叙事治疗对自我意识高于或低于常模儿童的影响

目的:研究叙事治疗对儿童自我意识的影响。方法:随机抽取20例自我意识高于常模的儿童及23例自我意识低于常模的儿童,分别进行10次叙事治疗,治疗前后使用Piers-Harris儿童自我意识量表(Children's self-concept scale,PHCSS)对两组进行评估。结果:自我意识低于常模组儿童治疗后PHCSS总分(t=10.126)及行为(t=3.259)、智力与学校情况(t=5.449)、躯体外貌与属性(t=4.069)、幸福与满足(t=4.374)分量表评分均高于治疗前,治疗后评分恢复正常(P0.01);自我意识高于常模组儿童治疗后PHCSS总分(t=4.383)及智力与学校情况(t=3.102)、躯体外貌与属性(t=3.952)分量表评分低于治疗前,治疗后评分恢复正常(P0.01)。结论:叙事治疗能有效改善儿童的自我意识。     

注意缺陷多动障碍患儿父母严厉管教、亲子依恋与自我意识的关系

目的:探讨学龄期注意缺陷多动障碍(ADHD)患儿父母严厉管教、亲子依恋与自我意识的关系。方法:分别对ADHD患儿(ADHD组,103例)及一般情况相匹配的正常儿童(对照组,103名)进行依恋安全性量表(KSS)、儿童自我意识量表(PHCSS)及自制的严厉管教方式问卷调查;分析ADHD患儿父母严厉管教、亲子依恋与自我意识的关系。结果:ADHD组PHCSS总分及各分量表评分显著低于对照组(P均0.01);ADHD组父亲责骂评分与PHCSS行为及幸福与满足因子分负相关(P0.05或P0.01),父亲体罚评分与PHCSS总分、行为、合群、幸福与满足因子分负相关(P0.05或P0.01);ADHD患儿父子依恋是父亲体罚与儿童自我意识间的完全中介变量;多元线性回归分析显示,父子依恋是ADHD患儿自我意识的重要影响因素(B=8.954,SE=2.216,β=0.373,P=0.014,R2=0.139,F=16.333)。结论:ADHD患儿自我意识低下受到不良的亲子依恋及严厉管教方式的影响;减少严厉管教方式有利于改善ADHD患儿亲子依恋关系,进而可以改善ADHD患儿的自我意识发展,促进ADHD患儿心理健康成长。     

新兵的应付方式、自尊水平与心理健康的关系

目的分析新兵的应付方式、自尊与心理健康的关系,为促进其心理健康提供理论依据。方法抽取陆军某部队2013夏秋入伍2~3周的421名新兵为研究对象,采用应付方式问卷(CSQ)、自尊量表(SES)、症状自评量表(SCL-90)对其心理应付方式、自尊水平和心理健康状况进行团体施测。结果 1独生子女新兵SES、解决问题因子评分低于非独生子女(t=-2.497,-2.445,P0.05),SCL-90总评分、自责与退避因子评分高于非独生子女(t=3.353,2.603,2.229,P0.05);城市新兵SCL-90总评分高于农村新兵(t=2.291,P0.05)。2新兵心理健康水平与解决问题、求助、自尊呈正相关(P0.05),与自责、幻想、退避、合理化呈负相关(P0.05);对心理健康水平影响大小依次是自责、自尊、幻想、解决问题、合理化因子。3解决问题、合理化、自责、幻想对心理健康产生直接影响(路径系数=-0.14,0.11,0.24,0.21),解决问题、合理化、自责通过自尊中介对心理健康产生间接影响(路径系数=0.35,0.17,0.36)。结论非独生子女与农村新兵心理健康水平较高,应付方式对新兵心理健康产生直接预测作用,自尊是应付方式与心理健康的中间变量。     

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。     

酒精所致精神障碍患者个性特征与应对方式

目的：探讨酒精所致精神障碍患者个性特征与应对方式的相关性。方法：运用艾森克人格问卷（EPQ）及应对方式问卷（CSQ）对55例酒精所致精神障碍患者（研究组）和43名无酗酒史的健康人（对照组）进行问卷调查,并对其相关因素进行分析。结果：与对照组相比,研究组的个性以精神质为显著特征;EPQ评分除内外向因子外其他维度如精神质（t=4.75,P〈0.001）、神经质（t=4.95,P〈0.001）以及掩饰程度（t=-2.47,P〈0.015）差异均有统计学意义。两组CSQ评分比较,研究组的应对方式不成熟,以退避（t=9.08,P=0.000）、幻想（t=10.33,P=0.000）和自责（t=8.74,P=0.000）评分较对照组显著增高。相关分析发现,研究组神经质与合理化（r=0.263,P〈0.05）、自责（r=0.298,P〈0.05）呈正相关;内外向与解决问题（r=0.532,P〈0.01）、求助（r=0.582,P〈0.01）呈显著正相关,精神质与解决问题（r=-0.270,P〈0.05）呈负相关。结论：酒精所致精神障碍患者的应对方式受其个性特征影响。     

长沙市公交车司机心理资本、应对方式和心理健康水平的关系

目的探讨长沙市公交车司机心理健康水平与心理资本、应对方式的关系,了解公交车司机心理健康的影响因素,为对其进行有针对性的心理干预提供理论支持。方法于2016年6月-8月,选取220名长沙市公交车司机和1 218名长沙市社区人群,通过现场调查的方式,采用症状自评量表(SCL-90)、心理资本问卷(PCQ)和特质应对方式问卷(TCSQ)进行施测。结果 (1)长沙市公交车司机SCL-90总均分高于社区人群和常模(P0.01),尤其躯体化、强迫症状、敌对、精神病性(P0.01)和偏执(P0.05)评分高于社区人群和常模;(2)公交车司机的积极应对方式(PC)评分高于社区人群和全国常模(P0.05),PCQ中自我效能和韧性评分均高于社区人群(P均0.05),且其PC评分与PCQ中4个维度评分呈正相关(r=0.237~0.409,P0.01),与SCL-90中9个因子评分呈负相关(r=-0.402~-0.319,P0.01);(3)心理资本中的"希望"(β=-0.320,t=-2.049,R~2=0.294,P0.05)和积极应对方式(β=-0.299,t=-1.669,R~2=0.294,P0.01)对心理健康水平有正向预测作用。结论公交车司机是身心疾病的高危群体,改善这一群体的心理资本和积极应对方式,有利于提高其心理健康水平。     

认知行为治疗对社区精神分裂症患者自我效能感、应对方式及社会功能的影响

目的:探讨团体认知行为治疗对社区精神分裂症患者自我效能感、应对方式的影响及与社会功能改善的相关性。方法:69例精神分裂症患者分为5个团体小组,在药物维持治疗基础上施行团体认知行为治疗,1次/周,每次约1.5 h,疗程6个月。于治疗前、治疗后12和24周,分别采用一般自我效能感量表(GSES)、应对方式问卷(CSQ)和社会功能缺陷筛选量表(SDSS)进行评估,并比较治疗前后的变化及各评分之间的相关性。结果:治疗后SDSS总分、CSQ的自责、幻想、退避、合理化得分显著下降;GSES总分、CSQ的解决问题、求助得分显著增高,治疗前后差异有统计学意义(F=30.789~3113.245,P0.01或P0.001);GSES评分显著增高(P0.01)。相关分析显示,SDSS与GSES呈负相关(r=-0.334,P0.01),与CSQ的自责、幻想、退避、合理化的应对方式呈正相关(r=0.079~0.388,P0.01);GSES与CSQ的幻想、退避的应对方式呈负相关(r=-0.154~-0.161,P0.05)。结论:团体认知行为训练可提高患者的自我效能感、改变应对方式,从而有效地改善患者的社会功能。     

精神分裂症与糖尿病患者家属照料负担及生存质量的研究

目的:探讨精神分裂症与糖尿病患者家属的照料负担与生存质量状况。方法:选取精神分裂症和糖尿病患者的家属作为研究对象,分为糖尿病健康家属组(A组,210名)、精神分裂症健康家属组(B组,279名)、精神分裂症合并糖尿病健康家属组(C组,89名)。以Zarit护理负担量表(ZBI)测试患者家属的照料负担,以中国居民主观幸福感量表(SWBS-CC20)测试主观幸福感,以世界卫生组织生存质量简表(WHOQOL-BREF)测试生存质量。结果:B组和C组护理负担高于A组,3组护理负担程度差异有统计学意义(χ~2=4.61,P0.05)。A组SWBS-CC20量表各项因子评分高于B组和C组,且B组在知足充裕、心理健康、自我接受、心理平衡因子分以及量表总分上高于C组(P均0.05)。A组WHOQOL-BREF量表各项因子评分均高于B、C组,且B组在生理领域、心理领域、环境领域因子分上高于C组(P均0.05)。结论:精神分裂症患者家属照料负担较糖尿病患者家属沉重,主观幸福感和生存质量水平较低。     

心理压力感与大学生网络攻击:主观幸福感的中介作用和性别的调节作用

目的探讨心理压力感与大学生网络攻击的关系以及主观幸福感和性别的作用,为降低大学生网络攻击提供参考。方法随机选取在校大学生500名,采用心理压力感量表(PSFS)、主观幸福感量表(GWB)和少年网络攻击行为评定量表(AOABS)进行评定,使用相关分析和回归分析探讨心理压力感、网络攻击和幸福感之间的关系。结果 (1)男性大学生GWB评分低于女性大学生(t=-3.218,P0.01),男性大学生AOABS评分高于女性大学生(t=2.002,P=0.046);(2)大学生PSFS评分与AOABS评分呈正相关(r=0.759,P0.01),GWB评分与AOABS评分呈负相关(r=-0.312,P0.01);(3)主观幸福感在心理压力感与大学生网络攻击之间的中介效应显著(Effect=-0.005,SE=0.002,Z=-2.170,P=0.030);(4)性别在GWB与AOABS评分之间起调节作用(b=-0.086,SE=0.037,t=-2.350,P0.05,95%CI:-0.1586～-0.0143)。结论主观幸福感在心理压力感与大学生网络攻击之间起中介作用,且该中介作用受性别因素的调节。     

绵阳市某地区农村留守妇女幸福感、安全感和心理健康状况的相关分析

目的研究绵阳市某地区农村留守妇女的幸福感,安全感与心理健康的现状,探讨它们之间的关系和影响因素。方法采用分层随机取样法,于2013年12月-2014年1月抽取绵阳市某周边县市的187名农村留守妇女,进行总体幸福感量表(GWB)、安全感-不安全感问卷(S-I)和症状自评量表(SCL-90)问卷调查。结果①61.7%的妇女报告存在不安全感;②主观幸福感得分与常模比较差异有统计学意义(t=38.813,P0.05);③SCL-90中躯体化、抑郁、焦虑三个维度得分与常模比较差异有统计学意义(t=2.30~8.45,P0.05)。④主观幸福感对心理健康状况具有一定的预测关系(β=0.326,t=4.36,P0.05)。结论绵阳市某地区农村留守妇女的主观幸福感状况较好,但半数以上缺乏安全感,主要存在"躯体化"、"抑郁"和"焦虑"心理问题;主观幸福感可能对心理健康状况具有一定的预测作用。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -