BACKGROUND & AIMS: :Pharmacotherapies for the behavioural and psychological symptoms of dementia are limited; novel agents for the symptoms are still needed. Herein, we report the case of an 80-year-old male patient with Alzheimer's disease whose severe agitation, insomnia and sexual delusions were successfully treated with a traditional natural Japanese (Kampo) medicine, keishi-ka-ryukotsu-borei-to. We found that administrating keishi-ka-ryukotsu-borei-to increased his serum luteinizing hormone level, which could be inversely associated with his behavioural and psychological symptoms. This report suggests that keishi-ka-ryukotsu-borei-to is a possible alternative treatment for the behavioural and psychological symptoms of dementia, especially sexual delusions.

背景与目标： : 针对痴呆症的行为和心理症状的药物疗法有限; 仍然需要针对这些症状的新型药物。在此，我们报告了一名80岁的男性阿尔茨海默氏病患者，其严重的躁动，失眠和性妄想已成功地用传统的天然日本 (Kampo) 药物keishi-ka-ryukotsu-borei-too治疗。我们发现，服用keishi-ka-ryukotsu-borei-会增加他的血清黄体生成激素水平，这可能与他的行为和心理症状成反比。该报告表明，keishi-ka-ryukotsu-borei-too可能是治疗痴呆症的行为和心理症状，尤其是性妄想的替代疗法。

BACKGROUND & AIMS: :The aim of this study was to assess the efficacy and safety of tandospirone, a 5-HT1A partial agonist, for treatment of behavioural and psychological symptoms of dementia (BPSD). Thirteen outpatients with DSM-IV diagnosis of Alzheimer's type or vascular dementia were enrolled in this study. Their BPSD and cognitive functions were evaluated with the Neuropsychiatric Inventory (NPI) and Mini-Mental State Examination, respectively, for an 8-wk period of treatment. The maximum benefit of tandospirone was achieved at a mean dose of 19.6 mg/d. There were significant improvements in the NPI subscores for delusion, agitation, depression, anxiety, and irritability at 2 or 4 wk after the start of administration of tandospirone. No patients experienced severe adverse effects. The results suggest that tandospirone was effective at improving BPSD symptoms and well-tolerated in elderly demented patients.

背景与目标： : 这项研究的目的是评估5-HT1A部分激动剂坦度螺酮治疗痴呆症 (BPSD) 的行为和心理症状的疗效和安全性。本研究招募了13例dsm-iv诊断为阿尔茨海默氏型或血管性痴呆的门诊患者。在8周的治疗时间内，分别通过神经精神病学量表 (NPI) 和迷你精神状态检查评估了他们的BPSD和认知功能。在19.6 mg/d的平均剂量下实现了坦度螺酮的最大益处。在开始服用坦度螺酮后的2或4周，对妄想，躁动，抑郁，焦虑和易怒的NPI子评分有显着改善。没有患者出现严重的不良反应。结果表明，坦度螺酮可有效改善老年痴呆患者的BPSD症状，并且耐受性良好。

BACKGROUND & AIMS: :We examined whether constructs outlined in self-determination theory (Deci & Ryan, 2002), namely, autonomy-supportive and controlling motivational climates and autonomous and controlled motivation, were related to attitudes toward performance-enhancing drugs (PEDs) in sport and drug-taking susceptibility. We also investigated moral disengagement as a potential mediator. We surveyed a sample of 224 competitive athletes (59% female; M age = 20.3 years; M = 10.2 years of experience participating in their sport), including 81 elite athletes. Using structural equation modeling analyses, our hypothesis proposing positive relationships with controlling climates, controlled motivation, and PEDs attitudes and susceptibility was largely supported, whereas our hypothesis proposing negative relationships among autonomous climate, autonomous motivation, and PEDs attitudes and susceptibility was not supported. Moral disengagement was a strong predictor of positive attitudes toward PEDs, which, in turn, was a strong predictor of PEDs susceptibility. These findings are discussed from both motivational and moral disengagement viewpoints.

背景与目标： : 我们研究了自我决定理论 (Deci & Ryan，2002) 中概述的结构，即自主支持和控制动机气候以及自主和控制动机，是否与运动和药物对提高表现药物 (ped) 的态度有关吸毒易感性。我们还调查了道德脱离作为潜在调解人的情况。我们调查了224名竞技运动员 (59% 名女性; M年龄 = 20.3岁; M = 10.2年参加运动的经验) 的样本，其中包括81名精英运动员。使用结构方程模型分析，我们的假设提出了与控制气候，受控动机以及PEDs态度和敏感性之间的正相关关系，而我们的假设提出了自主气候，自主动机以及PEDs态度和敏感性之间的负相关关系，则没有得到支持。道德脱离是对ped积极态度的有力预测因素，而这反过来又是ped易感性的有力预测因素。从动机和道德脱离的角度讨论了这些发现。

BACKGROUND & AIMS: :This Special Issue of Clinical Psychology: Science and Practice provides a series of articles detailing efforts to consider the concepts of emotion and emotion regulation in relation to clinical assessment and psychopathology intervention efforts across the lifespan. In our commentary, we review some common themes and challenges presented in these articles to move forward the discussion of emotion's role in psychological therapy. We discuss efforts to conceptualize the role of context in defining emotion concepts and maximizing the relevancy of such concepts to treatment. We review the importance of imbuing efforts to develop emotion-focused treatments with emphases on positive, as well as negative, emotions and flexibility in the expression of these emotions. We also highlight the relevance of a lifespan developmental approach to the accurate use of emotion and emotion regulation concepts within treatment. Finally, we discuss the application of these issues to our own treatment development and evaluation efforts regarding a unified approach to the treatment of emotional disorders in adults and adolescents.

背景与目标： : 本期《临床心理学: 科学与实践》特刊提供了一系列文章，详细介绍了在整个生命周期中考虑与临床评估和精神病理学干预工作相关的情绪和情绪调节概念的努力。在我们的评论中，我们回顾了这些文章中提出的一些常见主题和挑战，以推进对情感在心理治疗中的作用的讨论。我们讨论了将上下文在定义情感概念中的作用概念化并最大程度地提高这些概念与治疗的相关性的努力。我们回顾了努力开发以情绪为中心的治疗方法的重要性，重点是积极，消极的情绪和这些情绪表达的灵活性。我们还强调了寿命发展方法与在治疗中准确使用情绪和情绪调节概念的相关性。最后，我们讨论了这些问题在我们自己的治疗开发和评估工作中的应用，以统一的方法治疗成人和青少年的情绪障碍。

BACKGROUND & AIMS: :This study was aimed at determining the effects of dancing on the health status of older persons. A pool of 111 community-dwelling subjects were allocated to either an intervention group (IG), which included 23 sessions of dance over 12 weeks, or a control group (CG). All participants were assessed at baseline and 12 weeks. Physical outcome measures included the 6-min timed walking test (6MWT), trunk flexibility, body composition, lower limb endurance and strength, balance, the timed up-and-go test (TUG), resting heart rate and blood pressure. Quality of life was assessed by the Medical Outcomes Survey Short Form (SF-36) questionnaire. The IG's views toward dancing were also evaluated at 12 weeks. Significant difference was observed between the groups in six outcome measures: mean change in resting heart rate, 6MWT, TUG, lower limb endurance and the 'general health' and 'bodily pain' domains of SF-36. The majority of the dance group felt the intervention improved their health status. These findings demonstrate that dancing has physical and psychological benefits, and should be promoted as a form of leisure activity for senior citizens.

背景与目标： : 这项研究旨在确定跳舞对老年人健康状况的影响。将111个社区居住的受试者分配给干预组 (IG) 或对照组 (CG)，干预组 (IG) 包括12周的23次舞蹈。所有参与者均在基线和12周进行评估.身体结果指标包括6分钟定时步行测试 (6MWT)，躯干柔韧性，身体成分，下肢耐力和力量，平衡，定时上行测试 (TUG)，静息心率和血压。生活质量通过医疗结果调查 (SF-36) 问卷进行评估。IG对舞蹈的看法也在12周时进行了评估。在六个结果指标中，两组之间观察到显着差异: 静息心率，6MWT，TUG，下肢耐力以及SF-36的 “总体健康” 和 “身体疼痛” 领域的平均变化。大多数舞蹈团认为干预措施改善了他们的健康状况。这些发现表明，舞蹈具有身体和心理上的益处，应作为老年人休闲活动的一种形式加以推广。

BACKGROUND & AIMS: BACKGROUND:Cognitive Behaviour Therapy (CBT) is the front-line psychological intervention for step 3 within UK psychological therapy services. Counselling is recommended only when other interventions have failed and its effectiveness has been questioned. METHOD:A secondary data analysis was conducted of data collected from 33,243 patients across 103 Improving Access to Psychological Therapies (IAPT) services as part of the second round of the National Audit of Psychological Therapies (NAPT). Initial analysis considered levels of pre-post therapy effect sizes (ESs) and reliable improvement (RI) and reliable and clinically significant improvement (RCSI). Multilevel modelling was used to model predictors of outcome, namely patient pre-post change on PHQ-9 scores at last therapy session. RESULTS:Counselling received more referrals from patients experiencing moderate to severe depression than CBT. For patients scoring above the clinical cut-off on the PHQ-9 at intake, the pre-post ES (95% CI) for CBT was 1.59 (1.58, 1.62) with 46.6% making RCSI criteria and for counselling the pre-post ES was 1.55 (1.52, 1.59) with 44.3% of patients meeting RCSI criteria. Multilevel modelling revealed a significant site effect of 1.8%, while therapy type was not a predictor of outcome. A significant interaction was found between the number of sessions attended and therapy type, with patients attending fewer sessions on average for counselling [M = 7.5 (5.54) sessions and a median (IQR) of 6 (3-10)] than CBT [M = 8.9 (6.34) sessions and a median (IQR) of 7 (4-12)]. Only where patients had 18 or 20 sessions was CBT significantly more effective than counselling, with recovery rates (95% CIs) of 62.2% (57.1, 66.9) and 62.4% (56.5, 68.0) respectively, compared with 44.4% (32.7, 56.6) and 42.6% (30.0, 55.9) for counselling. Counselling was significantly more effective at two sessions with a recovery rate of 34.9% (31.9, 37.9) compared with 22.2% (20.5, 24.0) for CBT. CONCLUSIONS:Outcomes for counselling and CBT in the treatment of depression were comparable. Research efforts should focus on factors other than therapy type that may influence outcomes, namely the inherent variability between services, and adopt multilevel modelling as the given analytic approach in order to capture the naturally nested nature of the implementation and delivery of psychological therapies. It is of concern that half of all patients, regardless of type of intervention, did not show reliable improvement.

背景与目标：

BACKGROUND & AIMS: :Individuals with chronic pain are at an elevated risk of suicide, yet psychosocial factors that might be involved in increasing or decreasing vulnerability for suicidal ideation and behaviour have received little attention. Extant literature on the topic of suicide in individuals with chronic pain incorporates only a few of the wide array of known vulnerability and protective factors. This Review focuses on transdiagnostic psychological processes, (ie, those of relevance for both chronic pain and suicide). We reviewed a selection of published literature on chronic pain and suicide, concentrating on previously unexplored and underexplored lines of research, including future orientation, mental imagery, and psychological flexibility. A greater degree of crosspollination between the fields of chronic pain and suicide research is required to progress our understanding of why some people with chronic pain become suicidal and others do not.

背景与目标： : 患有慢性疼痛的人自杀的风险较高，但是可能与增加或减少自杀观念和行为的脆弱性有关的社会心理因素很少受到关注。关于慢性疼痛患者自杀的现有文献仅纳入了各种已知的脆弱性和保护因素中的少数。本文的重点是跨诊断心理过程 (即与慢性疼痛和自杀相关的过程)。我们回顾了一些有关慢性疼痛和自杀的已发表文献，重点是以前尚未探索和尚未探索的研究领域，包括未来取向，心理意象和心理灵活性。需要在慢性疼痛和自杀研究领域之间进行更大程度的交叉研究，以加深我们对为什么某些患有慢性疼痛的人自杀而另一些人没有自杀的理解。

BACKGROUND & AIMS: AIM:The prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population has been estimated to be 5.9%, 3.3% and 4.4% respectively. The aim of this study was to determine whether psychological problems are more prevalent following colorectal surgery. METHOD:Patients who had undergone colorectal resection in a 2-year period across four centres were asked to complete validated screening questionnaires for anxiety, depression and PTSD (GAD-7, PHQ-9, PCL-5) 12-48 months after surgery. Risk factors were identified using multiple linear regression analysis. RESULTS:After excluding those who had died or received palliative diagnoses, questionnaires were sent to 1150 patients. 371 responded (32.3% response rate); median age 67 (20-99) years; 51% were men. 58% of patients underwent surgery for cancer; 23% had emergency surgery. 28% of patients screened positive for at least one psychological condition, with 20% screening positive for anxiety, 22% for depression and 14% for PTSD. Patients who were younger, women, had surgery as an emergency, for benign conditions, had stomas and had critical care stay were more likely to have poorer psychological outcomes. Multiple linear regression found that only younger age (P = 0.000) and female gender (P = 0.048) were significant risk factors. CONCLUSION:The prevalence of anxiety, depression and PTSD appears to be high in patients who have undergone colorectal surgery. Younger patients and women are particularly at risk. Further work is needed to determine how best to prevent, detect and treat people with adverse psychological outcomes following colorectal surgery.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Although pregnancy was once thought of as a time of emotional wellbeing for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. OBJECTIVES:The primary objective of this review is to assess the effects, on mothers and their families, of psychosocial and psychological interventions compared with usual antepartum care in the treatment of antenatal depression. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (July 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to July 2006), EMBASE (1980 to July 2006) and CINAHL (1982 to July 2006). We also scanned secondary references and contacted experts in the field to identify other published or unpublished trials. SELECTION CRITERIA:All published, unpublished and ongoing randomised controlled trials of preventive psychosocial or psychological interventions in which the primary or secondary aim is to treat antenatal depression. We excluded quasi-randomised trials (for example, those randomised by delivery date, or odd versus even medical record numbers) from the analysis. DATA COLLECTION AND ANALYSIS:All review authors participated in the evaluation of methodological quality and data extraction. Results are presented using relative risk for categorical data and weighted mean difference for continuous data. MAIN RESULTS:One US trial was included in this review, incorporating 38 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Interpersonal psychotherapy, compared to a parenting education program, was associated with a reduction in the risk of depressive symptomatology immediately post-treatment using the Clinical Global Impression Scale (one trial, n = 38; relative risk (RR) 0.46, 95% confidence interval (CI) 0.26 to 0.83) and the Hamilton Rating Scale for Depression (one trial, n = 38; RR 0.82, 95% CI 0.65 to 1.03). AUTHORS' CONCLUSIONS:The evidence is inconclusive to allow us to make any recommendations for interpersonal psychotherapy for the treatment of antenatal depression. The one trial included was too small, with a non-generalisable sample, to make any recommendations.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The aim was to examine how traumatic and stressful events, responses to violence, child characteristics, and mothering quality, as measured in middle childhood predict psychological distress and positive resources in adolescence. METHOD:The participants were 65 Palestinian adolescents (17+/-.85 years; 52% girls), who had been studied during the First Intifada (T1), during the Palestinian Authority rule (T2) and before the Second Al Aqsa Intifada (T3) in Gaza. Psychological distress was indicated by PTSD, and depressive symptoms and positive resources by resilient attitudes and satisfaction with quality of life, all measured at T3. The predictors that were measured at T1 were exposure to military violence, active coping with violence and children's intelligence, cognitive capacity, and neuroticism. Mothering quality and stressful life-events were measured at T2, the former reported by both the mother and the child, and the latter by the mother. RESULTS:Adolescents' PTSD symptoms were most likely if they had been exposed to high levels of traumatic and stressful experiences and had poor cognitive capacity and high neuroticism in middle childhood. Only high levels of childhood military violence and stressful life-events predicted high depressive symptoms and low satisfaction with quality of life in adolescence. CONCLUSIONS:Military violence in childhood forms risks for both increased psychological distress and decreased positive resources. However, child characteristics such as cognitive capacity and personality are important determinants of psychological vulnerability in military trauma.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:Improving Access to Psychological Therapies (IAPT) is a national-level dissemination programme for provision of evidence-based psychological treatments for anxiety and depression in the United Kingdom. This paper sought to review and meta-analyse practice-based evidence arising from the programme. DESIGN:A pre-registered (CRD42018114796) systematic review and meta-analysis. METHODS:A random effects meta-analysis was performed only on the practice-based IAPT studies (i.e. excluding the clinical trials). Subgroup analyses examined the potential influence of particular methodologies, treatments, populations, and target conditions. Sensitivity analyses investigated potential sources of heterogeneity and bias. RESULTS:The systematic review identified N = 60 studies, with N = 47 studies suitable for meta-analysis. The primary meta-analysis showed large pre-post treatment effect sizes for depression (d = 0.87, 95% CI [0.78-0.96], p < .0001) and anxiety (d = 0.88, 95% CI [0.79-0.97], p < .0001), and a moderate effect on functional impairment (d = 0.55, 95% CI [0.48-0.61], p < .0001). The methodological features of studies influenced ESs (e.g., such as whether intention-to-treat or completer analyses were employed). CONCLUSIONS:Current evidence suggests that IAPT enables access to broadly effective evidence-based psychological therapies for large numbers of patients. The limitations of the review and the clinical and methodological implications are discussed. PRACTITIONER POINTS:IAPT interventions are associated with large pre-post treatment effect sizes in depression and anxiety measures. IAPT interventions are associated with moderate treatment effect sizes with regards to work and social adjustment. A reduction in dropout and also the prevention of post-treatment relapse via the offer of follow-up support are important areas for future development.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:The purpose of this study is to detail the natural coping strategies used by children involved in everyday road traffic accidents (RTAs). The relationship between coping strategies, post-traumatic stress disorder (PTSD), gender and age was investigated. DESIGN:Children aged 7-18 who attended an accident and emergency department following involvement in a RTA were assessed, 6 weeks after their accident (N = 97). A subgroup of 36 children were re-assessed approximately 8 months after the trauma. METHODS:The presence of PTSD was determined via a semi-structured interview incorporating the Clinician Administered Post-traumatic Scale for Children (CAPS-C). Self-completed psychometric assessments were undertaken to assess the presence of clinically significant levels of depression (Birleson Depression Inventory), anxiety (Revised Manifest Anxiety Scale) and coping style (Kidcope). RESULTS:Children involved in RTAs used between 5 and 7 different coping strategies. Younger children and those with PTSD used more strategies than older children and those not suffering from PTSD. Children with PTSD were more likely to use the strategies of distraction, social withdrawal, emotional regulation and blaming others. CONCLUSION:The limitations of Kidcope are discussed and the need to develop more complex ways of assessing childhood coping within a developmental framework highlighted.

背景与目标：

BACKGROUND & AIMS: :Recent research in the field of chronic pain has highlighted the importance of the assessment of psychological factors as part of the overall assessment of the chronic pain patient. Reliance only on self report of pain is inadequate. A number of different approaches have been taken to psychological evaluation, ranging from formal assessment of psychiatric illness to self-report questionnaires and clinical evaluation. In this chapter, each of the major types of assessment is described and illustrated with examples of specific tests or assessment instruments. The chapter highlights research which has attempted to appraise the relative value of different sorts of psychological information in assessment of the impact of pain or in the patient's response to treatment. Recommendations for the design of a simple comprehensive system for chronic pain are made.

背景与目标： : 慢性疼痛领域的最新研究强调了心理因素评估作为慢性疼痛患者总体评估的一部分的重要性。仅依靠痛苦的自我报告是不够的。心理评估采用了多种不同的方法，从精神疾病的正式评估到自我报告问卷和临床评估。在本章中，以特定测试或评估工具的示例描述和说明每种主要评估类型。本章重点介绍了试图评估不同类型的心理信息在评估疼痛影响或患者对治疗反应中的相对价值的研究。提出了设计简单的慢性疼痛综合系统的建议。

BACKGROUND & AIMS: OBJECTIVE:Studies in the general population report that unusual subjective experiences are relatively common. Such experiences have been conceptualized either as extreme personality traits or as vulnerability markers for psychosis, and often grouped under the expression "schizotypal experiences". This study investigates the heterogeneity of schizotypal traits using factor and latent class analysis. METHODS:One thousand and thirty-two adolescents were recruited for this study. Schizotypal experiences were assessed with the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE); psychological distress was assessed with the General Health Questionnaire (GHQ). Confirmatory Factorial Analysis (CFA) and Latent Class Analysis (LCA) were performed on the O-LIFE and on the association with the GHQ and demographic variables. RESULTS:CFA replicated the original 4-factor structure of the O-LIFE. Three latent classes (LC) of schizotypal features were identified: participants in LC1 (26% of the total sample) showed minimal level of item endorsement; LC2 accounted for 52% of the sample and showed overall higher item endorsement compared to LC1, especially for disorganization and positive signs of schizotypy, but not for negative affective items. LC3 (22%) showed an overall higher level of item endorsement across schizotypal dimensions, and positive association with psychological distress and family history of psychosis. DISCUSSION:Different latent class of schizotypal features can be empirically defined in adolescent community samples. The most extreme class is defined not only by a profile of higher positive replies to the items, but also by anhedonia, high psychological distress, and family history of psychosis. These findings can inform prevention research in schizophrenia.

背景与目标：

BACKGROUND & AIMS: :Posttraumatic stress disorder (PTSD) symptoms and pain after traumatic events such as motor vehicle collision (MVC) have been proposed to be mutually promoting. We performed a prospective multicenter study that enrolled 948 individuals who presented to the emergency department within 24 hours of MVC and were discharged home after evaluation. Follow-up evaluations were completed 6 weeks, 6 months, and 1 year after MVC. Path analysis results supported the hypothesis that axial pain after MVC consistently promotes the maintenance of hyperarousal and intrusive symptoms, from the early weeks after injury through 1 year. In addition, path analysis results supported the hypothesis that one or more PTSD symptom clusters had an influence on axial pain outcomes throughout the year after MVC, with hyperarousal symptoms most influencing axial pain persistence in the initial months after MVC. The influence of hyperarousal symptoms on pain persistence was only present among individuals with genetic vulnerability to stress-induced pain, suggesting specific mechanisms by which hyperarousal symptoms may lead to hyperalgesia and allodynia. Further studies are needed to better understand the specific mechanisms by which pain and PTSD symptoms enhance one another after trauma, and how such mechanisms vary among specific patient subgroups, to better inform the development of secondary preventive interventions.

背景与目标： : 创伤后应激障碍 (PTSD) 的症状和创伤事件 (例如机动车碰撞 (MVC)) 后的疼痛被认为是相互促进的。我们进行了一项前瞻性多中心研究，招募了948名在MVC 24小时内就诊至急诊科并在评估后出院的人。在MVC后6周，6个月和1年完成随访评估。路径分析结果支持以下假设: 从受伤后的最初几周到1年，MVC后的轴向疼痛始终促进过度唤醒和侵入性症状的维持。此外，路径分析结果支持以下假设: 一个或多个PTSD症状群在MVC后的一年中对轴向疼痛结果有影响，在MVC后的最初几个月中，过度唤醒症状最会影响轴向疼痛的持续。过度唤醒症状对疼痛持续性的影响仅在遗传易受压力引起的疼痛的个体中存在，提示过度唤醒症状可能导致痛觉过敏和异常性疼痛的特定机制。需要进一步的研究来更好地了解创伤后疼痛和PTSD症状相互增强的具体机制，以及这些机制在特定患者亚组之间如何变化，以便更好地为二级预防干预措施的发展提供信息。