脑外伤患者的SPECT显像与CT对比观察

对４８例脑外伤２进行了＾９９ｍＴｃ－ＥＣＤ ＳＰＥＣＴ脑血流灌注显像。其中４１例在ＳＰＥＣＴ检查的前后两周同时行脑ＣＴ检查，结果ＳＰＥＣＴ对轻、中、重型外伤的检出率分别为６０％、９０％和１００％；而ＣＴ分别为１０％、６０％和１００％，同一病人中ＳＰＥＣＴ比ＣＴ发现的病灶早、数目多，范围大。对脑外伤综合征及后遗症ＳＰＥＣＴ检出率分别为８０％和９０％，ＣＴ分别为２５％和７１．４２％。显然ＳＰＥＣＴ探测     

Review of A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD).

Reviews the book, A clinical handbook/practical therapist manual for assessing and treating adults with post-traumatic stress disorder (PTSD) by Donald Meichenbaum (see record 1995-97286-000). This text is a much needed addition in the burgeoning field that is coming to be called "psychotraumatology," including critical incident debriefing and related phenomena. Few fields of psychopathology have been fortunate enough to attract the attention of practitioners with the level of skill that Don Meichenbaum shows in this Manual, and his sobering, careful analysis of the traumatology literature in several very controversial areas deserves kudos. The reality is that this Handbook/Manual is in fact both a relatively comprehensive overview of the Post-Traumatic Stress Disorder literature, as well as a guidebook for treatment intervention strategies. Moreover, it is replete with appropriate cautions about variables that can interfere with treatment progress, together with strategic suggestions for overcoming that interference. The Manual is not only tremendously diverse, but is exceptional in its standards of scholarship and its careful application of those scholarly standards even to the most controversial topics. The author is also extremely credible in his treatment of potential harm from clinical techniques, and the Manual is replete with several examples of documented pitfalls, whether from comorbidity, relapse with substance-abusing populations, or the potential for harm to some individuals from simple repetitions of traumatic experiences. All in all, the reviewer strongly encourages Psychotherapy readers to avail themselves of this extremely well-written and thoughtful text. Both the book itself and the topic of PTSD deserve the excellent coverage devoted to them by this outstanding psychotherapy clinician and researcher. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical characteristics of adults reporting repressed, recovered, or continuous memories of childhood sexual abuse.

The authors assessed women and men who either reported continuous memories of their childhood sexual abuse (CSA, n = 92), reported recovering memories of CSA (n = 38), reported believing they harbored repressed memories of CSA (n = 42), or reported never having been sexually abused (n = 36). Men and women were indistinguishable on all clinical and psychometric measures. The 3 groups that reported abuse scored similarly on measures of anxiety, depression, dissociation, and absorption. These groups also scored higher than the control group. Inconsistent with betrayal trauma theory, recovered memory participants were not more likely to report abuse by a parent or stepparent than were continuous memory participants. Rates of depression and posttraumatic stress disorder did not differ between the continuous and recovered memory groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commemorative Landscapes to the Missing: The HMAS Sydney II Memorial

The sinking of Australian cruiser HMAS Sydney II in a mutually destructive battle with the German HSK Kormoran off the Western Australian coast in November 1941 was a national tragedy amplified by the failure to find the wrecked cruiser until 2008. Uncertainty over the ship’s fate and its crew led to a frenzy of speculation. Parallel to this public interest was the will to commemorate the missing sailors somewhere along the coastline opposite the battle site. And so the HMAS Sydney II Memorial in Geraldton, a highly symbolic and emotive memory landscape, was built. This paper explores this memorial as a memorial landscape to ‘the missing’—a special category of military death—and examines how this landscape offers closure to the trauma of survivors and subsequent generations by providing a narrative landscape that attempts to heal distress caused by an absent body.     

Intense fear, helplessness, “and” horror? An empirical investigation of DSM-IV PTSD Criterion A2.

In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM–IV; American Psychiatric Association [APA]), an experiential response was added to the posttraumatic stress disorder (PTSD) traumatic stressor criterion (Criterion A). In addition to witnessing or experiencing an event involving serious threat to one's life or physical integrity (Criterion A1), a traumatic stressor must also evoke an intensely negative emotional response (Criterion A2), operationalized as “intense fear, helplessness, or horror” (emphasis added, p. 428). There has been some question about, but little empirical investigation of, the PTSD predictive value of Criterion A2. Toward this end, a study was conducted to examine differential rates of PTSD among individuals who met Criterion A2 by reporting 1, 2, or all 3 A2 responses. Participants included 205 military personnel, military retirees, and military family members who were receiving services from 4 treatment programs at an army medical center. Forty-three percent of individuals who reported all 3 A2 responses met diagnostic criteria for PTSD; however, only 9% of individuals who reported fewer than 3 A2 responses met criteria for PTSD. The results suggest that the definition of PTSD Criterion A2 may be too broad. A revision or refinement of Criterion A2 in the next edition of the DSM may be indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three psychoanalytic realities.

Psychoanalysis works with three views of reality: factual reality, psychic reality, and coconstructed reality. The history of clinical psychoanalytic thinking about trauma demonstrates that these realities are often in conflict with each other and that they have cycled in use without any consensus developing about which is most correct. These three realities have also been used without consensus by the broader mental health field and in the study of myths, indicating that these realities are fundamental ways of understanding ambiguous psychological data. The uncertainty as to which reality is most correct is resolved by recognizing that it is part of the human condition to be constantly differentiating and integrating these realities, and so we best help our patients by engaging with them in the process of applying all three, rather than by making definite static decisions about which is most applicable. This approach is demonstrated with clinical material. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping men with the trauma of miscarriage.

Although much has been written about women and miscarriage, little has been researched or written about the partners of these women and their reactions to the pregnancy loss. The purpose of this paper is to review what is known about the subject and to suggest an approach to psychotherapy that is sensitive to the needs of these men and helps them make sense of their loss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of "training the trainers" course for helping tsunami-survivor children on Sri Lankan disaster volunteer workers.

The authors evaluated the impact of a "training the trainers" course for helping Sri Lankan tsunami-survivor children on education and mental health disaster volunteers. Sixty-two disaster volunteers were randomly assigned to either a school-based (ERASE Stress) "training the trainers" course or to an alternative "befriending" program that served as a control group. Participants in the ERASE Stress course significantly improved their perception of self-efficacy as tsunami survivors' helpers (Disaster-Helper Self-Efficacy Scale), self-mastery (Mastery scale), and optimism about their personal future (item from the Children's Future Orientation Scale). In addition, the perceived ability to use cognitive coping strategies (Cognitive Emotion Regulation Questionnaire) such as refocusing on planning, positive reappraisal, and putting the trauma into perspective was enhanced. The ERASE Stress course may be an effective method for strengthening local community capacity to deal with trauma survivors in developing countries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of resilience, resistance, and distress during ongoing terrorism: The case of Jews and Arabs in Israel.

This is the 1st longitudinal examination of trajectories of resilience and resistance (rather than ill-being) among a national sample under ongoing threat of mass casualty. The authors interviewed a nationally representative sample of Jews and Arabs in Israel (N = 709) at 2 times during a period of terrorist and rocket attacks (2004?2005). The resistance trajectory, exhibiting few or no symptoms of traumatic stress and depression at both time points, was substantially less common (22.1%) than has previously been documented in studies following single mass casualty events. The resilience trajectory, exhibiting initial symptoms and becoming relatively nonsymptomatic, was evidenced by 13.5% of interviewees. The chronic distress trajectory was documented among a majority of participants (54.0%), and a small proportion of persons were initially relatively symptom-free but became distressed (termed delayed distress trajectory; 10.3%). Less psychosocial resource loss and majority status (Jewish) were the most consistent predictors of resistance and resilience trajectories, followed by greater socioeconomic status, greater support from friends, and less report of posttraumatic growth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mourning the loss of a child who has not died.

This article presents material from the treatment of a woman who experienced her living son as dead. This fantasy is interpreted both as a response to and defense against the trauma of loss. Shattered expectations and insecure attachment immure her in a relationship in which hope leads repeatedly to affective dysregulation and crushing disappointment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)