【CASK EFFECT】0910F阅读全方位锻炼--越障【SCI】 1-12

tuziduiduiUID: 2599524

【CASK EFFECT】0910G阅读能力基础自测（速度、难度、深度、越障、真题、RAM）
https://bbs.gter.net/forum.php?mod=viewthread&tid=910464&highlight

【CASK EFFECT】0910F阅读全方位锻炼--越障【SCI】汇总贴
https://bbs.gter.net/thread-982020-1-1.html

规则：0 u, r. g$ C/ d+ [4 f5 C

我每天贴出1000字左右的一篇文字7 j) N0 Q, Q- ]( V4 E

没有别的要求，只要大家坚持读完就可以

如果你能坚持一个月，你会发现自己的阅读进化了~
[注]9 K7 C8 w4 {" L
1、直接在电脑屏幕面前做，虽然GRE阅读是在纸上考，但是这个过程会遏制你做笔记，同时给你的阅读造成视觉障碍，也就是把难度训练和抗干扰训练同步结合，增加效率（初期会很累，但是既然大家想要成为高手，那么就别对自己太温柔）

Today's topic: Efficacy of Dialectical Behavior Therapy in Women Veterans With Borderline Personality Disorder

Until very recently, there was only one punished randomized clinical trial of a psychosocial treatment for persons with borderline personality disorder (BPD), namely the report by Linehan, Axmstrong,Suarez, Allmon, and Heard (1991) on dialectical behavior therapy (DBT),summarized below. The need for replication of the treatment's efficacy at an independent site provided the primary impetus for the present study. Since our study was conducted, Bate-man and Fonagy (~1999) have reported significantly more favorable outcomes for patients diagnosed with BPD who were randomly assigned to a long term, psychodynamically oriented partial hospital program(average length of stay = 1.45 years) than for those randomly assigned to standard outpatient treatment that included no psychotherapy. It is certainly fortunate for patients and intriguing for researchers that there now appear to be two treatments for BPD with some demonstrated efficacy.

DBT was developed initially by Marsha Linehan(Linehan, 1993a, 1993b), specifically for the treatment of chronically suicidal and self-injurious women. Most of these women meet criteria for BPD. About 75%of those diagnosed with BPD are female, and chronic suicidal behavior is a common feature (Widiger & Frances, 1987).

Linehan et al. (1991) randomly assigned 44parasuicidal women diagnosed with BPD to 1 year of DBT or to treatment-as-usual(TAU) in the community. Women receiving DBT had significantly greater reductions in self-harm behaviors (including suicide attempts), in the medical risk of those behaviors, and in the frequency of psychiatric hospitalizations and lengths of stay, and lower treatment dropout rates than women receiving TAU. DBT also showed superior efficacy in reducing trait anger and improving Global Assessment Scale scores and both interviewer-rated and self-rated social adjustment (Linehan, Tutek, Heard, & Armstrong, 1994). On questionnaire measures of depression, hopelessness, reasons for living, and suicidalideation, however, although patients in both conditions showed significant improvement during the 12 months of treatment, the treatment conditions did not significantly differ (Linehan et al., 1991). Improved symptoms and functioning of patients were generally maintained at 6- and 12-month follow-up (Linehan,Heard, & Armstrong, 1993).

DBT has generated considerable interest since the Linehan et al. (1991) report, and was the subject of a recent critical review (Scheel, 2000) and accompanying series of commentaries. DBT principles and strategies increasingly are being used in a wide variety of clinical settings, perhaps, as Swenson (2000) has noted, not only because there has been no other treatment with any documented efficacy, but also because clinicians and clinical administrators may find numerous aspects of the treatment's principles and strategies very appealing.

DBT also has been adapted for use with a variety of populations other than suicidal borderline women, A few nonrandomized controlled studies have been conducted with these populations(Rathus & Miller, 1999, with suicidal adolescents; Telch, Agras, &Linehan, 1999, with binge eaters), and some randomized trials are in progress or recently completed (Linehan, Dimeff, Comtois, K_ivlahan, & McDavid,1999, with BPD and opiate dependence; Linehan et al., 1999, with BPD and drug dependence; Lynch et al., 1999, with depressed elderly; and van den Bosch,1999, with alcohol/drug dependence with or without BPD), but none are yet published.

Linehan and her colleagues are conducting a more rigorously controlled trial in which preliminary results so far again support the relative efficacy of DBT for suicidal borderline women (Linehan etal., 1998). However, as Scheel (2000) points out, conclusions about DBT's efficacy currently rest primarily on only one published randomized study(Linehan et al., 1991; Linehan et al., 1993; Linehan, Tutek, et al., 1994)conducted by the treatment's developer and "replication is clearly needed to ensure that initial results are reliable" (p. 80). Indeed, criteria designating a treatment as well-established adopted by the APA Division 12 Task Force on Promotion and Dissemination of Psychological Procedures require an independent demonstration of efficacy in a randomized trial (Chambless et al.,1996). DBT is the only treatment currently listed as "probably efficacious" for BPD, and no treatments are listed as"well-established"

We report results of the first randomized controlled trial of DBT conducted outside of its site of development. It was designed as a pilot study with a relatively small sample, with the goals of determining whether our research therapists could conduct DBT with adequate adherence and whether outcomes would be superior to those of usual care in the same setting and system.

Just as in Linehan et al. (1991), we compared DBT to TAU. Comparison with another standardized treatment would provide a stronger test of specific efficacy, but no such treatment manual was available,and TAU provides a useful, clinically meaningful comparison. TAU was somewhat more standardized in our study than in other randomized controlled trials of psycho dynamic or cognitive behavioral treatments for BPD (Bateman &Fonagy, 1999; Linehan et al., 1991) or for recurrent suicidal or self-injurious behavior (Evans et al., 1999; Salkovskis, Atha, & Storer,1990) in that all patients received their treatment in the same system (the local VA) and efforts were successfully made to ensure that all patients referred to TAU actually began treatment.

Because in our study recent parasuicide wasnot a criterion for study entry, we expected our sample to have less currentparasuicidal behavior than the sample of Linehan et al. (1991), andhypothesized that DBT would be associated with significant reductions in abroader range of symptoms. Because of its focus on distress tolerance skills,we predicted significant declines in both parasuicidal behavior and suicidalideation. Because DBT links behavioral change to specific goals and focuses ondeveloping a "life worth living;' we predictedthat it would reducehopelessnes s. In addition, we predicted that the focus on developing and usingemotion regulation and interpersonal effectiveness skills, together with thetargeted problem-solving approach, would significantly :reduce depression,anxiety, anger, and dissociation. We predicted that patients in DBT wouldchange significantly more on these variables than patients in TAU. We alsoassessed whether patients in either treatment changed in diagnostic statusfollowing treatment, as recommended by Turner (2000).

dairymanUID: 2683905

看完了，用时2min
没看明白……似乎是说了一种病，然后说了一种治疗方法，尽管不是最好的，怕是唯一的方法了
这个病没看懂，但是似乎涉及suicide……

lghscuUID: 2552043

解决！

bobo19890313UID: 2622130

哎。。。。