Measuring the expressed emotion in Chinese family caregivers of persons with dementia: Validation of a Chinese version of the Family Attitude Scale

BackgroundExpressed emotion (EE) captures the affective quality of the relationship between family caregivers and their care recipients and is known to increase the risk of poor health outcomes for caregiving dyads. Little is known about expressed emotion in the context of caregiving for persons with dementia, especially in non-Western cultures. The Family Attitude Scale (FAS) is a psychometrically sound self-reporting measure for EE. Its use in the examination of caregiving for patients with dementia has not yet been explored.ObjectivesThis study was performed to examine the psychometric properties of the Chinese version of the FAS (FAS-C) in Chinese caregivers of relatives with dementia, and its validity in predicting severe depressive symptoms among the caregivers.MethodsThe FAS was translated into Chinese using Brislin's model. Two expert panels evaluated the semantic equivalence and content validity of this Chinese version (FAS-C), respectively. A total of 123 Chinese primary caregivers of relatives with dementia were recruited from three elderly community care centers in Hong Kong. The FAS-C was administered with the Chinese versions of the 5-item Mental Health Inventory (MHI-5), the Zarit Burden Interview (ZBI) and the Revised Memory and Behavioral Problem Checklist (RMBPC).ResultsThe FAS-C had excellent semantic equivalence with the original version and a content validity index of 0.92. Exploratory factor analysis identified a three-factor structure for the FAS-C (hostile acts, criticism and distancing). Cronbach's alpha of the FAS-C was 0.92. Pearson's correlation indicated that there were significant associations between a higher score on the FAS-C and greater caregiver burden (r = 0.66, p < 0.001), poorer mental health of the caregivers (r = −0.65, p < 0.001) and a higher level of dementia-related symptoms (frequency of symptoms: r = 0.45, p < 0.001; symptom disturbance: r = 0.51, p < 0.001), which serves to suggest its construct validity. For detecting severe depressive symptoms of the family caregivers, the receiving operating characteristics (ROC) curve had an area under curve of 0.78 (95% confidence interval (CI) = 0.69–0.87, p < 0.0001). The optimal cut-off score was >47 with a sensitivity of 0.720 (95% CI = 0.506–0.879) and specificity of 0.742 (95% CI = 0.643–0.826).ConclusionsThe FAS-C is a reliable and valid measure to assess the affective quality of the relationship between Chinese caregivers and their relatives with dementia. It also has acceptable predictability in identifying family caregivers with severe depressive symptoms.     

一对一全程陪伴剖宫产模式对产妇负性情绪及产后恢复的影响

目的观察产妇引入一对一全程陪伴剖宫产模式对其负性情绪及产后恢复的影响。方法应用随机数字表将84例剖宫产产妇分为观察组和对照组,各42例。对照组开展常规护理干预,观察组实施一对一全程陪伴剖宫产模式。记录两组孕产妇在入院当天及产后2h的焦虑自评量表和抑郁自评量表评分,并且比较两组产妇产后恢复情况和成本。结果两组入院当天焦虑自评量表和抑郁自评量表评分差异无统计学意义(P0.05);观察组产后2h的焦虑自评量表和抑郁自评量表评分均低于对照组(P0.05)。产后观察组阴道流血量少于对照组,子宫恢复正常大小时间、产后首次进食及初乳分泌时间均早于对照组,产后6h尿潴留发生率低于对照组,差异均有统计学意义(P0.05)。观察组护理人力成本及实际护理总成本要高于对照组,且差异有统计学意义(P0.05)。两组间在材料成本、设备折旧费、作业费、行政管理费及教育研究费方面差异无统计学意义(P0.05)。结论一对一全程陪伴剖宫产模式能有效改善产妇消极情绪,且能促进产后机体恢复。     

基于谐波分析法观察抑郁症患者脑网络形态学改变

目的 评估基于谐波分析法观察抑郁症(DD)患者脑网络形态学改变的可行性。方法 对55例DD患者(DD组)和46名正常对照者(NC组)采集全脑3D高分辨T1WI,利用FreeSurfer 5.3.0工具构建脑网络6种形态学特征,包括脑区顶点数、表面积、灰质体积、平均皮层厚度、高斯曲率及折叠指数,以拉普拉斯矩阵特征分解获得公共谐波;比较组间不同形态学特征所在谐波能量及脑区灰质体积。结果 组间不同形态学特征总谐波能量差异均无统计学意义(P均>0.05)。组间特定谐波能量差异有统计学意义(P均<0.05),主要包括脑区顶点数谐波能量差异为第2、6、15、44、57谐波,表面积谐波能量差异为第2、6、16、57谐波,灰质体积谐波能量差异为第2、12、13、15、57谐波,平均皮层厚度谐波能量差异为第2、19、35、36、44谐波,高斯曲率谐波能量差异为第34、40、54、57谐波,以及折叠指数谐波能量差异为第5、16、21、57谐波。DD组左脑区颞横皮质区域灰质体积显著大于NC组(t=2.900,P=0.004)。结论 谐波分析法可用于观察DD患者脑网络形态学改变。     

农村初中生情绪行为问题及影响因素调查分析

目的 探讨农村初中生情绪行为问题状况及影响因素,为开展心理干预提供依据.方法 对1 958名初中生采用自编一般资料调查问卷和长处与困难问卷(学生版)进行测评分析.结果 农村初中生长处与困难问卷总困难分及多动因子、情绪因子、品行因子分均低于常模,同伴因子分高于常模.男生长处与困难问卷多动因子、品行因子、同伴因子分显著高于女生(P＜0.01);亲社会因子、情绪因子分显著低于女生(P＜0.01).初三学生总困难分及亲社会因子、多动因子、情绪因子分显著高于初一、初二(P＜0.01);初一学生同伴因子分显著高于初二、初三(P＜0.01).不同健康状况初中生长处与困难问卷总困难分及多动因子、情绪因子、同伴因子分差异有显著性(P＜0.05或0.01).不同学习成绩初中生长处与困难问卷总困难分及亲社会因子、多动因子、情绪因子、品行因子分差异有显著性(P＜0.01).结论 农村初中生存在多种情绪行为问题,同伴关系问题更为显著,影响因素众多,心理干预应具有针对性.     

综合心理干预对类风湿关节炎患者负性情绪的影响

目的探讨综合心理干预对类风湿关节炎患者焦虑、抑郁情绪的改善效果。方法将60例入住某院风湿科的类风湿关节炎患者按就诊顺序分为干预组和对照组,每组30例。对照组实施常规心理护理,干预组实施综合心理干预治疗。两组患者在治疗前和治疗6周后采用视觉模拟评分(visual analogue scale,VAS)、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)进行问卷调查。结果两组患者心理干预前VAS、SAS及SDS评分差异均无统计学意义(P0.05)。综合心理干预6周后,干预组患者焦虑、抑郁情绪明显改变,VAS评分中疼痛、疲劳、睡眠和焦虑等4项均较对照组患者有明显改善,差异有统计学意义(P0.01)。结论对类风湿关节炎患者实施综合心理干预,有助于缓解患者的焦虑、抑郁情绪,保持平衡适宜的心理状态,有利于疾病康复。     

Electroconvulsive therapy plays an irreplaceable role in treatment of major depressive disorder

Major depressive disorder is a serious and common neuropsychiatric disorder that affects more than 350 million people worldwide. Electroconvulsive therapy is the oldest and most effective treatment available for the treatment of severe major depressive disorder. Electroconvulsive therapy modifies structural network changes in patients with major depressive disorder and schizophrenia. And it can also affect neuroinflammatory responses and may have neuroprotective effects. Electroconvulsive therapy plays an irreplaceable role in the treatment of major depressive disorder.     

Emotional modulation of pain and spinal nociception in persons with major depressive disorder (MDD)

Major depressive disorder (MDD) is associated with risk for chronic pain, but the mechanisms contributing to the MDD and pain relationship are unclear. To examine whether disrupted emotional modulation of pain might contribute, this study assessed emotional processing and emotional modulation of pain in healthy controls and unmedicated persons with MDD (14 MDD, 14 controls). Emotionally charged pictures (erotica, neutral, mutilation) were presented in 4 blocks. Two blocks assessed physiological-emotional reactions (pleasure/arousal ratings, corrugator electromyography (EMG), startle modulation, skin conductance) in the absence of pain and 2 blocks assessed emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations. Results indicated pictures generally evoked the intended emotional responses; erotic pictures elicited pleasure, subjective arousal, and smaller startle magnitudes, whereas mutilation pictures elicited displeasure, corrugator EMG activation, and subjective/physiological arousal. However, emotional processing was partially disrupted in MDD, as evidenced by a blunted pleasure response to erotica and a failure to modulate startle according to a valence linear trend. Furthermore, emotional modulation of pain was observed in controls but not MDD, even though there were no group differences in NFR threshold or emotional modulation of NFR. Together, these results suggest supraspinal processes associated with emotion processing and emotional modulation of pain may be disrupted in MDD, but brain to spinal cord processes that modulate spinal nociception are intact. Thus, emotional modulation of pain deficits may be a phenotypic marker for future pain risk in MDD.     

心理行为干预对癌症化疗患者情绪的影响

目的 探讨心理行为干预对癌症化疗患者情绪的影响.方法 采用类实验性研究方法,将101例乳腺癌和肺癌患者分为干预组（50例）和对照组（51例）,对干预组进行一个化疗周期的心理行为干预（3周）,对照组接受常规的治疗和护理.采用简明心境量表对两组患者的情绪状况进行分析.结果 干预组患者在心理行为干预后情绪好转（P＜0.01或P＜0.05）,情绪状况好于对照组（P＜0.01）.结论 心理行为干预能改善癌症化疗患者的情绪状况,有利于疾病的恢复.