Electrophysiological correlates of adjustment process in anchoring effects

Anchoring is a judgmental bias that final judgments are assimilated toward the starting point of the judge's deliberations. The anchoring-and-adjustment heuristic holds that anchoring bias is caused by insufficient adjustment. With the manipulation of some subjective factors, previous research found that anchoring is an effortful process. However, there is little evidence supporting that the effortful process is an adjustment process. In the present work, number accuracy was introduced as an objective factor which involves in an adjustment process. An event-related brain potential (ERP) experiment on young normal subjects examined the impact of number accuracy on anchoring processes responding to anchors which were generated by subjects themselves. A dot-image paradigm was firstly employed to explore anchoring effects. Behavioral results found less accurate anchors which determined a coarser mental scale diminished the anchoring biases responding to self-generated anchors. A positive deflection at 250–800 ms after target onset can be taken as a direct electrophysiological evidence of the adjustment process, whose amplitude was more positive on more accurate anchors condition. The present results further support that people adjust upwards or downwards on a mental scale from the self-generated anchor, which is consistent with the adjustment heuristics.     

大学生学习适应及其与人格变量的关系

目的了解大学生学习适应的一般状况,揭示大学生学习适应性与人格之间的关系。方法采用分层整群抽样,抽取200名大学生进行调查,对数据进行相关分析和回归分析。结果大学二、三年级学习适应性呈现显著差异（P〈0.05）,不同性别大学生学习适应性没有呈现显著差异。在教学模式维度上,农村大学生和城市大学生呈现显著差异（P〈0.05）。人格变量中的活动水平和情绪化与大学生学习适应显著相关（P〈0.01）,并进入了大学生学习适应的回归方程。结论大学生具有一定程度的学习适应;大学生的人格活动水平、情绪化等能较好地预测其学习适应程度。     

Spécificités de l’approche psychothérapique d’inspiration analytique à l’adolescence

The commitment of a teenager in an individual psychotherapeutic work often faces multiple obstacles, related to incompatibilities inherent to the process of adolescence, but that often reflect the ups and downs of the work of psychic separation or the vicissitudes of “subjectivation”. Therapeutic setting adjustments, made necessary by the psychic and relationship operating constraints of the concerned adolescents, have been proposed by psychoanalysts, intended to take into account the narcissistic vulnerability of their young patients, and also to put their own associative abilities at their disposal. Exciting contributions of several psychotherapists working with teenagers on these issues will be summarized and extended by the reflections of the author based on his own experience as a psychotherapist and that derived of different supervisory groups he facilitated for several years. Some designs may thus be summarized, illustrated and reformulated in the light of the clinic. In this perspective the issues inherent, to the objectives of the psychotherapeutic work at this age, to the levers that can be used, to the obstacles related, not only to the process of adolescence challenges, but also to parental positions, to the nature of the underlying psychopathological organization and to the counter-transferences reactions of therapists, will be re-examined. In order to better control the potential risks of such an encounter, and to increase profits for young patients, it turns finally essential to rethink the design, and to advocate the strong practitioners’ commitment.     

Covariate adjustments in randomized controlled trials increased study power and reduced biasedness of effect size estimation

ObjectivesThis study aims to show that under several assumptions, in randomized controlled trials (RCTs), unadjusted, crude analysis will underestimate the Cohen's d effect size of the treatment, and an unbiased estimate of effect size can be obtained only by adjusting for all predictors of the outcome.Study Design and SettingFour simulations were performed to examine the effects of adjustment on the estimated effect size of the treatment and power of the analysis. In addition, we analyzed data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (older adults aged 65–94), an RCT with three treatment arms and one control arm.ResultsWe showed that (1) the number of unadjusted covariates was associated with the effect size of the treatment; (2) the biasedness of effect size estimation was minimized if all covariates were adjusted for; (3) the power of the statistical analysis slightly decreased with the number of adjusted noise variables; and (4) exhaustively searching the covariates and noise variables adjusted for can lead to exaggeration of the true effect size. Analysis of the ACTIVE study data showed that the effect sizes adjusting for covariates of all three treatments were 7.39–24.70% larger than their unadjusted counterparts, whereas the effect size would be elevated by at most 57.92% by exhaustively searching the variables adjusted for.ConclusionAll covariates of the outcome in RCTs should be adjusted for, and if the effect of a particular variable on the outcome is unknown, adjustment will do more good than harm.     

Patients' Understanding of and Adjustment to Epilepsy: Interim Findings from a European Survey

Summary: The purpose of the study was to discover how much European patients with epilepsy and their carers understand about epilepsy. This article reports the interim results for the first four European countries recruited to the study and includes data collected from 1,920 people with epilepsy and 2,136 carers. Clinical and demographic details and data on understanding of epilepsy were collected using self-completed questionnaires mailed to members of epilepsy support groups. There were no significant differences between people with epilepsy and carers for scores on the Epilepsy Knowledge Questionnaire, although people with epilepsy were more likely to score in the higher ranges. Higher scorers on the questionnaire were more likely to be better educated, to have lower scores on the impact of epilepsy scales, to have higher scores on the adjustment to epilepsy scale, and were less likely to report feeling stigmatized. The study confirms the findings of previous studies that people with epilepsy are reasonably well informed, although some gaps in their knowledge were evident. A comparison of country differences will be made and multivariate statistical analysis will allow a better understanding of the contribution of knowledge to people's overall adjustment to their condition.     

如何控制观察性疗效比较研究中的混杂因素：（一）已测量混杂因素的统计学分析方法

观察性疗效比较研究作为随机对照研究的补充,其应用价值越来越受到关注,混杂偏倚是其重要偏倚来源。本文介绍观察性疗效比较研究中已测量的混杂因素控制的统计分析方法。对于已测量的混杂因素,可采用传统的分层分析、配对分析、协方差分析或多因素分析,也可采用倾向性评分、疾病风险评分等方法进行混杂因素匹配、分层和调整。良好的设计需从源头控制各种混杂,事后统计分析则应在理解各类方法的应用前提下,严格把握适用条件。     

团体心理疗法促进大学新生环境适应的研究

目的　探索运用团体心理疗法 ,缓解或消除大学新生因环境变化而出现的生活、学习和人际交往适应障碍的有效性 ,增强适应能力 ,辅导并促进其心理健康成长。方法　采取心理测评量表 ( SCL-90 )和心理门诊约谈 ,将某医学院 97、98两个年级 1 1 2 6名新生中适应障碍新生各分 1组 ,每组 3 0人 ,运用团体心理疗法的基本技术 ,团体讨论、心理剧、行为放松练习等主要方法 ,结合自我评价表和心理量表前后对比研究。结果　 1治疗前后 ,97年级新生分享经验的差异显著 ( P<0 .0 1 ) ;98年级新生分享经验、了解自己、有责任感的差异显著 ( P<0 .0 5 ) ,喜欢参与的差异高度显著 ( P<0 .0 1 ) ,关怀别人、信任自己等差异高度显著 ( P<0 .0 0 1 )。 2治疗前后 ,97年级新生躯体化、人际关系、抑郁差异显著 ( P<0 .0 5 ) ,强迫、焦虑、恐怖和精神病性差异高度显著 ( P<0 .0 1 ) ;98年级新生躯体化、恐怖差异显著 ( P<0 .0 5 ) ,抑郁方面差异高度显著 ( P<0 .0 1 )。3 97、98年级治疗前后自我评价和心理健康同时相互比较 ,差异显著性不一。结论　 1团体心理疗法是治疗大学新生适应障碍的有效途径 ,具有改善面多、受众广等优点 ;2能较好地宣传和推动学校心理咨询工作 ,起到防患于未然的作用 ;有助于学生心理积极成长 ;3治疗     

大型三级公立医院门诊转型的探索和实践

公立医院改革是新医改的重要组成部分,三级公立医院应有主动革新的勇气来面对新的医疗体系格局。本研究以J医院为微观个案,分析其从门诊结构调整和合理用药管控的角度推进门诊转型的实践。     

叙事疗法对永久性肠造口患者病耻感影响的研究

目的 评价叙事疗法对永久性肠造口患者病耻感的影响。 方法 选取2018年4月—11月在某三级甲等医院胃肠外科、结直肠肛门外科行腹会阴联合直肠癌根治术的47例患者,通过一对一、面对面或视频通话的形式,对患者进行每周1次、每次30~45 min、共8次的叙事疗法;采用社会影响量表和造口适应量表评价干预前后的效果。 结果 出院前1 d、干预结束、干预结束后1个月,患者社会影响量表得分分别为（59.64±6.62）分、（53.87±8.78）分、（47.98±8.47）分,不同时间点病耻感差异有统计学意义（F=179.078,P<0.001）;造口适应量表得分分别为（40.49±7.13）分、（45.68±6.87）分、（46.70±7.11）分,不同时间点社会心理适应水平差异有统计学意义（校正后F=75.295,P<0.001）。 结论 叙事疗法有助于降低永久性肠造口患者的病耻感并提高其社会心理适应水平。     

糖尿病患者门诊注射胰岛素方案调整方法对比观察

[目的]观察门诊糖尿病患者注射胰岛素应用不同管理方法是否均安全、有效。[方法]选择我院内分泌科门诊就诊,86例新诊断的2型糖尿病患者,随机分为2组,一组管理方法,患者自己血糖监测,医生调整胰岛素剂量,自己注射胰岛素设为观察组;另一组管理方法,患者自己血糖监测,医生给出胰岛素用药方案原则后,自己调整胰岛素剂量,自己注射胰岛素设为对照组。针对不同管理方法对糖尿病患者的治疗疗效、达标时间及低血糖发生率进行比较。[结果]两组治疗效果相似,对照组达标时间较观察组稍长,但无统计学差异。对照组轻微低血糖发生率稍高于观察组,但两组无统计学差异。[结论]两种管理方法均安全有效。