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We develop and test theory regarding the effect of CEO paranoia, defined as stable tendencies toward suspicion, feelings of ill will or resentment, mistrust, and belief in external control or influence, on firm stakeholder engagement. We theorize that because CEOs higher in paranoia have tendencies toward hypervigilance and the biases of self-as-target and sinister attributions they typically avoid engagement with external stakeholders. Further, we argue that CEOs higher in paranoia are subject to paranoid activation when confronted with trait-relevant cues that confirm suspicions of being targeted by a malevolent external entity (here, regulatory rulings or rival attacks), thus eliciting a shift away from avoidance to a more aggressive engagement with those stakeholders. To do so, we develop a content-analytic measure of CEO paranoia following both theory and evidence in psychology and methodological best practices, finding evidence that broadly supports our premise. In total, our study draws attention to how the manifestation of CEO paranoia changes the way CEOs engage stakeholders over time, contributing to understanding in multiple ways. [ABSTRACT FROM AUTHOR]

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]

A common problem faced by contemporary retailers is consumers' tendency to avoid purchases that postpone or prevent cash flow for retailers, thus negatively affecting retailers' sales and profits. Little is known about the factors that drive consumers to avoid purchases or about marketing tactics that may reduce the tendency, especially from a cultural perspective. The authors attempt to fill this gap by exploring the role of an important cultural variable, namely, power distance belief (PDB), on consumers' tendency to avoid purchases. PDB is the extent to which people accept and endorse inequalities in society. A series of 14 studies (including 6 studies in the Web Appendix) using a variety of operationalizations of the key variables suggest that consumers high (vs. low) in PDB are less likely to avoid purchases (Studies 1a, 1b, and 1c) because they generally perceive greater constraints on their behavior (Study 2). These constraints are aversive, triggering the desire to overcome them and to have more as a compensatory mechanism, thereby reducing the tendency to avoid purchases. Accordingly, low (but not high) PDB consumers' tendency to forgo purchases is significantly decreased when they perceive greater constraints on their choices and decisions (Study 3) and when they experience a high social density (Study 4). However, high (but not low) PDB consumers' tendency to avoid purchases significantly increases when individuals perceive that constraints facilitate hierarchy (Study 5) or that constraints lead to positive outcomes (Study 6). Theoretical and managerial implications are discussed. [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]

Objective: Interpersonal problems have been identified as a plausible mechanism underlying the onset and maintenance of eating disorders. The Interpersonal Relationships in Eating Disorders (IR‐ED) scale is the first eating disorders‐specific measure of interpersonal problems, which was developed in a nonclinical sample. The aims of the current study were to (a) confirm the factor structure of the IR‐ED within a large clinical sample, (b) investigate measurement invariance of the IR‐ED across nonclinical and clinical samples, (c) examine the convergent validity of the IR‐ED using a generic measure of interpersonal problems, and (d) investigate the incremental clinical utility of the IR‐ED in uniquely predicting eating disorder symptomatology. Method: Treatment‐seeking individuals (N = 437) completed the IR‐ED at their initial assessment appointment at a specialist eating disorder outpatient service. Results: A multiple‐group confirmatory factor analysis supported an invariant bifactor structure comprising a general interpersonal problems factor and two group factors—Avoidance of Body Evaluation and Food‐Related Interpersonal Tension. Convergent validity was demonstrated by a large, statistically significant correlation with a generic measure of interpersonal problems (r = 0.62, p < 0.001). A series of structural equation models further revealed unique incremental predictive utility of the IR‐ED for eating disorder symptomatology. Discussion: The IR‐ED has strong psychometric properties and may prove beneficial in the assessment, formulation, and treatment of eating‐specific interpersonal problems among patients with eating disorders. [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]

Introduction: Nurses are now more likely to leave their current role in direct patient care than they were before the COVID-19 pandemic. Country culture and the organization of health care systems drive nurses' decisions to leave or stay in the profession. Methods: In a fall 2020 survey of nurse professional quality of life, a content analysis of responses to the open-ended question, " What has been challenging or rewarding during this pandemic experience?" was performed. Results were organized within Hofstede's Cultural Dimensions Theory. Results: Six hundred and fifty-six nurses across five countries responded to the question; 526 comments were analyzed. Most (53.6%) respondents were staff bedside nurses. Themes, such as Distress and Fatigue and Building and Experiencing Social Capital were found and understood to reflect cultural values and dimensions such as Uncertainty Avoidance and Power Distance. Discussion: Recommendations include strengthening culturally tailored leadership knowledge to inform and facilitate countries' nurse retention. [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]

Objectives: Clinical perfectionism, characterised by stringent standards and persistent striving, correlates with self-criticism and poor wellbeing. In this study we explored the mediating roles of psychological flexibility and inflexibility, and self-compassion, in the relationships of clinical perfectionism with distress, and clinical perfectionism and wellbeing. Methods: We used a cross-sectional correlational study design. A non-clinical sample of 210 Australian residents aged between 18 to 65 years old completed an online survey. Data were analysed using correlational, multiple regression, and parallel mediation analysis. Results: Heightened clinical perfectionism was associated with lower wellbeing and increased distress. Regression models revealed significant mediation by psychological inflexibility processes (self-as-content, experiential avoidance, cognitive fusion) and self-compassion. Cognitive fusion and inaction mediated clinical perfectionism-distress, while self-compassion and inaction mediated clinical perfectionism-psychological wellbeing. Conclusions: These findings support clinical perfectionism as a transdiagnostic predictor of distress and reduced wellbeing. Those with high clinical perfectionism tend to rigidly respond to perfectionistic thoughts, avoid uncomfortable emotions, and engage in value-disconnected inaction. Associations between psychological flexibility and inflexibility processes emphasise their multidimensional nature, distinct yet interrelated. Inaction emerges as a common process in clinical perfectionism-distress and clinical perfectionism-wellbeing, while cognitive fusion specifically influences distress, and limited self-compassion affects wellbeing. Key Points: What is already known about this topic: Clinical perfectionism is linked to psychopathology and transdiagnostic mechanisms, impacting distress and psychological wellbeing. Psychological inflexibility provides a transdiagnostic framework for understanding how rigid and self-limiting responses to feelings and thoughts are maintained despite negative consequences. Clinical perfectionism may be a form of psychological inflexibility, with rigid responses to perfectionistic thoughts, avoidance of uncomfortable emotions, and value-disconnected inaction. What this topic adds: Cognitive fusion and inaction are crucial for understanding clinical perfectionism's impact on distress. Self-compassion and inaction play a key role in understanding the relationship between clinical perfectionism and wellbeing. Understanding the functions of inaction is vital for fostering flexible responses to perfectionistic thoughts. [ABSTRACT FROM AUTHOR]

This study explores the reasons why young adults (ages 18–39) struggle to provide or avoid providing support to young adult cancer patients. The study also explores young adult cancer patients' perceptions of why they have not received support from individuals who did not provide support. A total of 722 reasons were collected through online surveys and analyzed: 438 were provided by young adults who knew a young adult with cancer (N = 131), and young adult cancer patients (N = 111) provided 284 reasons why they believe they did not receive support. Initially using a previous typology of 16 nonsupport reasons, an abductive thematic analysis yielded a total of 21 barriers to the provision of social support. These barriers were categorized across four higher-order categories: recipient-focused, supporter-focused, relationship-focused, and context-focused. Some reasons provided by young adult supporters were not provided by young adult patients and vice versa, suggesting the potential for discrepancies between why cancer patients believe they did not receive support and nonsupporters' actual reasons for not providing support. These various reasons why people struggled to provide support or avoided providing support can act as a list of barriers that future researchers and practitioners can address through the development of resources and interventions aimed at fostering adequate support provision throughout individuals' cancer experiences. Cancer patients can address the experience of nonsupport by individuals in their lives by being more direct in communicating their support desires and, when unsuccessful, using cognitive reappraisal strategies. [ABSTRACT FROM AUTHOR]

Women's agency in resisting violence and control within intimate relationships manifests in diverse forms, shaped by various social divisions and the socio-cultural contexts in which gender relations evolve. This research explores first-generation young Iranian immigrant women's responses to violence and control within their dating relationships in Canada. Employing an intersectional analysis, it delves into the multifaceted agency demonstrated by these women when confronting dating violence (DV). By contextualizing their agency within Collins's matrix of oppression, the study unveils how systems of oppression interlock to shape their agency. The findings underscored the substantial agency displayed by young women in asserting their self-determination and self-definition. This was evident in their ability to recognize the aggressor's controlling behaviors within their relationships and their outspoken critique of the deeply entrenched patriarchal and gendered norms prevailing in the dominant discourse within the Iranian community. The results underscore the pressing need for culturally sensitive interventions and education programs that move beyond mere DV awareness. [ABSTRACT FROM AUTHOR]

Background: The heterogeneity of persons with temporomandibular disorders (TMD) and the lack of effective treatments have called for a biopsychosocial model and the development of a more personalised treatment approach. Emphasis on phenotypes might be a beneficial approach. Objective: Identifying phenotypes among persons with TMD using potential prognostic factors, including personal characteristics and responses to clinical tests. Additionally, examining the distribution of TMD diagnoses within the identified phenotypes. Methods: A cross‐sectional study including 208 persons (85% females) seeking physiotherapy for problems in the temporomandibular area. All participants were examined clinically and answered questionnaires electronically. The phenotypes were identified using latent class analysis based on seven potential prognostic factors selected within pain, function and psychological domains. Table analysis was used to explore the distribution of TMD diagnoses within the identified phenotypes. Results: Most participants fit into one of three identified phenotypes. Phenotype 1 (32%) was characterised by functional disability, low psychosocial scores and low risk for developing chronicity and future work disability; Phenotype 2 (29%) by parafunctional habits, low psychosocial score and seeking treatment to reduce pain; and Phenotype 3 (39%) by high levels of mental distress, fear avoidance and a large risk of future work disability. Intra‐articular disorders dominated Phenotype 1, myalgia and TMD‐related headache Phenotype 2, while Phenotype 3 included all the different TMD diagnoses. Conclusion: The knowledge about the three identified phenotypes might be useful for clinicians treating persons with TMD and for the development of preventive strategies and more personalised treatment. [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]

Conflicts are common in adolescent friendships and romantic relationships. The ways girls in care navigate conflicts in close relationships have implications for their resilience, since their family relationships are compromised. We employed qualitative and quantitative approaches to explore the conflicts in the friend and romantic relationships of 37 girls in care. They completed an interview about the conflicts with their best friend and boyfriend and a measure on the positive and negative quality of the friendship and romantic relationship within which the conflicts took place. Thematic analysis indicated the girls experienced more intense and volatile conflicts with their boyfriend than best friend. However, the intensity of these conflicts was mitigated by their positive perceptions in their quantitative reports. Despite conflicts, the girls reported significantly higher levels of positive than negative relationship quality within their romantic relationships and similar levels of negative quality between the two relationships. Findings highlight the girls' struggles with their romantic relationship compared to their friendship and especially their attempts to interpret conflict within a more global assessment of relationship quality. The findings provide a nuanced understanding of the girls' relational patterns, which can be used to inform interventions to support their development of healthy relationships. [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]

Autobiographical memory (ABM) and social cognition are mutually constituted, and both are affected in autism. Meanwhile, very little is known about the heterogeneity of ABM in autism, how ABM differences are present in real-world contexts, and how to best respond to autistic children's ABM differences. The goals of this qualitative study were to examine the nature of ABM in autistic youth to understand its presentation and practical impacts in everyday life and to identify research priorities to inform clinical and educational practice. Nineteen parents of autistic children (ages 6-15) participated in a semi-structured interview designed to solicit information about their children's ABM. Interviews were transcribed and coded for the presence of themes. The main themes and their subthemes (in parentheses) were: (1) episodic memory problems (disorganized/overgeneralized narratives; poor episodic foresight; confabulation and avoidance/escape) that demonstrated an effect of task support and (2) ABM strengths (semantic memory; sensory-perceptual memory; emotional memory) that were described as forms of motivated memory. Results were broadly consistent with existing empirical data but expand understanding of the complexity of the memory profiles of autistic youth with important research, practice, and advocacy implications. We conclude that a focus on ABM assessment and support is overdue and critically relevant for clinical and educational goals involving social cognition and communication. [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]

BACKGROUND: Pediatric lower urinary tract symptoms (LUTS) are a set of common childhood problems. Community‐level interventions that target behavioral change among children with LUTS can improve symptoms outside of the clinic environment. Parents, navigating the home and school environments, are key in supporting healthy bladder behaviors. Thus, we asked parents about their perceptions and barriers related to pediatric bladder health. METHODS: English‐speaking parents (n = 30) of children ages 5‐10 years with and without LUTS were interviewed. Transcripts were coded iteratively by two independent coders using deductive and inductive approaches that emphasized consensus coding and peer debriefing. RESULTS: Ninety‐three percent of participants were women, 50% were 30‐39 years old, and 60% held a graduate degree. Parents identified school‐, classroom‐, and child‐based barriers to bladder health. These included the bathroom environment, restrictive policies for bathroom use, and anxiety on how and when to use the bathroom. CONCLUSIONS: Addressing school‐, classroom‐, and child‐based barriers is necessary to promote healthy bladder habits among children in the school environment and beyond. Recommended school‐based interventions include bathroom use and sanitation policies that support students' voiding needs, teachers' professional development, and school readiness initiatives. Limitations include participation of English‐speaking parents only. [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]

Culture and leadership display various patterns of interrelationship across countries and regions. However, research is sparse for Slavic countries and especially for small countries like the Republic of North Macedonia. Therefore, this paper tries to explore the linkages between culture dimensions and preferred leader behavior in the country focusing on differences between the capital city of Skopje and the rest of the country. The study utilizes Values Survey Module and Leader Behavior Description Questionnaire XII on a sample of 259 employees. The results show statistically significant differences for one cultural dimension and most of the preferred leader behavior dimensions. There is a complex matrix of positive and negative correlations between the culture dimensions and preferred leader behavior with regional variations in the correlation matrix. Having in mind the small and convenient sample, more studies are needed to further explore such linkages. [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]

Alcoholics Anonymous (AA) is a mutual aid program where social processes help individuals maintain recovery. This study aimed to gain insight into attachment characteristics that support the social processes in AA. AA member participants (N = 113), from a publicly available data set, were examined to identify predictors of increased recovery capital (RC), utilizing the independent variables of attachment anxiety, attachment avoidance, and self-esteem. Results from a multiple linear regression revealed a positive, strong, significant relationship between RC and self-esteem; a negative, moderate, significant relationship between RC and attachment avoidance; and no significant relationship between RC and attachment anxiety. [ABSTRACT FROM AUTHOR]

High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope. [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]

Background: Symptoms of emotional and physical stress near death may be related to previous experiences of trauma. Objective: To investigate current evidence regarding the following: (1) Is previous trauma identified in people who are dying, and if so, how? (2) How is previous trauma associated with the experience of death/dying in people with or without cognitive impairment? and (3) What palliative care interventions are available to people with previous trauma at the end of life? Design: This integrative review was conducted per Whittemore and Knafl's guidelines, which involves a stepped approach, specifically (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Methods: This integrative review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases were searched in August 2021 and updated in August 2023. The articles were quality appraised, and narrative data were analysed using Grounded Theory (GT). Results: Of 1310 studies screened, 11 met the inclusion criteria (four qualitative and seven quantitative) conducted in Australia, Canada, Japan and the United States; and American studies accounted for 7/11 studies. Eight were focused on war veterans. Descriptive studies accounted for the majority, with only two publications testing interventions. Re-living trauma near death has additional features to a diagnosis of post-traumatic stress disorder alone, such as physical symptoms of uncontrolled, unexplained acute pain and this distress was reported in the last weeks of life. Conclusion: This study proposes that re-living trauma near death is a recognisable phenomenon with physical and psychological impacts that can be ameliorated with improved clinical knowledge and appropriate management as a new GT. Further research is needed to enable past trauma identification at the end of life, and trauma-informed safe interventions at the end of life are an urgent need. [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]

This systematic review aimed to summarize the evidence regarding death anxiety (DA) and related factors among nurses. Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) databases were extensively searched using purpose-related keywords from the earliest to October 5, 2021. A total of 6819 nurses were included in 31 studies. The DA of nurses based on the Templer's Death Anxiety Scale was moderate. Factors such as personal anxiety, frequency and severity of job stress, burnout, dying patient avoidance behavior, euthanasia, sex, mental health status, social desirability, attitude toward the elderly, humor, social maturity, psychological hardiness, quality of life, lack of social activity, self-efficacy, coping with death, and life satisfaction were associated with nurses' DA. Therefore, nursing policymakers can promote nurses' health to improve the quality of nursing care by considering these related factors. [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]

Understanding the factors that are associated with individual differences in emotion regulation (ER) difficulties, which is one of the common transdiagnostic factors underlying many psychological disorders, is crucial for understanding and treating psychological disorders. The aim of the two investigations was to examine the mediator role of looming cognitive style (LCS) in the relationship of harm avoidance (HA) with both state and trait forms of ER difficulty. A total of 362 adults participated in Study 1 and 236 adults in Study 2. They completed measurements of HA, LCS, and ER. In Study 2, participants were induced into an anxious mood state and filled out a scale measuring ER in that process. Path analysis demonstrated that social looming between HA and trait ER and physical looming between HA and state ER had mediator roles. Finally, the alternative models which included HA and ER as the outcomes yielded poor fit. The results revealed that LCS significantly mediated the relationship of HA with both trait and state forms of ER difficulty, providing support for the model that aimed to explain how LCS contributes to the development and maintenance of psychological disorders. [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]

The elf dwellings of Icelandic rural storytelling culture and traditional folk belief appear to follow recurring, reasonably fixed patterns in their visual appearance, location, and ways in which local populations engage with them. This article presents a study of elf dwellings in the Strandir region of the Icelandic Westfjords, outlining these patterns through an in-depth engagement with a geographically limited but extensive dataset. The article shows how elf dwellings tend to be identified with erratic boulders and rocky hills of a particular size and appearance, generally located not in the 'wilderness', but close to places of everyday activity, especially near farmhouses, historic travel routes, and agricultural land. It highlights patterns of negative (avoidance) and positive (emotional attachment) engagement with such places. This makes a contribution not only to the study of traditional rural folk belief, but also to research discourses on the materiality of religion and spatiality of belief and storytelling. [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]