A guiding framework and approach for implementation research in substance use disorders treatment.

This paper introduces readers to the concepts of implementation science, implementation theory, and implementation frameworks and models. A wide range of models has been published in the literature related to implementation. The paper will present an overview of the Consolidated Framework for Implementation Research (CFIR), which is a comprehensive typology that unifies and consolidates the array of constructs that influence implementation from the perspective of these models. The CFIR is then used to evaluate implementation models used in studies of substance use disorder (SUD) treatments. Implementation research is scarce, with few prospective studies of theory-driven implementation. We assert that future research in SUD needs to meet three overarching objectives to promote wider implementation of evidence-based practices: (a) differentiation of core versus adaptable components of evidence-based interventions need; (b) development of methods to design implementation strategies, effectively adapted to the broad context; and (c) design and testing of predictive models to assess likelihood of effective implementation and prospects for sustainability while taking into account salient contextual factors. A recommended strategy for accomplishing these objectives is described. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Implementation of evidence-based substance use disorder continuing care interventions.

Continuing care following initial substance use disorder treatment often is associated with improved treatment outcomes and evidence-based interventions (EBIs) have been developed in this area. However, rates of patient participation in continuing care treatment and mutual help groups (MHGs) are low and a large gap exists between the existing EBIs and actual clinical care. This paper uses the Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2009) to review the literature on continuing care treatment and monitoring, and mutual help-group promotion. Although existing research provides implications for implementing EBIs in continuing care, few direct implementation trials have been conducted. This literature indicates that EBIs in continuing care have been successfully modified for different settings, that they can be delivered using different modalities (e.g., individual, group, and telephone-based care), and that low cost options are available. Additionally, much is known about the differential effectiveness of continuing care with different populations that may guide treatment programs and providers in selecting the most effective interventions for their clients. One significant barrier to successful implementation of EBIs for continuing care is the lack of information about incentives for providing continuing care across what in the CFIR terminology is a program's outer setting (i.e., external economic, political, and social setting), and its inner setting (i.e., internal political, structural, and cultural contexts). Implications for implementation of EBIs in substance use disorder continuing care are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Genetic essentialism: On the deceptive determinism of DNA.

This article introduces the notion of genetic essentialist biases: cognitive biases associated with essentialist thinking that are elicited when people encounter arguments that genes are relevant for a behavior, condition, or social group. Learning about genetic attributions for various human conditions leads to a particular set of thoughts regarding those conditions: they are more likely to be perceived as (a) immutable and determined, (b) having a specific etiology, (c) homogeneous and discrete, and (d) natural, which can lead to the naturalistic fallacy. There are rare cases of “strong genetic explanation” when such responses to genetic attributions may be appropriate; however, people tend to overweigh genetic attributions compared with competing attributions even in cases of “weak genetic explanation,” which are far more common. The authors reviewed research on people's understanding of race, gender, sexual orientation, criminality, mental illness, and obesity through a genetic essentialism lens, highlighting attitudinal, cognitive, and behavioral changes that stem from consideration of genetic attributions as bases of these categories. Scientific and media portrayals of genetic discoveries are discussed with respect to genetic essentialism, as is the role that genetic essentialism has played (and continues to play) in various public policies, legislation, scientific endeavors, and ideological movements in recent history. Last, moderating factors and interventions to reduce the magnitude of genetic essentialism, which identify promising directions to explore in order to reduce these biases, are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A practical, evidence-based approach for means-restriction counseling with suicidal patients.

Assessing a patient's access to potentially lethal means for suicide and taking steps to restrict access to means are common expectations for reasonable outpatient management of suicidal patients. Although scientific evidence supports means restriction as a suicide prevention strategy, means restriction continues to be infrequently utilized by clinicians, in large part because of the general lack of available training and guidance. The present article reviews the conceptual basis and empirical evidence for means restriction, discusses common barriers to means-restriction counseling, and provides practical procedures and tools (e.g., the means receipt, the crisis support plan) for accomplishing means-restriction counseling in routine clinical practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Meaning of words and the use of axiomatics in psychological theory.

Two problems are discussed: Can and should psychological concepts be defined, and can and should they be organized in an axiomatic system? I point out that definitions in terms of physiological or behavioral measures are strictly impossible because any particular measure can mean anything, whereas phenomenological definitions always point to antecedents and consequents. I then point out that definitions of antecedents and consequents can be given either in terms of causes or in terms of reasons, and that causes and reasons belong to two incompatible languages. Causes exist independently of persons and reasons exist only for persons. Only the latter belong to psychology, as I see it. The working of the system of psycho-logic is illustrated by an analysis of the conditions of trust. I conclude that psychological terms should be defined by means of semantic primitives, and that one should try to organize them in an axiomatic system. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

临床流行病学和循证医学的学科建设

临床流行病学是在临床医学领域内引入现代流行病学和统计学方法,从患病个体诊治扩大到患病群体研究,以探讨疾病病因、预防、诊断、治疗、预后等规律的临床基础学科。循证医学的核心思想是通过检索、评价和应用证据,结合医生技术经验和患者的具体情况,经医患共同决策作出符合患者需求的利大于弊的诊疗决定。加拿大McMaster大学的David Sackett及其学生Gorden Guyatt先后对临床流行病学这门学科的建立、完善和传播,对循证医学概念的提出、发展和推动,起到了里程碑式的作用。20世纪80年代初,我国第一批追随David Sackett的医生方法学家引入了临床流行病学的核心思想,即临床研究的设计、测量和评价,90年代又引入了循证医学的理念。30年来,临床流行病学和循证医学在我国生根、发芽、开花、结果,对我国现代医学的发展起到了巨大推动作用。在全面建设"健康中国"的新时代,加强临床流行病学和循证医学的学科建设刻不容缓。     

Underage drinking among young adolescent girls: The role of family processes.

Guided by family interaction theory, this study examined the influences of psychological, peer, and familial processes on alcohol use among young adolescent girls and assessed the contributions of familial factors. An ethnically diverse sample of 1,187 pairs of girls (M age = 12.83 years), and their mothers completed surveys online. Questionnaires assessed girls’ lifetime and recent alcohol use, as well as girls’ demographic, psychological, peer, and family characteristics. Hierarchical logistic regression models showed that although girls’ drinking was associated with a number of psychological and peer factors, the contributions of family domain variables to girls’ drinking were above and beyond that of psychological and peer factors. The interaction analyses further highlighted that having family rules, high family involvement, and greater family communication may offset risks in psychological and peer domains. Study findings underscore the multifaceted etiology of drinking among young adolescent girls and assert the crucial roles of familial processes. Prevention programs should be integrative, target processes at multiple domains, and include work with parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fundamental Clock of Biological Aging: Convergence of Molecular,Neurodegenerative, Cognitive and Psychiatric Pathways: Non-Equilibrium Thermodynamics Meet Psychology

In humans, age-associated degrading changes, widely observed in molecular and cellular processes underly the time-dependent decline in spatial navigation, time perception, cognitive and psychological abilities, and memory. Cross-talk of biological, cognitive, and psychological clocks provides an integrative contribution to healthy and advanced aging. At the molecular level, genome, proteome, and lipidome instability are widely recognized as the primary causal factors in aging. We narrow attention to the roles of protein aging linked to prevalent amino acids chirality, enzymatic and spontaneous (non-enzymatic) post-translational modifications (PTMs ^SP), and non-equilibrium phase transitions. The homochirality of protein synthesis, resulting in the steady-state non-equilibrium condition of protein structure, makes them prone to multiple types of enzymatic and spontaneous PTMs, including racemization and isomerization. Spontaneous racemization leads to the loss of the balanced prevalent chirality. Advanced biological aging related to irreversible PTMs ^SP has been associated with the nontrivial interplay between somatic (molecular aging) and mental (psychological aging) health conditions. Through stress response systems (SRS), the environmental and psychological stressors contribute to the age-associated “collapse” of protein homochirality. The role of prevalent protein chirality and entropy of protein folding in biological aging is mainly overlooked. In a more generalized context, the time-dependent shift from enzymatic to the non-enzymatic transformation of biochirality might represent an important and yet underappreciated hallmark of aging. We provide the experimental arguments in support of the racemization theory of aging.     

The Molecular Basis and Pathophysiology of Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a complex orofacial pain syndrome characterized by the paroxysmal onset of pain attacks in the trigeminal distribution. The underlying mechanism for this debilitating condition is still not clearly understood. Decades of basic and clinical evidence support the demyelination hypothesis, where demyelination along the trigeminal afferent pathway is a major driver for TN pathogenesis and pathophysiology. Such pathological demyelination can be triggered by physical compression of the trigeminal ganglion or another primary demyelinating disease, such as multiple sclerosis. Further examination of TN patients and animal models has revealed significant molecular changes, channelopathies, and electrophysiological abnormalities in the affected trigeminal nerve. Interestingly, recent electrophysiological recordings and advanced functional neuroimaging data have shed new light on the global structural changes and the altered connectivity in the central pain-related circuits in TN patients. The current article aims to review the latest findings on the pathophysiology of TN and cross-examining them with the current surgical and pharmacologic management for TN patients. Understanding the underlying biology of TN could help scientists and clinicians to identify novel targets and improve treatments for this complex, debilitating disease.     

高校新生心理适应与思想政治教育工作探微

大学生的心理健康目前越来越受到关注.促进大学生心理健康必须从新生的心理适应抓起.探讨大学新生心理适应问题的各种表现,研究相应的对策,明确高校思想政治教育工作者的责任,对于促进新生良好适应大学生活,保持心理健康具有重大意义.