test for interactions, gender did not moderate the effects of school connectedness in any of the models, while race moderated the relationships between school connectedness and both stress and social confidence. Students with higher school connectedness had lower trait anger and anger-out and higher behavior control, regardless of gender and/or race. White students higher in school connectedness had lower stress and higher social confidence. CONCLUSIONS: Findings indicate the protective effect of school connectedness on trait anger, anger-out, and behavior control in school-aged children, regardless of race or gender. The protective effect of school connectedness on stress and social confidence may depend on race.     

有自杀意念高中生的情绪和行为问题及与家庭环境的关系

目的 了解有自杀意念高中生的情绪和行为问题及其与家庭环境的关系。 方法 采用长处和困难问卷(学生版)、家庭环境量表中文版及中文版贝克自杀意念量表对1 577名高中生进行问卷调查。 结果 高中生自杀意念报告率为18.90%(n=298)。22.82%(n=68)的有自杀意念高中生存在情绪和行为问题,且有自杀意念高中生的困难总分、情绪问题、品行问题、多动注意不能和同伴交往问题得分均高于无自杀意念组,亲社会行为得分低于无自杀意念组,差异均有统计学意义(P＜0.01)。在有自杀意念组中,女生情绪问题得分显著高于男生(P＜0.01);高二学生同伴交往问题得分显著高于高一学生(P＜0.05)。回归分析显示,家庭亲密度、矛盾性、组织性和控制性是有自杀意念高中生情绪和行为问题的影响因素。 结论 有自杀意念高中生的情绪和行为问题发生率较高,家庭环境对其具有重要影响。     

Emotional availability and attachment across generations: variations in patterns associated with infant health risk status

Background The presence of limits or distortions in the children's communicative behaviours (due to a chronic illness) may interfere with the possibility to build secure attachment relationships. Moreover, the distress that the atypical chronic illness condition brings to family life may interfere the intergenerational transmission of attachment. Methods This study evaluated the associations between maternal attachment representations, emotional availability and mother–child attachment in a clinical and in a comparison group. Forty infants (23 female) in their 14th month of life and their mothers participated in this study, 20 dyads with clinical infants (10 premature infants and 10 infants affected by atopic dermatitis) and 20 full‐term and healthy comparison infants. The Adult Attachment Interview, the Emotional Availability Scales (EAS) and the Strange Situation Procedure were used to assess, respectively, the security of mothers' attachment representations, the emotional availability and the quality of mother–child attachment. Results We found that the two groups (clinical vs. comparison) did not differ with respect to the Adult Attachment Interview and the Emotional Availability Scales measures. A significant difference was found in the distribution of the infant–mother attachment patterns, with a higher incidence of insecure infants in the clinical group. In the typically developing group, more secure maternal attachment representations predicted more emotional availability in mother–infant interactions, which predicted more secure infant–mother attachments. However, we did not find similar support for intergenerational transmission of attachment in the clinical group. Conclusions We speculate that constant concerns about the child's health condition and communicative difficulties of clinical infants may hamper or even mitigate the intergenerational transmission of attachment.     

孤独症谱系障碍儿童情绪行为问题与其母亲焦虑状况关联分析

目的 比较孤独症谱系障碍(ASD)儿童与典型发育(TD)儿童母亲的焦虑状况,探索ASD儿童情绪行为问题与其母亲焦虑水平间的关系。方法 通过临床诊断招募55名6~12岁智商≥70的ASD儿童及74名TD儿童,采用状态-特质焦虑问卷(STAI)评估入组儿童母亲的焦虑情况,采用长处与困难问卷(SDQ)评估两组儿童情绪行为问题及表现。结果 ASD儿童组母亲状态焦虑得分与特质焦虑得分高于TD组母亲(t=5.272、4.484、P<0.05),ASD儿童SDQ困难总分及多动/注意力缺陷、情绪症状、同伴交往问题及品行问题因子得分高于TD组儿童(t=10.791、7.482、4.295、12.925、3.544),亲社会行为因子分(t=5.084)低于TD组儿童,差异均有统计学意义(P<0.01)。校正混杂因素后,ASD组母亲状态、特质焦虑得分与儿童困难总分 [S-AI: β=0.83 (95%CI: 0.19~1.46); T-AI: β=0.60 (95%CI: 0.05~1.14)]、情绪症状 [S-AI: β=2.28 (95%CI:0.72~3.84); T-AI: β=2.04 (95%CI: 0.74~3.33)]存在正相关关系(P<0.05)。TD组母亲状态焦虑得分与儿童困难总分 [β=0.50 (95%CI: 0.03~0.96)]、品行问题 [β=1.74 (95%CI: 0.19~3.30)]存在正相关关系;特质焦虑得分与品行问题 [β=1.54 (95%CI: 0.09~3.00)]存在正相关关系(P<0.05)。结论 ASD儿童母亲比TD儿童母亲更容易出现焦虑。其中ASD儿童母亲的焦虑水平与儿童情绪问题有关,TD儿童母亲的焦虑水平与儿童品行问题有关。     

Lifestyle and emotional well-being in men and women with type 2 diabetes (e-VitaDM-4; ZODIAC-48)

Background: Whether lifestyle is associated with well-being in patients with type 2 diabetes (T2D) is largely unknown. Uncovering and clarifying associations between these constructs may lead to new strategies for improving both.

Objectives: The aim was to investigate the relationship between lifestyle and well-being, focussing on gender differences.

Methods: This cross-sectional study included 1085 patients with T2D that participated in the e-Vita part of the Zwolle outpatient diabetes project integrating available care (ZODIAC) study. Patients were included from May 2012 until September 2014 from 52 general practices. Emotional well-being was assessed with the World Health Organization-5 well-being index (WHO-5). Lifestyle information on body mass index, smoking, physical activity and alcohol use was extracted from self-reported questionnaires. Multiple linear regression analyses were used.

Results: After adjustment for other lifestyle factors, physical activity, smoking and drinking 22–35 alcohol consumptions per week were associated with the WHO-5 score in men and physical activity and smoking were associated with the WHO-5 score in women. In the fully adjusted analyses for the total study population, physical activity and smoking were still associated with the WHO-5 score (b?=?1.1, P?P?=?.018, respectively). In the fully adjusted analyses stratified to gender only physical activity was associated with the WHO-5 score (in men: b?=0.8, P?=?.006, in women: b?=?1.4, P?=?.001).

Conclusion: This study shows a negative, non-clinically relevant association between smoking and emotional well-being in the total population with T2D and a positive, non-clinically relevant association between physical activity and emotional well-being in both men and women with T2D.