军队医学科技人员身心健康与影响因素的研究

To study the relationship between mental-physical health and coping behavior,job stress and job motivation in medical laboratory scientists and technicians. A cross-section survey was conducted,using the anxiety rating scale(SAS), depression rating scale(SDS), coping behavior rating scale,self-rating subhealth scale,self-rating stress scale,and self-rating job motivation scale among 289 medical laboratory scientists and technicians with analysis of ANOVA and Regression. The study was carried out in three steps:step1 is to analyze the general situation of the mental-physical health.Step 2 is to analyze the features of the main influencial facotors.Step 3 is to study the influence of the relative factors on mental-physical health.The following are the results: 1.The anxiety and depression scores of the medical researchers and technicians were 30±6 and 37±8 respectively,both significantly lower than those of the national norm（34±6 and 42±11 respectively,both P<0.01）,which are of significant difference. The depression score of the associate chief technician was 42±7, significantly higher than those of the medical researchers and technicians with any other professional titles (all P<0.05）, and the anxiety score of the associate chief technicians was 32±7, significantly higher than that of the research fellows（28±4, P<0.05），with no significant difference to the score of the medical researchers and technicians with other professional titles. The depression score,anxiety score and the subhealth score of the age group of 36～49 were 39±9,31±7 and 32±9 respectively, both higher than that of the age group of 20～35 （36±8,29±6 and 29±7 respectively,both P<0.05）,while there is much diference among other age groups. And the subhealth status has nothing to do with marital status,education background and professional titles. 2.The coping behaviors,job stress and motivation of the military medical laboratory scientists and technicians. 1）Coping behaviors:The seeking help score of the associate chief technicians was 2.8±0.5,not significantly different from that of the associate research fellows（2.8±0.5）,but significantly lower than those of the medical researchers and technicians with other professional titles(all P<0.01),and whose self-blame score was higher than that of the research fellows,which is of significant difference.The self-blame score and the imagination score of the associate research fellows were 2.0±0.5 and 2.4±0.5 respectively, significantly higher than that of the research fellows(1.6±0.4, 2.1±0.4,both P<0.01). The seeking help score of the females was 3.1±0.5, significantly higher than that of the males(2.9±0.5, both P<0.01),and the solving problem score was 3.4±0.6,significantly lower than the male(3.6±0.7, both P<0.01).There is no any significant difference in coping behaviors among researchers and technicians of different marital status,education background and age groups. 2)Job stress: The score of job stress of the age group of 35~49 and 50~60 were 23±8 and 25±6 respectively,significantly higher than that of the 20~35(21±7,both P<0.05). There is no any significant difference in job stress among researchers and technicians of different marital status,gender,professional titles and education background. 3)The score of meeting personal desire for reputation and interests of the males was 19.6±5.4，significantly higher than that of the females(18.4±5.0, both P<0.05), while there is no significant difference in job motivation among researchers and technicians of different titles,education,age and marital status. 3.The relationship of the mental-physical health of the military medical laboratory scientists and technicians with their coping behaviors,job stress and motivations 1) Coping behaviors:Regression analysis showed that, the best predictors of subhealth were anxiety,depression and escaping (β=-0.40,β=0.23, β=0.14, both P<0.01).the best predictors of anxiety and depression were active coping behaviors and negative coping behaviors (β=-0.40,β=0.40, both P<0.01).The moderate(rational) coping behaviors is the best predictor only of anxiety and of significant difference. 2)job stress : Regression analysis demonstrated that anxiety,depression,job stress 2 and job stress 4 are the best predictor for subhealth;job stress 12 is the best retro-predictor for depression; job stress 3 and 8 are the best predictor for depression;and job stress 2 and 9 are the best predictor for anxiety ,which are of significant difference. 3)Motivation:Regression analysis demonstrated that depression is the best predictor for subhealth while motivation itself doesn't predict subhealth;with respect to the specific contents of motivation,"probing unknown rules and making contributions to the human society "is the best retro-predictor for depression and has nothing to do with anxiety prediction. 4) The combined influences of coping behaviors,job stress and motivations: Regression analysis showed that, the best predictors for subhealth were anxiety,depression and job stress(β=0.41,β=0.24, β=0.19, both P<0.01).the best predictors for anxiety and depression were active coping behaviors and negative coping behaviors (β=-0.40,β=0.40, both P<0.01).The moderate(rational) coping behaviors is the best predictor only for anxiety and of significant difference. CONCLUSIONS: Regression analysis showed that the best predictors for anxiety and depression were active coping behaviors and negative coping behaviors, the best predictors for subhealth were anxiety,depression and job stress.Coping behaviors, job stress and motivations have significant influences on the mental-physical health of the military medical researchers and and technicians. Among them,coping behavior is the most important factor while job stress and motivation follow. Seeking help more often,less self-blame ,imagination and job stress could help release the anxiety, depression and improve the subhealth of the medical researchers and technicians. The findings of this study indicate we should address the physical and mental health of the military laboratory researchers and technicians.

心理测验中项目表述效应的特点、机制和预测因素研究

心理测验中项目的表述效应是测量误差的一个重要来源。本研究借助焦虑控制问卷，探讨心理量表中项目表述效应的心理测量学特点和其产生的方法学上的原因。研究首先考察了项目表述效应在不同的群体间的交互效度验证；然后通过反转项目表述方向的方法，构造出原问卷项目的相反表达的项目，进而通过不同组合形成四个版本的问卷，经过量表层面和项目层面的分析，考查了项目表述效应的心理测量学特点。然后通过项目反应理论分析和实验研究，考查了项目反应理论产生的作用机制。研究最后还考查了人格因素对项目表述效应的影响。主要研究结果如下： 1． 焦虑控制问卷（ACQ）中项目表述效应稳定的存在，中文版问卷的主要结构是一个特质性因子，另外还有两个方法因子。这一结构很好的拟合了中国被试的数据，不管是单个量表验证的结果还是两组被试交互验证的结果都支持这一结构； 2． 通过反ACQ问卷，构造了四个版本的量表，对四个版本验证性因素分析的结果表明，全正向表述项目量表和全反向表述项目量表没有项目表述效应出现，而同时存在正向和反向表述项目的原文卷和反转问卷都出现了方法效应；正向项目和反向项目得分分析的结果表明，总分上只有原量表和全反向量表没有显著差异，原量表和全正量表与全反量表都有显著的差异，表明项目表述效应的出项只和反向表述项目的反向记分有关； 3． 基于项目层面的研究中，用Rasch模型中的Rating Scale Model和full information Bifactor item Analysis 分别去拟合数据，发现Rasch模型对数据的拟合不好，而Bifactor items Analysis 对数据的拟合稍好一些，说明焦虑控制问卷中的项目表述效应因子与特质因子确实不是在同一个水平上的因子，表述效应因子是次级因子； 4． 项目表述效应的产生机制是由于人们只对与自己特质水平最近的项目作是的反应，而对与自己实际特质水平较远的项目作否的反应模式特点造成的； 5． 关于人格对项目表述效应出现的预测作用研究表明，自尊、社会赞许性对反向表述效应因子的产生具有正向预测作用，而行为抑制、行为激活和负向评价恐惧对反向表述因子的出现具有负向的预测作用。 总而言之，本研究得出的结论是，项目表述效应是一种人为造成的方法效应，它是被试只对与自己特质水平最近的项目作是的反应，而对与自己实际特质水平较远的项目作否的反应模式特点造成的。但同时，它又不是完全没有意义的“讨厌”因子，一些人格因素可以预测它的出现，即它的出现受到一些人格因素的影响。

人格特征对销售员绩效的预测

This research aims to discuss it is the complexity of interpersonal association and job autonomy that influence the predictive validity of personality for job performance. In addition, for service profession, incumbents' personality can predict not only contextual performance, but also task performance. Salesclerks in shopping center and life insurance agents are selected as subjects. The job performance rating scale is produced by using Critical Incidents Technique. The research method is measuring NEO-PI and collecting direct supervisors' rating of salespeople's job performance. The research results are as follows: 1. The factor analysis result of job performance is different from the west. That is to say, the support for organizations which belongs to contextual performance in the west can not be distinguished from task performance. Therefore, in China, or to say in the shopping center selected, task performance includes both technical proficiency and the support for organizations, and contextual performance includes job dedication and interpersonal facilitation. 2. For salespeople, personality can be the antecedent of contextual performance and task performance as well. However, the predictive validity for task performance is very low. 3. The more complexity of interpersonal association, the stronger relationship between personality and job performance. 4a. The correlation between job performance and facets of Big Five is higher than the one between job performance and factors of Big Five, such as Agreeableness, whose facets have different impacts on job performance, some positive and others negative. 4b. The correlation between personality and the items of job performance rating scale is higher than the one between personality and the factors of job performance. 4. Working experience is the moderator of the relationship between personality and job performance. For salesclerks, only if the working experience of subjects is less than 3 years, achievement striving-one facet of conscientiousness-is significantly correlated with the ratio of finished sales volume at 0.01 level.

冠状动脉旁路移植术后抑郁焦虑状态随访和分析

To explore the presence of depression, anxiety and cardiac events after coronary artery bypass grafting (CABG) prospectively and comparably. To analysis influential factors of depression and anxiety ( peri-operation and 1 year after operation ), and the effection on cardiac events in the year after operation. We followed the patients who underwent scheduled consecutive CABG. We interviewed patients to assess depression, anxiety symptoms using self-rating depression scale( SDS) and self-rating anxiety scale（SAS）before operation , before discharge and 1 year after operation. And cardiac events were also identified. All patients were divided into the group with depression and/or anxiety symptoms or the other group without depression and/or anxiety symptoms 3 times according to depression and anxiety symptoms before operation , before discharge and 1 year after operation. 69 patients completed the follow-up.24 patients (34.8%) had depression and/or anxiety symptoms before CABG, 31 patients (44.9%) had depression and/or anxiety symptoms before discharge, and 10 patients (14.5%) had depression and/or anxiety symptoms 1 year after operation. 6 patients(8.7%) had cardiac events, and 5 patients were re-admitted. Arhythmia before and after operation, the quantity of blood vessel grafted, length of stay , depression and anxiety symptoms before operation, cardiac events may lead to depression and anxiety symptoms 1 year after operation. The use of cardiopulmonary bypass grafting (CPB), Arhythmia after operation, the prolonged length of stay are influential factors of cardiac events. Though the incidence of depression and/or anxiety symptoms 1 year after operation is lower than before operation and before discharge, it is high still. Arhythmia before and after operation, the more blood vessels grafted, the prolonged length of stay , depression and anxiety symptoms before operation and cardiac events could be risk factors of depression and anxiety symptoms 1 year after operation. Much attention must be paid to this phenomenon. Heavy patient's condition, complicated surgery are risk factors of cardiac events, and bad emotion before operation and before discharge are independent to cardiac events. Key words： perspective research; depression；anxiety; coronary artery bypass grafting; follow up

维持性血液透析患者认知功能特点研究

Objective: To study the episodic memory, semantic memory, cognitive planning ability and inhibition ability in MHD patients. Method: Neuropsychological research methods such as Action memory of verb-object phrase, Trail Making Test (A and B), Verbal Fluency Test, Go-No/Go test and Stroop Color Naming Task were used to investigate Episodic Memory 、Semantic Memory、Executive Function of 40 MHD and 40 NC. Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale(SDS), Social Support Scale, Life Satisfaction Scale, and biochemical examination were applied and their relationships with cognitive function were analized. The mean age and education level of MHD group and NC group have no significant difference. Result: 1.Action memory of verb-object phrase differed significantly between MHD group and NC group. 2.Two tests of Verbal Fluency differed significantly between MHD group and NC group. 3.Trail Making Test A, Trail Making Test B, the baseline condition of Go-No/Go Test and Stroop Color Naming Test differed significantly between MHD group and NC group. 4.There is no significant difference between MHD group and NC group on the correct rate of No/Go Test and the baseline condition. Both groups showed Stroop Effect in Go-No/Go test, but MHD group performed significantly worse. 5.In Stroop Color Naming Task Test, NC group showed Stroop Effect, significant Repeated Distraction Promotion Effect and significant Negative Priming Effect,while MHD group showed only Stroop Effect and no Repeated Distraction Promotion Effect and no Negative Priming Effect. There is significant difference in Stroop Effect between MHD group and NC group. Conclusion: 1.Comparing with NC group, episodic memory, semantic memory, cognitive planning ability, and inhibition ability of MHD group were impaired significantly. 2.The pathological aging of Executive Function in MHD group showed: executive Function should be a unitary system. 3.Cognitive impairment is negatively correlated with serum creatinine, blood pressure and anxiety score in MHD patients; and is related with hemoglobin, hematocrit, social support and life satisfaction. Keyword: maintenance hemodialysis, episodic memory, semantic memory, cognitive planning, inhibition ability.

阿片药物依赖的神经机制---内侧前额叶与药物的心理依赖

Mental dependence, characterized by craving and impulsive seeking behavior, is the matter of intensive study in the field of drug addiction. The mesolimbic dopamine system has been suggested to play an important role in rewarding of drugs and relapse. Although chronic drug use can induce neuroadaptations of the mesolimbic system and changes of drug reinforcement, these mechanisms cannot fully account for the craving and the compulsive drug-using behavior of addicts. Acknowledging the reinforcement effects of drugs, most previous studies have studied the impact of environmental cues and conditioned learning on addiction behavior, often using established classical or operant conditioning model. These studies, however, paid little attention to the role of cognitive control and emotion in addiction. These mental factors that are believed to have an important influence on conditioned learning. The medial prefrontal cortex (mPFC) has close anatomic and functional connections with the mesolimbic dopamine system. A number of the cognitive neurological studies demonstrate that mPFC is involved in motivation, emotional regulation, monitoring of responses and other executive functions. Thus we speculated that the function of abnormality in mPFC following chronic drug use would cause related to the abnormal behavior in addicts including impulse and emotional changes. In the present study of a series of experiments, we used functional magnetic resonance imaging to examine the hemodynamic response of the mPFC and related circuits to various cognitive and emotional stimuli in heroin addicts and to explore the underlying dopamine neuromechnism by microinjection of tool drugs into the mPFC in laboratory animals. In the first experiment, we found that heroin patients, relative to the normal controls, took a much shorter time and committed more errors in completing the more demanding of cognitive regulation in the reverse condition of the task, while the neural activity in anterior cingulate cortex (ACC) was attenuated. In the second experiment, the scores of the heroin patients in self-rating depression scale (SDS) and Self-rating anxiety scale (SAS) were significantly higher than the normal controls and they rated the negative pictures more aversive than the normal controls. Being congruent with the behavioral results, hemodynamic response to negative pictures showed significant difference between the two groups in bilateral ventral mPFC (VMPFC), amygdala, and right thalamus. The VMPFC of patients showed increased activation than normal controls, whereas activation in the amygdala of patients was weaker than that in normal subjects. Our third experiment showed that microinjection of D1 receptor agonist SKF38393 into the mPFC of rats decreased hyperactivity, which was induced by morphine injection, in contrast, D1 receptor antagonist SCH23390 increased the hyperactivity, These findings suggest: (1) The behavior and neural activity in ACC of addicts changed in chronic drug users. Their impulsive behavior might result from the abnormal neural activity in the mPFC especially the ACC. (2) Heroine patients were more depress and anxiety than normal controls. The dysfunction of the mPFC---amygdala circuit of heroine addicts might be related to the abnormal emotion response. (3) Dopamine in the mPFC has an inhibitory effect on morphine induced behavior. The hyperactivity induced by chronic morphine was reduced by dopamine increase with D1 receptor agonist, confirm the first experiment that the neuroadaption of mPFC system induced by chronic morphine administration appears to be the substrate the impulse behavior of drug users.

中学生强迫症状及其心理、环境危险因素和整合模型研究

Obsessive-Compulsive Symptoms, which are one of common factors effected on mental health of secondary school students, have been rarely studied at home and abroad. In accordance with the problems existed in these literature up till now, the thesis had mainly studied the measured tool, contents and structure, developmental features, psychosocial risk factors and integrated model of obsessive-compulsive symptoms from them by means of investigation with quetionnaires. The entire research was divided into three phases. 3185 students(age 14.68±1.75 years) were firstly measured with the 20-item Leyton Obsessional Inventory-Child Version(LOI-CV) at four secondary schools including six grades in Beijing city, which was applied to revise LOI-CV, and to study the structure and contents, developmental features and screen of obsessive-compulsive symptoms. Then, 216 subjects with obsessive-compulsive symptoms, paired with controls in the light of school, grade and gender, were investigated with 10 self-rating scales on obsessive-compulsive symptoms, anxiety, depression, personality, coping and attributional style, negative life events, parent's rearing style, family environment and life adaptation in school, and with an inventory on social demography. The results were used to explore psychosocial risk factors and integrated model of obsessive-compulsive symptoms. The third survey was only carried out, about two months after the second, among 264 subjects with obsessive-compulsive symptoms through MMOCI and Negative Life Event Scale for Adolescents, in order to probe into the integrated model. The research had mainly found: (1) LOI-CV can be used as a screen tool for obsessive-compulsive symptoms in urban adolescents in China; (2) Total screening-out ratio of obsessive-compulsive symptoms was 13.6% (male:15.0%, female:12.2%). The most common manifestations of obsessive-compulsive symptoms were hating dirt and contamination, doing things in exact manner, angry if someone messes desk, bad conscience but no one else, worry about cleanliness, repeated thoughts or words; the least were favorite or special number, spending extra time on homework, special number or words to avoid, talking or moving to avoid bad luck, fussy about hands. The checking and repetition, cleanliness and tidiness, general obsessions were more common forms than numbers-luck; (3) No differences were existed in serious degree of obsessive-compulsive symptoms, but the screening-out ratio in male was higher than it in female; (4) No differences were detected in the serious degree of obsessive-compulsive symptoms except the scores of cleanliness and tidiness among grades, but the screening-out ratio of the grades justly entering secondary school or going to graduate were higher than other ones; (5) The main psychosocial risk factors for obsessive-compulsive symptoms included anxiety, mother's over-protecting and over-interfering, fantasy, flexibility, self-actualization, peers relationship, sense of responsibility, negative life events, mother's occupation, help-seeking, and (6) The integrated model on psychosocial risk factors suggested that the possible developed and sustained mechanism of obsessive-compulsive symptoms was that personality, coping and attributional styles constructed the developmental diathesis foundation of obsessive-compulsive symptoms; negative life events were promoting factors of them. There was a dynamic interaction between personality and environmental factors. Negative emotion played a core role in the developmental process of them. The continued existence of obsessive-compulsive symptoms was related to pre-existed obsessive-compulsive symptoms and negative life events experienced by an individual. Therefore, this research not only let us get a deeper understanding of obsessive-compulsive symptoms and more entirely find out psychosocial risk factors, firstly applied diathesis-stress theory to comprehend the psychological mechanism of obsessive-compulsive symptoms and, moreover, elaborate and expand it, but also has more important practice significance of treatment, prevent and education for obsessive-compulsive symptoms in secondary school students.