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Background Residents report high levels of distress but low utilization of mental health services. Prior research has shown several barriers that prevent residents from opting into available mental health services. Objective To determine the impact of a mental health initiative centered around an opt-out versus an opt-in approach to help-seeking, on the use of psychotherapy. Methods Resident use of psychotherapy was compared between 2 time frames. During the first time frame (July 1, 2020 to January 31, 2021), residents were offered access to therapy that they could self-initiate by calling to schedule an appointment (opt-in). The second time frame (February 1, 2021 to April 30, 2021) involved the switch to an opt-out structure, during which the same residents were scheduled for a session but could choose to cancel. Additional changes were implemented to reduce stigma and minimize barriers. The outcome was psychotherapy use by residents. Results Of the 114 residents, 7 (6%) self-initiated therapy during the opt-in period. When these same residents were placed in an opt-out context, 59 of the remaining 107 residents (55%) kept their initial appointment, and 23 (39%) self-initiated additional sessions. Altogether, across both phases, a total of 30 of the 114 residents initiated therapy (ie, 7 during the opt-in and 23 during the opt-out). The differences in therapy use between the 2 phases are statistically significant (P

Introduction: Our aim was to determine the psychological and educational impact of the 2017 Las Vegas mass shooting on the graduate medical education (GME) mission within two cohorts of resident physicians and attending faculty at two nearby academic trauma centers. Methods: A cross-sectional survey assessed 55 resident physicians and attending faculty involved in the acute care of the patients from the mass shooting. We measured the psychological impact of the event, post-traumatic growth, team cohesion, social support, and known risk factors for post-traumatic stress disorder (PTSD). Additionally, we assessed the impact of the event on GME-specific tasks. Results: Attending faculty and physicians in training in GME residencies evaluated over 300 penetrating trauma patients in less than 24 hours, and approximately 1 in 3 physicians had a patient die under their care. Despite this potential for psychological trauma, the majority of clinicians reported minimal distress and minimal impact on GME activities. However, 1 in 10 physicians screened positive for possible PTSD. Paradoxically, the minority of physicians who sought psychological counseling after the event (20%) were not those who reported the highest levels of distress. Residents generally assessed the event as having an overall negative impact on their educational goals, while attendings reported a positive impact. Psychological impact correlated inversely with social support and the amount of prior education relating to mass casualty incidents (MCI) but correlated directly with the degree of stress prior to the event. Conclusion: Despite the substantial level of exposure, most resident physicians did not report significant psychological trauma or an impact on their GME mission. Some reported post-traumatic growth. However, a minority reported a significant negative impact; institutions should consider broad screening efforts to detect and assist these individuals after a MCI. Social support, stress reduction, and education on MCIs may buffer the effects of future psychologically traumatic events on physicians in training.

Early studies of Weiner's attribution theory found that ascribing the cause of negative situations to stable factors was associated with more sympathy, less anger, and subsequently, greater willingness to help. Recent studies indicated the opposite pattern of results when the person in need was a close relational partner. The current mixed methods research used an experimental-causal-chain design to examine why people respond negatively toward their loved ones with depression. Study 1 found that participants felt they would be affected more negatively when presented with hypothetical information about their loved one's permanent (vs. temporary) depression, which was associated with more anger, and subsequently, less willingness to help. Participants also perceived their loved ones would be less able to fulfill relational obligations, which was associated with less sympathy and more anger, and these emotions were related to less willingness to help. Study 2 experimentally manipulated mediators from Study 1 (i.e., negative personal impact and psychological contract breach) and demonstrated that participants expressed more anger when they anticipated their loved one's depression would have a negative impact (vs. no impact) on their lives, which was associated with less willingness to help. Findings extend the current understanding of stability attributions and explain why perceived stability may engender unfavorable responses among relational partners., Author(s): Tara Muschetto [sup.1] , Jason T. Siegel [sup.1] Author Affiliations: (1) grid.254271.7, 0000 0004 0389 8602, Claremont Graduate University, , 150 E. 10th Street, 91711, Claremont, CA, USA Depression [...]

Psychological reactance theory posits that when people are faced with threats to, or elimination of, behavioral freedom, they experience an aversive motivational state (i.e., psychological reactance). Recent research indicates that people's state of mind affects reactance arousal processes. We hypothesized that being in a state of threatening uncertainty would cause people to experience less psychological reactance to a freedom-threatening communication than those in a state of certainty. We randomly assigned 114 students from a North American University to an uncertainty- or certainty-inducing recall task; they were then exposed to a reactance-arousing message. Compared to participants primed to feel certain, those primed with threatening uncertainty reported significantly less threat and more positive attitudes in response to a freedom threatening communication. Mediation analysis revealed an indirect effect of feelings of threatening uncertainty on people's behavioral intentions, through perceptions of the controlling message. Results support our hypothesis: people in a state of uncertainty experience less psychological reactance than those in a state of certainty., Author(s): Benjamin D. Rosenberg [sup.1] , Jason T. Siegel [sup.2] Author Affiliations: (1) grid.255148.f, 0000 0000 9826 3546, Dominican University of California, , 50 Acacia Ave, 94901, San Rafael, CA, [...]

The current study explored depression, help-seeking, and academic struggles among graduate students. Focus groups were conducted with graduate students who self-reported currently or previously experiencing depression. Mental health, help-seeking, and campus mental health culture were discussed. Participants described the emergence or reemergence of mental health challenges. Although some reported feeling comfortable discussing depression with friends, participants noted minimal institutional openness about mental health, being expected to be mentally and physically exhausted, and fear of stigmatization.

The COVID-19 pandemic transformed the final year of undergraduate medical education for thousands of medical students across the globe. Out of concern for spreading SARS-CoV-2 and conserving personal protective equipment, many students experienced declines in bedside clinical exposures. The perceived competency of this class within the context of the pandemic is unclear. We designed and distributed a survey to measure the degree to which recent medical school graduates from the USA felt clinically prepared on 13 core clinical skills. Of the 1283 graduates who matched at HCA Healthcare facilities, 90% (1156) completed the survey. In this national survey, most participants felt they were competent in their clinical skills. However, approximately one out of four soon-to-be residents felt they were clinically below where they should be with regard to calling consultations, performing procedures, and performing pelvic and rectal exams. One in five felt they were below where they should be with regard to safely transitioning care. These perceived deficits in important skill sets suggest the need for evaluation and revised educational approaches in these areas, especially when traditional in-person practical skills teaching and practice are disrupted. [ABSTRACT FROM AUTHOR]

Past research indicates that self-distancing through perspective-taking may increase help-seeking intentions among some people with depression. The current pre-registered study tested the effect of self-distancing through mental time-travel on help-seeking attitudes, intentions, outcome expectations, and self-stigma. Participants with elevated depressive symptomatology who had not yet sought help for current feelings of depression (n = 859) were randomly assigned to a self-distancing writing task, a self-immersive writing task, or a control condition. Help-seeking attitudes were significantly higher in the distancing condition than in the immersive or control conditions. Additionally, self-distancing through mental time-travel resulted in higher help-seeking intentions compared to the control condition but was not significantly different from the immersive condition. The immersive condition was not significantly different from the control for any outcomes. Interactions show that both self-distancing and the immersive task weakened the negative relationship between depression severity and help-seeking attitudes and intentions. Extending scholarship investigating self-distancing and help-seeking intentions, results show that self-distancing through mental time-travel can result in more favorable help-seeking attitudes compared to a control. [ABSTRACT FROM AUTHOR]

Guided by vested interest theory, we assessed whether a lack of stake explains the discrepancy between people having positive attitudes toward their loved one's recovery from depression and the provision of support. We further investigated whether increasing the perceived personal consequences of providing support (i.e. stake) increased willingness to provide support. A stake-boosting message had no direct, but significant indirect effects on willingness to provide support when compared to a control and comparison condition. In summary, increasing stake in a loved one's recovery indirectly increases intentions to provide support. [ABSTRACT FROM AUTHOR]