Depression and sensitization to stressors among young women as a function of childhood adversity

The authors tested a stress-sensitization version of a diathesis-stress approach to depression. In a 2-year longitudinal follow-up design, exposure to stressful life events was examined in young women in the transition to adulthood. The authors hypothesized that those who had experienced one or more significant childhood adversities would have a lower threshold for developing a depressive reaction to stressors. Results indicated that women with exposure to one or more childhood adversities--such as family violence, parent psychopathology or alcoholism, and others--were more likely to become depressed following less total stress than women without such adversity. The results could not be accounted for by chronic stress or prior depression. Both biological and psychological sensitization mechanisms may be speculated to play a role, but the actual mechanisms of stress sensitization remain to be explored.     

Self-reported trauma, cortisol levels, and aggression in psychopathic and non-psychopathic prison inmates

The relationship between self-reported traumatic childhood experiences, cortisol levels, aggression, and psychopathy was investigated in prison inmates (n=47) and healthy controls (n=27). Besides questionnaires, a brief salivary diurnal profile was measured. Results show that criminals (both psychopaths and non-psychopaths) demonstrate more traumatic childhood experiences than the control group. Within the group of criminals, psychopaths showed the lowest diurnal cortisol concentrations, whereas the non-psychopaths demonstrated highest daily average cortisol (DAC) scores. High levels of aggression were related to traumatic childhood experiences in non-psychopaths and control participants, but not in psychopaths. Although psychopathic offenders demonstrated low levels of cortisol, high levels of childhood traumatic experiences and high levels of aggression, cortisol was not a mediating factor between childhood traumatic experiences and aggression. Implications of the finding that psychopathic offenders displayed lower and non-psychopaths showed higher daily cortisol levels are discussed.     

中西医结合护理改善乳腺癌化疗患者生活质量的临床观察

目的 探讨中西医结合护理对乳腺癌化疗患者的应用效果。方法 选取2017年1月~2018年7月收治的90例乳腺癌化疗患者,随机分为对照组30例和实验组60例。对照组在化疗期间采用常规护理,实验组在此基础上配合中医辨证施护干预,比较两组的生活质量评分和护理总满意度。结果 实验组生活质量评分中,生理状况、情感状况、功能状况、附加关注低于对照组,实验组社会/家庭状况高于对照组,差异具有统计学意义（P＜0.05）。实验组的护理总满意度高于对照组（91.67% vs 73.33%）,差异具有统计学意义（P＜0.05）。结论 中西医结合护理可改善乳腺癌化疗患者的生活质量,提高患者的护理满意度。     

消化系统疾病患者生活满意度状况调查探究

目的 探讨消化系统疾病患者生活状况和生活满意度水平与疾病的相关性.方法 对130例消化系统疾病患者及98例正常人做基本问卷调查和生活满意度测量.结果 显示患病组的受困率显著高于对照组(χ2=7.52,P<0.05),患病组的总体生活满意度水平显著低于对照组(t=2.3486,P<0.05),在不同年龄组中,2组的生活满...     

Emotional distress and satisfaction in life among Holocaust survivors--a community study of survivors and controls

Results are reported from a large population study (of working people) comparing Holocaust survivors and a control group in regard to emotional distress, satisfaction in life and psychosomatic symptoms. It was found that, even 40 years after the traumatic experience, this group of survivors exhibited a slightly higher degree of emotional disorders than controls who were not under Nazi occupation during WWII. These long-term effects were usually more prominent in women than in men, and the relationship to age was minimal.     

Familial and developmental factors in characterological depressions

Patients with chronic low-grade depressions (screened to exclude primary affective illness and those secondary to rigorously defined nonaffective disorders) were divided into subaffective dysthymic versus character-spectrum groups and compared to 40 primary unipolar controls. A prior report found the 30 character-spectrums different from the 20 dysthymics (and usually from the unipolars) on pharmacological, phenomenological, REM sleep, social and outcome criteria. The present study parsed family history and developmental differences: The character-spectrum group had significantly lower incidence of familial depressions, but higher frequencies of loss of a parent in childhood, familial alcoholism, and parental assortative mating than both other groups--which did not differ. Just 10% of our 90 patients had bipolar family histories; 7 were dysthymics and 6 of these had earlier shown brief, tricyclic-induced hypomania. The results support, at the subsyndromal level, Winokur's separation of disorders with +FH for alcoholism from those with +FH for affective illness. Furthermore, data suggest the DSM-III concept of 'dysthymia' is too broad and needs further distinctions among several subaffective and nonaffective chronic depressions.     

Delayed and immediate onset posttraumatic stress disorder: The role of life events and social resources

The present study examined the role of life events and social resources in the development of combat-related delayed posttraumatic stress disorder (PTSD) after homecoming. For this purpose, life events after homecoming and social resources (social integration, loneliness, satisfaction with social network, and family environment) were assessed 2 years after the 1982 Lebanon War (August, 1984) in three groups of male Israeli frontline soldiers who participated in that war and who were matched for military and socio-demographic background: (1) delayed PTSD group, (2) immediate PTSD group, and (3) control group. Findings indicated that both control and delayed PTSD casualties reported similar and fewer life events at homecoming than did immediate PTSD casualties. However, delayed PTSD casualties evinced less social resources than did controls.     

Life stresses and premature labor: real connection or artifactual findings?

Three studies on the relationship between life stresses and premature labor were conducted. The first was a retrospective comparison of life events between a group of women who had had premature labor and a group of controls. It was carried out between 3 and 6 months after the premature delivery to neutralize possible effects of time closeness to the traumatic event and of mothers' anxiety for the babies' condition. Results showed no difference between groups. In a second, prospective study, women who afterwards developed premature contractions were found to have a slightly higher frequency of life events. A third study investigated effects of the stress of the Yom Kippur War upon incidence of premature deliveries. It was found that during the war and immediately after it, the frequency of premature deliveries was lower than a year later. Results showed that most research conducted in this field has led to doubtful conclusions. The need for prospective studies and for investigations of the effects of real-life stresses is underlined.     

Dissociative experiences during sexual behavior among a sample of adults living with HIV infection and a history of childhood sexual abuse

Little attention has been given to the occurrence of dissociative symptoms during sexual behavior in adults who have experienced childhood sexual abuse (CSA). For this study, 57 adults living with HIV infection who had experienced CSA and were entering a treatment study for traumatic stress completed study assessments and clinical interviews, including a 15-item scale of dissociative experiences during sexual behavior. Predictor variables included Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision diagnoses of posttraumatic stress disorder (PTSD) and dissociative disorders, rape by an intimate partner, duration of CSA, number of perpetrators of CSA, and current sexual satisfaction. A multiple regression analysis was conducted to identify significant associations between predictors and dissociation during sex. Mean differences by clinical diagnosis were also examined. Results indicated that PTSD, dissociative disorders, rape by an intimate partner, duration of CSA, and number of perpetrators of CSA were associated with increased dissociation during sexual behavior. Dissociation during sex likely increases vulnerability to sexual revictimization and risky sexual behavior. Standard behavioral prevention interventions may be ineffective for sexual situations when dissociation occurs, and prevention efforts should be integrated with mental health care for those who have experienced CSA.     

单侧颈内动脉闭塞后侧支循环开放及其临床表现

目的：探讨在清醒状态下颅内动脉狭窄支架置入术的可行性及临床意义.方法：2007年2月到2008年1月,在局麻下应用血管内支架置入术治疗颅内动脉狭窄患者12例,其中颈内动脉系狭窄7例,椎-基底动脉系狭窄5例.结果：本组12例均成功接受了血管内支架置入,术中患者清醒,配合良好,无不良反应.术后6个月复查DSA提示,颅内动脉狭窄程度由原来的67.5%±9.5%下降至9.5%±2.8%（P＜0.01）.随访12～23个月,12例患者症状均改善,无卒中发生.结论：局麻下行血管内支架置入术治疗颅内动脉狭窄,可将重要并发症的危险性降到最低;颅内动脉痛觉神经并不敏感,完全可以承受介入支架置入操作.     

The health status and life satisfaction of first-year medical students

The self-reported health status and life satisfaction of 286 first-year Duke University medical students in four consecutive classes were measured at the beginning and end of the school year and compared statistically with relevant sociodemographic and behavioral factors. Health status, quantitated in terms of Duke Health Profile scores, was generally lower for women than for men. Although there was a definite trend of worsening along all parameters of health and satisfaction during the year for both women and men, the most marked change was the increase in depressive symptoms. The students who were very satisfied with life had fewer symptoms of depression and anxiety; higher self-esteem, better physical, mental, and social health; stronger social ties; more physical activity; more sleep; and fewer stressful life events. Strong social ties was the factor most positively related to better health and life satisfaction.     

聚焦解决模式对改善围术期食管癌患者焦虑抑郁的影响

目的:研究并探讨聚焦解决模式对改善围术期食管癌患者的焦虑、抑郁情绪的作用。方法:于2012年1月-2015年12月,选取哈尔滨医科大学附属第四医院收治的100例食管癌手术患者作为研究对象,采取计算机随机抽取法将患者分为两组,每组50例。对照组实施常规护理模式干预,观察组在对照组的基础上实施聚焦解决模式护理干预。分别于干预前后对比两组患者的睡眠质量指数、焦虑评分、抑郁评分,并对比干预后两组患者的生活质量评分、护理满意度。结果:两组干预后均较干预前水平降低(F=744.043,1242.507,958.641;P=0.000),且观察组降低程度均大于对照组(F=41.929,32.376,38.523;P=0.000);观察组的躯体功能、心理健康、社会功能、物质生活等各项生活质量评分及生活质量总评分均较对照组明显更高(t=11.487,7.674,12.017,7.331,9.735;P0.05);观察组患者的护理满意度为96%,相比于对照组明显更高(χ~2=6.061,P0.05)。结论:在食管癌患者的围手术期护理中采取聚焦解决模式干预,可有效缓解患者的焦虑、抑郁,改善患者的睡眠质量和生活质量,有利于提高患者对护理服务的满意度。     

A study of post traumatic stress disorder in Vietnam veterans

Three groups of Vietnam-era veterans were compared on the frequency of symptoms typical of the diagnostic criteria for Post Traumatic Stress Disorder (PTSD), a diagnostic category introduced in DSM III (N = 90). The three groups consisted of veterans who had experienced (a) a war-related traumatic event; (b) a non-war-related traumatic event; or (c) no traumatic event. The results indicated that the two groups who experienced a traumatic event reported significantly more symptoms than the group who never experienced a traumatic event. Furthermore, the group who experienced a war-related traumatic event reported more symptoms than the group who experienced a non-war-related traumatic event. These results support the validity of PTSD.     

心理治疗与家庭干预对酒依赖患者康复的影响

目的探讨心理治疗和家庭干预对酒依赖患者康复的影响。方法对116例酒依赖患者采用单纯随机抽样方法划分为干预组59例和对照组57例,对干预组采用上门随访,电话随访等形式给予有关治疗的详细内容及注意事项,并给予心理支持治疗2年后与对照组家庭采用相应问卷进行评定。结果心理治疗与家庭干预组的复饮酒率明显低于对照组（P〈0.01）。结论对酒依赖患者进行系统的心理治疗和家庭干预可降低患者的复饮酒率。     

空气压力波治疗仪联合体感诱发电位监测预防脊柱骨折术后下肢深静脉血栓形成的应用效果

目的:分析空气压力波治疗仪联合体感诱发电位（SEP）监测预防脊柱骨折术后下肢深静脉血栓（DVT）形成的应用效果。方法:选择99例脊柱骨折患者,按照随机数字表法分为观察组（n=50）和对照组（n=49）。对照组采用SEP的疗法,观察组采用空气压力波治疗仪联合SEP监测的疗法。在治疗期间观察与记录两组患者的DVT发生率、住院期间疼痛、肿胀情况,血液流变学指标、恢复正常活动的时间和住院时间、生活质量量表-74（GQOL-74）以及护理服务的满意度情况。结果:观察组下肢DVT形成、疼痛和肿胀的发生率均低于对照组（P<0.05）。观察组下肢肿胀程度明显小于对照组（P<0.05）,下床时间、住院时间均短于对照组（P<0.05）。干预前,两组的相关血液流变学指标与GQOL-74评分比较,无明显统计学意义（P>0.05）;干预后,两组血浆粘度、全血低剪切粘度、高剪切粘度和红细胞聚集均下降,但是观察组以上指标明显低于对照组（P<0.05）。干预后,两组的GQOL-74评分均较干预前明显提高（P<0.05）,但观察组显著高于对照组（P<0.01）。观察组患者的护理服务满意度明显高于对照组（P<0.05）。结论:空气压力波治疗仪联合SEP干预措施有助于改善手术治疗的脊柱骨折患者的高凝状态和预防下肢DVT形成。此外,它还能有效缓解下肢疼痛和肿胀,提高生活质量和患者满意度,值得临床推广。     

Comparing mind-body wellness interventions for older adults with chronic illness: classroom versus home instruction

Two versions of a multicomponent mind-body wellness intervention were tested. One hundred seventy-eight physician-referred HMO patients (mean age = 64.5) were randomly assigned to a classroom intervention, a home study intervention, or a wait-list control group. Both interventions provided instruction on mind-body relationships, relaxation training, cognitive restructuring, problem solving, communication, behavioral treatment for insomnia, nutrition, and exercise. The home version was delivered by class videotapes and readings. Compared with the control condition, both interventions led to significant decreases in self-reports of pain, sleep difficulties, and symptoms of depression and anxiety. The home course also led to a significant decrease in self-reported frequency of medical symptoms, and the classroom program resulted in a significant decrease in "chance" health locus of control beliefs. No effects were obtained for health behaviors, life satisfaction, HMO satisfaction, and other health locus of control beliefs. A lower cost, more accessible home study version of a mind-body wellness program can be an effective alternative to classroom instruction.     

应用空气波压力治疗仪预防外伤性脾破裂术后 下肢深静脉血栓的效果观察

目的 探讨空气波压力治疗仪在预防外伤性脾破裂术后发生下肢深静脉血栓的效果。方法 选取2017年2月~2018年1月邛崃市医疗中心医院普外二病区收治的外伤性脾破裂患者48例,均行脾切除手术。根据入院先后顺序分为观察组23例和实验组25例。对照组采用传统预防下肢深静脉血栓的方法进行护理,实验组在对照组基础上于术后第1天采用空气波压力治疗仪进行辅助治疗。观察两组患者平均住院日、D-二聚体浓度、下肢深静脉血栓发生率、护理服务满意度。结果 实验组患者的平均住院日为（10.24±2.12）d,少于对照组的（12.27±3.25）d,差异有统计学意义（P＜0.05）。术后7 d实验组D-二聚体浓度为（0.57±0.19）mg/L,低于对照组的（0.75±0.31）mg/L,差异有统计学意义（P＜0.05）。实验组下肢肿胀、疼痛及下肢深静脉血栓发生率为0,低于对照组的21.73%,差异有统计学意义（P＜0.05）。实验组护理服务满意度评分为（4.83±1.64）分,高于对照组的（3.89±1.42）分,差异有统计学意义（P＜0.05）。结论 应用空气波压力治疗仪能有效预防外伤性脾破裂术后下肢深静脉血栓的发生,提高患者对护理服务的满意度,缩短平均住院日,节约卫生资源。     

河南省某县艾滋病致孤儿童生活质量评价

目的:揭示我国艾滋病致孤儿童生活状况及其生活质量脆弱性特点,为制定相应健康促进策略提供依据.方法:采用性别、年龄1∶ 1配对设计,使用儿少主观生活质量问卷对河南省某艾滋病高发县96对艾滋病孤儿(孤儿组)与普通家庭儿童(对照组)生活状况及主观生活质量进行调查分析.结果:(1)与对照组相比,艾滋病孤儿生活满意度更低(45.16% vs.62.37%,P=0.019),遭受更多欺侮与不公(35.48% vs.12.90%,P<0.001),更需打工挣钱(55.91% vs.23.66%,P<0.001),且医疗服务可及性更低(36.36% vs.78.85%,P<0.001).(2)孤儿组生活质量总分、认知成分总分及家庭生活、学校生活、生活环境与自我认知4个维度得分均低于对照组[如,生活质量总分(145.9±16.0)vs.(154.9±16.1,P<0.001].(3)男性孤儿的生活质量总分、认知成分总分及家庭生活、学校生活、生活环境、自我认知维度得分均低于男性对照组[如,生活质量总分(143.2±16.7) vs.(155.8±17.1),P<0.001].结论:艾滋病孤儿面临更多生活问题并影响其生活质量,主要体现在对自我及环境认知水平下降,对情绪情感与心理健康远期影响亦不容忽视.男性孤儿所受影响更为显著.     

Adult attachment as mediator between recollections of childhood and satisfaction with life

In accordance with attachment theory, the present study investigates whether internal working models of attachment mediated the association between childhood memories and satisfaction about life in adulthood. A convenient sample of 437 participants completed questionnaires assessing a broad range of childhood memories, working models of attachment and life satisfaction. After controlling for demographics, relational status and living condition, Baron and Kenny's mediation criteria were met for the association between memories about childhood, adult attachment and life satisfaction. That is, family warmth and harmony and parental support were associated with attachment security while parental rejection and adverse childhood events (e.g., abuse, parental psychopathology) were associated with an insecure attachment style. More securely attached individuals were in turn more satisfied about their current life than insecurely attached individuals. Sobel test confirmed these findings. These finding are in accordance with attachment theory and highlight the importance of this theory for understanding how early childhood experiences may impact adult life. Copyright © 2008 John Wiley & Sons, Ltd.     

Reproductive traits following a parent–child separation trauma during childhood: A natural experiment during World War II

Given the ethical limitations of exposing children to experimentally manipulated adverse experiences, evidence of the effects of childhood traumas on subsequent life history are based mostly on women's retrospective reports and animal studies. Only a few prospective studies have assessed the life‐long consequences of childhood trauma. We asked whether a traumatic separation from both parents during childhood is associated with reproductive and marital traits later in life, measured by age of onset of menarche, timing of menopause, period of fertile years, age at first childbirth, birth spacing, number of children, and history of divorce. We studied members of the 1934–1944 Helsinki Birth Cohort, including 396 former war evacuees from varying socioeconomic backgrounds, who were sent unaccompanied by their parents to temporary foster families in Sweden and Denmark, and 503 participants who had no separation experiences. Data on separation experiences, number of children, and divorces experienced came from national registers, and the remaining data from a survey among the participants aged 61.6 years (SD = 2.9). Former evacuees had earlier menarche, earlier first childbirth (men), more children by late adulthood (women), and shorter interbirth intervals (men), than the non‐separated. A traumatic experience in childhood is associated with significant alterations in reproductive and marital traits, which characterize both women and men. The implications are relevant to the 9.2 million child refugees living throughout the world today. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.