难治性精神分裂症患者临床特点

目的：探讨难治性精神分裂症患的临床特点。方法：在533例住院分裂症患(男性328例、女性205例)中有113例符合难治性标准的患人研究组。对照组则按照与研究组1：1的比例，分别在不同性别的非难治性精神分裂症患随机选取。对研究组与对照组的临床资料进行比较。结果：113例难治性精神分裂症患中男性有76例、女性有37例，总的难治性比率为21．20％。研究组与对照组相比。在受教育年限、首发年龄、治疗前病程、病程、住院次数、服药依从性、社会支持方面的差异有显性意义，而家庭经济水平方面差异无显意义。两组患在起病方式、病程特点、症状特点及诊断分型4个因素方面差异也有显性意义，而在性格、家族史上的差异则无显性意义。Logistic回归分析显示服药依从性、社会支持、诊断分型、症状特点、住院次数、病程特点6个因素对分裂症患疗效影响有显意义。结论：分裂症患难治的原因既有生物学因素，也有社会心理因素，在治疗分裂症患时应注意多因素的影响。     

男性海洛因依赖者渴求与心身症状的相关研究

目的了解男性海洛因依赖者(MPHD)渴求的影响因素。方法采用一般情况问卷(自拟)、渴求问卷(HCQ)、症状自评量表(SCL-90)、多伦多述情障碍量表(TAS)、抑郁自评问卷(SDS)、焦虑自评问卷(SAS)对湖南地区218名男性海洛因依赖者进行测评。结果渴求随吸毒年限的延长而逐渐加重(P<0.05或P<0.01)。HCQ中除“自我控制”因子外,与SDS、SAS总分、SCL-90总分及各因子均显著正相关(P<0.05或P<0.01),相关值在0.168~0.375之间。以HCQ总分为因变量进行多元回归分析,海洛因使用年限、SCL-90偏执因子、SAS总分、日吸烟量依次进入回归方程,标准化回归系数分别为0.099,0.321,0.032,0.022。结论MPHD有严重的药物渴求,渴求受多种因素影响。     

煤矿井下工伤事故经历者的心理研究

目的研究煤矿井下工伤事故经历者的心理健康状况。方法在煤矿井下工伤事故发生后1周,对事故亲身经历者进行症状自评量表（SCL-90）,焦虑自评量表（SAS）,抑郁自评量表（SDS）进行评定,并与对照组进行比较。结果研究组的SAS、SDS、SCL-90评分与对照组比较存在显著性差异。结论煤矿井下工伤事故经历者在强烈急性的应激创伤下,出现明显的紧张、焦虑、抑郁等情绪障碍,该人群需要科学的心理干预和良好的社会支持。     

The effect of stimulus significance on relatively sustained (tonic-like) and relatively transient (phasic-like) aspects of electrodermal, heart rate, and eyeblink response

To examine the influence of stimulus significance on more sustained as well as transient aspects of electrodermal, cardiac (HR), and eyeblink response, a 21-sec tone was sounded in one ear or the other. A click occurred during many tones, and a light followed offset by 9 sec. Four groups were studied: one pressed a pedal immediately on hearing any click; another only on click during tone in a specified ear; a third also responded only to the specified ear, but withheld press until the light; a fourth listened without any response. Results confirmed the important role of stimulus significance in each system whether between- or within-subject comparisons were made. Sustained responses were seen only when a significant signal was sought, involving in each case sustained HR deceleration, slowed blink rate, and heightened electrodermal level. Transient response to click and light also appeared only when there were significant signals. Response to tone-onset gave more ambiguous results. ANOVAs of response magnitude suggested that onset of nonsignificant tones might have elicited ORs, while binomial tests indicated these were not elicited with better than random frequency anywhere but on those trials occurring more frequently at the experiment's onset. Interpretations consistent with both the significance hypothesis and with a distinction between automatic and voluntary ORs can be made only here. Motor response had no effect on electrodermal or eyeblink response, and on HR was associated only with increased acceleration 1-2 sec after pedal-press. Studies using small motor responses to establish stimulus significance are therefore not likely to be substantially biased by the response itself.     

Ovarian carcinoma: Management of stress in patients and physicians

A discussion of the management of ovarian cancer invariably involves the problems of death and dying faced by the patient, her family, and her physician. This paper attempts to deal with the general fears, anxieties, and problems of terminality, and also places attention on specific issues involved in living with the ongoing disease and its treatments. Focus is on the effects of the disease on the woman's self-image, on her family and relationships, on life outside the hospital, and on her relationship with her attending physician. Specific problems relating to the periods of (1) diagnosis, (2) operative management and treatment, and (3) terminality are discussed. Understanding the psychosocial realities of the patient provides the physician with added insights into methods to assist the patient in adaptation and coping with this ultimately fatal disease.     

The teaching of interviewing skills: comparison of experienced and novice trainers

During a clerkship in psychiatry thirty-six medical students were randomly allocated to one of three teachers who differed widely in their experience of teaching essential interviewing skills. Each teacher taught two groups of six medical students using videotape feedback and discussion of practice interviews. Independent raters who were blind to the teachers to whom the students had been assigned rated pre and post-training interviews. All three teachers proved effective in teaching interviewing skills and it is concluded that most teachers could probably be taught to carry out this training.     

A systematic study of psychiatric illness in freshman college students

The majority of estimates of the rate of college student psychiatric illness has been based on data obtained from treated samples of students.^1,2 The biases inherent in treated samples have been extensively documented. Few studies have dealt with the occurrence of psychiatric illness in a randomly selected sample of students, a study design that avoids the problems of using a treated population. This study describes the psychiatric problems, during the freshman year, of such a randomly selected, prospectively studied sample of 158 college students.The questions to be answered by this report are: (1) What proportion of a college population have a psychiatric problem during the course of the freshman year? (2) What proportion will seek treatment? (3) What proportion of the ill group will seek treatment? (4) What is the predominant psychiatric disturbance seen?     

Development and evaluation of a placebo for studies of operant behavioral intervention

The role of credible placebo conditions in operant intervention research is reviewed. Three studies are presented which were designed to help develop such a placebo condition and then to evaluate its credibility. The results of the studies underscore the necessity for evaluating a placebo condition before employing it in the actual intervention study. Data are offered suggesting that a credible placebo for behavioral treatment of hyperactive children can be developed for use in teacher consultation studies. The data also suggest, however, that credibility ratings are influenced by the manner in which the evaluations are undertaken. The nature of the concept of credibility is also briefly discussed.     

Cardiovascular consequences of expressing anger in a mutually-dependent relationship

Twenty males were harrassed by a confederate of the experimenters while solving anagrams. Following this experience they played a mixed-motive, interpersonal game with the confederate. In comparison with non-harrassed controls the harrassed subjects expressed more anger at the end of the task. While solving anagrams they also exhibited greater increases in systolic blood pressure and heart rate and greater decreases in finger pulse amplitude and pulse wave transit time. The post- harrassment adjustment of cardiovascular behavior during the interpersonal games was contingent upon the subject's aggression guilt, level of exploitativeness, and uncertainty concerning the consequences of exploiting the confederate. The greater the subject's aggression guilt the less anger he expressed at the end of the anagrams task and the less he exploited the confederate. The more a subject exploited the confederate the lower his diastolic blood pressure at the end of the game. The greater the uncertainty of consequences of behavior the faster the transmission of pulses and the smaller the drop in blood pressure during the game. The potential utility of interpersonal games for studying behavioral and biological adjustments during post-anger interpersonal transactions in a mutually-dependent relationship is illustrated.