医学院校护理本科生逆商四维度培养路径的探索

如何提高医学院校护理本科生在应对公共卫生突发事件时逆转困境的能力,是亟待深入研究的问题。通过培养学生的逆商,提高学生逆商水平,是培养这种能力的一种有效的途径。本文阐明了逆商构成的4个维度,分析了护理专业大学生四维逆商形成的因素;提出了将四维逆商培养融入护理专业教育体系中,建立四维逆商水平评价体系和机制的路径;介绍了在护理专业实践教学中,通过倾听和沟通交流培养逆商的方法。     

Childhood adversity in alcohol- and drug-dependent women presenting to out-patient treatment

Eighty alcohol- and/or drug-dependent women who were consecutive admissions to a representative out-patient alcohol and drug service in Christchurch were interviewed with the aim of establishing the extent of exposure to childhood adversity including childhood sexual, physical and emotional abuse and parental problems. The results show that a sizeable percentage of the women came from backgrounds characterized by parental conflict and alcohol and drug problems. Within their first 15 years 51% were subjected to sexual abuse involving attempted or completed oral, anal or vaginal intercourse and 39% were exposed regularly to physical abuse perpetrated by their parents or main parental figures. Over half reported experiencing emotional abuse rated as being 'very distressing' and two-thirds had been exposed to 'very distressing' parental problems. The main implication for clinical practice arising from the results of this study is the need for the development of a broader approach to alcohol and drug service provision. In order to achieve positive treatment outcomes, alcohol and drug services may need to routinely screen and plan treatment for childhood adversity and associated problems in all clients presenting for alcohol and drug treatment.     

歧视知觉、逆境评价和流动人口心理适应的关系

目的:深入探讨流动人口歧视知觉、逆境评价与心理适应之间的作用。方法:采取方便取样的方式,在北京和杭州两地共抽取328名农村流动人口为被试。结果:①流动人口的平均流动时间接近7年,流动城市数目为2.79个,流动性为0.65±0.77;②男性的歧视知觉显著高于女性,高流动性群体的歧视知觉显著高于低流动性群体,同时,流动性越高,歧视知觉越高,自尊越低;③流动人口歧视知觉对心理适应的预测作用部分通过逆境评价来实现。结论:逆境评价在流动人口歧视知觉和心理适应之间发挥着部分中介作用。     

Early experience unpredictability in child development as a model for understanding the impact of the COVID-19 pandemic: A translational neuroscience perspective

Extensive evidence links adverse experiences during childhood to a wide range of negative consequences in biological, socioemotional, and cognitive development. Unpredictability is a core element underlying most forms of early adversity; it has been a focus of developmental research for many years and has been receiving increasing attention recently. In this article, we propose a conceptual model to describe how unpredictable and adverse early experiences affect children’s neurobiological, behavioral, and psychological development in the context of the COVID-19 pandemic. We first highlight the critical role of unpredictability in child development by reviewing existing conceptual models of early adversity as they relate to subsequent development across the lifespan. Then, we employ a translational neuroscience framework to summarize the current animal- and human-based evidence on the neurobiological alterations induced by early experience unpredictability. We further argue that the COVID-19 pandemic serves as a global “natural experiment” that provides rare insight to the investigation of the negative developmental consequences of widespread, clustered, and unpredictable adverse events among children. We discuss how the pandemic helps advance the science of unpredictable early adverse experiences. As unpredictability research continues to grow, we highlight several directions for future studies and implications for policymaking and intervention practices.     

The social environment and IL-6 in rats and humans

Inflammatory cytokine levels predict a wide range of human diseases including depression, cardiovascular disease, type 2 diabetes, autoimmune disease, general morbidity, and mortality. Stress and social experiences throughout the lifecourse have been associated with inflammatory processes. We conducted studies in humans and laboratory rats to examine the effect of early life experience and adult social position in predicting IL-6 levels. Human participants reported family homeownership during their childhood and current subjective social status. Interleukin-6 (IL-6) was measured from oral mucosal transudate. Rats were housed in groups of three, matched for quality of maternal care received. Social status was assessed via competition for resources, and plasma IL-6 was assessed in adulthood. In both humans and rats, we identified an interaction effect; early social experience moderated the effect of adult social status on IL-6 levels. Rats that experienced low levels of maternal care and people with low childhood socioeconomic status represented both the highest and lowest levels of IL-6 in adulthood, depending on their social status as young adults. The predicted interaction held for non-Hispanic people, but did not occur among Hispanic individuals. Adversity early in life may not have a monotonically negative effect on adult health, but may alter biological sensitivity to later social experiences.     

MAOA Alters the Effects of Heavy Drinking and Childhood Physical Abuse on Risk for Severe Impulsive Acts of Violence Among Alcoholic Violent Offenders

Background: A polymorphism in the promoter region of the monoamine oxidase A gene (MAOA) has been shown to alter the effect of persistent drinking and childhood maltreatment on the risk for violent and antisocial behaviors. These findings indicate that MAOA could contribute to inter‐individual differences in stress resiliency. Methods: Recidivism in severe violent crimes was assessed after 8 years of nonincarcerated follow‐up in a male sample of 174 impulsive Finnish alcoholic violent offenders, the majority of whom exhibited antisocial (ASPD) or borderline personality disorder (BPD) or both. We examined whether MAOA genotype alters the effects of heavy drinking and childhood physical abuse (CPA) on the risk for committing impulsive recidivistic violent crimes. Results: Logistic regression analyses showed that both heavy drinking and CPA were significant independent predictors of recidivism in violent behavior (OR 5.2, p = 0.004 and OR 5.3, p = 0.003) among offenders having the high MAOA activity genotype (MAOA‐H), but these predictors showed no effect among offenders carrying the low MAOA activity genotype (MAOA‐L). Conclusion: Carriers of the MAOA‐H allele have a high risk to commit severe recidivistic impulsive violent crimes after exposure to heavy drinking and CPA.     

Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents

This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.     

Défaite sociale et schizophrénie : hypothèses,arguments, mécanismes

There is growing evidence for a main role of environment in the occurrence of mental disorders such as a psychosocial risk factor, for example, childhood trauma, discrimination linked to minority status, or migrant status. One hypothesis is that social adversity factors influence the risk of schizophrenia through a common pathway: social defeat which could be defined as the impotence of a subject in the face of a situation of social adversity, with a consequential experience of devaluation on the social scale. This review proposes to explain the animal model of social defeat which provides an overview of the neurobiological consequences of chronic stress. Then, we expose this topic in humans, the assessment methods, and its psychopathological field. Finally, we expose epidemiologic and neurobiological evidences, in particular the dopaminergic sensitization process, which provide evidence of a significant role of social defeat in schizophrenia risk due to exposure to psychosocial factors. This etiopathogenic hypothesis has several issues. First, a common pathway to several environmental risk factors could allow an ethiopathogenic model more parcimonious for schizophrenia. It could also allow the assessment and prevention of adversity factors involved in social defeat so as to finally improve the outcome of subjects who have an individual risk for schizophrenia.