A longitudinal analysis of the role of potentially morally injurious events on COVID-19-related psychosocial functioning among healthcare providers
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SUBMITTER: Borges L
PROVIDER: S-EPMC8589198 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionPotentially morally injurious events (PMIE) are events that violate one's deeply held moral values or beliefs, and that have the potential to create significant inner conflict and psychological distress. PMIE have been recognized as an important psychological risk factor in many high-risk occupational groups. However, no study to date has investigated how PMIE relate to the mental health of aid workers. Furthermore, little is known about the mechanisms by which PMIE might be associated with mental health indicators.MethodsParticipants were 243 aid workers (72% female; M age = 39.31) who had completed at least one aid assignment (M = 8.17). They completed an online questionnaire about their PMIE, trauma history, and mental health. A structural equation model was constructed to examine the roles of negative cognitions and subsequent self-care behaviors in the relationship between PMIE and PTSD symptoms, depression symptoms, and posttraumatic growth, above and beyond the contribution of potentially traumatic events.ResultsWithin the model, the indirect effect through negative cognitions fully accounted for the associations between PMIE and symptoms of PTSD and depression. For the association between PMIE and posttraumatic growth, two indirect effects emerged: the first through negative cognitions and subsequent self-care and, the second, through self-care alone.DiscussionThis study highlighted PMIE as a novel psychological risk factor for aid workers and pointed to two possible mechanisms by which these events may lead to PTSD, depression, and posttraumatic growth. This study adds to the current understanding of how high-risk occupational groups adapt psychologically to PMIE.
| S-EPMC10133712 | biostudies-literature
Project description:ObjectivesFew studies have examined domain-specific psychosocial functioning in Bipolar Disorder (BD) youths. This prospective study examines (1) Interpersonal Relationships with Family; (2) Interpersonal Relationships with Friends; (3) School/Work; (4) Recreation; (5) Life Satisfaction, in BD youths.MethodA Course and Outcome of Bipolar Youth subsample (n = 367; mean intake age = 12.6 years, SD = 3.3; 46.6% female) was previously grouped into 4 Classes based on their illness trajectories and percentage of time euthymic using Latent Class Growth Analysis: Class 1 Predominantly Euthymic; Class 2 Moderately Euthymic; Class 3 Ill with Improving Course; Class 4 Predominantly Ill. Psychosocial functioning within the domains were examined for greater than 10 years using the Adolescent Longitudinal Interval Follow-Up Evaluation.ResultsClass 1 demonstrated better functioning across all domains; Class 4 demonstrated worse functioning across all domains. Class 2 showed worsening relationships and recreation, and improvement in work/schoolwork. Class 3 showed variable domain declines and improvements. Despite symptomatic remission, 13%-20% of Class 1 and 20-47% of Classes 1/3 still had impairments across different domains. Early age of BD onset impacted impairment across most domains, and low SES significantly predicted impairment in family relationships.LimitationsThe study does not have a healthy control group to compare functioning findings.ConclusionsParticipants with more symptomatic mood trajectories had greater impairment across domains. Moreover, even with symptomatic remission, participants still exhibited impairment. Each Class and domain had different trajectories for impairment. Results suggest the importance of examining specific (vs. global) domains for targeted treatment, even when symptomatically remitted.
| S-EPMC7103497 | biostudies-literature
Project description:ImportanceMoral injury in health care professionals (HPs) has worsened over the course of the COVID-19 pandemic. The trauma and burnout associated with moral injury has profound implications for the mental health of HPs.ObjectiveTo explore the potential factors associated with moral injury for HPs who were involved in patient care during the COVID-19 pandemic in 2020, prior to the availability of vaccines.Design, setting, and participantsIn this qualitative study, HPs were actively recruited to participate in a survey via snowball sampling via email and social media in 2 phases of 5 weeks each: April 24 to May 30, 2020 (phase 1), and October 24 to November 30, 2020 (phase 2). Overall, 1831 respondents answered demographic questions and assessments for moral injury, intrinsic religiosity, and burnout. Of those, 1344 responded to the open-ended questions. Responses to open-ended questions were coded iteratively and thematically analyzed within the framework of moral injury.ExposuresWorking in a patient care setting during the COVID-19 pandemic prior to the availability of vaccines.Main outcomes and measuresInductive thematic analysis of open-response survey answers identified dominant emotions and common stressors associated with moral injury.ResultsThere were 335 individuals (109 [32.6%] aged 35-44 years; 288 [86.0%] women; 294 [87.8%] White) in phase 1 and 1009 individuals (384 [38.1%] aged 35-44 years; 913 [90.5%] women; 945 [93.7%] White) in phase 2. In phase 1, the respondents were predominantly nurses (100 [29.9%]), physicians (78 [23.3%]), advanced practice practitioners (APPs) (70 [20.9%]), and chaplains (55 [16.4%]). In phase 2, the respondents were predominantly nurses (589 [58.4%]), physicians (114 [11.3%]), and APPs (104 [10.3%]). HPs faced numerous stressors, such as fear of contagion, stigmatization, short-staffing, and inadequate personal protective equipment. The emotions experienced were (1) fear in phase 1, then fatigue in phase 2; (2) isolation and alienation; and (3) betrayal.Conclusions and relevanceThese findings suggest that HPs experienced moral injury during the COVID-19 pandemic. Moral injury was not only experienced after a single moral dilemma but also from working in morally injurious environments. These experiences can serve as potential starting points for organizations to engender and enhance organizational and individual recovery, team building, and trust. System-level solutions that address shortages in staffing and personal protective equipment are needed to promote HP well-being.
| S-EPMC8613593 | biostudies-literature
Project description:Background: Simulation education can benefit healthcare providers (HCPs) by providing opportunities to practice complex neonatal-resuscitation tasks in low-stake environments. To our knowledge, no study investigated the role of growth mindset on longitudinal performance on neonatal resuscitation before and after simulation-based training. Objectives: This study examines whether 1) the RETAIN digital/table-top simulators facilitate HCPs' neonatal resuscitation knowledge gain, retention, and transfer and 2) growth mindset moderates HCPs' longitudinal performance in neonatal resuscitation. Methods: Participants were n = 50 HCPs in a tertiary perinatal center in Edmonton, Canada. This longitudinal study was conducted in three stages including 1) a pretest and a mindset survey, immediately followed by a posttest using the RETAIN digital simulator from April to August 2019; 2) a 2-month delayed posttest using the same RETAIN neonatal resuscitation digital simulator from June to October 2019; and 3) a 5-month delayed posttest using the low-fidelity table-top neonatal resuscitation digital simulator from September 2019 to January 2020. Three General Linear Mixed Model (GLMM) repeated-measure analyses investigated HCPs' performance on neonatal resuscitation over time and the moderating effect of growth mindset on the association between test time points and task performance. Results: Compared with their pretest performance, HCPs effectively improved their neonatal resuscitation knowledge after the RETAIN digital simulation-based training on the immediate posttest (Est = 1.88, p < 0.05), retained their knowledge on the 2-month delayed posttest (Est = 1.36, p < 0.05), and transferred their knowledge to the table-top simulator after 5 months (Est = 2.01, p < 0.05). Although growth mindset did not moderate the performance gain from the pretest to the immediate posttest, it moderated the relationship between HCPs' pretest and long-term knowledge retention (i.e., the interaction effect of mindset and the 2-month posttest was significant: Est = 0.97, p < 0.05). The more they endorsed a growth mindset, the better the HCPs performed on the posttest, but only when they were tested after 2 months. Conclusions: Digital simulators for neonatal resuscitation training can effectively facilitate HCPs' knowledge gain, maintenance, and transfer. Besides, growth mindset shows a positive moderating effect on the longitudinal performance improvement in simulation-based training. Future research can be conducted to implement growth-mindset interventions promoting more effective delivery of technology-enhanced, simulation-based training and assessment.
| S-EPMC7921319 | biostudies-literature
Project description: Not available
| S-EPMC8048746 | biostudies-literature
Project description:While patterns of adolescent personality development are country-specific, previous studies that have examined them have been limited to the Netherlands and Finland. This study aimed to identify the patterns of personality development and examine the relationship between these patterns and psychosocial functioning among Japanese adolescents. Overall, 618 Japanese adolescents (49.5% girls; 16 years) participated in the annual longitudinal survey from 2013 to 2016. Using latent class growth analysis, the following four patterns of personality development were identified: resilient, over-controlled, vulnerable, and moderate. Although the mean-level changes in the Big Five domains were generally insignificant among the four patterns, the vulnerable pattern showed a progressive increase in conscientiousness, and the moderate pattern showed a decrease in neuroticism and an increase in conscientiousness. Furthermore, multivariate analysis of variance tests indicated that the resilient pattern showed higher subjective well-being and lower psychosocial problems than the other personality patterns; the over-controlled pattern showed higher internalizing problems than the resilient pattern; the vulnerable pattern showed lower subjective well-being and higher internalizing problems than the other patterns; and the moderate pattern scored between the resilient, over-controlled, and vulnerable patterns in both subjective well-being and psychosocial problems. These findings suggest that the vulnerable and moderate patterns, which are immature patterns compared to the resilient and over-controlled ones, showed positive changes to the direction of maturity from middle to late adolescence in Japan.
| S-EPMC9864498 | biostudies-literature
Project description:Pathological narcissism involves maladaptive efforts to regulate the self and is conceptualized by 2 key features: narcissistic grandiosity and narcissistic vulnerability. Prior research has found that narcissism is associated with poorer functioning over the long term, especially interpersonal functioning. Despite this, the specific contributions of grandiosity and vulnerability to different domains of functioning remain understudied. In particular, there has been scant literature investigating pathological narcissism and its effects on functioning in large clinical samples. Understanding how grandiosity and vulnerability each contributes to dysfunction will help inform the conceptualization, prognosis, and treatment recommendations, alike, for narcissism. This study examined the relations between narcissism and different domains of dysfunction in a sample of 288 current or recent psychiatric outpatients. Results suggest that narcissistic grandiosity is associated with specific deficits in interpersonal functioning, whereas vulnerability is associated with all forms of dysfunction. However, after accounting for the shared variance in the predictors, vulnerability continues to be predictive of all forms of dysfunction, whereas grandiosity serves as a modest protective factor. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
| S-EPMC6710132 | biostudies-literature
Project description:BackgroundA recent paradigm shift has highlighted the importance of considering how sleep, physical activity and sedentary behaviour work together to influence health, rather than examining each behaviour individually. We aimed to determine how adherence to 24-h movement behavior guidelines from infancy to the preschool years influences mental health and self-regulation at 5 years of age.MethodsTwenty-four hour movement behaviors were measured by 7-day actigraphy (physical activity, sleep) or questionnaires (screen time) in 528 children at 1, 2, 3.5, and 5 years of age and compared to mental health (anxiety, depression), adaptive skills (resilience), self-regulation (attentional problems, hyperactivity, emotional self-control, executive functioning), and inhibitory control (Statue, Head-Toes-Knees-Shoulders task) outcomes at 5 years of age. Adjusted standardised mean differences (95% CI) were determined between those who did and did not achieve guidelines at each age.ResultsChildren who met physical activity guidelines at 1 year of age (38.7%) had lower depression (mean difference [MD]: -0.28; 95% CI: -0.51, -0.06) and anxiety (MD: -0.23; 95% CI: -0.47, 0.00) scores than those who did not. At the same age, sleeping for 11-14 h or having consistent wake and sleep times was associated with lower anxiety (MD: -0.34; 95% CI: -0.66, -0.02) and higher resilience (MD: 0.35; 95% CI: 0.03, 0.68) scores respectively. No significant relationships were observed at any other age or for any measure of self-regulation. Children who consistently met screen time guidelines had lower anxiety (MD: -0.43; 95% CI: -0.68, -0.18) and depression (MD: -0.36; 95% CI: -0.62, -0.09) scores at 5. However, few significant relationships were observed for adherence to all three guidelines; anxiety scores were lower (MD: -0.42; 95% CI: -0.72, -0.12) in the 20.2% who adhered at 1 year of age, and depression scores were lower (MD: -0.25; 95% CI: -0.48, -0.02) in the 36.7% who adhered at 5 years of age compared with children who did not meet all three guidelines.ConclusionsAlthough adherence to some individual movement guidelines at certain ages throughout early childhood was associated with improved mental health and wellbeing at 5 years of age, particularly reduced anxiety and depression scores, there was little consistency in these relationships. Future work should consider a compositional approach to 24-h time use and how it may influence mental wellbeing.Trial registrationClinicalTrials.gov number NCT00892983.
| S-EPMC8385859 | biostudies-literature
Project description:Using data derived from the World Mental Health Japan Survey (n = 1,186), this study examined the intergenerational continuity of potentially injurious physical discipline of children in a community sample from Japan with a special focus on the confounding effects of 11 other types of childhood adversities (CAs) and the intervening effects of mental disorders and socioeconomic status. Bivariate analyses revealed that having experienced physical discipline as children and five other CAs was significantly associated with the use of physical discipline as parents in the Japanese community examined. However, childhood physical discipline was the only CA that remained significant after adjusting for the other CAs. The association of childhood physical discipline with adult perpetration was independent of the respondents' mental disorders and household income. No significant gender differences were found in the associations between childhood physical discipline and adult perpetration. The current study on Japan provided empirical support consistent with results found in other countries regarding the intergenerational transmission of child physical abuse.
| S-EPMC4607286 | biostudies-other
Project description:The purpose of this study was to review the current evidence base of psychosocial treatments for suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) in youth. We reviewed major scientific databases (HealthSTAR, MEDLine, PsycINFO, PubMed) for relevant studies published prior to June 2013. The search identified 29 studies examining interventions for suicidal or nonsuicidal SITBs in children or adolescents. No interventions currently meet the Journal of Clinical Child and Adolescent Psychology standards for Level 1: well-established treatments. Six treatment categories were classified as Level 2: probably efficacious or Level 3: possibly efficacious for reducing SITBs in youth. These treatments came from a variety of theoretical orientations, including cognitive-behavioral, family, interpersonal, and psychodynamic theories. Common elements across efficacious treatments included family skills training (e.g., family communication and problem solving), parent education and training (e.g., monitoring and contingency management), and individual skills training (e.g., emotion regulation and problem solving). Several treatments have shown potential promise for reducing SITBs in children and adolescents. However, the probably/possibly efficacious treatments identified each have evidence from only a single randomized controlled trial. Future research should focus on replicating studies of promising treatments, identifying active treatment ingredients, examining mediators and moderators of treatment effects, and developing brief interventions for high-risk periods (e.g., following hospital discharge).
| S-EPMC4557625 | biostudies-literature