Developing a short form of the simple Rathus assertiveness schedule using a sample of adults with sickle cell disease

Helping adolescents and young adults (AYA) with cancer manage identity distress: Enhancing clinician-AYA patient communication to promote identity development

OBJECTIVE

A cancer diagnosis during adolescence and young adulthood (AYA) disrupts AYAs' identity formation, a critical task for healthy development, and contributes to psychological distress called identity distress. Clinical communication is central to promoting AYAs' healthy identity development. We sought to identify aspects of clinician-diagnosed AYA communication that can promote AYAs' identity development and potentially buffer them from distress.

METHODS

In-depth, semi-structured interviews were conducted with two groups (AYA oncology clinicians and diagnosed AYAs). Transcripts were thematically analyzed to capture communication that clinicians and AYAs perceive promotes AYAs' identity development and buffers related distress.

RESULTS

Fourteen diagnosed AYAs and 7 clinicians identified three clinician- or AYA-led communication approaches and associated strategies that they perceive can buffer identity distress and promote identity development: 1) clinicians' using person-centered communication (e.g., empathic communication); 2) promoting AYAs' control/self-management of care (e.g., not dictating AYAs' behavior); and 3) prioritizing/seeing the person behind the patient (e.g., knowing the AYA as a person).

CONCLUSION/PRACTICE IMPLICATIONS

Both AYA oncology clinicians and diagnosed AYAs can communicate in ways that protect AYAs' identity development and related psychological well-being. Findings can be implemented into targeted communication skills interventions to teach health-promoting behavior and augment AYAs' psychosocial oncology care.

Understanding Sexual Aggression in UK Male University Students: An Empirical Assessment of Prevalence and Psychological Risk Factors

University-based sexual aggression is an international public health issue; however, to date, there have been no formal assessments of the prevalence or psychological indicators associated with the proabuse behaviors of the most common perpetrators at UK universities: heterosexual male students. To facilitate the development of effective primary prevention interventions for domestic students who have sexually harmed, we assess across two empirical studies (Ns = 259 and 295) the psychological risk factors associated with recent sexual aggression amongst two distinct samples of UK male university students. Cumulatively, results highlighted that one in nine participants (11.4%) self-reported recent sexual aggression. These participants could be statistically differentiated from their non-offending peers on various established indicators of general sexual offending, of which logistic regression analyses highlighted atypical sexual fantasies, general aggression, hostility toward women, and rape myth acceptance as being the most reliable predictors. Our data extend the international evidence base by providing the first detailed overview of sexual aggression amongst UK male university students, as well as the psychological risk factors associated with their proabuse behaviors. We discuss the importance of our findings for the development of more effective evidence-based reduction strategies and primary prevention interventions for male students who have sexually harmed.

From Self-efficacy to Imposter Syndrome: The Intrapersonal Traits of Surgeons

BACKGROUND

Demographic differences among surgical trainees regarding intrapersonal traits, such as imposter syndrome and assertiveness, have become widely acknowledged. However, many of these characteristics have not been examined in tandem, nor among both trainees and surgeons in practice. This study aimed to address these knowledge gaps.

METHODS

This was an anonymous, voluntary survey study comprised of validated measures of (1) self-efficacy, (2) imposter syndrome, (3) assertiveness, (4) perfectionism, and (5) self-rated likeability. A multimodal recruitment strategy was used and surgeons across all subspecialties were eligible for inclusion.

RESULTS

A total of 296 participants were included, with 54% identifying as female (n = 161) and 72% between the ages of 25 and 40 years of age (n = 212). Imposter syndrome, assertiveness, and perfectionism scales were normally distributed; self-efficacy and self-rated likeability scales demonstrated slight negative skew. Self-identified male sex was associated with less imposter syndrome (P < 0.001) and perfectionism (P = 0.035) and higher assertiveness (P < 0.001). Imposter syndrome was less common among older age groups (P = 0.001).

CONCLUSIONS

Surgeons are a self-efficacious group of perfectionists with widespread variability in imposter syndrome and assertiveness. Female sex and younger age were associated with more imposter syndrome and less assertiveness, highlighting an opportunity for early career coaching.

Assertiveness in the patients with thalassaemia major: A qualitative study

Aim

To explore the concept of assertiveness in the patients with thalassaemia major.

Design

It was a qualitative study with a conventional content analysis design.

Method

Data were collected using a semi‐structured interview. The research sample included 16 patients with thalassaemia major who were selected using purposeful sampling method from among such patients at educational and therapeutic centres. Then, they were analysed using MAXQDA10 software.

Results

During the analysis of data for the concept of assertiveness, three sub‐concepts of "courage to self‐presentation," "demonstrating the abilities" and "attendance in groups" were developed.

Υoung Adults' Assertiveness in Relation to Parental Acceptance-Rejection in Greece and in Bosnia and Herzegovina

This study explored the relation between assertiveness and parental behavior as perceived by young adults through parental acceptance-rejection and behavioral and psychological control. Αssertiveness is a mode of personal behavior and communication characterized by willingness to stand up for one's own needs and interests in an open and direct way. Inappropriate parenting may be associated with assertiveness difficulties and as evidence-based findings from many surveys have shown that assertive skills can be improved, it seems to be of great importance to examine the relation between assertiveness and parental rejection along with lack of support, and vice versa. In this study, assertiveness was investigated using the Rathus Assertiveness Schedule and parental behavior was studied using the Adult Parental Acceptance-Rejection/Control Questionnaire. Psychosocial personality traits and psychological control were assessed through the Adult Personality Assessment Questionnaire and the Psychological Control Scale, respectively. The sample consisted of 1,117 university students from Greek universities in Athens, Greece, and in Sarajevo, Bosnia and Herzegovina (B&H). For all measures and their psychometric structure, factor equivalence for the two countries was verified through congruence coefficients and through confirmatory factor analyses. Findings showed that in respect to the Greek sample (but not the B&H sample), assertive-behavior skills are more common among men than women. Assertiveness for all participants is correlated with maternal psychological control and paternal acceptance and also with self-evaluation and worldview. Apparently, maternal psychological control and paternal acceptance-rejection seemed to be associated with young adults' levels of assertiveness to a greater degree than with the other parental behavior parameters assessed in the present research.

A transdiagnostic minority stress intervention for gender diverse sexual minority women's depression, anxiety, and unhealthy alcohol use: A randomized controlled trial

OBJECTIVE

To remedy the notable gap in evidence-based treatments for sexual minority women, this study tested the efficacy of a minority-stress-focused cognitive-behavioral treatment intended to improve this population's mental and behavioral health.

METHOD

The intervention, EQuIP (Empowering Queer Identities in Psychotherapy), was adapted from a transdiagnostic cognitive-behavioral treatment as also recently adapted for sexual minority men. Sexual minority women at risk of mental and behavioral health problems (n = 19) and expert providers with this population (n = 12) shaped the treatment's development, including by supporting its primary focus on universal and minority-stress-focused processes underlying this population's disproportionately poor mental and behavioral health. The resulting treatment was then delivered to young adult sexual minority women (n = 60; M age = 25.58; 41.67% racial/ethnic minority; 43.33% transgender/nonbinary) experiencing depression/anxiety and past 90-day heavy alcohol use.

RESULTS

Compared to waitlist (n = 30), participants randomized to immediately receive EQuIP (n = 30) experienced significantly reduced depression and anxiety (d = 0.85, 0.86, respectively); effects for alcohol use problems were smaller (d = 0.29) and marginally significant. In pre- to post-intervention pooled analyses, effect sizes for minority stress processes (mean d = .25) and universal risk factors (mean d = .48), through which the treatment was expected to work, were small and moderate, respectively, and in the expected direction.

CONCLUSIONS

This study provides initial support for a minority-stress-focused transdiagnostic cognitive-behavioral treatment for sexual minority women. These first results can launch exploration of other mechanisms and modalities through which to equip this population with evidence-based support. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Systematic literature review and assessment of patient-reported outcome instruments in sickle cell disease

Background

Sickle cell disease (SCD) is a chronic condition associated with high mortality and morbidity. It is characterized by acute clinical symptoms such as painful vaso-occlusive crises, which can impair health-related quality of life (HRQL). This study was conducted to identify validated patient-reported outcome (PRO) instruments for use in future trials of potential treatments for SCD.

Methods

A systematic literature review (SLR) was performed using MEDLINE and EMBASE to identify United States (US)-based studies published in English between 1997 and 2017 that reported on validated PRO instruments used in randomized controlled trials and real-world settings. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the quality of PRO instruments.

Results

The SLR included 21 studies assessing the psychometric properties of 24 PRO instruments. Fifteen of those instruments were developed and validated for adults and 10 for children (one instrument was used in both children and young adults aged up to 21 years). Only five of the 15 adult instruments and three of the 10 pediatric instruments were developed specifically for SCD. For most instruments, there were few or no data on validation conducted in SCD development cohorts. Of the 24 PRO instruments identified, 16 had strong internal reliability (Cronbach’s α ≥0.80). There was often insufficient information to assess the content validity, construct validity, responsiveness, or test-retest reliability of the instruments identified for both child and adult populations. No validated PRO instruments measuring caregiver burden in SCD were identified.

Conclusions

The evidence on the psychometric properties of PRO instruments was limited. However, the results of this SLR provide key information on such tools to help inform the design of future clinical trials for patients with SCD in the US.

Electronic supplementary material

The online version of this article (10.1186/s12955-018-0930-y) contains supplementary material, which is available to authorized users.

An evaluation of a specialist firesetting treatment programme for male and female mentally disordered offenders (the FIP-MO)

Individuals who set deliberate fires are frequently encountered by clinicians working in forensic mental health services. However, little attention has been paid to developing standardised treatment for this behaviour, and few evaluations of treatment have been conducted in forensic mental health services. This study evaluates a new standardised group cognitive behavioural treatment programme for individuals residing in forensic psychiatric hospitals who have engaged in deliberate firesetting (The Firesetting Intervention Programme for Mentally Disordered Offenders; FIP-MO). Sixty-three male and female patients with a history of deliberate firesetting commenced FIP-MO treatment. Patients who met the referral criteria for treatment but who resided at hospitals where FIP-MO treatment was not available were recruited as a treatment as usual comparison group. The treatment group completed a battery of psychometric assessments pre- and post-treatment, with the comparison group completing these at similar time points. Results showed that patients who completed the FIP-MO made significant improvements post-treatment, relative to the comparison group on fire-related measures (e.g., problematic interest and associations with fire) and anger expression. Further, effect size calculations showed that the treatment group made larger pre-post treatment shifts on the majority of outcome measures compared to the comparison group. These findings suggest that FIP-MO treatment is effective for reducing some of the key factors associated with deliberate firesetting.

Exploring Transition to Self-Management Within the Culture of Sickle Cell Disease

Purpose: The aim of this study was to explore the meaning of transition to self-management in sickle cell disease. Design/Method: Twelve audio-recorded semistructured interviews were conducted with a sample of 21- to 25-year-olds recruited from a comprehensive sickle cell center in the northeast region of the United States. Data were analyzed using an existential framework according to van Manen’s phenomenological method. Findings: The meaning of transition to self-management was found in lived time, space, body, and human relationship. The emerging themes highlighted in this article include: Best Mother Ever, Growing up in the Hospital, I’m Not Trying that Again, Doing it on My Own, Living Day-by-Day, and Not a Kid any Longer. The themes reflected meaning and insight into this unique experience. Conclusion/Practice Implications: Study results emphasize the culturally constructed meaning of transition to sickle cell disease self-management and need to integrate transcultural perspectives into nursing practice to support this emerging phenomenon.

Female Fire-Setters: Gender-Associated Psychological and Psychopathological Features

OBJECTIVE

Female fire-setters are reported to commit nearly one-third of deliberately set fires, yet there are limited studies examining the characteristics that distinguish them from suitable comparison groups. The aim of this study is to compare incarcerated female fire-setters with incarcerated male fire-setters and female offender controls on psychopathological and psychological features that could be targeted via therapeutic interventions.

METHOD

We recruited 65 female fire-setters, 128 male fire-setters, and 63 female offenders from the prison estate. Participants completed a battery of validated tools assessing psychiatric traits and psychological characteristics (i.e., inappropriate fire interest, emotion/self-regulation, social competence, self-concept, offense-supportive attitudes, and boredom proneness) highlighted in the existing literature.

RESULTS

Major depression and an internal locus of control distinguished female fire-setters from male fire-setters. Alcohol dependence, serious/problematic fire interest, and more effective anger regulation distinguished female fire-setters from the female offender control group.

CONCLUSIONS

This is the first study to examine differences between female fire-setters, male fire-setters, and female control offenders on both psychopathological features and psychological traits. These findings highlight the gender-specific and offense-specific needs of female fire-setters that clinicians need to consider when implementing programs that ensure client responsivity.

Specialist group therapy for psychological factors associated with firesetting: Evidence of a treatment effect from a non-randomized trial with male prisoners

Despite huge societal costs associated with firesetting, no standardized therapy has been developed to address this hugely damaging behavior. This study reports the evaluation of the first standardized CBT group designed specifically to target deliberate firesetting in male prisoners (the Firesetting Intervention Programme for Prisoners; FIPP). Fifty-four male prisoners who had set a deliberate fire were referred for FIPP treatment by their prison establishment and psychologically assessed at baseline, immediately post treatment, and three-months post treatment. Prisoners who were treatment eligible yet resided at prison establishments not identified for FIPP treatment were recruited as Treatment as Usual controls and tested at equivalent time-points. Results showed that FIPP participants improved on one of three primary outcomes (i.e., problematic fire interest and associations with fire), and made some improvement on secondary outcomes (i.e., attitudes towards violence and antisocial attitudes) post treatment relative to controls. Most notable gains were made on the primary outcome of fire interest and associations with fire and individuals who gained in this area tended to self-report more serious firesetting behavior. FIPP participants maintained all key improvements at three-month follow up. These outcomes suggest that specialist CBT should be targeted at those holding the most serious firesetting history.

Virtual reality for treatment compliance for people with serious mental illness

BACKGROUND

Virtual reality (VR) is computerised real-time technology, which can be used an alternative assessment and treatment tool in the mental health field. Virtual reality may take different forms to simulate real-life activities and support treatment.

OBJECTIVES

To investigate the effects of virtual reality to support treatment compliance in people with serious mental illness.

SEARCH METHODS

We searched the Cochrane Schizophrenia Group Trials Register (most recent, 17th September 2013) and relevant reference lists.

SELECTION CRITERIA

All relevant randomised studies comparing virtual reality with standard care for those with serious mental illnesses. We defined virtual reality as a computerised real-time technology using graphics, sound and other sensory input, which creates the interactive computer-mediated world as a therapeutic tool.

DATA COLLECTION AND ANALYSIS

All review authors independently selected studies and extracted data. For homogeneous dichotomous data the risk difference (RD) and the 95% confidence intervals (CI) were calculated on an intention-to-treat basis. For continuous data, we calculated mean differences (MD). We assessed risk of bias and created a 'Summary of findings' table using the GRADE approach.

MAIN RESULTS

We identified three short-term trials (total of 156 participants, duration five to 12 weeks). Outcomes were prone to at least a moderate risk of overestimating positive effects. We found that virtual reality had little effects regarding compliance (3 RCTs, n = 156, RD loss to follow-up 0.02 CI -0.08 to 0.12, low quality evidence), cognitive functioning (1 RCT, n = 27, MD average score on Cognistat 4.67 CI -1.76 to 11.10, low quality evidence), social skills (1 RCT, n = 64, MD average score on social problem solving SPSI-R (Social Problem Solving Inventory - Revised) -2.30 CI -8.13 to 3.53, low quality evidence), or acceptability of intervention (2 RCTs, n = 92, RD 0.05 CI -0.09 to 0.19, low quality evidence). There were no data reported on mental state, insight, behaviour, quality of life, costs, service utilisation, or adverse effects. Satisfaction with treatment - measured using an un-referenced scale - and reported as "interest in training" was better for the virtual reality group (1 RCT, n = 64, MD 6.00 CI 1.39 to 10.61,low quality evidence).

AUTHORS' CONCLUSIONS

There is no clear good quality evidence for or against using virtual reality for treatment compliance among people with serious mental illness. If virtual reality is used, the experimental nature of the intervention should be clearly explained. High-quality studies should be undertaken in this area to explore any effects of this novel intervention and variations of approach.

Male imprisoned firesetters have different characteristics than other imprisoned offenders and require specialist treatment

OBJECTIVE

This study investigated whether a group of firesetters (n = 68) could be distinguished, psychologically, from a matched group of non-firesetting offenders (n = 68).

METHOD

Participants completed measures examining psychological variables relating to fire, emotional/self-regulation, social competency, self-concept, boredom proneness, and impression management. Official prison records were also examined to record offending history and other offense-related variables. A series of MANOVAs were conducted with conceptually related measures identified as the dependent variables. Follow-up discriminant function and clinical cut-off score analyses were also conducted to examine the best discriminating variables for firesetters.

RESULTS

Firesetters were clearly distinguishable, statistically, from non-firesetters on three groups of conceptually related measures relating to: fire, emotional/self-regulation, and self-concept. The most successful variables for the discrimination of firesetters determined via statistical and clinical significance testing were higher levels of anger-related cognition, interest in serious fires, and identification with fire and lower levels of perceived fire safety awareness, general self-esteem, and external locus of control.

CONCLUSIONS

Firesetters appear to be a specialist group of offenders who hold unique psychological characteristics. Firesetters are likely to require specialist treatment to target these psychological needs as opposed to generic offending behavior programs.