Lichen sclerosus in childhood

Lichen sclerosus in childhood involves predominantly the genital area, often with purpura and erosions, which raises concerns of sexual abuse. Potent topical corticosteroids give a good clinical response over several months, although maintenance with weaker formulations is usually required. The long-term prognosis remains uncertain.     

Abuse liability of flunitrazepam among methadone-maintained patients

Abuse liability and acute subjective and psychomotor effects of flunitrazepam were assessed in ten methadone-maintained males with history of benzodiazepine and alcohol use, who voluntarily participated in a double-blind, controlled, cross-over, randomized clinical trial. There were six experimental sessions in which a single oral dose of flunitrazepam 1, 2, and 4 mg; triazolam 0.5 and 0.75 mg; and placebo was given. Evaluations included physiological measures; psychomotor performance tasks (simple reaction time, Digit Symbol Substitution Test, balance task, Maddox-wing device); and self-administered subjective effects questionnaires [Addiction Research Center Inventory (ARCI), Profile of Mood States (POMS), a series of visual analog scales (VAS)]. All drugs but flunitrazepam 1 mg caused an impairment of psychomotor tasks. Effects were more evident with the highest doses of both drugs. Only flunitrazepam 4 mg produced a significant decrease in balance time. Triazolam 0.75 mg induced increases in sedation measured by ARCI-PCAG, depression in POMS, and VAS-drowsiness scores. Flunitrazepam 4 mg caused euphoria-related effects as measured by increases in ARCI-MBG and “high” scores in the VAS. Our findings of flunitrazepam-induced euphoria in methadone-maintained subjects together with epidemiological evidence of flunitrazepam abuse by opioid dependents, suggest that it may be included in the group of benzodiazepines with a relatively high abuse potential. Received: 13 February 1998/Final version: 1 May 1998     

Degree of Somatoform and Psychological Dissociation in Dissociative Disorder Is Correlated with Reported Trauma

In this study, the prevalence and severity of traumatic experiences as reported by patients with dissociative disorders and with other DSM-IV psychiatric diagnoses were compared. Furthermore, the predictive value of emotional, physical, and sexual trauma with respect to somatoform and psychological dissociation was analyzed. In contrast with comparison patients, dissociative disorder patients reported severe and multifaceted traumatization. Physical and sexual trauma predicted somatoform dissociation, sexual trauma predicted psychological dissociation as well. According to the memories of the dissociative disorder patients, this abuse occurred in an emotionally neglectful and abusive social context. Pathological dissociation was best predicted by early onset of reported intense, chronic and multiple traumatization. Methodological limitations restricting causal inferences between reported trauma and dissociation are discussed.     

Magnetic resonance imaging reveals no ventriculomegaly in polydrug abusers

Previous studies of cerebral structure in substance abusers yielded controversial results, largely due to issues of subject selection and/or limitations of experimental techniques. The purpose of the present study was to assess whether the ventricle-to-brain ratio (VBR), determined volumetrically by magnetic resonance imaging (MRI), differed in polysubstance abusers (n = 10), as compared with age-matched controls (n = 10). Subjects were male volunteers 21–39 years of age. The values of VBR in the polydrug abuse group were not larger than those in control group, nor was there any tendency toward relative ventriculomegaly in the substance abusers. Therefore, the present findings provide no evidence that polysubstance abuse produces abnormalities of gross brain structure in relatively young and physically healthy men.     

Special issue: Group treatment after child and adolescent sexual abuse: Introduction

This introduction traces the increasing awareness of the prevalence of child sexual abuse over the last 20 years, examines the nature and consequences of such abuse and summarizes current information on the use of group treatment and its evaluation with sexually abused children and adolescents and their parents. Four examples of group treatment with different populations of abused children are described in this issue.     

The Effects of Early Childhood Abuse and the Development of Resiliency

Recently, the number of young children who have suffered from the traumas of abuse and neglect has increased. There are negative cognitive, neurological, and psychological effects from this maltreatment which is described in this article. Interventions which can prevent neglect and abuse and further resiliency in the young victims are discussed. As concerned individuals, we need to advocate for preventive and therapeutic efforts which promote resiliency in maltreated children.     

Phenylpropanolamine: reinforcing and subjective effects in normal human volunteers

The reinforcing and subjective effects of phenylpropanolamine (PPA, 25 and 75 mg, PO) were compared with those of d-amphetamine (AMP, 5 mg) in a group of normal, healthy adults (eight males, nine females) with no history of drug abuse. A discrete-trial choice procedure was used in which subjects first sampled placebo and a dose of one of the drugs. Subjects were then allowed to choose between self-administration of drug or placebo on three separate occasions. The relative frequency with which active drug was chosen over placebo was used as the primary index of the drug's reinforcing efficacy. Subjective effects were measured with the Profile of Mood States, a short version of the Addiction Research Center Inventory and a series of visual analog scales. Ratings of drug liking, drug labelling, general activity level and strength of drug preference were also obtained. As expected, AMP was chosen significantly more often than expected by chance (69% of occasions). AMP also increased ratings of drug liking, preference strength, and activity level, and produced a profile of subjective effects consistent with its well-established stimulant and euphorigenic properties. The low dose of PPA was without effect on most measures. PPA 75 mg was chosen significantly less often than expected by chance (39% of occasions). This dose of PPA was most frequently labelled as a stimulant, and produced significant increases on ratings of Anxiety and stimulated, and decreases on ratings of sedated and hungry. Unlike AMP, PPA did not affect ratings of drug liking or mood scales reflecting euphoria. In sum, these results indicate that PPA does not possess AMP-like dependence potential.     

模拟教学联合心理暗示在耳鼻咽喉头颈外科住培模拟教学中的应用

目的 分析模拟教学联合心理暗示在耳鼻咽喉头颈外科住培模拟教学中的应用价值。方法 选取于清华大学附属北京清华长庚医院耳鼻咽喉头颈外科进行住培的36例住培医师,按不同教学模式将其分为研究组（n=20,模拟教学联合心理暗示）与对照组（n=16,传统教学）。比较两组住培医师考核成绩、综合能力、教学效果及教学满意度。采用SPSS 22.0进行t检验和卡方检验。结果 带教后,两组住培医师理论考试、技能考核成绩、学习兴趣、自学能力、沟通能力及临床诊疗水平评分均较带教前上升,且研究组上升程度明显优于对照组（P<0.05）。研究组兴趣程度、难易程度、可参与性、掌握程度评分均明显高于对照组（P<0.05）。研究组住培医师教学总满意度为95.00%,明显高于对照组的68.75%（P<0.05）。结论 模拟教学联合心理暗示在耳鼻咽喉头颈外科住培教学中可提高学员理论知识、技能操作水平、综合能力及教学水平,且学员对该教学方法满意度高。     

父母文化程度与高师学生心理健康问题研究

目的 了解高师学生心理健康现状和父母文化程度对高师学生心理健康水平的影响。方法 对河南省部分高师学生进行问卷调查。结果 河南省大部分高师学生心理健康状况是好的和比较好的；15.13%的高师学生心理健康状况不良，教师、咨询人员和家长应高度重视，密切配合，正确地对他们进行引导和教育。结论 父母文化程度不同对高师学生心理健康水平的影响有差异。但差异不显著。     

筑起抗击"非典"的心理长城

目的 探讨心理疗法对防治SARS的作用,方法 本文综合国内外心理疗法研究成果,提出了应对非典的心理处方：“接纳恐惧,顺其自然;平衡思维,端正认识;积极暗示,增强信心;切已体察,心理常态”;结果 从原理上解释其发生作用的机制,明确心理处方的实际操作,提出具体的步骤和要点,并对日常生活中的不妥做法进行了剖析。结论 采用心理疗法可增强抗击“非典”的信心及提高免疫功能。