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Taverna E, Kline N, Kumar SA, Iverson KM. Experiences of intimate partner violence and valued living among women veterans: The role of self-efficacy. J Trauma Stress 2024. [PMID: 38861277 DOI: 10.1002/jts.23059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 06/12/2024]
Abstract
Predominantly cross-sectional research suggests that self-efficacy may play an important role in women's psychological health after experiencing intimate partner violence (IPV). However, few studies have examined these associations over time or with respect to broader aspects of psychological well-being. Valued living, which reflects behavioral engagement within personally important life domains, represents a key aspect of well-being that may be negatively impacted by experiences of IPV. Participants were 190 women veterans who completed three web-based surveys. We examined whether IPV experiences at Time 1 were associated with valued living at Time 3 (i.e., 4 years after Time 1) through self-efficacy at Time 2 (i.e., 3 years after Time 1). We separately examined overall, psychological, physical, and sexual IPV and investigated lifetime and recent (i.e., past 6 months) IPV experiences for each subtype. Separate path analysis models indicated that lifetime overall, β = -.10, 95% CI [-.19, -.02]; psychological, β = -.08, 95% CI [-.17, -.001]; physical, β = -.10, 95% CI [-.18, -.01]; and sexual, β = -.11, 95% CI [-.22, -.01], IPV experiences were indirectly associated with less valued living through less self-efficacy, whereas the indirect effect only emerged for recent physical IPV, β = -.26, 95% CI [-.50, -.02], but not for recent overall, psychological, or sexual IPV. These findings suggest that experiencing IPV is associated with less self-efficacy and valued living, which highlights the importance of providing early psychosocial interventions to enhance well-being among individuals managing the effects of experiencing IPV.
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Affiliation(s)
- Emily Taverna
- Women's Health Sciences Division of the National Center for PTSD, Boston, Massachusetts, USA
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Nora Kline
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Shaina A Kumar
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Behavioral Science Division of the National Center for PTSD, Boston, Massachusetts, USA
| | - Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, Boston, Massachusetts, USA
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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Esiason DC, Ciesinski N, Nurse CN, Erler W, Hattrich T, Deshpande A, Virginia O’Hayer C. The psychological burden of NMOSD - a mixed method study of patients and caregivers. PLoS One 2024; 19:e0300777. [PMID: 38551980 PMCID: PMC10980246 DOI: 10.1371/journal.pone.0300777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/05/2024] [Indexed: 04/01/2024] Open
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed.
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Affiliation(s)
- Darcy C. Esiason
- Esiason O’Hayer Institute for Behavioral Medicine, Philadelphia, Pennsylvania, United States of America
| | - Nicole Ciesinski
- Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States of America
| | - Chelsi N. Nurse
- Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States of America
| | - Wendy Erler
- Alexion Pharmaceuticals, Boston, Massachusetts, United States of America
| | - Tom Hattrich
- Alexion Pharmaceuticals, Boston, Massachusetts, United States of America
| | - Ankita Deshpande
- Alexion Pharmaceuticals, Boston, Massachusetts, United States of America
| | - C. Virginia O’Hayer
- Esiason O’Hayer Institute for Behavioral Medicine, Philadelphia, Pennsylvania, United States of America
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Campoli J, Cummings JA. "Becoming a Person Who Does Self-Care": How Health Care Trainees Naturalistically Develop Successful Self-Care Practices. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205231223321. [PMID: 38234585 PMCID: PMC10793186 DOI: 10.1177/23821205231223321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/11/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Self-care is an ethical imperative for health professionals as it can mitigate the adverse effects of stress on professional functioning and health. Yet, there tends to be a lack of self-care among healthcare trainees and an insufficient focus on self-care in medical education. The objective of this study was to develop a grounded theory of how health trainees become successful self-care users. METHODS Semi-structured interviews were conducted with 17 students in a variety of healthcare disciplines. Data were analyzed using grounded theory methodology. RESULTS Health trainees underwent 4 iterative phases to become successful at self-care: Having a Wake-Up Call, Building Skills, Gaining Confidence, and Building an Identity. Our model also explained why some trainees were unsuccessful at developing self-care practices. CONCLUSION We offer the first theory to explain how health trainees develop effective self-care habits. Understanding how self-care practices naturalistically develop has critical implications for developing interventions and curricula: By basing curricula about self-care on knowledge of what works, we have an opportunity to be more successful as educators. Indeed, other researchers have noted a lack of success in self-care and anti-burnout interventions for healthcare professionals. We conclude by discussing implications and recommendations for medical training and curriculum for health professions, including augmenting naturally occurring processes, linking self-care to personalized values, providing opportunities for deliberate practice, focusing on persistence with self-care, and faculty promotion and acceptance of trainee self-care.
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Affiliation(s)
- Jessica Campoli
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jorden A Cummings
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
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Shanahan L, Johnson-Ferguson L, Loher M, Steinhoff A, Bechtiger L, Murray AL, Hepp U, Ribeaud D, Eisner M. The worst and the best: new insights into risk and resilience in young adults from the COVID-19 pandemic. ADVERSITY AND RESILIENCE SCIENCE 2023:1-15. [PMID: 37361562 PMCID: PMC10132952 DOI: 10.1007/s42844-023-00096-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 06/28/2023]
Abstract
Historic declines in young people's mental health began to emerge before the COVID-19 pandemic. In the face of this youth mental health crisis, the pandemic constituted a naturalistic stressor paradigm that came with the potential to uncover new knowledge for the science of risk and resilience. Surprisingly, approximately 19-35% of people reported better well-being in the first few months of the COVID-19 pandemic than before. Therefore, in May and September 2020, we asked N=517 young adults from a cohort study to describe the best and the worst aspects of their pandemic lives (N=1,462 descriptions). Inductive thematic analysis revealed that the best aspects included the deceleration of life and a greater abundance of free time, which was used for hobbies, healthy activities, strengthening relationships, and for personal growth and building resilience skills. Positive aspects also included a reduction in educational pressures and work load and temporary relief from climate change concerns. The worst aspects included disruptions and changes to daily life; social distancing and restrictions of freedoms; negative emotions that arose in the pandemic situation, including uncertainty about the future; and the growing polarization of society. Science that aims to reverse the youth mental health crisis must pay increased attention to sources of young people's distress that are not commonly measured (e.g., their educational, work, and time pressures; their fears and uncertainties about their personal, society's, and the global future), and also to previously untapped sources of well-being - including those that young people identified for themselves while facing the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s42844-023-00096-y.
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Affiliation(s)
- Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
- Department of Psychology, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland
| | - Lydia Johnson-Ferguson
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Michelle Loher
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | | | - Urs Hepp
- Meilen Institute Zurich, Stockerstrasse 45, CH-8002 Zurich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
- Institute of Criminology, University of Cambridge, Sidgwick Avenue, Cambridge, CB3 9DA UK
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Tunç H, Morris PG, Kyranides MN, McArdle A, McConachie D, Williams J. The relationships between valued living and depression and anxiety: A systematic review, meta-analysis, and meta-regression. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Petersen JM, Barney JL, Barrett TS, Lensegrav-Benson T, Quakenbush-Roberts B, Twohig MP. Values engagement as a predictor of eating disorder severity in a residential sample of female adolescents with eating disorders. Eat Disord 2022; 31:388-404. [PMID: 36469583 DOI: 10.1080/10640266.2022.2141710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Values are freely chosen life directions and/or qualities of being that can motivate behavior change. There is nascent support for the utility of values work as a part of the therapeutic process across treatments, particularly in third wave therapy approaches (e.g., acceptance and commitment therapy). However, therapeutic values work is underresearched in clinical samples of youth. The aim of the present study is to examine the role of the two distinct values processes (engagement and obstruction), body image inflexibility, alongside other common comorbid symptoms of eating disorders (anxiety, depression) in a sample of female adolescents with eating disorders attending a residential eating disorder treatment program. Participants (N = 75) were patients at a residential eating disorder treatment facility and completed a battery of measures at time of admission. Correlational analyses and multiple regression were performed. Results found correlations between eating disorder severity, values engagement, values obstruction, body image flexibility, anxiety, and depression in the expected directions. Regression results found body image inflexibility, progression towards values, and anxiety as significant predictors of eating disorder severity (adjusted R2 = .54). This study points to the importance of emphasizing values engagement in youth with eating disorders, highlighting a potential treatment target for future research.
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Affiliation(s)
- Julie M Petersen
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Jen L Barney
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Tyson S Barrett
- Department of Psychology, Utah State University, Logan, Utah, USA
| | | | | | - Michael P Twohig
- Department of Psychology, Utah State University, Logan, Utah, USA
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Fields JS, Browne RK, Wieman ST, Lord KA, Orsillo SM, Liverant GI. Associations between valued living and responsiveness to daily rewards. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pavlacic JM, Dixon LJ, Schulenberg SE, Buchanan EM. Examining daily-level associations between nightly alcohol use and next-day valued behavior in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:963-967. [PMID: 32669050 DOI: 10.1080/07448481.2020.1785473] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 04/14/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveAdverse consequences of binge drinking episodes are well-established, but fewer studies have investigated how incremental changes in daily alcohol use relate to well-being. We examined within- and between-person associations in alcohol use and next-day valued living to enhance our understanding of the impact of alcohol use on following-day outcomes in college students. Participants. During November 2018, 73 undergraduate participants (65.7% female) completed surveys through Qualtrics. Method: Using daily diary methodology, participants completed nightly surveys (N = 784) on their cellular devices over a two-week period. Results: Within-participant variations in evening alcohol use demonstrated a negative linear association with next-day valued living, controlling for relevant variables. Conclusions: Findings supplement other studies demonstrating the impact of individual variability in alcohol use on engagement in valued behaviors. Knowledge of the hazards of alcohol use within the context of valued living has the potential to inform alcohol use prevention and intervention programs.
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Affiliation(s)
| | - Laura J Dixon
- University of Mississippi, University, Mississippi, USA
| | | | - Erin M Buchanan
- Harrisburg University of Science and Technology, Harrisburg, Pennsylvania, USA
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Kealy D, Rice SM, Seidler ZE, Oliffe JL, Ogrodniczuk JS. Reflective functioning and men's mental health: Associations with resilience and personal growth initiative. Stress Health 2021; 37:706-714. [PMID: 33486859 DOI: 10.1002/smi.3030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 11/06/2022]
Abstract
Mentalizing, or reflective functioning, refers to the capacity to reflect on one's own and others' mental states in terms of desires, intentions, and feelings. Reflective functioning in men's mental health is poorly understood, particularly in reference to men's resilience and motivation for personal growth. Using a cross-sectional design, the present study investigated impaired reflective functioning in relation to resilience and personal growth initiative among men with mental health concerns. An online sample of 1065 men self-reporting mental health concerns completed measures of reflective functioning, psychological distress, resilience, and personal growth initiative. Logistic regression examined reflective functioning in relation to likely serious mental illness, including interaction with age. Subsequent regression analyses controlled for distress severity in examining associations with resilience and personal growth initiative, and in examining the potential mediating role of reflective functioning. Impaired reflective functioning was significantly associated with serious psychological distress irrespective of age and, after controlling for distress severity, with resilience and personal growth initiative. Moreover, impaired reflective functioning was a significant mediator of the relationship between resilience and personal growth initiative. Findings provide preliminary support for reflective functioning as salient to men's resilience and agency for personal change, indicating a potentially important target in men's mental health work.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Simon M Rice
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Zac E Seidler
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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