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Women are more likely than men to be targets of incivility in the workplace. Scholars have referred to this pattern as selective incivility and suggest that incivility directed toward women—that is, selective incivility—is a form of modern sexism in the workplace. However, it remains unclear whether women themselves make sense of incivility from men as a form of gender bias, and when such perceptions shape whether women engage in unique responses to incivility perceived as selective. Drawing on social identity theory, we develop a conceptual model to better understand these relationships. Across two studies with working women, we show that women perceive male‐instigated incivility as selective. Further, our findings show that women are more likely to engage in problem‐focused‐responses (i.e., direct confrontation and formal reporting), rather than emotion‐focused responses (i.e., avoidance) in response to incivility perceived as selective and that these coping responses are, at times, moderated by the frequency of incivility. Overall, our research advances the literature on incivility, selective incivility, and gender bias at work, offers practical implications for managers seeking to foster workplace inclusion, and suggests novel directions for future research. [ABSTRACT FROM AUTHOR]

Studies examining behavioural responses to emotional stimuli usually report one of two patterns of responses to negative stimuli. Some studies find faster responses to negative material. Other studies find slower responses to negative stimuli. While the attentional mechanisms proposed to explain these findings (attentional capture in the former case, delayed disengagement in the latter) are not at odds with one another, the behavioural findings do need to be reconciled. We posit that arousal, being the primary differentiator of threatening and nonthreatening stimuli, needs to be more carefully considered. To this end, two experiments were conducted evaluating the role of stimulus arousal and valence in the processing of schematic emotional faces. In Experiment 1, stimulus arousal was manipulated via the presence or absence of eyebrows in the schematic faces in a faces flanker task. Results showed faster responses to faces with eyebrows but no differences in the faces flanker asymmetry between faces with and without eyebrows. In Experiment 2, participants rated the faces on an evaluative space grid. Results showed the presence of the eyebrows had a greater impact on negative ratings for negative faces than for the other expressions. This suggests that stimulus valence and arousal were manipulated by the eyebrows and the reaction time differences could not be attributed purely to perceptual differences. Together these results suggests that both valence and arousal impact the processing of emotional schematic faces, and that these effects are dissociable. [ABSTRACT FROM AUTHOR]

Aims: To describe intensive care unit nurses' experiences of moral distress during the COVID‐19 pandemic, and their recommendations for mitigative interventions. Design: Interpretive description. Methods: Data were collected with a purposeful sample of 40 Canadian intensive care unit nurses between May and September 2021. Nurses completed a demographic questionnaire, the Measure of Moral Distress—Healthcare Professionals survey and in‐depth interviews. Quantitative data were analysed using descriptive statistics. Qualitative data were categorized and synthesized using reflexive thematic analysis and rapid qualitative analysis. Results: Half of the nurses in this sample reported moderate levels of moral distress. In response to moral distress, nurses experienced immediate and long‐term effects across multiple health domains. To cope, nurses discussed varied reactions, including action, avoidance and acquiescence. Nurses provided recommendations for interventions across multiple organizations to mitigate moral distress and negative health outcomes. Conclusion: Nurses reported that moral distress drove negative health outcomes and attrition in response to moral events in practice. To change these conditions of moral distress, nurses require organizational investments in interventions and cultures that prioritize the inclusion of nursing perspectives and voices. Implications for the Profession: Nurses engage in a variety of responses to cope with moral distress. They possess valuable insights into the practice issues central to moral distress that have significant implications for all members of the healthcare teams, patients and systems. It is essential that nurses' voices be included in the development of future interventions central to the responses to moral distress. Reporting Method: This study adheres to COREQ guidelines. Impact: What Problem did the Study Address?: Given the known structural, systemic and environmental factors that contribute to intensive care unit nurses' experiences of moral distress, and ultimately burnout and attrition, it was important to learn about their experiences of moral distress and their recommendations for organizational mitigative interventions. Documentation of these experiences and recommendations took on a greater urgency during the context of a global health emergency, the COVID‐19 pandemic, where such contextual influences on moral distress were less understood. What Were the Main Findings?: Over half of the nurses reported a moderate level of moral distress. Nurses who were considering leaving nursing practice reported higher moral distress scores than those who were not considering leaving. In response to moral distress, nurses experienced a variety of outcomes across several health domains. To cope with moral distress, nurses engaged in patterns of action, avoidance and acquiescence. To change the conditions of moral distress, nurses desire organizational interventions, practices and culture changes situated in the amplification of their voices. Where and on Whom Will the Research Have an Impact on?: These findings will be of interest to: (1) researchers developing and evaluating interventions that address the complex phenomenon of moral distress, (2) leaders and administrators in hospitals, and relevant healthcare and nursing organizations, and (3) nurses interested in leveraging evidence‐informed recommendations to advocate for interventions to address moral distress. What Does this Paper Contribute to the Wider Global Community?: This paper advances the body of scientific work on nurses' experiences of moral distress, capturing this phenomenon within the unique context of a global health emergency.Nurses' levels of moral distress using Measure of Moral Distress—Healthcare Professional survey were reported, serving as a comparator for future studies seeking to measure and evaluate intensive care unit nurses' levels of moral distress.Nurses' recommendations for mitigative interventions for moral distress have been reported, which can help inform future interventional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Shame is an intensely painful emotion that adversely impacts mental health and social relationships. Although shame proneness is associated with insecure attachment and sexual satisfaction, independently, no research has examined how shame proneness relates to both of these constructs simultaneously. Such an investigation is necessary due to pervasive cultural messaging that intertwines shame, attachment, and sexuality. The present study addressed this gap in the literature through testing a moderated mediation model with an online sample of 384 American adults. Results indicate that sexual self-esteem mediated the relationship between insecure attachment style and sexual satisfaction among the present sample. Shame proneness moderated the relationship between avoidant attachment and sexual satisfaction. These findings provide implications for relationship and sex therapists working with clients impacted by shame. [ABSTRACT FROM AUTHOR]

Insecure attachment styles, widely recognized as negative predictors in most Western samples, have been found to impair marital satisfaction for individuals high in attachment anxiety and attachment avoidance. However, Chinese culture is more tolerant of some features of attachment avoidance, which may lead to different implications of attachment styles for marital relationships. Besides, considering that responses of the partner play a vital role in the interaction of intimate relationships, the current study examined how attachment styles affect marital satisfaction through perceived partner responsiveness (PPR). This study is based on dyadic data from 668 Chinese couples across six marital stages, whose average length of marriage was 15.22 years (ranging from 0.03 to 67.57 years, SD = 13.88). Using the actor-partner interdependence model (APIMeM) to analyze these data, results suggested that: (a) individuals' attachment anxiety was negatively associated with marital satisfaction for both themselves and their partner, and these associations were partially mediated by PPR; (b) PPR was a full mediator of the positive association between individuals' attachment avoidance and their own marital satisfaction; (c) wives' PPR fully mediated the positive association between their attachment avoidance and their partner's marital satisfaction, whereas husbands' PPR partially mediated the positive association between their attachment avoidance and their partner's marital satisfaction. These findings differ from previous studies based on Western samples and advance our understanding of how attachment styles are related to PPR and marital satisfaction in Chinese context, providing practical guidance on marital interactions for people with insecure attachment styles. [ABSTRACT FROM AUTHOR]

Anxiety is very pertinent to systemic family therapy (SFT), however, there is little research that seeks to understand people's experiences with anxiety symptoms and how they impact people's lives and relationships. The aim of this study was to examine the trending hashtag #ThisIsWhatAnxietyFeelsLike—a commonly used hashtag related to anxiety—to look more closely at how users talk about their anxiety symptoms on Twitter and how these symptoms influence people's interactions and relationships with others. We used a qualitative thematic analysis to analyze 1318 relational tweets posted with this hashtag that occurred between February 2017 and February 2018 and uncover themes related to experiences with anxiety. The analysis revealed six core themes: (a) deflated self in relation to others and their perceptions; (b) fear, worry and avoidance behaviors that influence relationships; (c) negative emotional responses leading to feeling misunderstood, lonely, and like a failure; (d) social triggers; (e) anxiety management strategies; and (f) things for others to avoid. [ABSTRACT FROM AUTHOR]

We examined the feasibility, acceptability, and clinical potential of a smartphone-based Approach-Avoidance Modification Training (AAMT) that required users to deliberately display anger and positive emotions (AAMT-AP) to move (dys-)functional stress-related beliefs away from and towards themselves, respectively. The per protocol sample consisted of N = 30 participants randomized to an AAMT-AP condition, a swipe control condition, or an inactive control condition. Feasibility and acceptability of the intervention and study design were assessed directly and changes in clinical outcomes (perceived stress (primary outcome), dysfunctional beliefs, symptoms of depression, and emotion regulation skills) one week after intervention completion. The results indicated that AAMT-AP was feasible and acceptable to participants. Moreover, notable effect sizes for clinical outcomes in comparison with both control conditions provided preliminary evidence for its therapeutic potential. Future research should evaluate the efficacy of AAMT-AP in sufficiently powered randomized controlled trials. [ABSTRACT FROM AUTHOR]

Misophonia is a sound sensitivity disorder characterized by a strong aversion to specific sounds (e.g., chewing). Here we present the Sussex Misophonia Scale for Adults (SMS-Adult), within an online open-access portal, with automated scoring and results that can be shared ethically with users and professionals. Receiver operator characteristics show our questionnaire to be "excellent" and "good-to-excellent" at classifying misophonia, both when dividing our n = 501 adult participants by recruitment stream (self-declared misophonics vs. general population), and again when dividing them with by a prior measure of misophonia (as misophonics vs. non-misophonics). Factor analyses identified a five-factor structure in our 39 Likert-type items, and these were Feelings/Isolation, Life consequences, Intersocial reactivity, Avoidance/Repulsion, and Pain. Our measure also elicits misophonia triggers, each rated for their commonness in misophonia. We offer our open-access online tool for wider use (www.misophonia-hub.org), embedded within a well-stocked library of resources for misophonics, researchers, and clinicians. [ABSTRACT FROM AUTHOR]

Insecure attachment is proposed to be a risk factor in the development and persistence of severe grief. Although prior research demonstrates positive cross-sectional and longitudinal correlations between attachment styles and prolonged grief symptoms, controlled longitudinal analyses yield fewer convincing results. Therefore, we sought to further clarify the concurrent and longitudinal associations between these constructs. A sample of 225 bereaved Dutch adults (87% women; Mean age: 48.86 years) participated in a three-wave longitudinal survey including measures of attachment anxiety and attachment avoidance at baseline and prolonged grief symptoms at baseline and 6- and 12-month follow-up. Attachment anxiety and attachment avoidance were significantly positively correlated with prolonged grief symptoms at all time-points. However, multiple regressions, controlling for baseline symptoms, showed that attachment anxiety, attachment avoidance, and their interaction did not predict residual change in prolonged grief symptoms. These findings cast doubt on the proposed role of insecure attachment styles in prolonged grief. [ABSTRACT FROM AUTHOR]

Background: The inclusion of family therapy in residential treatment centers (RTCs) has increased over time. However, there is little data on whether empirically-supported family therapies (ESFTs) are being adopted and if they contribute to treatment effectiveness. This study aimed to test whether Attachment-Based Family Therapy (ABFT), an ESFT integrated into a large residential psychiatric system, would improve perceived attachment insecurity (anxiety and avoidance) and contribute to decreases in depression for adolescents. Method: ABFT was integrated into the clinical program of a large, residential psychiatric system. All family therapists were trained to a level of certification. Improvement was measured by changes in adolescent's perceived attachment to caregivers and reduction in depressive symptoms. The sample included 4786 patients. Attachment insecurity and depressive symptoms were measured at intake, week 3, and week 5. A random-intercept, cross-lagged panel model was used to examine the relationships between attachment and depression over time. Results: The results generally supported hypotheses. Attachment insecurity and depressive symptoms improved over the five weeks of treatment. Improvements in attachment avoidance preceded improvements in depressive symptoms within subjects, over time. Simultaneously, improvements in depressive symptoms preceded those in both dimensions of attachment. Thus, improvement in perceived attachment was associated with a reduction in depressive symptoms. Conclusion: RTCs that can generate improvements in attachment insecurity and depressive symptoms, via ABFT or other ESFTs, might improve treatment outcomes, and ideally, adolescents' successful transition back home to families. More research is needed to disentangle the contribution of ABFT and other treatment elements in a multimodal, residential treatment program. The study supports the call for increased incorporation of families into the RTC treatment process. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the mediating role of social stigma in the relationship between the effects of traumas to which Syrian refugees have been exposed and their self-disclosure expectations. The study included 510 Syrians (218 women, 292 men) who sought refuge in Turkey since 2011. The analysis results of the path model in the study indicated that the created model had a perfect goodness of fit (χ2/df = 1.06, p =.371). Additionally, stigmatization was found to have a full mediating effect on anticipated utilities from hyperarousal and self-disclosure and a partial mediating effect on the anticipated risks of hyperarousal and self-disclosure. Stigmatization also exhibited no significant mediating effect on the avoidance and re-living sub-dimensions and utility and risk (GFI =.997, AGFI =.985, CFI = 1.0, and RMSEA =.011). It was observed that all components of PTSD had a negative relationship with self-disclosure utility expectations and a positive relationship with self-disclosure risk expectations. Consequently, it is evident that as the severity of traumatic experiences escalates, Syrian refugees perceive self-disclosure as increasingly risky. [ABSTRACT FROM AUTHOR]

Objectives: Although treatments of patients with borderline personality disorder (BPD) were historically associated with relatively high dropout rates, dropout rates in contemporary evidence‐based treatments for BPD are typically substantially lower. However, only a few studies have investigated dropout rates in mentalization‐based treatment (MBT), and even fewer have investigated predictors of dropout in this type of treatment. In this study, we investigated dropout rates in two types of MBT (day hospital MBT [MBT‐DH] and intensive outpatient MBT [MBT‐IOP]) using data from a recent multicenter randomized clinical trial. Given the central importance of attachment considerations in MBT, we also investigated the relationship between dropout in these two treatments and attachment dimensions. Design: Within a multicenter randomized clinical trial, 114 BPD patients were randomized to MBT‐DH (n = 70) or MBT‐IOP (n = 44). Methods: Dropout in both types of MBT was investigated using descriptive analyses, and its association with attachment anxiety and attachment avoidance, as measured by the Experiences in Close Relationships questionnaire at baseline, was investigated using regression analyses. Results: Dropout rates were relatively low (10.5% across both types of MBT) and did not significantly differ between groups (11.4% in MBT‐DH, 9.1% in MBT‐IOP). Attachment avoidance and attachment anxiety did not impact dropout, nor did their interaction or the interaction with the type of MBT. Conclusions: Low dropout rates in both types of MBT indicate a high level of engagement of patients in both programmes. Attachment dimensions were not associated with dropout, consistent with the principle that MBT is tailored to each individual's needs. More research is needed, however, to investigate to what extent attachment is a dynamic context‐bound adaptive process rather than a static personality feature. [ABSTRACT FROM AUTHOR]

Background: Mental health disparities persistently cause inequity and social exclusion. Extensive research underpins the need to embrace the social determinants of health and facilitate network learning at various ecosystem levels. Despite valuable quality frameworks and ratified conventions, local practices which counter health inequity are scarce. Methods: The Dutch HOP-TR study collected health and needs of Homeless Service Users (HSU) in a rights-based, transdiagnostic, recovery framework. We assessed the survival modes and conducted a socio-ecological analysis, exploring what happened in care pathways at three ecosystem levels: individual HSU, caregiver networks, society. While documenting vital conditions for growth and citizenship, we explore major opportunities to develop 'fair space for life'. Results: Under low distress levels, prosocial behavior is prominent (32.9%). High distress levels are found with an avoidant (42.0%) or aggressive mode (24.9%). Rising distress levels give more frictions in relations, psychiatric admissions, and police-justice contacts. The distress-induced descent in the social hierarchy causes social withdrawal, alienation, and marginalization. At society level, fair conditions for growth and citizenship are challenged by the cumulative impact of distress over the HSU' lives. Discussion: This care monitor uncovers the impact of distress on caregiver interactions. The care pathways reveal that the survival strategies reflect a systematic, pervasive neglect. Unfair representations hold HSU personally responsible of their situation, disregarding the cumulative impact of environmental conditions over their lives. The diverse sources of unfairness are intrinsic to the health care system and culture. Therefore, the survival modes ask for profound culture transformations in a whole-system-whole-society approach. Conclusion: Given the need for action on health equity and the social determinants of health, this paper provides an example of a dynamic care monitor. The actionable data elicit dialogs and stimulate to enrich opportunities for inclusion and growth in communities and societies. [ABSTRACT FROM AUTHOR]

Why do some perceive a partner's response as heartening while others interpret the same response as demoralizing? This study examined how attachment anxiety and avoidance influence perceived partner responses toward capitalization attempts (PRCA) and perceived mattering (PM) among married couples (N = 103 dyads). Dyadic analyses delineating the actor and partner effects revealed that wives' attachment avoidance predicted own PRCA, PM, and their husbands' PRCA. Whereas husbands' attachment avoidance predicted own PM and their wives' PRCA and PM, husbands' attachment anxiety predicted only their PRCA and PM. The interaction between wife and husband attachment anxiety also predicted the husbands' PRCA and PM. Husbands, but not wives, perceived the lowest level of PRCA and PM when both couples had high attachment anxiety. The results were discussed in the context of the interplay between attachment orientations and partner responsiveness in Turkish culture. [ABSTRACT FROM AUTHOR]

Existing work on the contribution of life events and person characteristics to changes in attachment has mostly overlooked interactions between events and characteristics. Using 15 common events and ten personality characteristics in a multi-wave longitudinal study of 6,566 people, we examined whether person characteristics moderate the impact of life events on change in attachment. Although we found more interactions than were expected by chance, they did not consistently involve specific events or person characteristics and had small effect sizes. The largest number of event-person interactions were observed for changes in attachment security, followed by anxiety and avoidance. We found a similar number of interactions between events and within-person variation in person characteristics and "traditional" PxE interactions where the person characteristics are stable. These results suggest the need to look at both the traditional PxE interactions and the way dynamically varying person characteristics interact with events to understand changes in attachment. [ABSTRACT FROM AUTHOR]

Purpose: Evidence on rehabilitation after revision total hip replacement (THR) is inadequate and development of rehabilitation interventions is warranted. Even so, little is known about patients' experiences with revision THR rehabilitation. This study aimed to explore patients' rehabilitation exercise experiences after revision THR. Materials and methods: Using constructivist grounded theory, we conducted semi-structured qualitative interviews with twelve patients with completed or almost completed rehabilitation exercise after revision THR. Data collection and analysis were a constant comparative process conducted in three phases; initial, focused, and theoretical. Findings: From the data, we generated a substantial theory of the participant's circumstances and ability to integrate rehabilitation exercise into their everyday life after revision THR. Four categories were constructed based on patients' experiences in different contexts: hesitance, fear avoidance, self-commitment, and fidelity. Conclusions: This study highlighted that patients' expectations, past experiences, attitudes, trusts, and circumstances interact to influence engagement and adherence to rehabilitation exercise and described four categories relating to the integration of revision THR rehabilitation exercise into their everyday life. Clinicians should be aware of and account for these categories during rehabilitation exercise. Tailored individual rehabilitation exercise interventions and clinician approaches to optimize engagement and adherence are needed among patients with revision THR. IMPLICATIONS FOR REHABILITATION: Patients' rehabilitation exercise experiences after revision total hip replacement may serve as guidance for clinicians. A need exists to tailor individual rehabilitation interventions and clinicians' approaches to optimize patients' engagement and rehabilitation exercise adherence following revision total hip replacement. Clinicians can tailor rehabilitation exercise for patients with revision total hip replacement by focusing on therapeutic relationships, support needs, and physical function while incorporating insights from previous rehabilitation exercise experiences. An important goal of rehabilitation exercise is to enhance patient engagement, thereby facilitating the integration of rehabilitation exercises into the patients' everyday life. [ABSTRACT FROM AUTHOR]

Background/Objectives: Empathy and emotional regulation (susceptibility and resistance) play an important role in a nurse's well-being and the provision of high-quality care. This phenomenon has not yet been studied in the context of nurses working in neuroscience. This study aimed to explore the perceptions related to empathy among nurses working in neuroscience contexts. Methods: Employing a mixed-methods approach, we conducted an online quantitative survey with 211 nurses working in various neuroscience settings using the Balanced Emotional Empathy Scale (BEES) and 15 online semistructured qualitative interviews to delve deeper into empathetic experiences. The mean and measures of dispersion, such as standard deviation, were used to analyze the quantitative data. Thematic analysis investigated qualitative data, and data triangulation was performed. Results: The quantitative findings revealed no significant differences in empathy or emotional regulation across the different neuroscience settings but highlighted an increase in susceptibility related to young age (under 29) and years of service (first 5 years). The interviews brought to light the challenges nurses face in highly emotional situations and the strategies they employ to manage empathy and maintain professional detachment, such as self-care strategies, awareness development, and team support. One hindering factor is managers. Conclusions: The findings of this study underscore the essential role of empathetic capability in nursing care in neuroscience. The experience of younger nurses and the first 5 years of employment are elements to be considered by managers for burnout risk. Nurses demonstrate susceptibility and resistance and maintain a balance in dealing with high-emotional-stress situations. The implications of these findings are significant and should guide future research and practice in the field of neuroscience nursing. [ABSTRACT FROM AUTHOR]

Introduction: The present study investigates the feasibility and usability of a sensorbased eHealth treatment in psychotherapy for pediatric obsessive-compulsive disorder (OCD), and explores the promises and pitfalls of this novel approach. With eHealth interventions, therapy can be delivered in a patient's home environment, leading to a more ecologically valid symptom assessment and access to experts even in rural areas. Furthermore, sensors can help indicate a patient's emotional and physical state during treatment. Finally, using sensors during exposure with response prevention (E/RP) can help individualize therapy and prevent avoidance behavior. Methods: In this study, we developed and subsequently evaluated a multimodal sensor-based eHealth intervention during 14 video sessions of cognitivebehavioral therapy (CBT) in 20 patients with OCD aged 12-18. During E/RP, we recorded eye movements and gaze direction via eye trackers, and an ECG chest strap captured heart rate (HR) to identify stress responses. Additionally, motion sensors detected approach and avoidance behavior. Results: The results indicate a promising application of sensor-supported therapy for pediatric OCD, such that the technology was well-accepted by the participants, and the therapeutic relationship was successfully established in the context of internet-based treatment. Patients, their parents, and the therapists all showed high levels of satisfaction with this form of therapy and rated the wearable approach in the home environment as helpful, with fewer OCD symptoms perceived at the end of the treatment. Discussion: The goal of this study was to gain a better understanding of the psychological and physiological processes that occur in pediatric patients during exposure-based online treatment. In addition, 10 key considerations in preparing and conducting sensor-supported CBT for children and adolescents with OCD are explored at the end of the article. This approach has the potential to overcome limitations in eHealth interventions by allowing the real-time transmission of objective data to therapists, once challenges regarding technical support and hardware and software usability are addressed. [ABSTRACT FROM AUTHOR]

Aims: This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID‐19 pandemic. Additionally, we explored the association of such levels with personal and professional variables. Design: Cross‐sectional study. Methods: Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work‐related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested. Results: In total, 18.8% of the sample scored above the cut‐off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%–53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work‐related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre‐pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID‐19. Conclusion: Healthcare workers showed high levels of psychological impact during the COVID‐19 pandemic. Such impact was predicted from some work‐stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression. Impact: Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims While elevated levels of anxiety are associated with worse prognosis of cardiovascular disease (CVD), this association may vary between different aspects of anxiety. The aim of this study was to analyse self-reported behavioural, physiological, affective, and cognitive aspects of anxiety and their relation to the risk of recurrent CV events. Methods and results This prospective cohort study utilized data from the U-CARE Heart trial. Participants (N = 935, post myocardial infarction) answered the Hospital Anxiety and Depression Scale (HADS: Anxiety subscale) and the Cardiac Anxiety Questionnaire (CAQ: Fear, Avoidance & Attention subscales). HADS Anxiety reflected physiological aspects, CAQ Fear reflected cognitive and affective aspects, CAQ Avoidance reflected behavioural aspects, and CAQ Attention reflected cognitive aspects of anxiety. Cox regression was used to estimate the risk between anxiety and recurrent major adverse cardiac event (MACE). During the follow-up period (mean 2.9 years), 124 individuals (13%) experienced a specified MACE endpoint. HADS Anxiety and CAQ Total were both associated with increased risk of MACE [hazard ratio (HR) = 1.52, 95% confidence interval (CI): 1.15–2.02 and HR = 1.30, 95% CI: 1.04–1.64, respectively]. Among the CAQ subscales, there was support for an association between Avoidance and risk of MACE (HR = 1.37, 95% CI 1.15–1.64), but not for Attention and Fear. Conclusion The results support that anxiety is associated with an increased risk of recurrent MACE in post-myocardial infarction patients. The association between anxiety and risk was strong for the aspects of anxiety relating to behaviour and physiology, while the support for an association with cognitive and affective aspects was lacking. [ABSTRACT FROM AUTHOR]

This study aimed to examine the psychometric properties of the Chinese version of the family accommodation scale for obsessive–compulsive disorder (OCD) patient version (FAS-PV). A total of 171 adult OCD patients and 145 family members were enrolled in the present study. The majority of the adult OCD patients (89.5%) reported engaging in at least one accommodating behavior in the past week. The FAS-PV comprised three components that included (a) direct participation and facilitation, (b) provision of reassurance and assumption, and (c) modification of routines and avoidance. The FAS-PV demonstrated excellent internal consistency. The correlation between the total FAS-PV score and the criteria measure demonstrated excellent convergent validity when assessing the OCD symptom severity, global functioning, family functioning, and functioning impairment. The findings supported that the FAS-PV could be used widely in evaluating and identifying the accommodating behavior both in clinical and in research settings, especially in adult OCD patients who usually present to the clinic alone. [ABSTRACT FROM AUTHOR]

A significant proportion of frontline nurses developed post-traumatic stress disorder (PTSD) symptoms as a result of working during the COVID-19 pandemic. This study aimed to determine the efficacy of a mindfulness- and acceptance-based smartphone app intervention among nurses traumatized by the COVID-19 pandemic. This was a two-arm, randomized controlled trial. We randomly assigned 60 frontline nurses working in various clinical settings in the United States during the pandemic to either the intervention group (i.e. participants used the mindfulness app for 6 wk) or the wait-list control group. We assessed the app's efficacy through outcome measures of PTSD symptom severity, experiential avoidance, rumination, mindfulness, and resilience, measured at pre-, mid-, and post-intervention periods and a 1-month follow-up. Intervention satisfaction and perceived usability of the app were assessed within the intervention group. There was strong evidence of within-between interaction for PTSD, experiential avoidance, and rumination, implying significant improvement of these outcomes for the intervention group as compared to the control group. We only found a within-group interaction effect for mindfulness, indicating significant improvement of mindfulness within the intervention group only. Participants in the intervention group reported high satisfaction levels and perceived usability with the app. Findings highlight that mindfulness- and acceptance-based smartphone apps can improve PTSD symptoms of nurses traumatized by the pandemic. Healthcare organizations should provide nurses with accessible interventions (e.g. mindfulness apps) to treat and prevent secondary behavioral consequences of the pandemic, such as PTSD. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the associations between anxiety, depression, and coping in healthcare workers during coronavirus disease 2019. Methods: A survey used the Generalized Anxiety Disorder 2 to assess anxiety, the Patient Health Questionnaire 2 to assess depression, and the Brief Coping Orientation to Problems Experienced (COPE) scale to evaluate coping mechanisms. Results: Of the 1172 participants who provided data, 24.7% screened positive for anxiety and 15.7%for depression. Logistic regression indicated that avoidance coping (odds ratio [OR], 3.92 [95% confidence interval (CI), 2.91-5.29]; P < 0.001) and substance use coping (OR, 1.39 [95% CI, 1.00-1.90]; P = 0.049) were associated with higher odds of depression. Avoidance coping (OR, 2.81 [95% CI, 2.15-3.67]; P < 0.001) and social support coping (OR, 1.59 [95% CI, 1.22-2.08]; P = 0.001) were associated with higher odds of anxiety. Conclusions: Interventions are needed to improve healthcare workers' coping and well-being. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate empirically the direct effect and potential mechanism of family resilience on patient‐reported outcomes among young stroke dyads in China. Background: Young patients with stroke have been becoming an important public health issue. According to relevant theories and previous studies, we found that family resilience might play an important role in patient's symptoms. However, it is less clear about the specific relationship and potential mechanisms of these two variables. Design: We used a prospective cross‐sectional design. Methods: A multi‐item questionnaire was used to assess the constructs of interest. Researchers progressively constructed and validated conditional process models. The PROCESS macro was used to verify the research hypotheses. Results: A total of 560 questionnaires were collected in this study. We found that family resilience of stroke patients and their spouses had a direct effect on the physical, psychological and social aspects of patient‐reported symptoms. We further revealed that caregiver preparedness partially mediated the relationship between family resilience and patient's symptoms in stroke patient‐spouse dyads, while perceived social support moderated the relationship between caregiver preparedness and patient's symptoms. Finally, we observed that the impact of caregiver readiness and social support on patients' symptoms predominantly manifested in physical and physiological outcomes. Conclusions: Our research provides evidence about the positive impact of family resilience on patient‐reported symptoms in young stroke dyads. Meanwhile, it further revealed how caregiver preparedness and perceived social support may play out in the relationship. Practice Implications: Our research introduces a novel perspective and pathway to enhance short‐term recovery outcomes for patients. It also furnishes clinicians and nurses with evidence to guide the implementation of interventions aimed at improving patient health outcomes and facilitating smoother transitions from the hospital to home. Impact: What problem did the study address? Families play a crucial role in a patient's recovery process from illness, with family resilience serving as an important force for families to overcome adversity. However, the impact on patient symptoms and the underlying mechanisms of this relationship are uncertain. Empirical research is required to validate these aspects. What were the main findings? Family resilience has a positive impact on the physical, psychological and social aspects of patient‐reported symptoms in young stroke dyads. Both the actor effect and partner effect are supported. The impact of caregiver readiness and social support on patient‐reported symptoms is primarily observed in physical and physiological outcomes. Where and on whom will the research have an impact? This study offers a novel approach to enhance the short‐term recovery of stroke patients. The researchers believe that the findings of this study will play an even more significant role during patients' transition from the hospital to home. Reporting Method: This study followed the STROBE statement of cross‐sectional studies. Patient or Public Contribution: The study was conducted by patients, their spouses, healthcare professionals and the research team. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationships among factors affecting compassion fatigue/secondary traumatic stress, burnout, and compassion satisfaction in Japanese nurses, focusing on self‐compassion, fears of compassion, and attachment styles. Methods: This cross‐sectional observational study enrolled 400 clinical nurses (aged ≥20 years) in Japan, registered with an online survey company, from June 6 to June 26, 2021. The subjects completed a web‐based questionnaire that assessed compassion fatigue/secondary traumatic stress, burnout, compassion satisfaction, self‐compassion, fears of compassion for self, anxiety, and avoidance. Additionally, descriptive statistics, correlation analysis, multiple regression analysis and path analysis were performed to examine the relationships among the influencing factors. Results: Compassion fatigue/secondary traumatic stress was influenced by anxiety and fears of compassion for self (R2 =.31). Burnout was affected by compassion fatigue/secondary traumatic stress, compassion satisfaction, self‐compassion, anxiety, and avoidance (R2 =.63). Compassion satisfaction was impacted by self‐compassion, anxiety, and fears of compassion for self (R2 =.31). Additionally, self‐compassion (R2 =.28) and fears of compassion for self (R2 =.55) were influenced by anxiety and avoidance. Conclusions: Compassion fatigue/secondary traumatic stress leads to burnout, whereas compassion satisfaction moderates burnout. Furthermore, there were associations among the factors leading to compassion fatigue/secondary traumatic stress and burnout and compassion satisfaction. Therefore, an approach that enhances self‐compassion and promotes the development of a stable attachment style could mitigate compassion fatigue/secondary traumatic stress and fears of compassion for self while moderately maintaining and improving compassion satisfaction. [ABSTRACT FROM AUTHOR]

Migration-related risk factors may impact the association between coping strategies, resilience, and identity development, one of the fundamental developmental tasks in adolescence. We examined the relationship between resilience and coping strategies in immigrant and non-immigrant adolescents' identity development. On a sample of Turkish adolescents (n = 399, 50.9% girls), we conducted six hierarchical regression models to predict identity dimensions from resilience and coping strategies. For both immigrants and non-immigrants, seeking social support predicted a more mature and successful identity while avoidance predicted less reconsideration of commitment. For non-immigrants, seeking social support and avoidance was associated with in-depth exploration whereas for immigrants, only seeking social support was linked to in-depth exploration. Additionally, resilience predicted a successful identity for immigrants. Results were discussed considering migration-related difficulties [ABSTRACT FROM AUTHOR]

This cross-cultural study examines the differences in TikTok use among users from the United States, Spain, and Chile. A survey, in English, European Spanish, and Latin American Spanish respectively, was administered to 556 TikTok users across the three countries. These users shared similar demographic characteristics, and multigroup measurement models were established to support cross-country measurement invariance. Our results show that Chilean TikTokers are the least engaged on the platform, but have more followers on average than their American and Spanish counterparts. Additionally, users' motivations for and uses of TikTok are associated with their countries' national cultural values. For instance, TikTok users in Chile and Spain, which are collectivistic societies, view the platform as a socialisation tool more than users in the individualistic United States. Lastly, Chileans, who have a high uncertainty avoidance level, tend to avoid self-expression and archiving on TikTok compared to Americans, who have a low uncertainty avoidance level. [ABSTRACT FROM AUTHOR]

Anxiety and depression are among the most common mental health concerns in youth, with rates of these internalizing problems continuing to rise. Universal school-based interventions have shown promising results in improving poor mental health outcomes; however, more research is needed across different cultural contexts. This study is part of an ongoing evaluation of A Lust for Life Schools Programme, a universal process-based cognitive behavioral therapy intervention for Irish primary school children. This study investigated the efficacy of the program through a cluster randomized controlled trial. Nine schools were randomly allocated to the intervention or control groups. Four hundred and seventy participants completed measures at three timepoints (baseline, post-intervention, and 6-week follow-up) assessing internalizing problems, anxiety, and depressive symptoms (primary outcomes) and avoidance, problem-solving, seeking social support, academic self-efficacy, social self-efficacy, and emotional self-efficacy (secondary outcomes). Although participants reported that they were mostly satisfied with the intervention, results revealed that the intervention did not have a significant effect on the outcome variables compared to the control group. Implications of the findings and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

The current study examined the association between approach and avoidance coping strategies and psychological stress during the novel coronavirus (COVID-19) pandemic. Participants were 62 adults who were recruited from Amazon's Mechanical Turk. Data collection lasted for 29 d in May 2020. Multilevel modeling revealed no significant association between approach coping strategies and psychological stress among individuals, and engaging in approach coping more than the usual days was also not associated with lower stress. Regarding avoidance coping strategies, they were positively associated with psychological stress among individuals, and when individuals engaged in avoidance coping more than usual, those individuals were more likely to experience psychological stress. Interestingly, the strength of the association between approach coping strategies and psychological stress was dependent on the levels of psychological stress, where the strength became weaker as the level of stress increased. Similarly, the strength of the association between avoidance coping and stress was also dependent on stress at the beginning of the study, where the strength of the association became stronger as the level of stress increased. Current results raise the importance of being mindful of an individual's psychological stress as the effectiveness of coping strategies may differ based on one's level of stress. [ABSTRACT FROM AUTHOR]

Shame-proneness refers to one's dispositional tendency to experience shame across a variety of situations. Shame-proneness is significantly related to a wide range of mental health disorders including depression, anxiety, post-traumatic stress, substance abuse, and more. Attachment theory and interpersonal neurobiology suggest that secure attachment protects against shame-proneness, whereas insecure attachment contributes to shame-proneness. However, there is scant empirical research exploring this relationship. This study explored childhood attachment with primary caregivers as a predictor of shame-proneness in adulthood. A sample of 340 adults, U.S. residents aged 18 and over, was recruited through Amazon Mechanical Turk (MTurk), an online crowdsourcing platform. Multiple regression analyses revealed that certain insecure attachment styles, specifically anxiety and disorganization, significantly related to shame-proneness, whereas avoidance did not. Secure attachment was negatively related to shame-proneness, but the relationship was statistically insignificant. Social workers and other mental health professionals can benefit from an increased understanding of the relationship between childhood attachment and shame-proneness that this study provides. [ABSTRACT FROM AUTHOR]

Fear of failure undermines students' learning and well-being. However, despite the prevalence of fear of failure, there is a lack of a measurement tool explicitly designed to assess the fear of failure in learning among Chinese students. This study aimed to adapt and validate the Chinese version of the Fear of Failure in Learning Scale (C-FOFLS). Exploratory factor analyses were conducted for the adaptation group (N = 353) and a four-factor solution was found. The construct validity of the four-factor structure was subsequently confirmed by item-level analysis and confirmatory factor analysis for the validation group (N = 366). The final scale was comprised of 22 items and had four underlying dimensions: shame, performance avoidance, learned helplessness, and self-handicapping. Pearson correlation analyses demonstrated satisfactory convergent validity and concurrent validity of the C-FOFLS. C-FOFLS could be a valuable tool for conducting research on the fear of failure in learning of Chinese students. [ABSTRACT FROM AUTHOR]

The present study investigated burnout among esports players and its association with mental toughness and resilience. Esports players (N = 453; Mage = 23.0, SD = 4.18; in the top 40% of in-game rank) from seven team-based esports completed the Athlete Burnout Scale (ABO-S), Mental Toughness Questionnaire 18 (MTQ-18), and the Connor-Davidson Resilience Scale (CD-RISC-10). Latent profile analysis identified three distinct burnout profiles: "low burnout risk" (LBR; 33.8%), "medium burnout risk" (MBR; 28.0%), and "high burnout risk" (HBR; 38.3%). Low burnout profiles were associated with higher mental toughness and resilience. The LBR profile was characterized by low levels of reduced accomplishment (RA), physical exhaustion (PE), and negative feelings (NF), while [MBR and HBR reported similar PE and NF scores but] differed in RA, with HBR showing the highest RA and total burnout. This study is the first to show distinct burnout profiles among esports players, indicating a significant prevalence of burnout symptoms. This should be monitored by both players and support staff (e.g. club managers, programme managers, and high-performance support staff). Additionally, mental toughness and resilience appear to play a protective role against burnout. [ABSTRACT FROM AUTHOR]

Psychological treatments for social anxiety disorder (SAD) in adolescents have shown poorer outcomes than for other anxiety disorders. A relevant factor to consider for improving outcomes may be negative imagery. In this pilot study, we examined negative 'flashforward' imagery of feared catastrophic outcomes in adolescents with SAD and evaluated the feasibility and preliminary outcomes of a short eye movement desensitization and reprocessing (EMDR) intervention targeting this imagery. We used a case series design with a 1‐week baseline period. Outcomes included symptoms of social anxiety and avoidance related to selected social situations and features of associated flashforward imagery as the proposed mechanism of change during the intervention. We found that six out of seven assessed adolescents reported to experience flashforwards and rated image distress, vividness and threat appraisal as high. In these six participants (aged 14–17 years old), the short EMDR flashforward intervention appeared feasible and was followed by a decrease in social anxiety and avoidance in five participants, while no notable changes were observed during the baseline period. Furthermore, we observed a decrease in flashforward imagery features in at least five participants. Nonparametric tests of the overall (group‐based) changes during the intervention period partially supported these findings. Limitations include the small sample size and the lack of a control group. Results suggest that vivid and distressing flashforward imagery is a common experience and that targeting flashforwards with EMDR may be beneficial in treating social anxiety in youth. Further experimental research on effects and added value to current treatments is necessary. Trial Registration: Dutch Clinical Trial Register (National Trial Register [NTR]): NL8974 [ABSTRACT FROM AUTHOR]

Objective: To compare attitudes and behaviors of American adults who have experienced food shaming versus those who have not. Design: This was an online survey of 2003 US adults, followed by an additional 5 one-on-one in-depth interviews, for a total of 2008. Data were collected between September and November 2022. Participants: US adults (n = 2008) recruited via commercial research panels. Main Outcome Measures: Prevalence of food shaming, and attitudes and behaviors among adults who have experienced food shaming versus those who have not. Analysis: χ2 and analysis of covariance investigating associations between experience with food shaming and foodrelated attitudes and behaviors, controlling for body mass index where possible. Results: Nearly 3 in 10 American adults report that they have experienced food shame. Experiencing food shame correlates with higher guilt and shame, greater likelihood to engage in regimented eating, and more prevalent, as well as negative, emotions around food and imagined interactions with food and nutrition professionals. Conclusions and Implications: Food shaming is a phenomenon with wide-reaching impacts on attitudes and behaviors. We expect that this innovative study will inform registered dietitian nutritionists and other health professionals to help people develop healthy, sustainable relationships with food. [ABSTRACT FROM AUTHOR]

Objective: Childhood traumas (CT), particularly sexual abuse, are linked with sexual dysfunction and reduced sexual satisfaction. This study explores the association between CT, anxiety, and sexual satisfaction in individuals with erectile dysfunction (ED). Method: The study cohort consisted of 93 patients with ED and 95 control group volunteers. Participants completed self-report forms on demographic data and sexual histories, along with the Childhood Trauma Questionnaire (CTQ), the State and Trait Anxiety Inventory (STAI), and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Results: Forty participants from the ED groups also had a co-diagnosis of premature ejaculation (PE). Those with co-morbid PE were categorized as a separate group (ED + PE). Physical abuse, sexual abuse, and minimization as measured by the CTQ, along with impotence, infrequency, and dissatisfaction as measured by the GRISS, were significantly lower in the control group compared to the ED and ED + PE groups (p<0.001). Anxiety scores were significantly different between the ED + PE group and both the ED and control groups (p<0.001). A history of childhood sexual abuse was linked to avoidance behavior (p<0.05). Significant correlations were observed between emotional maltreatment and PE (p<0.05), impotence and minimization (p<0.001), impotence and psychical neglect (p<0.05), and tactile avoidance and emotional neglect (p<0.01). Conclusion: This study highlights the importance of CT, including types other than sexual abuse, in contributing to sexual dysfunction and diminished satisfaction. [ABSTRACT FROM AUTHOR]

Patient health literacy, including basic anatomy knowledge, leads to improved communication and better health outcomes. Limited empirical data suggests that external genital anatomy may represent a particular knowledge gap. To inform future health literacy improvement efforts, we explored patient perspectives about how gynecologic anatomical literacy is generated and applied. Twenty semi-structured interviews with obstetrics and gynecology patients at a tertiary care centre were conducted to explore their knowledge of female genital anatomy and the origins of that knowledge. Thematic analysis was performed comparatively and iteratively, informed by principles of constructivist grounded theory. Participants highlighted an overwhelming lack of health education and high levels of internalized shame, leaving them ill-equipped to engage in conversations about their genitalia with healthcare providers. To combat this, participants attempted to construct knowledge for themselves; however, many grappled to identify reliable sources of information and felt uncertainty when communicating about their bodies. These findings contribute to an ongoing conversation about how an avoidance of naming may perpetuate the passivity and embarrassment that women experience regarding their reproductive health. Healthcare providers are well-situated to improve patient self-perception by using purposeful language and working to address both patient knowledge and activation. [ABSTRACT FROM AUTHOR]

Attachment insecurity, including attachment anxiety and attachment avoidance, is proposed as a key factor disrupting adaptive recovery following bereavement, resulting in complicated grief. However, findings are inconsistent across studies. This review aimed to synthesise existing research on attachment patterns in adults experiencing complicated grief to better understand this relationship. 22 cross-sectional and longitudinal studies (5149 participants), published between 2003 and 2020, met inclusion criteria. Higher levels of attachment anxiety were consistently associated with symptoms of complicated grief. Higher levels of attachment avoidance were associated with symptoms of complicated grief, although this relationship was less consistent. The review has implications for clinical practice as bereaved adults with insecure attachment histories may be particularly vulnerable to experiencing complicated grief. The research is limited by the reliance on mainly cross-sectional studies. Future research should focus on longitudinal studies, and studies that explore men's experiences, and of individuals living in non-Western countries. [ABSTRACT FROM AUTHOR]

A history of maltreatment can increase risk for dating violence (DV) and risky sexual behaviour (RSB) among adolescents. Secure parent-child attachment may reduce this risk, yet few studies have examined this as a protective factor. This study differentiated developmentally appropriate, exploratory sexual behaviours from RSB and examined whether maltreatment experiences and parent-child attachment in adolescence predicted DV and RSB reported five years later in a high-risk sample. Participants were 179 adolescents (46% girls; Mage = 15.34, range = 12–18 years) at risk for aggressive and antisocial behaviour. Adolescents reported their maltreatment histories and attachment to their parents at Time 1; five years later, at Time 2, they reported their experiences with DV perpetration and victimization and engagement in RSB. Both bivariate correlations and structural analyses demonstrated that maltreatment was associated with DV perpetration and victimization but not RSB, and attachment avoidance was associated with fewer RSB but not DV. Attachment anxiety was associated with physical DV perpetration and greater condom use, but only at the correlational level; attachment anxiety was not associated with DV or RSB in the structural model. There were no significant interaction effects. Findings highlight the importance of considering key developmental factors such as maltreatment and parent-child attachment in understanding adolescent risk for DV and RSB, and may inform future research that accounts for contextual factors such as motivation for violence perpetration and contraceptive use with multiple and/or casual sex partners. [ABSTRACT FROM AUTHOR]

Anxiety and externalizing concerns create notable challenges for families. One factor that has been widely studied in relation to anxiety concerns, which may also be influenced by externalizing symptoms, is parental accommodation. Most research on parental accommodation has tended to focus on behaviors, while not accounting for accommodation beliefs. The current study sought to examine the relation between both parental accommodation beliefs and behaviors and also determine to what extent externalizing symptoms may influence this relation in youth. Treatment-seeking youth (N = 260; M age = 13.48, range: 8–17) and their caregivers in the U.S. Midwest completed measures on anxiety symptoms, externalizing symptoms, and parental accommodation. Results indicated that parental accommodation behaviors had a direct influence on anxiety-related family impairment and avoidance but not anxiety symptom severity. There were no direct associations for parental accommodation beliefs. Externalizing symptoms moderated the relation between accommodation behaviors and family impairment, suggesting that the influence of parental accommodation on reported family impairment is attenuated at greater levels of externalizing symptoms. These findings highlight the importance of considering externalizing symptoms when examining the relation between parental accommodation and anxiety presentations, as well as further researching how accommodation-specific beliefs may influence accommodation behaviors and anxiety in youth. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has caused governments and individuals to face important but difficult trade‐offs between health and the economy. How do individuals choose between health and economic outcomes during the pandemic? Based on the behavioural immune system (BIS) theory and the life history (LH) theory, the present study examined the effects of individual differences in pathogen disgust sensitivity and life history strategy on people's health‐economic trade‐offs during the COVID‐19 pandemic. Results of an online study (N = 300) showed that people with higher pathogen disgust sensitivity felt less sense of control during the pandemic, and therefore chose health‐related options over economic‐related options. In addition, the association between pathogen disgust sensitivity and health outcome preference only existed in people with relatively faster life history strategies. Further, people's health‐economic trade‐offs were not influenced by their current economic status. Findings have important implications for policymakers and the public to understand people's health‐economic choices during the pandemic. [ABSTRACT FROM AUTHOR]

Despite the conceptual assumption that attachment-related anxiety or avoidance negatively affects parenting, studies have not provided consistent evidence. Furthermore, most studies have included only mothers and focused on young children. This knowledge gap may limit family therapy practitioners' ability to address attachment-related issues effectively when working with parents. Using structural equation modeling to test an Actor-Partner Interdependence Model, we examined emotion dysregulation as a mediator between adult attachment-related anxiety and avoidance style and nurturing and harsh parenting behaviors. For fathers, attachment-related anxiety was negatively related to nurturing parenting. For mothers, harsh parenting was positively associated with attachment-related avoidance. Parent's nurturing behaviors tend to increase when the other parent has higher attachment-related anxiety through the associated difficulties they experience in some ER areas. Including both mothers and fathers in the same model allowed for the identification of gender differences between parents and has important implications for research and programmatic approaches to parenting. [ABSTRACT FROM AUTHOR]

Objectives: People with psychosis delay accessing recommended treatments, resulting in poor healthcare outcomes and increased risk of relapse. Means of improving help‐seeking and help‐acceptance could reduce duration of untreated psychosis (DUP). This study examined the role of attachment style in help‐seeking and help‐acceptance in psychosis. Design: We used an experimental design to test the effect of attachment imagery priming on help‐seeking and help‐acceptance intentions, in a sample with self‐reported psychosis. The independent variables were attachment imagery condition (secure vs. avoidant) and time (pre‐ vs. post‐prime). The dependent variables were state paranoia, help‐seeking intentions and help‐acceptance intentions. Methods: We used an online research platform to recruit people with psychosis (n = 61). Participants were randomly allocated to the secure or avoidant attachment priming condition. All completed measures of state paranoia, help‐seeking, and help‐acceptance, before and after priming. Results: In comparison with the avoidant condition, secure attachment imagery resulted in reduced paranoia and increased help‐seeking and acceptance intentions, all with large effect sizes. Conclusions: This is the first study to use an experimental design to assess the role of attachment style in help‐seeking and help‐acceptance in a clinical sample. Attachment style is causally linked to behavioural intentions that contribute to DUP. Clinicians should assess attachment and help‐seeking and acceptance, highlight these in formulation, and prioritise in treatment planning. Interventions that enhance help‐seeking and acceptance could improve access to recommended treatments and reduce DUP. [ABSTRACT FROM AUTHOR]

Mother–child memory conversations are a nuanced and important factor in children's memory development. The current study focuses on maternal characteristics that are related to individual differences in maternal elaborative style. It also examines the role of maternal elaborative style in children's elaborativeness in the context of reminiscing and recounting. Two hundred and nine Turkish mothers (Mage= 36.32, SD = 4.99) and their 5- to 6-year-olds (Mage in months = 66.88, SD = 4.04) (110 girls, 99 boys) participated in the current study. Results revealed that maternal individuation and balanced self-construal type predicted maternal elaborativeness, which in turn predicted child elaborativeness in reminiscing and recounting. Yet, such a relation was not observed for maternal attachment styles or sensitivity. Findings suggested the importance of maternal individuation and balanced self-construal for mothers' and children's elaborativeness in memory conversations. [ABSTRACT FROM AUTHOR]

We investigated the extent to which individuals deliberately avoid the topic of pornography use with their partner and how such avoidance influences the association between pornography use and sexual satisfaction. We reasoned that such communicative avoidance may account for some of the negative relational effects associated with pornography use. A sample of 191 participants in mixed-sex relationships completed online measures of pornography use, sexual satisfaction, and domain-specific and overall measures of communicative avoidance. Men tended to avoid the topic of pornography use more than other topics that have the potential to cause relationship conflict. Women did not avoid the topic of pornography use more or less than other relationship topics. Controlling for pornography use, men and women who were more likely to avoid the topic of pornography use were less likely to be sexually satisfied; this association remained significant for men (but not women) after controlling their overall communicative avoidance. Lastly, men who were high pornography users and reported high levels of overall communication avoidance were most likely to report lower sexual satisfaction. Our findings underscore the need to pay careful attention to relational processes and dynamics when investigating the influence of pornography use on intimate relationships. [ABSTRACT FROM AUTHOR]

Background: Psychological distress can cause burnout, which affects mental and physical well‐being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems. Aim: The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN). Approach and Methods: In this cross‐sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC). Findings: Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work‐related and patient‐related burnout. A significant positive correlation was found between distress and behavioural escape‐avoidance, cognitive escape‐avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape‐avoidance, cognitive escape‐avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal‐related and work‐related burnout. Negative correlation was demonstrated between staff resources and patient‐related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape‐avoidance were more likely to have moderate or high distress. Conclusion: The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout. [ABSTRACT FROM AUTHOR]

Purpose: Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) are understudied conditions characterized by hallmark hypermobility and chronic pain. Disease manifestations lead to significant disability. Understanding predictors of disability, over and above the univariate construct of pain severity, is necessary to tailor treatment. Thus, the current study examined the impact of the Fear-Avoidance Model [FAM] on disability in hEDS/HSD. Fear of falling was included as a novel fear-avoidance factor impacting disability. Methods: A total of 168 individuals with hEDS/HSD answered a cross-sectional online survey regarding FAM constructs, fear of falling, disability, and clinical-demographic factors. A hierarchical regression analysis was used to assess whether FAM constructs and fear of falling significantly predicted disability, over and above pain severity and age. Results: Pain catastrophizing, anxiety, and fear of falling contributed significant unique predictive relations, above age and average pain severity. Pain severity and fear of falling were the strongest unique predictors of disability. Conclusions: This is the first study to assess the relations among FAM constructs, pain severity, and disability in hEDS/HSD, and introduces fear of falling as a novel fear-avoidance factor specific to this population. Future research should apply these findings towards individualized interventions to improve disability in hEDS/HSD. IMPLICATIONS FOR REHABILITATION: Disability is significant in hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders, and may be predicted by psychosocial factors of anxiety, pain catastrophizing, and fear of falling. Our findings suggest that improving disability in hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders involves the consideration of physical factors, such as pain severity, along with psychosocial factors, the latter of which are amenable to change through individualized intervention plans. Fear of falling is a novel fear-avoidance construct that should be considered in future research and clinical settings to increase functionality in this frequently falling population. [ABSTRACT FROM AUTHOR]

Objectives: The ways that people seek support during times of stress influence their mental health outcomes, including depression. Insecure attachment is a risk factor for depression and may also interfere with adaptive support and feedback‐seeking behaviour during stress. The purpose of the present study was to test theorized associations between insecure attachment, support and feedback seeking, and changes in depression symptoms over 1 year, in a sample of mothers of school‐age children in the context of stress elicited by the COVID‐19 pandemic. Methods: Participants (N = 70 mothers) completed self‐report measures of anxious and avoidant attachment and depression severity at baseline in spring 2020 and then completed measures of past‐year engagement in direct and indirect support seeking and excessive reassurance seeking (ERS), preference for negative feedback, and depression severity at a follow‐up assessment in summer 2021. Results: Greater attachment anxiety at baseline predicted more frequent direct support seeking, indirect support seeking, and ERS during the 1‐year follow‐up period. In turn, greater indirect support seeking predicted greater increases in depression from baseline to follow‐up. Greater attachment avoidance at baseline predicted less direct support seeking during the 1‐year follow‐up period. Greater attachment avoidance at baseline also predicted depression severity at follow‐up, particularly among mothers with moderate to high levels of attachment anxiety, although none of the examined support and feedback‐seeking behaviours mediated this association. Conclusions: These results provide support for the role of activated attachment systems in determining support and feedback‐seeking behaviour during stress, as well as the role of support and feedback‐seeking behaviour in the maintenance and exacerbation of depression. [ABSTRACT FROM AUTHOR]

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The current study investigated the associations among trait perfectionism, worry about mistakes, mistake rumination, L2 anxiety, and willingness to communicate in adolescents. A key element was examining the psychometric properties of a new measure of worry about mistakes as well as the Mistake Rumination Scale and the short Child-Adolescent Perfectionism Scale and its two dimensions (i.e., self-oriented and socially prescribed perfectionism). Our participants were 954 Iranian adolescent English learners. Psychometric tests supported the psychometric properties and use of the mistakes and perfectionism measures. Correlation analyses indicated that both trait perfectionism dimensions were associated with mistake rumination and worry about mistakes, and socially prescribed perfectionism was associated with L2 anxiety. However, self-oriented perfectionism was associated with greater willingness to communicate. Further analyses showed that worry about mistakes and mistake rumination mediated the association that socially prescribed perfectionism had with L2 anxiety. The vulnerabilities of adolescent perfectionists are discussed in terms of the approach-avoidance conflict as it relates to worry about mistakes and pressures to be perfect. It is evident that adolescents who are vulnerable must learn cognitive and emotional regulation techniques to effectively manage mistakes and the pressure to be perfect. [ABSTRACT FROM AUTHOR]

This investigation aimed to explore a theoretical model that examines the relationship between patterns of insecure attachment to God (i.e., anxious, avoidant), God-focused religious coping (i.e., divine struggles, positive religious coping), and mental health and well-being (i.e., happiness, depressive symptoms). The study's participants were 340 Israeli Jewish and Muslim individuals who completed electronic self-report questionnaires to assess the main variables of the study. The theoretical model was tested using Structural Equation Modeling. The analysis' findings indicated that there were no direct links between both patterns of insecure attachment to God and both happiness and depressive symptoms. Additionally, both anxious and avoidant attachment to God were found to be positively associated with divine struggles, and the latter mediated the relationship between both anxious and avoidant attachment to God and depressive symptoms. Furthermore, there were no significant associations between positive religious coping and any of the other variables in the study. Moreover, a comparative analysis revealed that the pattern of associations between the variables in the study was not dependent on gender or religious affiliation. Theoretical and practical implications of the findings are discussed. [ABSTRACT FROM AUTHOR]