Emotional Communication in Advanced Pediatric Cancer Conversations

ContextCancer is a life-changing diagnosis accompanied by significant emotional distress, especially for children with advanced disease. However, the content and processes of discussing emotion in advanced pediatric cancer remain unknown.ObjectivesTo describe the initiation, response, and content of emotional communication in advanced pediatric cancer.MethodsWe audiorecorded 35 outpatient consultations between oncologists and families of children whose cancer recently progressed. We coded conversations based on Verona Coding Definitions of Emotional Sequences.ResultsAbout 91% of conversations contained emotional cues, and 40% contained explicit emotional concerns. Parents and clinicians equally initiated cues (parents: 48%, 183 of 385; clinicians: 49%) and concerns (parents: 51%; clinicians: 49%). Children initiated 3% of cues and no explicit concerns. Emotional content was most commonly related to physical aspects of cancer and/or treatment (28% of cues and/or concerns, present in 80% of conversations) and prognosis (27% of cues and/or concerns, present in 60% of conversations). Clinicians mostly responded to emotional cues and concerns implicitly, without specifically naming the emotion (85%). Back channeling (using minimal prompts or words that encourage further disclosure, e.g., uh-huh) was the most common implicit response that provided space for emotional disclosure (32% of all responses). Information advice was the most common implicit response that reduced space for further emotional disclosure (28%).ConclusionEmotional communication in advanced pediatric cancer appears to be a subtle process where parents offer hints and clinicians respond with non-emotion-laden statements. Also, children were seldom engaged in emotional conversations. Clinicians should aim to create an environment that allows families to express emotional distress if and/or when ready.     

Developmental trajectory of the late positive potential: Using temporal-spatial PCA to characterize within-subject developmental changes in emotional processing

The late positive potential (LPP) is characterized by temporal and spatial changes across development—though existing work has primarily relied on visual or statistical comparisons of relatively few electrodes and averaged activity over time. The current study used an empirically based approach to characterize temporal and spatial changes in ERPs over time. Data were utilized from a large longitudinal study (N = 380) in which the LPP was recorded to pleasant, neutral, and unpleasant pictures around age 9 and again around age 12. Age 9 ERPs were subtracted from age 12 ERPs for all three image types; the resulting ERPs for each subject at each electrode site were then submitted to a temporospatial principal component analysis (PCA). A PCA factor was greater in amplitude for emotional pictures compared to neutral pictures between ages 9 and 12, evident as an occipital negativity and frontocentral positivity that peaked approximately 850 ms following picture presentation. Furthermore, the factor scores to emotional pictures for this component increased as a function of age 12 pubertal development, consistent with the notion that the LPP shifts from occipital to more frontocentral sites in relation to developmental changes from childhood to adolescence. A similar factor was observed when PCA was applied to all ERPs from both ages 9 and 12. Using temporospatial PCA on ERPs collected from the same subjects over time—especially within-subject subtraction-based ERPs—provides a concise way of characterizing and quantifying within-subject developmental changes in both the timing and scalp distribution of ERPs.     

浙江淳安小学生流行性癔病的心理社会因素探讨

本文报告对前文所述文昌乡中心小学四个流行性癔病发病班137名学生进行了问卷调查,其中曾发病者36人(女31,男5)与未发病的45人(女38,男7)对照组进行比较。结果显示发病组 EPQ 测定 N 分(神经质)高,平时情绪消极,应对能力差,依赖性强,体质较差,关系密切同学中患病者多,害怕鬼神等特点,与对照组相比,均有显著性差异。     

Guided self-help for binge eating/purging anorexia nervosa before inpatient treatment

Abstract

The goal of this study was to develop a cognitive–behavioral self-help manual for anorexia nervosa. Patients diagnosed with anorexia nervosa (N=102), binge eating/purging type (AN-B/P), were consecutively assigned to one of two conditions: 6-week manualized guided self-help or a wait-list control. All patients thereafter received inpatient treatment in a hospital for behavioral medicine. The primary outcome variable was the number of days in inpatient treatment. Secondary outcome variables were measures of psychopathology. Results showed that duration of inpatient treatment was significantly shorter (by 5.2 days) among participants receiving guided self-help. Body image, slimness ideal, general psychopathology, and some bulimic symptoms improved significantly during self-help. The authors conclude that, to increase effects of therapist-guided self-help in AN-B/P, additional variants of a self-help manual should be tried in different therapeutic settings.     

Oxytocin attenuates amygdala responses to emotional faces regardless of valence.

BACKGROUND: Oxytocin is known to reduce anxiety and stress in social interactions as well as to modulate approach behavior. Recent studies suggest that the amygdala might be the primary neuronal basis for these effects. METHODS: In a functional magnetic resonance imaging study using a double-blind, placebo-controlled within-subject design, we measured neural responses to fearful, angry, and happy facial expressions after intranasal application of 24 IU oxytocin compared with placebo. RESULTS: Oxytocin reduced right-sided amygdala responses to all three face categories even when the emotional content of the presented face was not evaluated explicitly. Exploratory whole brain analysis revealed modulatory effects in prefrontal and temporal areas as well as in the brainstem. CONCLUSIONS: Results suggest a modulatory role of oxytocin on amygdala responses to facial expressions irrespective of their valence. Reduction of amygdala activity to positive and negative stimuli might reflect reduced uncertainty about the predictive value of a social stimulus and thereby facilitates social approach behavior.     

How disgust facilitates avoidance: an ERP study on attention modulation by threats

This study investigated the attention modulation of disgust in comparison with anger in a dot-probe task. Results indicated a two-stage processing of attention modulation by threats. When participants viewed the cues that were represented by Chinese faces (i.e. the in-group condition), it was found at the early processing stage that an angry face elicited a larger occipital P1 component whereas a disgusted face elicited a smaller P1 for validly than for invalidly cued targets. However, the result pattern was reversed at the later processing stage: the P3 amplitudes were larger for valid disgust cues but were smaller for valid angry cues, when both were compared with invalid cue conditions. In addition, when participants viewed the cues that were represented by foreign faces (i.e. the out-group condition), the attention modulation of disgust/anger diminished at the early stage, whereas enhanced P3 amplitudes were observed in response to validly cued targets in both disgusting and angry conditions at the later stage. The current result implied that although people can perceptually differentiate the emotional categories of out-group faces as accurately as in-group faces, they may still be not able to psychologically understand the subtle differences behind different categories of out-group facial expressions.     

5A模式在困难性下腔静脉滤器取出术围术期的应用

目的评价5A模式在困难性下腔静脉滤器(IVCF)取出术患者围术期的应用及其效果。方法选取2020年6月至2022年6月在北京积水潭医院治疗的困难性IVCF取出术患者共140例为研究对象,根据护理方法分为5A模式组(n=66)及常规护理组(n=74)。5A模式组采用5A模式护理,常规护理组采用常规护理。比较两组患者的围术期并发症发生率、自我护理能力、负性情绪、护理满意度、远期并发症发生率。结果护理实施后,5A模式组患者围术期并发症发生率低于对照组(18.18%vs 35.14%,P<0.05)。5A模式组自我护理能力各项评分均高于常规护理组(P<0.05)。实施护理后,两组HAMA、HAMD评分均低于护理前,且5A模式组汉密乐顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均低于常规护理组(P<0.05)。5A模式组护理满意度高于常规护理组(92.42%vs 79.73%,P<0.05)。滤器取出术6个月后,5A模式组患者远期并发症总发生率低于常规护理组(12.12%vs 18.92%,P<0.05)。结论5A模式护理应用于困难性IVCF取出术患者有利于提升患者自护能力,缓解患者负性情绪,降低并发症发生率,提升患者护理满意度。     

月经周期不同时相恐惧表情对时间知觉的影响

目的:探索在月经周期3个时相中,正常育龄女性体验恐惧情绪对时间知觉的影响。方法:方便选取19～29岁女性85名,运用时间等分任务,比较被试在卵泡初期、排卵期和黄体中期体验恐惧和中性表情后的长反应比例。结果:月经时相的主效应显著,排卵期时对时距判断的长反应比例高于黄体期(P0.05);恐惧面孔刺激下的长反应比例高于中性面孔(P0.05);时距主效应显著,长反应比例在400～1600 ms范围内随时距增加呈增加趋势(均P0.01);月经时相和时距的交互作用显著(P0.05)。结论:女性在排卵期相对于其他时相表现出高估时间的倾向;与体验中性情绪相比,被试体验恐惧表情的时间知觉加长。     

汽车驾驶员疲劳综合征与焦虑抑郁情绪及人格特征的关系

目的探讨汽车驾驶员疲劳综合征与个体情绪状态及人格特征关系。方法采用自编疲劳综合征问卷、焦虑自评量表、抑郁状态问卷、EPQ量表测评心理状况,统计分析采用t检验、χ2检验和直线相关分析。结果292名职业驾驶员中76例(26.0%)存在疲劳综合征症状,女性发生率明显高于男性(χ2=6.028,P0.05);105例(36.0%)存在焦虑情绪,女性明显高于男性(χ2=38.652,P0.05);72例(24.7%)存在抑郁情绪,男、女之间无明显差别(χ2=2.826,P0.05);分析疲劳综合征、焦虑抑郁情绪与EPQ的关系发现,分量表中N分呈正相关关系、抑郁情绪与E分呈正相关关系(r=0.711,P0.05);焦虑、抑郁情绪与P、L分无显著性差异(P0.05)。结论汽车驾驶员易出现焦虑、抑郁情绪,这些情绪与其人格特征有密切的关联性。