Adulthood

成年期
  • 文章类型: Journal Article
    亲密关系是情感的温床。本文介绍了成年后夫妻情绪调节研究的主要发现和当前方向,这是老年人不仅保持功能,而且可能胜过年轻成年人的关键背景。首先,我介绍关键概念,定义质量(即,动态,共同监管,双向,二价),和措施(即,自我报告与基于表现的)夫妇的情绪调节。第二,随着社会情感选择性理论的出现,我强调了我们对成人发展的理解的社会情感转变。第三,我提供了关于夫妻情绪调节的终生发展视角(即,在婴儿期,青春期和年轻的成年,中年,和晚年)。最后,我提出了这样一种观点,即情绪调节可能会在成年后从“我到我们”转变,并讨论了夫妻的情绪调节如何变得更加重要,更好,并且越来越重要(例如,对于关系结果,幸福,和健康)随着年龄的增长。然后讨论了未来研究的想法。
    Intimate relationships are hotbeds of emotion. This article presents key findings and current directions in research on couples\' emotion regulation across adulthood as a critical context in which older adults not only maintain functioning but may also outshine younger adults. First, I introduce key concepts, defining qualities (i.e., dynamic, coregulatory, bidirectional, bivalent), and measures (i.e., self-report versus performance-based) of couples\' emotion regulation. Second, I highlight a socioemotional turn in our understanding of adult development with the advent of socioemotional selectivity theory. Third, I offer a life-span developmental perspective on emotion regulation in couples (i.e., across infancy, adolescence and young adulthood, midlife, and late life). Finally, I present the idea that emotion regulation may shift from \"me to us\" across adulthood and discuss how emotion regulation in couples may become more important, better, and increasingly consequential (e.g., for relationship outcomes, well-being, and health) with age. Ideas for future research are then discussed.
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  • 文章类型: Journal Article
    目的:对于接受肛门直肠畸形(ARM)手术的男性患者的长期预后存在知识差距。这项研究的目的是调查肠道功能,膀胱功能,男性肛门直肠畸形患者的健康相关生活质量(HRQoL)。
    方法:这项基于横断面问卷的研究包括1994年至2017年在我们机构接受ARM治疗的男性。用肠功能评分(BFS)评估肠功能,用下尿路症状(LUTS)问卷评估尿路功能。使用年龄相关问卷(KIDSCREEN和PGWBI)调查与健康相关的生活质量(HRQoL)。从病历中回顾性收集患者特征,并使用描述性统计进行分析。将功能结果与性别和年龄匹配的对照进行比较,而将HRQoL与规范数据进行比较。该研究得到了伦理审查机构的批准。
    结果:130名男性中有58名(44.6%)回答了问卷。关于肠道功能,57例患者中有24例(42.1%),85例对照中有81例(95.3%),分别,报道了以BFS≥17为代表的良好肠道功能(p<0.001)。随着年龄的增长,污染问题和“感觉冲动”项目显着改善。在线性回归模型中,BFS随年龄显著增加。对于大多数参数,ARM患者中出现下尿路症状的比例较大,虽然不重要,与对照组相比。然而,ARM患者报告的紧张和压力性尿失禁的频率明显更高。在患者和对照组中,根据有症状的患病率和累积症状数量,排尿结局随年龄增长而下降.儿童和成人报告类似或,在某些领域,与欧洲规范数据相比,HRQoL结果更好。
    结论:男性ARM患者的肠功能受损,但随着年龄的增长而显著改善。尿路功能受到影响,但总体上与对照组相当。HRQoL未受影响。研究结果之间没有显着关联。
    方法:III.
    OBJECTIVE: There is a knowledge gap regarding long-term outcomes for males undergoing surgery for an anorectal malformation (ARM). The purpose of this study was to investigate bowel function, bladder function, and health-related quality of life (HRQoL) in male patients with an anorectal malformation.
    METHODS: This cross-sectional questionnaire-based study included males treated for ARM at our institution between 1994 and 2017. Bowel function was assessed with bowel function score (BFS) while urinary tract function was assessed with lower urinary tract symptoms (LUTS) questionnaires. Health-related quality of life (HRQoL) was investigated using age-relevant questionnaires (KIDSCREEN and PGWBI). Patient characteristics were retrospectively collected from the medical records and descriptive statistics were used for analysis. Functional outcomes were compared with gender and age-matched controls while HRQoL was compared to normative data. The study was approved by ethics review authorities.
    RESULTS: A total of 58 (44.6%) of 130 males responded to the questionnaires. Regarding bowel function, 24 (42.1%) of 57 patients and 81 (95.3%) of 85 controls, respectively, reported a well-preserved bowel function represented by a BFS ≥ 17 (p < 0.001). Soiling issues and \'feels urge\' items improved significantly with age. In a linear regression model, BFS increased significantly with age. For most parameters, the proportion of ARM patients with lower urinary tract symptoms was larger, though not significantly, compared to the controls. However, straining and stress incontinence were reported significantly more often by ARM patients. In patients and controls, voiding outcomes in terms of prevalence of having symptoms and the number of cumulative symptoms drop with increasing age. Children and adults reported similar or, in some domains, better HRQoL outcomes when compared to normative European data.
    CONCLUSIONS: Bowel function is impaired in male patients with ARM but significantly improves with age. Urinary tract function was affected, but overall comparable to the controls. HRQoL was unaffected. No significant association between the studied outcomes could be shown.
    METHODS: III.
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  • 文章类型: Case Reports
    重要的是要考虑DDMS作为任何儿童早期癫痫发作患者的鉴别诊断。早期诊断和优化管理是降低DDMS致残效应的关键。
    It is important to consider DDMS as a differential diagnosis in any patient with early childhood onset of epilepsy. Early diagnosis and optimal management are key to reducing the disabling effect of DDMS.
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  • 文章类型: Journal Article
    成骨不全症(OI)是一种孟德尔结缔组织疾病,与骨脆性增加和其他临床表现相关,最常见的是由于生产异常。结构,或I型胶原蛋白的翻译后修饰。直到最近,关于OI的大多数研究都集中在儿科人群上,而对OI在成人人群中的影响的关注则少得多.这是对文献的叙述性回顾,重点是可能影响衰老个体的OI成人的骨骼和非骨骼表现。我们发现证据表明OI是一种全身性疾病,不仅涉及骨骼,还有心肺和胃肠系统,软组织,肌腱,肌肉,和关节,听力,视力,牙齿健康,以及OI中女性的健康,并可能对健康相关的生活质量增加负面影响。我们的目标是指导临床医生,并提请注意明显的知识差距和需要进一步研究成人OI。
    Osteogenesis imperfecta (OI) is a Mendelian connective tissue disorder associated with increased bone fragility and other clinical manifestations most commonly due to abnormalities in production, structure, or post-translational modification of type I collagen. Until recently, most research in OI has focused on the pediatric population and much less attention has been directed at the effects of OI in the adult population. This is a narrative review of the literature focusing on the skeletal as well as non-skeletal manifestations in adults with OI that may affect the aging individual. We found evidence to suggest that OI is a systemic disease which involves not only the skeleton, but also the cardiopulmonary and gastrointestinal system, soft tissues, tendons, muscle, and joints, hearing, eyesight, dental health, and women\'s health in OI and potentially adds negative affect to health-related quality of life. We aim to guide clinicians as well as draw attention to obvious knowledge gaps and the need for further research in adult OI.
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  • 文章类型: Case Reports
    Bochdalek疝是最常见的先天性diaphragm肌畸形,后外侧部分有缺陷。其成年后临床表现少见。这通常是偶然的发现,它的诊断可能具有挑战性。高度怀疑是必要的,尤其是在出现心肺或腹部症状且初次胸部X线检查发现不明确的情况下。我们介绍了一例无症状的50岁男性患者,患有笨重的左侧Bochdalek\'s疝气。需要手术治疗,并在大网膜疝复位后直接缝合缺损,横结肠,胰腺的尾部从上中线剖腹手术进行。术后进展顺利,患者在术后第五天出院。讨论了在急性和慢性环境中患有此类疝气的成年患者的管理,并提出了一些建议,以尽量减少不必要的陷阱。
    Bochdalek\'s hernia is the most common congenital malformation of the diaphragm with a defect in its posterolateral part. Its clinical manifestation in adulthood is rare. It is often an incidental finding, and its diagnosis may be challenging. A high index of suspicion is necessary, especially in cases presenting with cardiopulmonary or abdominal symptoms and an ambiguous finding on the initial chest X-ray. We present a case of an asymptomatic 50-year-old male patient with a bulky left-sided Bochdalek\'s hernia. Surgical treatment was indicated, and a direct suture of the defect after reduction of the herniated greater omentum, transverse colon, and tail of the pancreas was performed from the upper midline laparotomy. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. The management of adult patients with these kinds of hernias in both acute and chronic settings is discussed, and some recommendations are mentioned to minimize unnecessary pitfalls.
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  • 文章类型: Journal Article
    青春期的兄弟姐妹关系为发展早期成人浪漫关系提供了丰富和相关的社交机会,但是关于兄弟姐妹对未来浪漫伴侣关系的影响知之甚少。使用一个潜在的,纵向设计,我们调查了观察到的积极行为(温暖,支持,积极沟通),青春期的兄弟姐妹对(第七,8th,9th,和10年级),以及近二十年后(M年龄=31岁)的成年浪漫伴侣之间观察到的相同行为。在结构方程模型(SEM)中,我们测试了4种感兴趣的二元途径:(1)个体行为连续性;(2)唤起伴侣效应;(3)兄弟姐妹建模;(4)兄弟姐妹与伴侣匹配.在多组分析中,我们还调查了不同兄弟姐妹的性别社会化效应(即,兄弟;姐妹姐妹;和混合性别的兄弟姐妹对)。结果显示,从青春期对兄弟姐妹的行为到成年早期对浪漫伴侣的相同行为具有很强的连续性,但是没有证据表明兄弟姐妹建模效果或兄弟姐妹匹配。我们还发现,在唤起途径上,与兄弟姐妹和混合性别兄弟姐妹双子体相比,姐妹兄弟姐妹双子体之间存在显着差异。研究结果强调了兄弟姐妹关系中积极青少年行为的“长远观点”,以塑造成年后未来的浪漫伙伴关系。
    Sibling relationships in adolescence provide rich and relevant socializing opportunities for developing early adult romantic relationships, but much less is known regarding the effect of siblings on future romantic partnerships. Using a prospective, longitudinal design, we investigated the association between observed positive behaviors (warmth, support, positive communication), sibling pairs during adolescence (7th, 8th, 9th, and 10th grades), and the same observed behaviors between adult romantic partners nearly two decades later (M age = 31 years old). In structural equation models (SEMs), we tested four dyadic pathways of interest: (1) individual behavioral continuity; (2) evocative partner effects; (3) sibling modeling; and (4) sibling-to-partner matching. In multiple group analyses, we also investigated gendered socialization effects for different sibling dyads (i.e., brother-brother; sister-sister; and mixed-sex sibling pairs). Results showed strong continuity from adolescent behavior toward their sibling to the same behavior toward their romantic partner in early adulthood, but there was no evidence for sibling modeling effects nor for sibling matching. We also found significant differences between sister-sister sibling dyads compared to brother-brother and mixed-sex sibling dyads for the evocative pathway. Findings highlight the \"long view\" of positive adolescent behavior in sibling relationships for shaping future romantic partnerships in adulthood.
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  • 文章类型: Journal Article
    目的:随着对自闭症谱系障碍(ASD)在整个生命周期中的了解增加,成年后首次被识别为ASD的人数也是如此。了解ASD人群中同时发生的精神疾病是越来越多的研究重点;然而,对首次诊断为ASD的成年人开精神病药物的比率知之甚少.这项研究的目的是在美国的临床样本(2012-2022)中检查成年后被诊断为ASD的人的自我报告药物使用情况。
    方法:本研究为回顾性记录综述。参与者(n=281)来自专门诊断成人ASD的门诊诊所。参与者使用药物清单自我报告以前和当前的精神病药物处方。
    结果:大约50%的参与者自我报告在初次评估时至少开了一种精神科药物。最常用的精神科药物是抗抑郁药(23.8%),其次是兴奋剂(16.7%)。
    结论:与儿童时期被诊断为ASD的个体相似,那些在成年后首次被确诊为ASD的患者,其服用精神科药物的比例远高于同龄非自闭症患者.这些结果可以为未来的研究和实践提供信息,以改善自闭症成年人的预后。尤其是那些一生中大部分时间都未被诊断的人。
    OBJECTIVE: As the understanding of autism spectrum disorder (ASD) across the lifespan has increased, so has the number of individuals being identified with ASD for the first time in adulthood. Understanding co-occurring psychiatric conditions in this subset of the ASD population is a growing focus of research; however, little is known about the rate at which psychiatric medications are prescribed to adults with a first-time diagnosis of ASD. The purpose of this study was to examine self-reported medication use in persons diagnosed with ASD in adulthood in a clinic sample (2012-2022) in the United States.
    METHODS: The present study was a retrospective record review. Participants (n = 281) were drawn from an outpatient clinic specializing in the diagnosis of ASD in adults. Participants self-reported previous and current psychiatric medication prescription using a medication checklist.
    RESULTS: Approximately 50% of participants self-reported being prescribed at least one psychiatric medication at the time of their initial evaluation appointment. The most commonly prescribed psychiatric medications were antidepressants (23.8%), followed by stimulants (16.7%).
    CONCLUSIONS: Similar to individuals diagnosed with ASD in childhood, those identified with ASD for the first time in adulthood are prescribed psychiatric medication at a much higher rate than their same-age non-autistic peers. These results can inform future research and practice for improving outcomes for autistic adults, particularly those who were undiagnosed for much of their lives.
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  • 文章类型: Journal Article
    患有智力障碍的自闭症年轻人想要自主,但不如其他人自主。然而,他们可以在适当的支持下自主。我们想学习如何支持患有智力障碍的自闭症成年人变得更加自主。我们在五个自闭症社区合作伙伴的帮助下设计了我们的研究,以确保这项研究与自闭症患者相关,并改善他们的生活。我们与8名患有智力障碍的自闭症年轻人讨论了自主性。我们将“谈话”定义为口头语言,以及肢体语言等非语言暗示,面部表情,发声,和笑声。我们在聊天的时候做艺术项目和玩游戏。我们在多个会议上分成小组。我们的参与者告诉我们,自主意味着能够做自己。他们告诉我们三种主要方式来支持他们的自主权:(1)有选择和控制,(2)能够以自己的方式进行交流,(3)在安全的环境中。家庭,支持人员,和照顾者可以使用这些信息来帮助自闭症青少年智障人士自主。
    UNASSIGNED: Autistic young adults with intellectual disabilities want to be autonomous but are less autonomous than other people. However, they can be autonomous with appropriate support. We wanted to learn how we can support autistic adults with intellectual disabilities to be more autonomous. We designed our study with help from five autistic community partners to make sure the research was relevant to autistic people and would improve their lives. We talked with eight autistic young adults with intellectual disabilities about autonomy. We defined \"talk\" as verbal language, as well as non-verbal cues such as body language, facial expressions, vocalizations, and laughter. We did art projects and played games while we talked. We met in small groups over multiple sessions. Our participants told us that being autonomous meant being able to be themselves. They told us three main ways to support their autonomy: (1) having choice and control, (2) being able to communicate in their own way, and (3) being in a safe environment. Families, support staff, and caregivers can use this information to help autistic young adults with intellectual disabilities to be autonomous.
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  • 文章类型: Journal Article
    这项研究旨在分析参与五项针对行为问题的儿童预防性干预试验的参与者在儿童和青少年时期冲动增长的人之间的异质性。此外,我们旨在测试与成人精神病理学相关的个人资料成员资格。代表2、4、5、7、8和10年级冲动行为的测量项目,以及攻击性,物质使用,自杀意念/企图,和成年期的焦虑/抑郁从五项试验中整合(N=4,975)。我们对这个样本应用了潜在的类增长分析,以及样本分为非干预(n=2,492)和干预(n=2,483)参与者。在所有样品中,剖面的特点是高,中度,低,和低增加的冲动水平。关于成人的结果,在所有样品中,高,中度,与低调相比,低调认可了更高的攻击性。在自杀意念/企图和焦虑/抑郁方面,样本和资料之间存在细微差别。在样品中,药物使用情况之间没有显著差异.总的来说,我们的研究有助于了解冲动性的发展过程和预后,以及增加协作努力将多项研究中的数据联系起来,以更好地了解发展过程。
    This study aimed to parse between-person heterogeneity in growth of impulsivity across childhood and adolescence among participants enrolled in five childhood preventive intervention trials targeting conduct problems. In addition, we aimed to test profile membership in relation to adult psychopathologies. Measurement items representing impulsive behavior across grades 2, 4, 5, 7, 8, and 10, and aggression, substance use, suicidal ideation/attempts, and anxiety/depression in adulthood were integrated from the five trials (N = 4,975). We applied latent class growth analysis to this sample, as well as samples separated into nonintervention (n = 2,492) and intervention (n = 2,483) participants. Across all samples, profiles were characterized by high, moderate, low, and low-increasing impulsive levels. Regarding adult outcomes, in all samples, the high, moderate, and low profiles endorsed greater levels of aggression compared to the low-increasing profile. There were nuanced differences across samples and profiles on suicidal ideation/attempts and anxiety/depression. Across samples, there were no significant differences between profiles on substance use. Overall, our study helps to inform understanding of the developmental course and prognosis of impulsivity, as well as adding to collaborative efforts linking data across multiple studies to better inform understanding of developmental processes.
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  • 文章类型: Journal Article
    尽管大学生的主观社会地位与抑郁之间的关系已经确立,这种联系可以被视为虚假的。先前的研究表明,财务资源和年龄等关键变量可能在解释社会地位和心理健康结果的差异方面发挥关键作用。在这项研究中,我们评估了主观社会地位之间复杂的相互关系,在青年和中年阶段的大学生中,他们可以支配的财政资源和抑郁症状。
    在加纳的一所大学进行了横断面调查,通过偶然抽样对1134名大学生进行了抽样。McArthur量表和WHO-5幸福感测量用于数据收集。
    结果显示,较高的主观社会地位与较低的抑郁水平相关。进一步发现,学生零花钱与年龄之间的相互作用在主观社会地位与抑郁之间的关系中起着独特的作用。
    研究结果呼吁教育领域的利益相关者探索资助机会,并研究赋予父母(经济上)充分支持学生的方式。健康教育家和促进者,包括心理学家,学校辅导员和家长可以通过自我调节或管理技能来帮助培养和增强学生的能力,以帮助改善他们的福祉。需要不断努力改善学生的财务状况和心理健康。
    Although the relationship between subjective social status and depression in university students has been well-established, this association could be seen as a spurious one. Previous studies have shown that key variables like financial resources and age could play key roles in explaining the variances in social status and mental health outcomes. In this research, we assessed the complex interrelationships between subjective social status, financial resources at their disposal and depressive symptoms among university students within their young and middle adulthood stages.
    A cross-sectional survey was conducted in a university in Ghana to sample 1134 university students through accidental sampling. The McArthur Scale and WHO-5 Well-being measure were used for the data collection.
    The results revealed that higher levels of subjective social status were associated with lower levels of depression. It was further found that the interaction between students\' pocket money and age played unique roles in the relationship between subjective social status and depression.
    The study findings call on stakeholders in education to explore funding opportunities and to examine ways of empowering parents (financially) to adequately support the students. Health educationists and promoters, including psychologists, school counsellors and parents could compliment these efforts by helping to train and empower students through self-regulation or management skills to help improve their well-being. Continuous efforts are required to improve the financial status and mental health of students.
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