dissociation

解离
  • 文章类型: Journal Article
    关于ICD-11复杂的PTSD和DSM-5边缘性人格障碍(BPD)是否是同一综合征的争论正在进行中。关于这两种情况重叠的程度以及它们在亚洲文化中是否表现出不同的临床相关性知之甚少。这项研究检查了ICD-11复杂的PTSD和DSM-5BPD在香港治疗寻求者样本中的共同出现(N=220)。参与者完成了经过验证的自我报告措施,评估他们是否符合各自的诊断标准。在这个样本中,30.9%仅满足复杂PTSD的ICD-11标准,10.0%仅符合BPD的DSM-5标准,和28.2%满足这两个条件的标准。复杂的PTSD症状与抑郁症状(β=.347,p<.001)和创伤相关的适应不良信念(β=.337,p<.001)密切相关,而BPD症状与分离症状的相关性最强(β=.281,p<.001)。这项研究首次表明ICD-11复杂的PTSD和DSM-5BPD通常共同发生,但在亚洲背景下不是相同的结构。他们的症状与不同的人口统计学和临床因素有关.DSM和ICD的未来版本不应将这两种情况合并为单个诊断。
    There is an ongoing debate regarding whether ICD-11 complex PTSD and DSM-5 borderline personality disorder (BPD) are the same syndrome. Little is known about the extent to which these two conditions overlap and whether they exhibit distinct clinical correlates in Asian cultures. This study examined the co-occurrence of ICD-11 complex PTSD and DSM-5 BPD in a sample of treatment seekers in Hong Kong (N = 220). Participants completed validated self-report measures which assessed if they met the respective diagnostic criteria. In this sample, 30.9 % met the ICD-11 criteria for complex PTSD only, 10.0 % met the DSM-5 criteria for BPD only, and 28.2 % met the criteria for both conditions. Complex PTSD symptoms were most strongly associated with depressive symptoms (β =.347, p <.001) and trauma-related maladaptive beliefs (β =.337, p <.001), while BPD symptoms were most strongly associated with dissociative symptoms (β =.281, p <.001). This study is the first to show that ICD-11 complex PTSD and DSM-5 BPD commonly co-occurred but were not the same construct in the Asian context, and their symptoms were associated with different sets of demographic and clinical factors. Future editions of DSM and ICD should not merge the two conditions into a single diagnosis.
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  • 文章类型: Journal Article
    前庭性偏头痛(VM)和梅尼埃病(MD)的特征是持续时间相似的眩晕发作。众所周知,仅根据患者病史,并不总是可以区分两种疾病。体检,和听力学测试。此外,前庭功能的量化也有帮助,因为,在MD患者中,正常/伪正常视频头脉冲测试(vHIT)和降低热量测试之间通常存在分离。这项验证性研究的目的是确定敏感性,特异性,以及这种分离的阳性和阴性预测值(PPV和NPV),以区分MD和VM以及MD和其他前庭疾病。我们对2,101例患者进行了回顾性分析。检查组由1100名患者组成;其中,根据Bárány协会的诊断标准,627(57%)患有MD,473(43%)患有VM。对照组包括1,001例其他外周患者,中央,或功能性前庭疾病。统计分析揭示了解离的以下发现:MD与VM:特异性:83.5%,灵敏度:58.9%,PPV:82.6%,净现值:60.5%,和MDvs.所有其他前庭疾病(VM加其他):特异性:83.5%,灵敏度:58.9%,PPV:60.3%,净现值:82.7%。正常vHIT和降低的热量响应之间的解离是由于适合于MD和VM之间的区分的高特异性和PPV。该研究的这一部分证实了先前在大量患者队列中的发现。在区分MD和所有观察到的前庭疾病时,如果没有分离,MD的诊断可能性不大.
    Vestibular migraine (VM) and Menière\'s disease (MD) are characterized by episodes of vertigo of similar duration. It is well known that differentiation between both diseases is not always possible based only on the patient history, physical examination, and audiological testing. In addition, the quantification of the vestibular function can also be helpful since, among patients with MD, there is often a dissociation between a normal/pseudo-normal video head impulse test (vHIT) and reduced caloric testing. The goal of this confirmatory study was to determine the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of this dissociation to differentiate between MD and VM as well as between MD and other vestibular diseases. We performed a retrospective analysis of 2,101 patients. The examination group consisted of 1,100 patients; of these, 627 (57%) had MD according to the diagnostic criteria of the Bárány Society and 473 (43%) had VM. The comparison group consisted of 1,001 patients with other peripheral, central, or functional vestibular disorders. Statistical analysis revealed the following findings for the dissociation: MD vs. VM: specificity: 83.5%, sensitivity: 58.9%, PPV: 82.6%, and NPV: 60.5%, and MD vs. all other vestibular disorders (VM plus others): specificity: 83.5%, sensitivity: 58.9%, PPV: 60.3%, and NPV: 82.7%. The dissociation between a normal vHIT and a reduced caloric response is due to the high specificity and PPV suited for the differentiation between MD and VM. This part of the study confirms previous findings in a large cohort of patients. When it comes to differentiating between MD and all observed vestibular disorders, if there is no dissociation, the diagnosis of MD is unlikely.
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  • 文章类型: Journal Article
    血液样品中肌钙蛋白I(cTnI)和肌钙蛋白T(cTnT)的心脏亚型的免疫检测广泛用于诊断急性心肌梗塞。心肌肌钙蛋白复合物(ITC复合物),包括cTnI,cTnT,和肌钙蛋白C(TnC),构成心肌细胞坏死后释放到血液中的大部分肌钙蛋白。然而,ITC复合物的稳定性尚未得到充分研究。本研究旨在研究血液样品中ITC复合物的稳定性。将天然ITC复合物在缓冲溶液中孵育,血清,和柠檬酸盐,肝素,或各种温度下的EDTA血浆。进行蛋白质印迹和凝胶过滤,使用特异性单克隆抗体检测肌钙蛋白。ITC复合物在37°C下在有或没有抗凝剂的缓冲液中解离,在柠檬酸盐中,肝素,和EDTA血浆,在血清中,成二进制cTnI-TnC复合物(IC-complex)和游离cTnT。在含有肝素和EDTA的血浆中,IC复合物进一步解离成游离的TnC和cTnI。除EDTA血浆外,所有基质在4°C或室温(RT)下在24小时内均未发现解离。在EDTA血浆和血清中37°C孵育后,解离伴随着cTnI和cTnT的蛋白水解降解。样品中抗肌钙蛋白自身抗体的存在阻碍了ITC复合物的解离。ITC复合物在37°C下在体外解离以形成IC复合物和游离cTnT,但在4°C或RT下大部分是稳定的。IC复合物的进一步解离在37°C下在含有肝素和EDTA的血浆中发生。
    Immunodetection of cardiac isoforms of troponin I (cTnI) and troponin T (cTnT) in blood samples is widely used for the diagnosis of acute myocardial infarction. The cardiac troponin complex (ITC-complex), comprising cTnI, cTnT, and troponin C (TnC), makes up a large portion of troponins released into the bloodstream after the necrosis of cardiomyocytes. However, the stability of the ITC-complex has not been fully investigated. This study aimed to investigate the stability of the ITC-complex in blood samples. A native ITC-complex was incubated in buffer solutions, serum, and citrate, heparin, or EDTA plasma at various temperatures. Western blotting and gel filtration were performed, and troponins were detected using specific monoclonal antibodies. The ITC-complex dissociated at 37 °C in buffers with or without anticoagulants, in citrate, heparin, and EDTA plasmas, and in serum, into a binary cTnI-TnC complex (IC-complex) and free cTnT. In plasma containing heparin and EDTA, the IC-complex further dissociated into free TnC and cTnI. No dissociation was found at 4 °C or at room temperature (RT) in all matrices within 24 h except for EDTA plasma. After incubation at 37 °C in EDTA plasma and serum, dissociation was accompanied by proteolytic degradation of both cTnI and cTnT. The presence of anti-troponin autoantibodies in the sample impeded dissociation of the ITC-complex. The ITC-complex dissociates in vitro to form the IC-complex and free cTnT at 37 °C but is mostly stable at 4 °C or RT. Further dissociation of the IC-complex occurs at 37 °C in plasmas containing heparin and EDTA.
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  • 文章类型: Journal Article
    四氢呋喃(THF)浓度对混合甲烷水合物形成的影响,解离,和稳定性进行了研究。实验在286.2K和6MPa下在静态反应器中进行。低于2.5mol%的THF的存在没有显示水合物形成的证据。然而,2.5mol%以上的浓度提高了甲烷生成速率和甲烷消耗。作为表面张力降低的结果,增加THF浓度减少了诱导时间。此外,由于水合物成核程度较高,甲烷的吸收和形成速率随THF浓度的增加而增加。解离实验后的甲烷回收率高达96%。此外,水合物稳定性增加,水合物解离动力学随THF浓度的增加而降低。增强和改善水合物形成动力学和稳定性的最佳THF浓度是其化学计量浓度。
    Effects of tetrahydrofuran (THF) concentration on the mixed methane hydrate formation, dissociation, and stability were investigated. The experiment was conducted at 286.2 K and 6 MPa in a quiescent reactor. The presence of THF below 2.5 mol% did not show the evidence of hydrate formation. However, the concentration above 2.5 mol% enhanced the methane formation rate and the methane consumption. Increasing the THF concentration decreased the induction time as the result of the decrease in the surface tension. Moreover, the methane uptake and formation rate increased with the THF concentration due to the higher degree of hydrate nucleation. The methane recovery after the dissociation experiment showed up to 96%. Furthermore, the hydrate stability increased, and the hydrate dissociation kinetics decreased with the increase in the THF concentration. The optimum THF concentration to enhance and improve the hydrate formation kinetics and stability is its stoichiometric concentration.
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  • 文章类型: Journal Article
    目的:解离症状既是暴露于心理创伤的病理结果,也是N-甲基-d-天冬氨酸(NMDA)受体拮抗剂药物的副作用;因此,对这些症状进行准确有效的评估很重要。23项临床医生管理的分离状态量表(CADSS)的心理测量特性已在氯胺酮和艾氯胺酮文献中得到表征。这里,我们在有或没有创伤后应激障碍(PTSD)和心理创伤暴露史的样本中检查了其表现.
    方法:有心理创伤史的参与者(N=148)和没有(N=100)诊断为PTSD的参与者以及没有精神障碍或创伤史的健康参与者(N=28)通过23项CADSS和其他心理和神经心理学评估进行评估。进行分析以检查内部一致性,收敛效度和判别效度,要素结构,据报道,人群中的不同表现或多或少可能报告分离症状(例如,有和没有PTSD的患者),以及对暴露于与创伤相关的视觉和声音而产生的变化的敏感性。
    结果:发现23项CADSS具有较高的内部一致性(Cronbach\'salpha0.91)和单因素结构。创伤暴露的PTSD参与者的CADSS总分高于无创伤暴露的PTSD参与者和非创伤非PTSD参与者。最后,与伊拉克战斗有关的PTSD的退伍军人在接触与战斗有关的幻灯片和声音后,CADSS总分显着提高。
    结论:23项CADSS,已经验证为测量与NMDA受体拮抗剂药物施用相关的解离的工具,以可靠和有效的方式评估受心理创伤的参与者的分离。
    OBJECTIVE: Dissociative symptoms are both a pathological consequence of exposure to psychological trauma as well as a side effect of N-methyl-d-aspartate (NMDA) receptor antagonist medications; therefore, accurate and valid assessment of these symptoms is important. The psychometric properties of the 23-item Clinician Administered Dissociative States Scale (CADSS) have been characterized in the ketamine and esketamine literatures. Here, we examine its performance in a sample with and without posttraumatic stress disorder (PTSD) and a history of exposure to psychological trauma.
    METHODS: Participants with a history of psychological trauma with (N = 148) and without (N = 100) the diagnosis of PTSD and healthy participants without a psychiatric disorder or history of trauma (N = 28) were assessed with the 23-item CADSS and other psychometric and neuropsychological assessments. Analyses were performed to examine internal consistency, convergent and discriminant validity, factor structure, differential performance in populations reported to be more or less likely to report dissociative symptoms (e.g., patients with and without PTSD), and sensitivity to change resulting from exposure to trauma-related sights and sounds.
    RESULTS: The 23-item CADSS was found to have high internal consistency (Cronbach\'s alpha 0.91) and a single-factor structure. CADSS total scores in trauma-exposed participants with PTSD were higher than those in trauma-exposed participants without PTSD and non-traumatized non-PTSD participants. Finally, veterans with Iraq combat-related PTSD showed a significant increase in CADSS total score after exposure to combat-related slides and sounds.
    CONCLUSIONS: The 23-item CADSS, already validated as a tool to measure dissociation related to administration of NMDA receptor antagonist medication, performs in a reliable and valid manner in the assessment of dissociation in psychologically traumatized participants.
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  • 文章类型: Journal Article
    使用音乐作为运动期间和运动后恢复的辅助手段是一个日益引起科学兴趣的领域。我们调查了任务中的影响,异步音乐和活跃音乐(即,用于在高强度运动发作之间积极恢复的音乐)在一系列心理上,心理生理和心理生理结果。参与者(N=28;14名女性)进行了五次实验室访问:(a)预先测试/熟悉情况;(b)超运动发作期间的快节奏音乐和活动恢复期的中等节奏音乐;(c)运动期间的快节奏,恢复期间没有音乐;(d)运动期间没有音乐,恢复期间的中等节奏;(e)整个过程中没有音乐控制。采用基于周期测功机的HIIT方案,包括以100%Wmax进行6×60-s回合,并主动恢复75-s。在超大型发作和活跃恢复期结束时采取措施(RPE,国家关注,核心影响,国家动机),然后在停止协议(记住的快乐和运动享受)。在整个过程中都采取了心率和心率变异性(HRV)措施。音乐操纵只对国家动机有影响,与无音乐控制(科恩的d=0.49)相比,在快节奏-中节奏条件下更高(p=.036),和HRV的SDNN分量,与对照(科恩的d=0.32)相比,在快节奏-无音乐条件下更低(p=.007)。总的来说,目前的发现不支持任何关于音乐相关操作的研究假设,并且不同意相关研究的结果(例如,Karageorghis等人。,2021)。参考现有理论讨论了意想不到的结果,并就音乐相关应用提供建议。
    The use of music as an aid to recovery during and after exercise is an area of growing scientific interest. We investigated the effects of in-task, asynchronous music and respite-active music (i.e., music used for active recovery in between high-intensity exercise bouts) on a range of psychological, psychophysical and psychophysiological outcomes. Participants (N = 28; 14 females) made five laboratory visits for: (a) pre-test/familiarisation; (b) fast-tempo music during supramaximal exercise bouts and medium-tempo during active-recovery periods; (c) fast-tempo during exercise and no music during recovery; (d) no music during exercise and medium-tempo during recovery; and (e) a no-music (throughout) control. A cycle ergometer-based HIIT protocol comprising 6 × 60-s bouts at 100% Wmax with 75-s active recovery was administered. Measures were taken at the end of supramaximal bouts and active recovery periods (RPE, state attention, core affect, state motivation), then upon cessation of the protocol (remembered pleasure and exercise enjoyment). Heart rate and heart rate variability (HRV) measures were taken throughout. The music manipulations only had an effect on state motivation, which was higher (p = .036) in the fast tempo-medium tempo condition compared to no-music control (Cohen\'s d = 0.49), and the SDNN component of HRV, which was lower (p = .007) in the fast tempo-no music condition compared to control (Cohen\'s d = 0.32). Collectively, the present findings do not support any of the study hypotheses regarding the music-related manipulations, and do not concur with the findings of related studies (e.g., Karageorghis et al., 2021). The unexpected results are discussed with reference to extant theory, and recommendations are offered in regard to music-related applications.
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  • 文章类型: Journal Article
    全球精神创伤屏幕(GPS)是一个简短的诊断筛查,涵盖了广泛的创伤相关疾病以及已知影响症状过程的风险因素。
    我们分析了在澳大利亚的非洲战争难民(n=70)的数据,包括GPS,DSM-5疾病的结构化临床访谈(SCID-5),DSM-5的临床医师管理PTSD量表(CAPS-5),和简短弹性量表(BRS)。
    使用YoudenJ指数检查测量PTSD的GPS分量表的临床有效性,解离,抑郁症,和广泛性焦虑症(GAD),我们发现创伤后应激障碍子量表得分为3分或更高,抑郁和离解子量表得分为1分或更高,对于检测可能的诊断(分别为Youden的J=0.76,J=0.72和J=0.90)具有最佳的敏感性和特异性。由于GAD发生率低,我们无法测试GAD的GPS临床有效性。GPS弹性项与总分无关(r=0.02),表明韧性的收敛有效性较低。危险因素,包括当前的压力源和童年创伤史,与更严重的GPS症状评分有关,虽然缺乏韧性,社会支持,精神病史没有。
    我们得出结论,GPS可能是PTSD的有用筛查工具,抑郁症,和难民中的分离亚型。
    UNASSIGNED: The Global Psychotrauma Screen (GPS) is a brief transdiagnostic screener that covers a broad range of trauma-related disorders as well as risk factors known to influence the course of symptoms.
    UNASSIGNED: We analyzed data from African war refugees in Australia (n = 70), including the GPS, the Structured Clinical Interview for DSM-5 Disorders (SCID-5), the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and the Brief Resilience Scale (BRS).
    UNASSIGNED: Using the Youden\'s J Index to examine the clinical validity of the GPS subscales measuring PTSD, dissociation, depression, and generalized anxiety disorder (GAD), we found that a PTSD subscale score of 3 or higher, and a depression and dissociation subscale score of 1 or higher, was optimally efficient for detecting a probable diagnosis (Youden\'s J = 0.76, J = 0.72, and J = 0.90, respectively) with high sensitivity and specificity. We were unable to test the GPS clinical validity for GAD due to the low GAD occurrence. The GPS resilience item was not related to the total score (r = 0.02), indicating low convergent validity for resilience. Risk factors, including current stressors and childhood trauma history, were related to more severe GPS symptom scores, while lack of resilience, social support, and history of mental illness were not.
    UNASSIGNED: We conclude that the GPS may be a useful screening tool for PTSD, depression, and the dissociative subtype in refugees.
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  • 文章类型: Journal Article
    从诗人和一年级精神分析培训候选人的角度来看,本文通过将精神分析和佛教的过程与诗歌实践的过程进行类比,以定义资本主义价值体系下病态分离的替代方法,从而发展了杰里米·赛峰关于精神分析和佛教之间辩证法的思想。本文详细介绍了作家在办公室工作的经历以及她随后试图通过写诗来克服和批评的病态分离。在工作中写的各种诗歌被分享和分析作为证据。从Safran的编辑卷绘图,精神分析和佛教,然后,作者确定了禅宗佛教冥想实践和精神分析过程的各个方面,这些过程侧重于与现实联系,然而冲突,而不是逃避它。本文是在精神分析学家和禅宗老师BarryMagid的指导下撰写的。
    From the perspective of a poet and first-year psychoanalytic training candidate, this paper develops Jeremy Safran\'s ideas about the dialectic between psychoanalysis and Buddhism by drawing an analogy between their processes and those of a poetry practice to define an alternative to pathological dissociation under capitalist systems of value. The paper details the writer\'s experience of working a day job in an office and the pathological dissociation which she subsequently attempts to overcome and critique through writing poetry. Various poems written at work are shared and analyzed as evidence. Drawing from Safran\'s edited volume, Psychoanalysis and Buddhism, the author then identifies aspects of Zen Buddhist meditation practice and the psychoanalytic process that focus on connecting with reality, however conflicted, as opposed to escaping it. This paper was written under the mentorship of the psychoanalyst and Zen teacher Barry Magid.
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  • 文章类型: Journal Article
    利用密度泛函理论研究了Y对Mg17Al12的H/H2吸附性能的机理。我们得到了对于Y吸附系统,Y倾向于占据相邻Mg原子之间的桥位置。对于Y取代的曲面,Y原子倾向于取代表面上的Mg原子。我们发现,在Mg17Al12(110)系统上的氢(H/H2)吸收通过添加Y得到改善,吸附能的顺序如下:清洁Mg17Al12(110)>Y取代表面>Y吸附表面。此外,H2分子可以在含Y的系统上解离而没有势垒能。电子性质表明,对于H2的吸附,原子H的s态主要与Y的d态杂化。Y-H键的形成以及Y和H原子之间的相互作用可以阐明含Y表面促进氢化性能的机理。
    The mechanism of Y on H/H2 adsorption performance of Mg17Al12 were studied by the density functional theory. We obtained that for the Y-adsorbed systems, Y tended to occupy on the bridge site between adjacent Mg atoms. For the Y-substituted surfaces, Y atoms inclined to replace Mg atoms on the surfaces. We found that hydrogen (H/H2) absorption on the Mg17Al12(110) systems were improved by adding Y, the order of adsorption energy was as follows: clean Mg17Al12(110) > the Y-substituted surfaces > the Y-adsorbed surfaces. In addition, H2 molecules could dissociate on the Y-containing systems without barrier energy. Electronic properties showed that for H2 adsorption, the s states of atomic H mainly hybridized with the d states of Y. The formations of the Y-H bonds and the interactions between Y and H atoms could expound the mechanism for the promoted hydrogenation performance of the Y-containing surfaces.
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  • 文章类型: Journal Article
    没有研究通过实验测试感觉输入的时间整合/隔离如何与分离体验的出现和情绪功能的改变相关联。36名参与者完成了3项感觉统合任务。心理测量阈值被估计为时间整合/隔离过程的指标。我们收集了任务前分离特征水平的自我报告测量,以及任务前和任务后的分离和情绪变化。21名受试者的独立样本完成了管理注意力网络测试的对照实验。结果表明:(i)完成感觉统合任务后,分离体验显着增加,但不是在ANT任务之后;(ii)主观阈值预测了分离状态的出现;(iii)时间整合努力影响积极情绪,这可以通过依赖于任务的解离状态的程度来解释。目前的发现表明,可以通过“超分离”和“超整合”过程之间的不平衡来理解解离。
    There are no studies that have experimentally tested how temporal integration/segregation of sensory inputs might be linked to the emergence of dissociative experiences and alterations of emotional functioning. Thirty-six participants completed 3 sensory integration tasks. Psychometric thresholds were estimated as indexes of temporal integration/segregation processes. We collected self-report measures of pre-task trait levels of dissociation, as well as pre- post-task changes in both dissociation and emotionality. An independent sample of 21 subjects completed a control experiment administering the Attention Network Test. Results showed: (i) a significant increase of dissociative experiences after the completion of sensory integration tasks, but not after the ANT task; (ii) that subjective thresholds predicted the emergence of dissociative states; (iii) temporal integration efforts affected positive emotionality, which was explained by the extent of task-dependent dissociative states. The present findings reveal that dissociation could be understood in terms of an imbalance between \"hyper-segregation\" and \"hyper-integration\" processes.
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