Dreaming conundrum

Dreaming, a common yet mysterious cognitive phenomenon, is an involuntary process experienced by individuals during sleep. Although the fascination with dreams dates back to ancient times and gained therapeutic significance through psychoanalysis in the early twentieth century, its scientific investigation only gained momentum with the discovery of rapid eye movement (REM) sleep in the 1950s. This review synthesises current research on the neurobiological and psychological aspects of dreaming, including factors influencing dream recall and content, neurophysiological correlates, and experimental models, and discusses the implications for clinical practice.

Supervision of psychoanalytic therapies based on the professional development of the supervisee

Supervision of psychoanalytic therapy practitioners can be divided into three career developmental phases. Novice therapists need instruction about mental functions that make dynamic techniques efficacious. Journeyman therapists do better when technical matters regarding conflict and defense are the focus. Supervision of master therapists allows for more free-flowing mutual associations, intersubjective interchanges, and mutual attainment of interpretive approaches.

Shadows of doubt: Ambivalent acknowledgment of abuse and identification with the aggressor

BACKGROUND

Child sexual abuse (CSA) not only poses a substantial risk to the mental and physical health of adult survivors, but it may also involve doubt around its labeling, a phenomenon known as ambivalent acknowledgment. The trauma literature suggests that ambivalent acknowledgment has clinical, legal, and social consequences, and that the unique victim-perpetrator dynamic, manifested in identification with the aggressor (IWA), may contribute to this phenomenon. However, no study has yet explored the relationship between IWA and ambivalent acknowledgment.

OBJECTIVE

Addressing this gap, the present study examined the relationship between IWA and ambivalent acknowledgment, as well as the contribution of IWA profile type in explaining ambivalent acknowledgment beyond CSA features.

PARTICIPANTS AND SETTING

The sample consisted of 437 CSA survivors, with a mean age of 34.10 (S·D = 9.5). Of these, 106 (24.3 %) acknowledged CSA, while the remaining 331 (75.7 %) reported ambivalent acknowledgment.

METHODS

An online survey was conducted among Israeli female adults using self-report measures.

RESULTS

Results indicated that ambivalent acknowledgment was related to higher levels of IWA, and respondents with a higher IWA profile were more than twice (OR = 2.59) as likely to belong to the ambivalent acknowledgment group, even after accounting for the perpetrator's gender, the perpetrator' role in the victim's life, the severity of the abuse, and the recurrence of the abuse.

CONCLUSIONS

These findings suggest that survivors' ambiguity around CSA labeling may be rooted in IWA. Therefore, the development of therapeutic approaches aimed at reducing IWA may help survivors to acknowledge their abuse.

"Bringin' in the sheaves:" Meditations on gathering the transference

The unanticipated appearance during psychoanalytic supervision, conducted in the Hebrew language, of the uncommon expression "gathering the transference" spoken in Hebrew-le'e'sof et ha-transference-sparked my own desire to explore the history of the concept and its value, via the etymology of the English verbs "gather" and "harvest," and of the Hebrew verb le's'sof (to gather). Antithetical meanings of the Hebrew root a'saf, and some particulars of the biblical laws pertaining to gathering and harvesting fields, such as the "forgotten sheaf," expose new dimensions of "gathering the transference" that are not explicit from the English term and its roots. Comparison is made to Heidegger's concept of listening as "gathering."

Artificial Intelligence and the Future of Psychotherapy: A Medical Student Perspective

This article explores the ways artificial intelligence (AI) may impact the field of psychotherapy through the perspective of a prospective psychiatric trainee. The author discusses how AI may facilitate psychotherapy training and increase psychotherapy treatment outcomes. Therapy chatbots and their potential to increase access to care, particularly for marginalized populations, are discussed. Concerns regarding the integration of AI with psychotherapy are also examined, including the potential diminishment of the role of psychotherapists, negative sequelae of therapy chatbots, ethical concerns, and limitations of AI. The author concludes that psychotherapists may cautiously embrace and explore AI technology.

Adverse childhood experiences and infidelity: The mediating roles of anxious and avoidant attachment styles

Infidelity is any behavior that breaks the implied agreement of exclusivity within a romantic relationship and is a leading cause of divorce. Previous literature has established a relationship between Adverse Childhood Experiences (ACEs) and infidelity perpetration. As experiencing childhood adversity does not guarantee an individual will engage in infidelity, mechanisms explaining this relationship should be explored. We investigated whether avoidant and anxious attachment styles mediate the relationship between ACEs and cheating frequency. A sample of 584 participants aged 18-82 years (M = 35.31, SD = 11.68, 67.0% female) was recruited and completed online versions of the Childhood Experiences Survey-17, the Relationship Structures Questionnaire, and frequency of cheating behavior in their current or most recent relationship. After dichotomizing gender and testing assumptions, data from 553 participants were available for analysis. A parallel mediation provided support for the first hypothesis, and partial support for the second. Specifically, ACEs were positively associated with anxious and avoidant attachment styles, but only avoidant attachment was significantly and positively associated with cheating frequency. As such, only avoidant attachment acted in a manner consistent with a mediator in the relationship between ACEs and infidelity. This result suggests a potential link between childhood adversity and the development of both avoidant and anxious attachment styles, but that individuals with an avoidant attachment style are more likely to engage in infidelity. These findings provide insight into the role attachment styles play in infidelity post-childhood adversity, and have the potential to guide therapeutic interventions for affected individuals.

Neuroscience-based relational art therapy and deep brain reorienting in the treatment of dissociative identity disorder

Art therapy (AT) has been proposed as a treatment for post-traumatic conditions, potentially by providing somatic sensory input that can (i) enhance the client's sense of self and embodiment, (ii) modulate arousal, and (iii) aid in rethinking and reframing traumatic memories. However, evidence supporting AT as a treatment for dissociative disorders remains limited. The theoretical basis for the efficacy of AT is discussed in relation to findings regarding the traumatized person's brain and mindset, as well as its altered functional network connectivity. It is crucial to consider specific alterations in brain networks associated with trauma, particularly those occurring in the deep brain regions, which include the midbrain, the brainstem, and the cerebellum. The hypothesis suggests that early or severe trauma can impair the brain's higher regulatory functions, as explained by the cascade theory. This theory explains how diverse activation patterns within the midbrain's periaqueductal gray (PAG) of the midbrain influence the limbic system and cortices, thereby modulating states of being and behavior. Phase-specific, resource-oriented, and long-term therapy for complexly traumatized and dissociative individuals can benefit from novel insights from neuroimaging studies to inform and enhance therapeutic methods. This is illustrated in a clinical vignette with a client diagnosed with dissociative identity disorder (DID), where deep brain reorienting (DBR) was combined with relational AT. The AT component is hypothesized to have facilitated a sense of grounding in the present moment and enhanced the client's access to her neurophenomenological self. Moreover, changes may have occurred at implicit and non-verbal levels. DBR is believed to have helped the client remain present with her previously avoided and unbearable internal experience. To validate these assumptions, the second author conducted a semi-structured interview that focused on the client's experiences of being dissociative and in psychotherapy, including the effect of DBR when introduced after AT. The client's experiences were articulated through a thematic analysis of the interview, which yielded the following themes: Loneliness, getting help, and moving towards togetherness. Further research on and development of therapy methods that enhance the neuroplasticity necessary for highly dissociative clients to change and heal are highly recommended.

Decolonizing psychiatry: An example from Hinduism and psychoanalysis

In 2021, university scholars hosted a conference titled "Dismantling Global Hindutva," which prompted Hindu activists to criticize psychoanalysts for superimposing colonial frameworks onto Hindus. Indian media organizations have questioned the validity of psychoanalysis as scholars uncover the complicity of psychoanalysts with the British Empire. Drawing upon concepts in cultural psychiatry, this article operationalizes ontological perspectivism as a way to decolonize the application of psychological theories among historically-marginalized communities. It presents three perspectives on psychological phenomena. It begins with analyzing the first psychoanalytic study on Hindu scriptures by the psychoanalyst-British colonial administrator Owen Berkeley-Hill through his autobiography, writings from contemporaries, the study itself, and subsequent citations. This study served as model for future work in psychoanalysis that portrayed Hindus in ways that Hindu activists now criticize. Next, the essay presents translations of Sanskrit commentaries on the same scriptures from Hindu philosophers to see how observant Hindus have received their tradition. Finally, it examines writings from contemporary psychoanalysts and psychiatrists who have tried reconciling mental health theories and Hinduism. Ontological perspectivism offers an approach for intercultural dialogues among scholars in distinct intellectual traditions to develop a postcolonial psychiatry.

Revisiting Cultural Humility in Psychotherapy Supervision: A Descriptive Status Report

OBJECTIVE

The first substantive article to address cultural humility in psychotherapy supervision appeared in a 2016 issue of this journal. The aim of this review is to update that 2016 article, providing a conceptual-practical and empirical status report about cultural humility's increasing integration into psychotherapy supervision.

METHODS

A hybrid database-snowballing search process was used. Database searches were conducted by using PubMed and PsycInfo with the words "cultural humility" and "supervision." Backward and forward snowballing were also used to identify possible missed articles for inclusion.

RESULTS

Twenty-nine articles on cultural humility and supervision, all appearing since the original 2016 article, were identified. Seventeen articles were conceptual-practical, whereas 12 articles were empirical research studies. The conceptual-practical articles provided support for a cultural humility-supervision nexus via proposed models, supervision interventions, and case examples (e.g., demonstrating the facilitation of culturally informed work with minoritized supervisees). The research articles were similarly supportive, providing empirical data that indicated cultural humility's beneficial impact on supervision (e.g., making rupture repair more likely).

CONCLUSIONS

Since 2016, the host of supervisors who conceptualize about, practice, and research cultural humility in supervision have seemingly converged on one point: cultural humility is a supervision enhancer, contributing to both positive supervision processes and outcomes. It indeed appears that, where supervisor cultural humility goes, so too goes a strengthened supervisory alliance, heightened supervisee satisfaction, and increased supervisee self-disclosure. Based on this status report, the authors contend that supervisors could greatly benefit from learning about cultural humility and incorporating it into their supervisory practice.

'Cosigning questions': patients' inquiries about the obvious

Patients often ask questions to which they already know the answer. Despite their ubiquity, little is written about understanding or handling them. The following paper uses Speech Act Theory and the concept of "cosigning" to present a theoretical understanding of patients' questions about the obvious along with three clinical vignettes to demonstrate their technical management. The unconscious intent behind such questions can be inferred by analyzing their effects on the analytic process, the analyst's moment-to-moment countertransference, and the pressure they exert on the analytic relationship. The optimal response to cosigning questions depends on the particular dynamics which necessitate their use. For patients who can mentalize their behavior, direct interpretation or observation followed by interpretation can be used. For patients whose mentalization capacity is limited, consciously playing along with the questions can serve as a preamble to offering interpretations of the motives behind them.

Beyond the Narrowness of Disciplinary Borders: Biology and the Unconscious in Ferenczi's Thalassa-Primordial Phylogenetic Trauma and its Recapitulation in Ontogenesis

In this article, we present and discuss the essay Thalassa: A Theory of Genitality (1924) by Sándor Ferenczi, a pioneer and one of the greatest innovators of psychoanalysis. This essay-which Freud lauded as the most ingenious application of psychoanalysis-proposed a theory that can bridge the gap between the ontogenetic and phylogenetic development of genitality and the sexual act. Ferenczi speculatively elaborated a theory of genital development that connects two important Freudian works, namely Three Essays on Sexual Development (1905) and Beyond the Pleasure Principle (1920), with Haeckel's Fundamental Biogenetic Law, which discusses the recapitulation of phylogenesis in ontogenetic development. According to Ferenczi, coitus and sexual relations are driven by the desire to return to the mother's body, a desire that hearkens back to a period in evolution when life was entirely aquatic and life forms were ocean-dwelling. It has been claimed that the environmental catastrophes of sea recession and land emergence have had traumatic effects on animals' living conditions (resulting in the development of sexual differences) and genitality. Although the essay presented some fanciful, suggestive, and dubious theories, it remains relevant due to its epistemological and methodological implications, which are based on an utraquistic argumentative procedure (i.e., founded on the constant comparison of and recourse to isomorphisms and analogies among various disciplines, including biology, embryology, zoology, and psychoanalysis), laying the foundation for a method of bioanalysis.

Dynamic duo is inseparable: Self-compassion and compassion for others interact to predict well-being

While previous studies have examined the independent effect of self-compassion or compassion for others on well-being, the present study examined how self-compassion may interact with compassion for others in predicting well-being. Two studies were conducted. In Study 1, 457 participants completed assessments at baseline and 229 participants were retained and completed the assessment at 4-month follow-up. Results showed that baseline self-compassion predicted higher levels of subsequent well-being when baseline compassion for others was moderate or high. Study 2 recruited 147 participants and they were assigned to either the self-compassion condition or the control condition. Results showed that participants who practiced self-compassion for 1 week in the self-compassion condition showed more reduction in negative affect than the control condition when baseline compassion for others was high. Findings showed that the effects of compassion for the self on one's well-being may be contingent on one's compassion for others.

Theories on the Etiology of Deviant Sexual Interests: A Systematic Review

Not much is known about the etiology, or development, of deviant sexual interests. The aim of this systematic review was to provide a broad overview of current theories on the etiology of sexual deviance. We conducted a systematic search of the databases PubMed and APA PsycInfo (EBSCO). Studies were included when they discussed a theory regarding the etiology or development of sexual deviance. Included studies were assessed on quality criteria for good theories. Common etiological themes were extracted using thematic analysis. We included 47 theories explaining sexual deviance in general as well as various specific deviant sexual interests, such as pedophilia and sadism/masochism. Few theories (k = 7) were of acceptable quality as suggested by our systematic assessment of quality criteria for good theories (QUACGOT). These theories indicated that deviant sexual interests may develop as the result of an interplay of various factors: excitation transfer between emotions and sexual arousal, conditioning, problems with "normative" sexuality, and social learning. Neurobiological findings could not be included as no acceptable quality neurobiological theories could be retrieved. The important roles of excitation transfer and conditioning designate that dynamic, changeable processes take part in the etiology of sexual deviance. These same processes could potentially be deployed to diminish unwanted deviant sexual interests.

Corrected Myopia and Its Association with Mental Health Problems Among Rural Primary School Students in Northwest China

PURPOSE

The aim of this study was to evaluate the myopia correction and its association with mental health problems among rural primary school students in China.

METHODS

Using survey data from 17,950 students in 251 rural primary schools, this study examines the association between corrected myopia and mental health problems, as well as academic performance among rural students in China. Vision exams were offered to sample students, and student mental health status was measured using the Mental Health Test (MHT).

RESULTS

The results show that 21.98% of sample students failed the vision screening for myopia. Over 65% of sample students showed some form of anxiety, with 56.86% experiencing learning anxiety and 18.71% experiencing body anxiety. The MHT score of myopic students was higher than that of students with normal vision, indicating that myopic students had worse mental health overall. Correcting myopia with eyeglasses was associated with better mental health, indicated by a lower MHT score (by 0.62 points) when controlling for covariates. Myopic students with high baseline academic performance who wore eyeglasses benefited especially from myopia correction, as they had a lower total MHT score (by 1.77 points) and lower body anxiety score (by 0.49 points, p < 0.05) than their high-performing peers with uncorrected myopia.

CONCLUSIONS

These findings suggest that future mental health prevention programs in rural China should focus on reducing the prevalence of myopia and providing eyeglasses to myopic students as potential interventions.

Behavioral problems, dissociative symptoms, and empathic behaviors in children adopted in infancy from institutional and foster care in the Czech Republic

This study examined if considerably different caregiving experiences in infancy influence socio-emotional development later in childhood. We included children aged 6-9 years who were, immediately after birth, placed in quality state-run institutions (N = 24) or quality state-run foster care with one family (N = 23). All children have lived in stable families since their adoption before 15 months of age. Children in the comparison group have always lived with their biological parents (N = 25). We found that the previously institutionalized group had significantly more behavioral problems, more dissociative symptoms, and lower empathic behavior scores than the comparison group. The previously fostered group also exhibited more behavioral problems and dissociative symptoms than the comparison group but, notably, significantly fewer behavioral problems than the previously institutionalized group. The findings underscore the beneficial role of foster care compared to institutional care and that quality and consistency of early caregiving play a crucial role in later socio-emotional development.

My Bad, You Got This: witnessing, therapist attitude and the synergy between psychedelics and inner healing intelligence in the treatment of trauma

The MAPS (Multidisciplinary Association for Psychedelic Studies) sponsored MDMA-assisted therapy protocol has had greater success in treating trauma in preliminary clinical trials than any prior psychotherapeutic, pharmacologic, or combined approach. It is predicated on a synergy between drug action and the participant's inner healing intelligence. The latter is described mainly by analogy with the body's capacity to heal itself, and the treatment is characterized as a means of activating or accessing this capacity. How is this rather mysterious-sounding process so effective? I suggest that the therapist's full commitment to, and trust in this treatment framework, along with the medication's subjective enhancement of trust, encourages individuals who have suffered trauma and have difficulty trusting others to engage the therapist as a kind of witness. I discuss parallels between the therapeutic attitude implied in the inner healing intelligence model and the way a therapist can act as witness in the resolution of dissociative enactment in relational psychoanalysis. Trusting the healing capacity of one's inner healing intelligence is dynamically equivalent to trusting the relational process. This makes trusting one's inner healing intelligence a process of feeling witnessed. In both settings, the therapist's willingness to acknowledge her technical limitations or failings, coupled with a conviction that the participant/patient's primary need in processing trauma is to feel witnessed, facilitates the integration of dissociated experience.

The sense of safety theoretical framework: a trauma-informed and healing-oriented approach for whole person care

Objectives

This research describes four aspects of the development of the Sense of Safety Theoretical Framework for whole person care: exploring the meaning of the phrase "sense of safety"-the whole person language; the range of human experience that impacts sense of safety-whole person scope; the dynamics that build sense of safety-the healing goals; and the personal and cross-disciplinary trauma-informed practitioner skills and attitudes that facilitate sense of safety.

Methods

This qualitative participatory study was conducted in two phases. Researchers iteratively explored the concept of sense of safety using focus groups and semi-structured interviews. Overarching research questions were: "Does the transdisciplinary concept of Sense of Safety make sense as an approach to the whole person in distress?"; "How do participants describe the meaning of the phrase "sense of safety"?"; "What does a person experience when they feel safe?" and "What can practitioners do to facilitate a sense of safety?" Phase One involved rural and urban family doctors, mental health clinicians across multiple disciplines, people with lived experience of mental distress, and Indigenous Australian academics. Phase Two widened the scope of disciplines involved to iteratively reflect on their clinical and personal experience with "sense of safety" and included international family doctors, physiotherapists, occupational therapists, social workers, teachers, multidisciplinary rural clinicians and multidisciplinary clinicians with a lived experience of physical trauma, grief, and severe mental illness.

Results

The everyday language "sense of safety" was found to describe a whole person experience that integrates awareness of self, others, and context. The scope of human experience that impacts sensed safety was found to include seven domains: Environment, Social Climate, Relationships, Body, Inner Experience, Sense of Self and Spirit/Meaning (Whole Person Domains). Five dynamic healing goals were identified that build sense of safety: Broad Awareness; Calm Sense-Making; Respectful Connection; Capable Engagement; and Owning Yourself (Sense of Safety Dynamics). Five practitioner skills and attitudes that facilitate sense of safety were named: Valuing the Whole Picture; Holding Story Safely; Being with You; Learning Together; and Validating Dignity (Sense of Safety Practitioner Skills).

Conclusion

The Sense of Safety Theoretical Framework developed in this study focusses on an experience that is a fundamental prerequisite of health. Sense of safety is affected by, and influences, life story, relationships, meaning, sense of self, and - physical health: the whole person. The language "sense of safety" communicates an integrative experience that can help clinicians to see the whole person and describe a cross-disciplinary goal of care. The Whole Person Domains clarify the scope of care required, while the Sense of Safety Dynamics offer practical processes of care. The Sense of Safety Practitioner Skills describe trauma-informed skills and attitudes that facilitate a sense of safety. Each of these parts of the Sense of Safety Theoretical Framework translate practitioner, lived experience, and First Nations wisdom and a wide existing transdisciplinary literature into a framework and language ready for practice. Assessing and building sense of safety prioritizes a healing-oriented and trauma-informed approach. The Sense of Safety Theoretical Framework facilitates a paradigm shift that towards integrating sensation, subjective experience, physiology, and social determinants into everyday quality care in health, education and public policy.

An (un)answered cry for help: a qualitative study exploring the subjective meaning of eating disorders in the context of transgenerational trauma

BACKGROUND

Current research on the transmission of trauma and eating disorders across generations is limited. However, quantitative studies suggest that the influence of parents' and grandparents' eating disorders and their prior exposure to trauma are associated with the development of eating disorders in future generations. Qualitative research exploring personal accounts of the impact of transgenerational trauma on the development of eating disorders has been largely unexplored. The aim of the current qualitative study was to explore the meaning that participants ascribed to their eating disorders in the context of transgenerational trauma across three generations.

METHODS

Six adult female participants who had received a diagnosis of anorexia nervosa and/or bulimia nervosa completed multiple unstructured interviews, informed by a psychoanalytical methodology.

RESULTS

Four themes were developed from the material that emerged from the interviews: (1) The toll of undigested emotions (2), A need for safety (3), "It's not just me" - making connections with the past, and (4) "Last link" in the chain?

CONCLUSIONS

The themes were discussed in respect of previous literature, with a particular emphasis on Gerson's concept of the dead third, which emphasises an unconscious compulsion to repeat unprocessed transgenerational traumas. Clinical implications of the research underscores the importance of a holistic approach to the treatment of eating disorders, recognising both individual and familial traumas within the family system. Moreover, the research demonstrates the significant impact that mental health clinicians can have in eating disorder treatment by fostering a supportive, safe and trusting therapeutic relationship.

"Do No Harm?" Moral Distress Among Medical Students During the Surgical Clerkship

OBJECTIVES

Moral distress, reported among healthcare workers across a variety of settings, is associated with negative mental health consequences, burnout, and intention to leave a position. The scant literature exploring medical students' moral distress does not specifically examine moral distress during the surgical clerkship nor does it characterize the type of moral distress experienced by medical students. Thus, we aimed to explore and characterize medical students' moral distress during the surgical clerkship.

SETTING/PARTICIPANTS

This study was conducted at the University of Michigan Medical School evaluating narrative essays written by 3 cohorts of students (2018-19, 2019-20, 2020-21) who completed the surgical clerkship during their third year of medical school.

DESIGN

Deductive content analysis was used to evaluate 180 narrative essays for the presence of moral distress using a 5-subcategorization schema developed by Morley et al. (constraint-distress, tension-distress, dilemma-distress, uncertainty-distress, and conflict-distress).

RESULTS

Four of the 5 sub-categories of moral distress (constraint-distress, tension-distress, dilemma-distress and uncertainty-distress) were identified in medical student essays. There were no examples of conflict-distress.

CONCLUSIONS

Medical students described 4 of the 5 sub-types of moral distress during their surgical clerkship. The sub-types of moral distress most often experienced by medical students are different than sub-types of moral distress previously reported among nurses, suggesting the varied roles and responsibilities of the healthcare team impact the scenarios most likely to present moral distress. Additionally, medical students were hesitant to raise concerns with their team when they experienced events discordant with their moral beliefs; they cited their position in the medical hierarchy, fearing implications on their future career, and perceived lack of knowledge and experience as factors limiting their willingness to share. Finally, this study identifies morally distressing scenarios as opportunities for transformative learning for medical students specifically in the realm of professional identity formation.

Attachment-Based Family Therapy for LGBTQ Youth in a Community Setting: A Community-Engaged, Qualitative Pilot Study of Youth and Parent Experiences

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth who experience family rejection are at increased risk for depression and suicide. Attachment-Based Family Therapy (ABFT) demonstrates promising results for reducing this risk with LGBTQ youth. This community-participatory, mixed-method study piloted the use of ABFT with LGBTQ youth. Fourteen families completed treatment with adolescent youth, pre- and post-individual and family interviews, and a measure of youth mental health. Post-therapy, 80% of youth showed a significant reduction in psychological distress. The qualitative thematic analysis constructed four themes describing how families present to therapy with emotional distress, caregiver support needed during ABFT, how caregivers acquired new listening and communication skills, and LGBTQ youth experiences of finding freedom to explore and talk about sexual and gender identities. Implications from the study suggest the need to challenge heteronormative emotional structures of families for increasing emotional support of fathers with their LGBTQ children.

The Structure of Identity Dysfunction in Self-Report Measures

Identity dysfunction is considered core to psychopathology, contributing to emotional and interpersonal problems across psychiatric diagnoses. Despite its centrality in theories of personality and psychopathology, the empirical research on the structure of identity dysfunction is fragmented by a plethora of self-report measures assessing varied domains of identity dysfunction. This project examines conceptual domains of identity dysfunction in self-report assessments, with the goal of elucidating a clear structure of identity dysfunction to advance both theory and measurement. Toward this aim, we a) investigate the factor structure of identity dysfunction in existing self-report measures, using exploratory factor analysis and b) examine relationships between identity dysfunction and closely related constructs, using exploratory structural equation modeling. We assess responses from 632 young adults to 17 commonly used identity functioning self-report measures. In a series of exploratory factor analyses, we identified four content-domains of Identity Dysfunction (Self-Alienation, Susceptibility to External Influence, Self-Dysregulation, and Contingent Self-Esteem) and three content domains of Identity Clarity (Self-Consistency, Reflective Functioning, and Authentic Living). These content domains were largely well-represented by a single factor. In a series of exploratory structural equation models, emergent factors related similarly to personality, emotion dysregulation, and values and problems in interpersonal relationships.

Evaluating Communication Performance in Rotating Electrical Machines Using RSSI Measurements and Artificial Intelligence

This paper introduces a novel methodology for evaluating communication performance in rotating electric machines using Received Signal Strength Indication (RSSI) measurements coupled with artificial intelligence. The proposed approach focuses on assessing the quality of wireless signals in the complex, dynamic environment inside these machines, where factors like reflections, metallic surfaces, and rotational movements can significantly impact communication. RSSI is used as a key parameter to monitor real-time signal behavior, enabling a detailed analysis of communication reliability. The methodology comprises several stages, including data collection, preprocessing, feature extraction, and model training. Various machine learning models are implemented and evaluated. Among these, the SVM model with a Radial Basis Function (RBF) kernel outperforms others, achieving an accuracy of 97%, with high precision and recall scores, confirming its robustness in classifying RSSI data and handling complex signal behavior. The confusion matrix further supports the SVM model's accuracy, showing minimal misclassification.

Study on the impact of children's myopia on parental anxiety levels and its related factors

OBJECTIVE

To assess how children's myopia affects the psychological state of their parents, especially their anxiety levels, and its related factors.

METHODS

Using a cross-sectional case series design, this study employed the Beck Anxiety Inventory (BAI) to assess the anxiety status of parents of myopic children who visited Beijing Children's Hospital from May to August 2024. Data were statistically analyzed using Chi-square test, t-test, and analysis of variance, and Spearman correlation analysis was used to explore the relationship between myopia and anxiety.

RESULTS

Among the 242 parents surveyed, 64.46% (156) showed no anxiety symptoms, 17.36% (42) exhibited mild anxiety, 9.5% (23) had moderate anxiety, and 8.68% (21) had severe anxiety. There was a significant gender difference in anxiety levels, with mothers generally experiencing more anxiety. Specifically, the average anxiety score for mothers was 8.58 ± 12.01, while that for fathers was 7.19 ± 9.16. Univariate analysis revealed that mothers of girls aged under40 with the myopia degree ranging from -0.25D to -6.00D exhibited more pronounced myopic anxiety. In addition, difference analysis indicated that the higher the degree of myopia in the child, the higher the anxiety score of the parents (P < 0.05). Younger children were typically associated with a higher anxiety level of parents. Spearman correlation analysis showed a positive correlation between the degree of myopia in the child and the anxiety level in the parents, while there was a negative correlation between the age of the child and anxiety scores (P < 0.05).

CONCLUSION

Children's myopia has a significant impact on the mental health of parents, especially mothers. The anxiety level is closely related to the gender of the child and the severity of myopia. Therefore, it is particularly important to provide positive psychological support for promoting children's vision health and enhancing family psychological harmony.

Rediscovering one's own voice in a brief psychoanalytic group intervention aimed at malignant mesothelioma patients and their families

Occupational and/or environmental exposure to asbestos can lead to clinical manifestation of a variety of diseases, including malignant mesothelioma (MM), a rare cancer with a particularly high incidence rate in areas with a long history of asbestos processing. This paper aims to describe brief psychoanalytic groups (BPGs), which is an intervention model aimed at MM patients and their families in the early stages of the disease, shortly after diagnosis. The BPG model comprises 12 weekly sessions of 1 h each, co-led by two psychoanalytically oriented psychotherapists who are trained in working with cancer patients and their families and in the specifics of the BPG setting. Reflections in this paper on the BPGs will attempt to trace the voice of the group in clinical material, paying attention to its horizontal unfolding as a melodic development over time and its vertical unfolding as a harmonic interweaving between the different individual voices, which, even when opposed to each other, can find a generative interlocking of meaning. In the BPG, then, it is possible to set in motion transformations that allow one to embrace the different and diverse affective colorations of experience, evolve toward a thinking that is capable of incorporating intense emotions related to death and grief, follow healthier paths of interaction on an intrapsychic and interpersonal level, and find traces of one's own vitality.

Challenged by patients: a qualitative study of clinical supervisions of endocrinologists conducted by psychiatric liaison clinicians

BACKGROUND

Clinical supervision by psychiatric liaison clinicians is frequently provided in medical settings such as oncology and palliative care, but rarely in endocrinology. Consequently, the specific psychosocial issues faced by endocrinologists in their daily clinical practice and how they deal with them remain largely unknown. We aimed to explore individual supervisions of endocrinologists to gain insight into what kind of clinical situations they present, how they react to them and how this is worked through in supervision.

METHODS

The data set consisted of eight audio-recorded first supervision sessions of endocrinologists conducted by liaison psychiatry clinicians, which were transformed into written core stories accounting for key components of each session. A secondary analysis of these core stories was conducted using an interpretative approach, focusing on (i) the types of clinical situations and (ii) the supervisees' counter-attitudes towards patients. Additionally, particular attention was given to how the supervisors worked through these elements.

RESULTS

Endocrinologists presented patients who did not adhere to treatment, behaved inexplicably, or held moral values that differed from their own. Challenged by these situations, supervisees experienced negative emotions (e.g., anxiety, irritation, guilt), associated with behavioral reactions (e.g., avoidance) and/or defensive stances (e.g., denial, rationalization). In half of the supervisions, addressing these difficulties allowed supervisees to link key characteristics of the patient interaction with their own unresolved issues; in the other half, supervisees were less inclined to confront themselves with their own contributions to the patient interaction and the supervisor adopted a more active stance, making specific contributions (e.g. support, advise).

CONCLUSIONS

The findings call for training programs addressing "difficult" patients and advocate for closer collaboration between endocrinologists and liaison psychiatry clinicians.

Conforming to reforming: A systems understanding of aesthetic sport coaches' behaviors and practices toward female athletes' bodies

Coaches' role in athletes' eating pathology has been largely understood according to athletes' accounts of the coaching behaviors and practices that harmed them. Uniquely, this study engaged coaches as research participants to more fully inform future intervention efforts. Using a multiparadigm approach, this study explored how coaches' understood, constructed, and communicated sport-related body ideals with their female athletes through specific coaching behaviors and practices along with systems of influence and interaction that informed them. Ten coaches (Mage= 35.6) of female aesthetic sport athletes were interviewed. Data were analysed via interpretive description. Results indicated coaches' negative experiences as athletes themselves informed their intention to prevent harm with athletes they coached. Coaches nonetheless emphasized weight, shape, size, and appearance ideals steeped in sport tradition. Dissonance was salient between wanting to prevent harm using strategic approaches to body-related communication, while also reinforcing body ideals believed to promote high performance. Yet, neither athletes' performance goals nor prevention of harm were attained. Influences across coaches' ecosystems explained their behaviors and practices. A novel framework is proposed to describe five intersectional body ideal orientations embodied by the coaches, ranging from body ideal conformity to body diversity advocacy. This framework can inform coach-centered, systems-based education and research.

Death Attitudes Among Middle-Aged and Older Adults in Japan: A Qualitative Study Based on Erikson's Theory of Generativity

There are few opportunities for ordinary people not familiar with death to think about it, whereas basic research on death attitudes is insufficient. This study thus examined the attitudes toward death among ordinary people through a qualitative analysis using Erikson's theory of generativity. Semi-structured interviews were conducted with 13 middle-aged and older Japanese individuals. The results showed that death attitudes were individualized and consisted of seven components, mainly those related to agency and communion. The change in death attitudes manifested as a change in weight from agency to communion, a change in meaning and perspective, and an orientation toward well-being. In conclusion, the change in death attitudes is to become more generative by balancing agency and communion through the function of narration. This change might be termed "the maturity of death attitudes" because it is oriented toward eudaimonic well-being.

Regression and Formlessness in the Work of Winnicott and Bion

This paper focuses on a convergence of late Bion's (1970) and late Winnicott's (1969a, b) discovery and technique. Both authors describe a special state of mind which adds formlessness, un-differentiation to regression as a major mechanism of psychic change. Bion describes this state mainly in the analyst, while Winnicott focuses on this state of mind in the patient. The combination of both approaches brings us in contact with an essential phenomenon of psychoanalysis which seems difficult to reach and contain without the psychoanalytic frame and in which both analyst and patient play a complementary role.

Conversation: Bion and Winnicott

In 2023, THE A-SANTAMARIA PSICOANALISIS MEXICO ASSOCIATION planned the Online Conversations of W. Bion to generate dialogues with outstanding colleagues about the divergences and convergences of Bion with the work of André Green, Jean Laplanche, Ignacio Matte Blanco and D.W. Winnicott. The need to share thoughts about these authors' works and their links with others, facilitated widespread international dialogues about these authors and placed them all in a field of exchange, debate and challenge. The Online Conversations underlined the new dimensions in which Bion and Winnicott placed psychoanalytic theory and technique. Five outstanding presentations illustrate their understanding and grasping of these dimensions, each followed by an author exchange. These authors provide an in-depth inquiry into a wide range of topics: Angela Joyce looks at object constancy and absence through the lens of Winnicott's (1977) The Piggle; Dominque Scarfone examines the concept of contact barriers among Freud, Bion and Winnicott; Howard B. Levine discusses absence, failure and the negative in the work of Bion, Winnicott and Green; Lesley Caldwell links the works of Bion and Winnicott in addressing being alone and with others, and communicating and not communicating; finally, Rudi Vermote shows how Bion's and Winnicott's views on regression and formlessness complement each other.

Student-teacher relational entitlement and its association with students' and teachers' characteristics

INTRODUCTION

One's sense of entitlement-the subjective perception of what one deserves from another person-can contribute to social attitudes and behaviour in positive or negative ways, depending on the way in which one construes this subjective sense. Previous work has examined how adolescents' sense of entitlement towards their parents contributes positively or negatively to their well-being. In this study, we extend this line of research and focus on adolescents' sense of entitlement towards another important authority figure-teachers, while examining its associations with both students' and teachers' characteristics and implications for students' functioning at school.

METHOD

We adapted the Adolescents' Sense of Relational Entitlement towards Parents scale to tap students' relational entitlement towards their teachers. We then examined the factor structure of the adapted scale and its associations with students' and teachers' relevant psychological measures in three samples (N = 1588).

RESULTS

Findings confirmed the three-factor structure of student-teacher entitlement. Studies 2-3 also revealed that students' sense of entitlement was associated with both students' variables (e.g., psychological well-being, self-esteem, perceptions of teachers' acceptance of them and students' school engagement) and teachers' emotional difficulties. Study 3's findings indicated that students' sense of entitlement was associated with their school engagement.

CONCLUSION

Students' sense of entitlement towards teachers seems to be associated with teachers' emotional makeup and attitudes towards students. In addition, this subjective sense is associated with students' school engagement. These findings suggest that there is theoretical value and practical implications for further unpacking both teachers' and students' factors associated with students' sense of entitlement and examining its association with academic functioning at school.

Childhood trauma and social anxiety in adolescents: Mediating role of cardiovascular response to social stress

Adolescents exposed to childhood trauma are at an elevated risk for social anxiety. However, the physiological mechanisms linking childhood trauma and adolescents' social anxiety remain poorly understood. This study examined whether cardiovascular reactivity to acute social stress was a mechanism underlying this association. Participants were Chinese adolescents (N = 172; Mage = 12.95). They first reported their childhood trauma and social anxiety using the Childhood Trauma Questionnaire and the Social Interaction Anxiety Scale. They then participated in a social stress task, during which their cardiovascular data [heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP)] were monitored. The results showed that high levels of childhood trauma were associated with blunted HR, SBP, and DBP reactivity, which in turn were associated with high levels of social anxiety. Mediation analysis indicated that childhood trauma was indirectly associated with social anxiety via blunted cardiovascular reactivity. The findings suggest that blunted cardiovascular reactivity may serve as a physiological pathway linking childhood trauma and adolescents' social anxiety.

Contact barriers between Freud, Bion and Winnicott

The author discusses the idea that psychoanalysts could benefit from a common paradigm, not necessarily a single theory, but a general frame through which to view their work. Focusing on perception as a basic modality of psychic life, in combination with the system-environment approach, could provide this common baseline. The text explores how this approach relates to the work of Freud, Bion, and Winnicott, emphasizing the interconnectedness of systems and their environments, the role of perception, and the concept of a contact barrier. The notion of tangential interlocking is proposed as a way of illustrating how the system Freud called perception-consciousness is the contact-barrier common to all the psycho-somatic functions of interest to psychoanalysis.

Premonition: Hope and Dread in the Analytic Hour

Analytic awareness of the process of meaning-making involves tracking premonitions and intuitions to their sources. As precursors of symbolic processing, premonitions are essential elements in any relationship, including the analytic relationship. They provide unconscious communication that informs and amplifies internal and external body and object relations. These relations facilitate depth and dimensionality between and within persons. They also enable the representational processes to establish psychic structure. When traumatized, a person can lose faith in these processes and defend against relationship. Exploring precursors of the emotional experiences of hope and dread enables the analytic dyad to re-vitalize lost potentials and the representation of experience. A clinical example is given to demonstrate the application of these ideas.

A systematic scoping review of the literature on sexual orientation obsessive compulsive disorder (SOOCD): Important clinical considerations and recommendations

Obsessive Compulsive Disorder (OCD) is characterised by the occurrence of persistent thoughts, urges, or images that are experienced as intrusive and unwanted (obsessions), and compulsive actions that the individual feels driven to act on in response to an obsession. These actions are carried out by an individual in order to try and prevent or reduce anxiety or distress, or to prevent something terrible from happening (American Psychiatric Association, APA, 2013). The aim of this review was to identify studies which have explored SOOCD. Because this is a relatively under-researched field, the decision was made for the present systematic review to take an inclusive approach. A systematic PRISMA review was conducted. A total of eleven studies were identified in this review. Two were cases and nine were empirical studies. Overall, the studies in this review highlight that although relatively common in individuals with OCD, SOOCD is frequently misunderstood by both clinicians and patients. This emphasises the need for education and training (or they are not even aware of the condition).

Association between childhood trauma and social anxiety in adolescents: The mediating role of self-compassion and loneliness

BACKGROUND

Previous studies have shown a correlation between childhood trauma and social anxiety. However, the underlying mechanism of this association is not well understood.

OBJECTIVE

The aim of this study was to examine the relationship between childhood trauma and social anxiety in adolescents, and to explore the mediating role of self-compassion and loneliness.

PARTICIPANTS AND SETTING

In total 1309 adolescents (531 of whom were female) were recruited, and their mean age was 15.4 ± 2.30 years.

METHODS

Participants completed the Adolescent Social Anxiety Scale, Childhood Trauma Questionnaire Short Form, Self-Compassion Scale, and University of California, Los Angeles Loneliness Scale. Pearson correlation analysis was conducted to investigate the relationships among childhood trauma, self-compassion, loneliness, and social anxiety. The PROCESS Macro Model 80 was used for regression analysis to explore the mediating effects of self-compassion and loneliness on the relationship between childhood trauma and social anxiety.

RESULTS

After controlling for the influence of gender and parental marital status, self-compassion mediated the association between childhood trauma and social anxiety, in which positive self-compassion alleviated the relationship between childhood trauma and social anxiety, while negative self-compassion aggravated the relationship between childhood trauma and social anxiety. Furthermore, self-compassion and loneliness chain-mediated the relationship between childhood trauma and social anxiety.

CONCLUSION

These results offer theoretical support for the research and intervention of adolescents' social anxiety, and are crucial for developing adolescents' mental health education and promoting interpersonal communication.

Object constancy and absence in Winnicott through the lens of the piggle

This paper revisits D. W. Winnicott's famous account of his patient Piggle to examine the profound nature of her response to the birth of her baby sister in the light of the concepts of object constancy and absence. The author speculates that recent scholarship revealing the mother's Holocaust family history enables us to hypothesise that Piggle's infancy might have been marked by her mother's psychic absence. This contributed to difficulties in the establishment of object constancy leaving her vulnerable to more extreme responses to later absences, such as at the birth of her sister. The focus of Winnicott's interpretations at an Oedipal level is critiqued as is the significance of the psychoanalysis-on-demand setting of the work.

Associations Among Beliefs Supporting Patriarchal Principles, Conflict Avoidance, and Economic Violence in Intimate-Partner Relationships of Ultra-Orthodox Jews

Beliefs that uphold patriarchal principles may influence individuals' willingness to avoid conflict in their intimate-partner relationships, which can, in turn, increase the likelihood of intimate-partner economic violence. However, these associations remain underexplored in current research. This study examines these dynamics within a sample of 321 adults from the Ultra-Orthodox Jewish community-a patriarchal and traditional culture. Specifically, it examines associations among beliefs supporting patriarchal principles at the micro (gendered domestic roles), meso, and macro (institutional power of men and the inherent inferiority of women) levels; conflict avoidance; economic violence; and sex differences in these factors. Descriptive statistics were used to analyze sex differences in the study variables, and path analysis was used to examine the correlations between research variables for men and women. The findings indicate that beliefs in patriarchal ideologies were moderate across all levels but slightly higher among men. Men were significantly more likely than women to avoid conflict with their intimate partners. Beliefs in support of patriarchal ideologies were predictive of conflict avoidance, particularly among women. Contrary to prior research, this study revealed nonsignificant sex differences in the prevalence of economic-violence victimization. These findings, however, do not negate the role of sex-based dynamics in economic-violence victimization. We discuss the findings and the meanings assigned to conflict avoidance by men and women, while considering gender disparities of power and control. We suggest that men's tendency to avoid conflict likely moderated their likelihood of perpetrating economic violence.

Mister Rogers (1928-2003) Through the Holistic "Health & Wellness" Lens : Current and Historiographic Lessons

In the 1960s, Fred Rogers created Mr. Rogers' Neighborhood ( MRN ), a television shows for children. Although Rogers may not have been aware that his series carried the potential for a public health model, such an observation becomes apparent in contemporary terms. This transdisciplinary narrative explores MRN through the lens of holistic "health & wellness." Several themes come in perspective as they relate to health as defined by the World Health Organization for present and future communities. Targeting a young population, Rogers focuses on emotional nurturing and health with safety for all and within a happy and healthy community-themes that are the core of public health. Through the "health & wellness" lens, the footprints for a child's behavioral and social model are evident; a model particularly relevant to present and future generations with emotional growth, health, and community spirit as essential. In MRN , children are learning through the visual and audio arts, self-esteem, caring, and positive behaviors for personal and social health. Through this lens, besides the footprints to an educational model, another evidence manifests itself, which is the timeless impact of the content of Rogers' life lessons that are constantly adjusting to the next audience of this age group by updating its format in parallel with an advancing technology, which supports the validity of MRN ' potential for a holistic public health model toward complete physical, mental, spiritual, and social well-being, and as previously proposed by the World Health Organization.

Effects of Social Acknowledgment and Interpersonal Shame on Complex Posttraumatic Stress Disorder Symptoms of Sexual Violence Survivors in South Korea

Sexual violence (SV) survivors face negative social reactions, which can affect their recovery. Based on the socio-interpersonal model of trauma, understanding how societal circumstances impact SV survivors' mental health is important. This study examined conditional indirect effects of interpersonal shame and social acknowledgment on the relationship between perceived SV event severity and complex post-traumatic stress disorder (CPTSD) symptoms. Cross-sectional data from 157 community-based adults who had previously experienced SV were collected from an online panel. Exploratory factor analysis of the Social Acknowledgment Questionnaire was conducted, followed by conditional indirect analyses using Models 1, 4, and 7 of PROCESS macro. First, results showed that a two-factor model of social acknowledgment consisting of "social disapproval" and "social recognition" was more suitable for this study than a three-factor model predominantly used by Western societies. Second, interpersonal shame partially mediated the relationship between perceived SV event severity and CPTSD symptoms. Third, the conditional indirect effect of social disapproval on the mediating effect of interpersonal shame was significant when the social disapproval level was high. This indicates that the indirect effect of interpersonal shame on CPTSD increases when the social disapproval level is high. This study supported the socio-interpersonal perspective of trauma and suggested that increasing social acknowledgment beyond personal-level intervention would be a critical step for recovery of SV survivors to decrease their interpersonal shame and CPTSD.

Psychological Interventions for Mesothelioma Patients and Their Caregivers: A Systematic Literature Review

Malignant Mesothelioma (MM) has a striking impact on the somatopsychic balance of patients and their families, including physical, psychological, and interpersonal problems. The aim of this systematic literature review was to investigate what psychological interventions are offered to patients with MM and their caregivers worldwide.

METHODS

The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 12 articles. Results were categorized into five categories. 1. Individual psychological support, 2. Group psychological support, 3. Cognitive-behavioral group psychotherapy, 4. Brief psychoanalytic groups, 5. Multifamily group.

RESULTS

The interventions differed in terms of form, duration and resources used. Most of them were group-based and psychoanalytically oriented, although individual and cognitive-behavioral interventions were also described. Despite the differences, the interventions appeared to be fundamental in facilitating the processing of mental pain and anger related to the diagnosis.

CONCLUSION

Our study has shown that there are still few psychological interventions available for MM patients and their caregivers. The somatopsychic consequences of MM in patients and caregivers should encourage institutions and healthcare professionals to develop assessment and intervention models that address the different dimensions of their suffering and promote their residual vitality.

Confirmatory validation of a brief patient-reported outcome measure assessing psychological distress in caregivers of malignant mesothelioma patients: the Mesothelioma Psychological Distress Tool-Caregivers

Objective

The diagnosis of malignant mesothelioma (MM) can be devastating for both patients and caregivers, who may experience intense suffering from a physical, psychological, and interpersonal perspective. Despite the extensive literature on caregiver distress, there is a lack of validated measures to provide evidence of psychological distress of caregivers of MM patients. Therefore, in a previous study we developed the Mesothelioma Psychological Distress Tool-Caregivers (MPDT-C) to evaluate the specific profile of psychological distress in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-C.

Methods

The analyses of this work first aimed to confirm the previous factorial structure. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. Examination of the fit of the factorial model was conducted using a Bayesian approach.

Results

The final version of the MPDT-C is a 7-item self-report questionnaire consisting of one factor (Burden for the caregiver).

Conclusion

Having a short self-report questionnaire to assess the psychological distress experienced by caregivers of MM patients has several advantages. First, it is suited to epidemiological studies where multiple variables and measures are involved. Second, it is easy to administer and does not take much time to complete. Therefore, the MPDT-C can also be administered in clinical contexts, perhaps when MM patients attend follow-up medical evaluation. Lastly, short measures are less affected by cognitive fatigue, which is very common in a long battery of tests and could affect response reliability.

Socioecological factors influencing the risk of developing hypertensive disorders of pregnancy in India: a rapid review

BACKGROUND

The prevalence of hypertensive disorders of pregnancy (HDPs) in India is 11%, which is one of the highest rates globally. Existing research on HDPs in India primarily focuses on biological risk factors, with minimal research on how socioecological factors combine to increase risk of HDPs. We conducted a rapid review using Bronfenbrenner's Ecological Model to understand the social and cultural factors associated with HDPs among Indian pregnant women to identify possible intervention targets that may uniquely improve health in this population. Bronfenbrenner's Ecological Model is a framework that can be used to understand the complex relationship between multiple influences on health.

METHODS

We reviewed studies published between January 2010 and January 2024 using PubMed, Science Direct, and Scopus databases. Search terms included variants of hypertension, pregnancy, and India. Inclusion criteria were: (1) peer-reviewed journal article; (2) published between January 2010 to January 2024; (3) participants consisted of Indian women living in India; (4) studies evaluated socioecological risk factors associated with HDPs. One independent reviewer performed searches, screening, data extraction, and quality assessment. Each included study was then organized within Bronfenbrenner's Ecological Model.

RESULTS

A total of 921 studies were generated from the initial search, with 157 exclusions due to duplicates. Following screening for inclusion and exclusion criteria at the title/abstract and full text levels, 17 studies remained in the final review. Socioecological risk factors of HDPs were identified at each level, with the most commonly identified influences including: low socioeconomic status (SES), lacking community education and knowledge on HDP management and prevention, and lacking prenatal HDP screening.

CONCLUSION

This study determined that the high risk for HDPs in India is influenced by many intertwined socioecological factors. Women in rural and low SES areas need more health education on HDP management and prevention. There also needs to be more adequate prenatal HDP screening, with at least 4 and ideally 8 prenatal visits. Prenatal screenings should be accompanied with culturally appropriate patient education, especially for low SES women who have limited literacy, so that they can effectively make individual and microsystemic lifestyle decisions aimed at either managing or preventing HDPs.

They Will Surveil You to Death: Gangstalking as a Cultural Concept of Distress

Understanding local worldviews is a challenge during clinical encounters, especially when they involve cultural references without acceptance from the medical community. Gangstalking is a Western cultural notion which refers to systematic harassment, surveillance, and torture from unseen or covert assailants or networks. It is not a 'real phenomenon' compared with genuine stalking, but experients report worse depression, post-traumatic symptoms, suicidal ideation, and longer lasting encounters. They report physical pain and impossible feats of espionage technologically orchestrated by unknown malevolent actors. Using conversational data from targeted individual podcasts, I explore gangstalking as a cultural concept of distress (CCD) by highlighting associated explanations, idioms, and symptoms. Clinically, gangstalking is likely diagnosed as paranoid schizophrenia. However, its association with frightening events parallels Susto and Nervios. Physical symptoms parallel Open Mole and Brain Fag Syndrome. Like many CCDs, gangstalking is a multi-dimensional phenomenon not neatly mapped onto psychiatric categories. Misinterpreting gangstalking cases as unique or isolated is a likely outcome even when they fit within a well-known Western subculture and techno-science belief system. Moving past prior, outdated notions of folk illnesses and culture-bound syndromes, gangstalking as a CCD helps end the assumption that only the other has exotic or non-psychiatric categories of distress.

Psychological interventions for emotional well-being in adults with advanced progressive life-limiting illness

OBJECTIVES

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of psychological interventions compared to treatment as usual, waiting list, active control, or another psychological intervention to improve emotional well-being in adults with an advanced progressive life-limiting illness.

Variation in grandmaternal investment in Ukraine

BACKGROUND

Grandmothers vary in their contributions to grandchildren based on their relatedness and the sex of the child. Maternal grandmothers decrease grandchildren's risk of mortality and increase grandchildren's health more significantly than paternal grandmothers, but limited evidence suggests that paternal grandmothers may invest more in female than male grandchildren.

AIMS

In this study, I test whether contact frequency between grandmothers and grandchildren is influenced by their relatedness (maternal vs paternal) or the sex of the child. This research was carried out in Ukraine because it is neither matrilocal nor patrilocal, and Ukrainian grandmothers are known to provide a high rate of childcare.

METHODS

This study included interviews with 60 grandmothers that asked about contact frequency with grandchildren, relatedness (maternal or paternal), and contact frequency between the grandchild and the other grandmother. A dataset generated for each grandchild (n = 128) included sex, age, and contact frequency with both maternal and paternal grandmothers. Linear mixed models were fit to the data to explore the relationship between grandmother relatedness and contact frequency.

RESULTS

On average, maternal grandmothers saw their grandchildren 173.8 days/year, while paternal grandmothers saw their grandchildren 87.5 days/year (p < 0.001). The sex of the child was not a significant factor in determining contact frequency.

CONCLUSION

In Ukraine, maternal grandmothers have more frequent contact with their grandchildren. This finding supports the idea that grandmaternal investment is an evolutionarily adaptive strategy. However, the bias towards maternal grandmothers may also be explained by a post-socialist cultural context, which necessitates grandmaternal care.