Background: This article aims to investigate and compare rejection sensitivity patterns in patients from Asian and European cultural backgrounds who have experienced social exclusion. Rejection sensitivity, a psychological construct characterized by heightened responsiveness to perceived rejection, is often associated with negative psychological outcomes. By examining the experiences of exclusion and their impact on rejection sensitivity in patient populations across diverse cultural contexts, this study seeks to shed light on the interplay between socio-cultural influences and psychological and physiological responses to social exclusion.

The most common reason for a malpractice claim is suicide or attempted suicide. It is argued that suicide can be prevented if the danger is recognized and proper and timely treatment is provided. Failure to make an informed decision as to whether to admit an individual to a psychiatric unit generally constitutes the initial breach in a claim of negligence. The present study was designed to identify exactly what essential data was missing from files of completed suicides, using 39 medical case records of the risk-management files of the state-owned malpractice insurance company between 2004 and 2022 in Israel. We found that a great deal of important information was missing from those files (e.g., records of previous suicide attempts, documentation of disagreement between the emergency department and the patient as to whether the individual should be hospitalized, and information regarding a history or lack thereof of suicidal tendencies in the individuals immediate family). Our study demonstrates that lacking the proper documentation of vital patient history, allegations of negligence would be very difficult to disprove.

Paranoia and persecutory delusions comprise the symptoms of established disorders such as schizophrenia in clinical populations. Paranoia is believed to exist on a continuum within the general population as well. There is limited research on the possible underpinnings of paranoia, but theoretical models of paranoia suggest that negative life events, trauma, negative views of the self and others, and emotional distress are important factors. Specifically, shame and traumatic life events/stress has been extensively entwined with the development of paranoid ideations among individuals. In this study, we explored the role of internal and external shame along with traumatic stress as it related to paranoia and emotional distress in a sample of ninety college students. Results showed that all variables were modestly correlated but further analysis showed that only external shame was related to the presence of paranoid ideation; internal shame was linked to anxiety and depression. Implications for the role of shame in paranoia are discussed.

Using Ludwig van Beethoven and Bruce Springsteen as case studies, I argue that through a process of catharsis music can simultaneously express and transform severe psychosocial disability. Both musicians experienced an existential crisis around the age of 32, when already launched on successful musical careers. As well as providing written testaments to their distress, both expressed it in their contemporary musical compositions: La Malinconia and The Tempest; Born to Run, Darkness on the Edge of Town and Dancing in the Dark. Both were experiencing fundamental problems of identity: Beethoven’s anguish was precipitated by his encroaching deafness and its effect on his future abilities; Springsteen’s by his growing sense of alienation from his cultural base. Both had strong factors predisposing them to depression, centred around longstanding difficult relationships with their fathers, rendering them angry at the world and themselves. But for both, music was a means of sublimation, of channelling their aggression and their despair, of finding purpose beyond the self. Beethoven’s belief in his mission to express the full range of his art to the world gave him the strength to continue, while for Springsteen the key was a growing awareness of his mission to map the distance between the American dream and American reality. Both experienced further periods of turbulence later in life, but were able to use their musical outputs – for example La Cavatina and Long Time Comin’ - as forms of maintenance therapy. For their audiences, their music continues to provide powerful antidotes to despair.