Characterisation of a university student sample with a lifetime history of non-suicidal self-injury: mixed-methods analysis of stress factors, coping mechanisms and reasons for self-injury

Long-term Outcomes After Acute Kidney Injury: Where We Stand and How We Can Move Forward

Why Won’t It Stop: Workplace Violence in Emergency Care

A lifetime history of non-suicidal self-injury (NSSI) is a risk factor for subsequent behavioural and emotional problems, including depression, aggression and heightened emotional reactivity. Traumatic experiences, which are frequently reported by individuals with NSSI, also show predictive links to these mental health problems. However, the exact connections between these areas and their subdomains remain unclear. To explore in detail the relationships of specific characteristics of NSSI (e.g. termination in adolescence, duration, frequency, reinforcement mechanisms) and various types of traumatic experience (emotional, physical, sexual) with distinct aspects of emotional reactivity (sensitivity, intensity, persistence), aggression (behavioural, cognitive, affective) and severity of depression in university students. Via online survey, 150 university students aged 18 to 25 years, who had self-injured at least once, provided information on NSSI, and completed questionnaires including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Emotion Reactivity Scale, and Aggression Questionnaire. Regression analyses were conducted to determine risk factors linked to increased depression scores, aggression and emotional reactivity. The study was pre-registered in the German Clinical Trials Register (DRKS00023731). Childhood emotional abuse contributed to emotional reactivity, aggression and depressive symptom severity (β = 0.33-0.51). Risk factors for sustained NSSI beyond adolescence included increased automatic positive reinforcement (odds ratio: 2.24). Childhood emotional abuse significantly contributes to emotional and behavioural problems and needs to be considered in NSSI therapy. NSSI was found to persist into adulthood when used as an emotion regulation strategy.

Background: Low levels of affective mentalization have been linked to depression severity. Objective: Our objective was to examine how affective mentalization relates to and predicts depression severity and whether an affective-mentalization-intervention reduces state-depression severity. Methods: In Study 1, we investigated the cross-sectional association between affective mentalization measured with the Emotion Beliefs Questionnaire and depression severity gauged with the Patient-Health-Questionnaire-9 in a clinical sample of psychosomatic outpatients (N = 729). In Study 2, we examined the lagged longitudinal association in a prospective general-population-MTurk-sample (N = 318). In Study 3, we experimentally tested the effect of an affective-mentalization-intervention on an induced depression state in MTurk-participants (N = 691). Results: Affective mentalization is negatively related to depression severity in patients diagnosed with, r s(668) = -.30, p < .001 (Study 1) and predicted depression severity over time and above the lagged-criterion, β = -0.06, p = .049 (Study 2). Exposing state-depressed participants to an affective-mentalization-intervention significantly reduced depression states (d = 0.38) compared to state-depressed participants and did not differ from no-treatment-control-participants (Study 3). Discussion: Affective mentalization relates to the development and maintenance of depression states and severity, and interventions employing affective mentalization might reduce depression severity.

Background: Mental health is a major public health concern affecting many populations worldwide, including university students. There has been mounting evidence of various coping mechanisms which are being utilised by the university student population and various studies have shown their effects on mental health. Physiotherapy students undergo health personnel training which is attributed to high levels of stress due to the high clinical demands, academic pressure and practical skills that must be developed to deliver hands-on expertise. Although various studies on stress levels and coping mechanisms have been documented internationally, stress levels and stress-coping mechanisms have not been studied extensively in the university setting locally, among physiotherapy students, and not much has been seen about the use of physical exercise (PE) as an effective and healthy stress-coping mechanism. Objective: To investigate the role of PE as a stress-coping mechanism amongst physiotherapy students at the University of Zambia (UNZA), Ridgeway campus. Methodology: A qualitative descriptive method was used in this study. A quota sampling method was used to get a representation of the entire full-time, undergraduate physiotherapy student population. Focus group discussions were used to collect data. Four focus groups were formed with each class having 7, 10, 10, and 8 participants, respectively. Audio-recorded data was transcribed and reported verbatim, and deductive thematic analysis was employed as the focus group discussion guide was based on predetermined themes from the objectives of the study. Results: The study showed that student stress levels differed significantly with the year of study, with senior students (fourth and fifth years) reporting to feel more stressed. On the other hand, for the junior students, while second years found their course load to be manageable, most third years described their course load to be stressful. Stress-coping mechanisms differed among students. Most females were seen to use emotion-focused and avoidant coping mechanisms such as sleeping, talking to people, listening to music, watching movies, and stress-eating. While most males were seen to use problem-focused coping such as jogging, running, and taking walks. Students also showed awareness of the physiological effects exercise has in improving a person’s mood. Conclusion: The physical benefits of physical exercise are well known and documented, but its use in mental health promotion amongst students is not known. The findings showed that despite most of the participants being aware of the role of physical exercise in stress-coping, very few intentionally utilise it to cope with stress. This finding shows that more efforts should be channelled into health promotion and collaborations with university management to promote mental health and incorporate PE and its importance in mental health and overall well-being.

This paper talks about how to insist staying in changed mindset based on the assigned cognitive reframing principles, and finally the changed mindset become a forever psychological status by PSI model proposed by this study. P is the cognitive reframing principle of positive psychology, happiness in this case; S is self-efficacy, which plays the important role in maintaining the stress taker to psychologically stay in the changed mindset in the long run. I represent of insisting power, the mental toughness to against the adverse negative emotions. Improving university students’ stress coping skills through the psychological dynamics formed by cognitive reframing principles of positive psychology, self-efficacy, and mental toughness will help them effectively deal with stressful events. This study aims to reduce university students’ stress level by increasing their ability to cope with stress, and improving their life satisfaction by understanding the mechanism for mindset-shift of university students and proposal of the new PSI reframing model for creating a new path to let students view stressors as challenge, not hindrance. Theories adopted in this study include cognitive reframing principles, appraisal theory, hindrance-challenge theory, cognitive reframing the schema. In the introduction section, the authors will clearly depict the logics for utilization of these theories in supporting the proposed PSI model. This research was divided into two studies. Study 1 postulated that cognitive reframing principles of positive psychology, self-efficacy, and mental toughness have a positive mediating effect in the causal relationship between university students’ stress level and life satisfaction. Findings revealed that stressful life events negatively predict the level of LS. Also, PP, SE, and MT exert a positive and significant impact on the relationship between stressful life events and LS. PP strengthens individuals’ perception of stressful life events as challenges instead of hindrances. This study showed that individuals need to think positively and develop self-efficacy in order to generate mental toughness when confronted with challenges from stressful life events, and needs to have self-efficacy and confidence towards cognitive reframing principles of positive psychology in their mind, and finally form a mental toughness competence to protect the newly changed mindset in the long run.

Background and Aim:Aging is a stage during which stressful events occur frequently. The method of coping with this stress can play an important role in an elderly's mental health. The present study aimed at investigating the role of coping strategies in stressful life events associated with depression.Method:The present study was a correlational one conducted by structural equation analysis. As many as 841 elderly people were selected from the general population by adopting a cluster sampling method. Beck's Depression Inventory as well as strategies of coping with stress and stressful events were applied.Results:The model test, analyzed by AMOS by using path analysis, indicated that age is positively associated with stressful life events and depression. The “stressful life events” variable is directly and indirectly associated with depression. The emotion-focused coping strategies were positively associated with depression, and problem-focused coping strategies were negatively associated with depression.Conclusion:As an individual grows older and experiences stressful life events, his/her depression increases. Elderly people with problem-focused coping strategies are likely to experience less depression.

Objectives: The aim of this study is to determine the level of stressful life events during the spread of the COVID-19 virus, as well as the strategies used to deal with these stressful events and the relationship between stressful life events and psychological adjustment. Methods: A cross-sectional web-based observational study. A survey was carried out among Jordanian universities using random sampling. The validity and reliability of the study tools (Psychological Adjustment Scale, Coping Strategies with Stressful Life Events Scale, and Stressful Life Events Scale) were confirmed. 229 participants, with an average age of 36.15 ± 14.05 years were selected to participate in this study. Results: The findings revealed that the overall level of stressful life events was moderate. Political events were ranked first, followed by economic, emotional, health, social, and family events. The findings also indicated that the positive interaction strategy was one of the most widely used approaches to dealing with stressful life events. Most of the correlations between stressful life events and the degree of psychological adjustment were inverse correlations (r = -0.58, p = 0.01). Conclusions: The individual interacts globally using a positive interaction strategy when facing stressful life events to transform it from a source of fear into a source of success.

The present study is to investigate whether diabetes mellitus (DM) increases risk of adverse long-term outcomes after intracranial stent placement. Patients receiving intracranial stenting were assigned to DM group and non-DM group according to diabetes status. The long-term follow-up endpoint was composite of any stroke and death within 30 days, any ischemic stroke beyond 30 days, and transient ischemic attack in the territory of the stented artery at any time. A total of 44 stenoses in 43 patients were retrospectively analyzed. The cumulative probability of the composite outcomes were 15.4% (95% CI 15.3-47.3%) at 1 year and 30.8% (95% CI 26.5-33.6%) at 2 years for DM group; 17.5% (95% CI 16.0-31.2%) at both 1 year and 2 years for non-DM group (log-rank test, P = 0.424). After adjusting for the confounders, the risk of DM versus non-DM for composite outcomes remained insignificant (hazard ratio: 2.84, 95% CI 0.46-17.66; P = 0.26). Our results showed that there is no significant difference between patients with DM and without DM in cumulative probability of the composite outcomes. It suggests that based on our data, there is no evidence that DM increases the risk of adverse long-term outcomes after intracranial stent placement.

Introduction: Various factors contribute to the development of dissociative disorders. The ability to cope with different stressful events is key to symptom manifestations in this disorder. This study aims to explore various stressors, and coping strategies in patients with dissociative disorder, and the relationship between coping strategies with stressors and clinicodemographic characteristics. Methods: This descriptive cross-sectional study evaluated patients with dissociative disorder presenting at the Department of Psychiatry in a tertiary care teaching hospital for 6 months (May to October 2017). We collected data on the demographic and clinical characteristics. We used the Presumptive Stressful Life Event Scale (PSLES) and Brief COPE scale to record the stressors and the coping responses, respectively. We summarized numerical variables with median and interquartile range (IQR) and categorical variables with proportions. Spearman rank correlation was run to determine the relationship between the PSLES and each coping strategy. Results: Of 108 patients, 86 (79.62%) patients were studied. 77 (89.53%) patients reported stressful life events, and failure in the examination was the most common stressor. Overall, coping strategies were used minimally. Problem-focused coping strategies were used slightly more frequently. There was no statistically significant correlation between stressors and coping strategies. Only religious coping was found to have a significant correlation with age. Conclusions: The majority had stressful events. The use of coping strategies was uncommon. Problem-focused coping strategies were used more frequently.

Life-Satisfaction, Engagement and Social Support: Do they Predict Depression Severity, Suicide Ideation, and History of Attempt in Late-life Depression?

Unipolar depression is frequently a recurrent or chronic disorder. In studies on predicting its course, outcomes are typically linked to either psychiatric features or stressful life events. In order to integrate the 2 approaches, 51 unipolar patients were assessed periodically over at least 1 year for symptoms, stressful events, and chronic stressors. It was hypothesized that adverse family history and early age of onset impair role functioning and coping capabilities, thereby contributing to stressful circumstances that predict severity of depressive reactions. Results of causal modeling analyses supported a model in which background factors were associated with severity of depressive outcomes as mediated by their effects on stress variables. Such a model implicates the self-perpetuating nature of clinical depression, both for the individual and across generations.

The present research focused on gender differences in reactions to stressful life events in Israel. The sample of Study 1 consisted of 350 individual participants, 56.3 per cent women and 43.7 per cent men, who completed questionnaires assessing their cognitive appraisals and affective reactions to the most stressful life event they encountered during the two years prior to the study, and the strategies they used to cope with the event. Women scored higher than men on threat appraisals, negative affective reactions, and the use of emotional expression and support seeking strategies in coping with the stressful event. Threat appraisals and emotional expression/support seeking coping strategies mediated the effects of gender on negative affective reactions to the stressful event. Study 2 which consisted of 151 married couples, each couple assessing the same stressful event, replicated the Study 1 results in regard to gender. Wives were more threatened by the stressful events and reported higher negative affect and more frequent use of emotional expression/support seeking coping and avoidance coping, compared with their husbands. In both studies, women and men did not differ on problem-focused coping, challenge appraisals and positive affective reactions. The results support the cognitive model of stress and coping.

According to empirical evidence, trait anger and emotion regulation strategies are associated with depression severity. The objective of this study was to investigate the impact of trait anger and maladaptive emotion regulation strategies in explaining the variance of depressive symptoms severity. Two hundred three participants diagnosed with major depressive disorder completed measures of depression, trait anger, depressive rumination, anger rumination and experiential avoidance. Path analysis using Mplus was employed for data analysis. Trait anger and depressive rumination were significant predictors of the level of depressive symptomatology, while experiential avoidance and anger rumination did not predict the level of depressive symptoms severity. Maladaptive emotion regulation strategies and trait anger seem to be associated with the level of depressive symptoms, and, as such, should also be investigated when working with depressive symptomatology.

Background Despite the increase of more inclusive practices in work, school, and other settings, the neurodiverse community often gets overlooked in a predominately neurotypical world. The pandemic introduced many challenges and opportunities that shifted our sense of “normal” as a society (i.e., online schooling and social isolation). Objective To explore the impact of COVID-19 on daily lives, coping strategies, accommodations, and accessibility of services in a sample of undergraduate university students. Method Semi-structured interviews were conducted virtually or in person with 17 neurodivergent university students ( N = 17) surrounding the impacts of COVID-19 on their daily lives, coping strategies, accommodations, and service accessibility. Open-ended responses were qualitatively coded using an inductive thematic analysis. Participants were asked questions regarding the effects of the COVID-19 pandemic on their daily life, coping strategies, symptoms, barriers, and advice they have for others with a similar diagnosis. Results Challenges included exacerbation of symptoms, difficulties following protocols, increased challenges in school, social settings, and overall negative impacts on mental health. However, despite these challenges, the pandemic also offered opportunities to live authentically, self-reflect, connect with an online community, and for some participants, gain a formal diagnosis. Conclusion The COVID-19 pandemic brought both challenges and opportunities to the neurodiverse community of university students.