Causal Beliefs Research Articles

Latina immigrants' breast and colon cancer causal attributions: genetics is key.

Latinos in the US suffer health disparities including stage of disease at time of breast or colon cancer diagnosis. Understanding Latinas' causal attributions of breast and colon cancer may provide insight into some of the individual level determinants of cancer disparities in this population. Cultural consensus analysis (CCA) is one way to study causal beliefs. The objective of this study was to describe Latina immigrants' causal attributions of breast and colon cancer. We conducted Spanish-language interviews with 22 Latina immigrants using a qualitative exploratory design comprised of freelisting, ranking, and open-ended questions. Participants freelisted causes and risk factors for breast and colon cancer then ranked risk factors according to their perceived role in the development of each cancer. CCA was conducted on rank orders to identify whether a cultural consensus model was present. Participants answered semi-structured, open-ended questions regarding the risk factors and rankings. Interviews were transcribed and subjected to thematic analysis. CCA showed no consensus around rank of causes for either cancer, and residual agreement analysis suggested the presence of two subcultural groups. "Genetics" and "hereditary factors" ranked first and second on average across participants for both cancers. Based on interview data, participants were less aware of colon cancer than breast cancer. Participants' endorsement of heredity as a cause of breast and colon cancer was similar to beliefs reported in studies of primarily non-Latina populations.

Exploring health and illness perceptions to identify the perceived cause of pregnancy-related pelvic girdle pain. A mixed-methods study among primiparous women in The Netherlands

BackgroundPregnancy-related pelvic girdle pain (PPGP) is common and considered a multifactorial condition with biomechanical and psychosocial contributions. The patient's perceived cause is an important aspect of illness perceptions, and a strong predictor of self-management and healthcare utilization. It is unknown what causal beliefs primiparae hold regarding PPGP. ObjectiveTo explore and describe health and illness perceptions among primiparae towards PPGP and its cause. DesignExploratory, convergent parallel mixed-methods. SettingAt the participants’ homes. ParticipantsSixteen primiparae with and without PPGP. FindingsPrimiparae with and without PPGP held comparable causal beliefs about PPGP. PPGP was described as the result of hormonal softening and loosening of the pelvis, and failure of the muscular system to compensate for that. Women who experienced similar physical symptoms attributed them differently, leading to different coping strategies. Interestingly, maternal healthcare providers reinforced the unidimensional- and predominantly biomechanical view when women sought healthcare. ConclusionThe causal mechanism of PPGP held by the women was not determined by their lived experience. It was primarily based on the concept of inevitable hormonal softening of the pelvis. This biomechanical belief is based on theories that are not in line with current knowledge of PPGP and contemporary pain science, yet they were reinforced by maternity healthcare providers. Implications for practiceHealthcare seeking behavior is influenced by illness beliefs. Maternity healthcare providers may play a key role in providing reassurance and addressing the multifactorial nature of PPGP when providing care and support to pregnant women.

Trauma, genes, or spirits? Development of a scale to provide a more nuanced understanding of refugees' causal attributions for mental health problems

Only a small proportion of refugees requiring treatment actually receive psychotherapy. Alongside structural barriers, it has been hypothesized that causal attributions for mental health problems that deviate from Western explanatory models may reduce refugees' help-seeking behavior. Prevailing assumptions suggest that refugees predominantly hold causal beliefs that are incompatible with the rationales of psychotherapy. Testing these assumptions requires a reliable assessment tool to evaluate refugees' causal beliefs. Therefore, we developed the Causal Attributions for Mental Health Problems Scale (MH-CAUSE) and validated it in a sample of Middle Eastern refugees living in Germany (N = 429). The outcomes of the psychometric analysis, which included exploratory and confirmatory factor analysis, internal consistency, and convergent validity, indicate that the MH-CAUSE is a suitable instrument for assessing refugees' causal beliefs about mental health problems. Our findings suggest that refugees' causal attributions are in line with a biopsychosocial-spiritual model of mental illness. Contrary to common assumptions, the majority of participants predominantly explained mental illness via psychosocial and biomedical causes, whereas spiritual beliefs were relevant only for a minority of participants. We observed significant associations between causal beliefs and help-seeking attitudes and behavior. However, effect sizes were only small to moderate. While mental health beliefs might contribute to mental health inequities, alleged cultural differences of refugees should not be overemphasized.

Adolescent help-seeking: an exploration of associations with perceived cause of emotional distress.

Help-seeking is intrinsic to efforts to manage the onset, maintenance, or escalation of mental health difficulties during adolescence. However, our understanding of adolescent help-seeking remains somewhat nebulous. A greater comprehension of help-seeking behavior from the perspective of adolescents is needed. It is also prudent to explore help-seeking behavior in the context of perceived cause for emotional distress, particularly as causal beliefs have been found to influence help-seeking behavior in adults. The present study sought to categorize adolescents' experiences of help-seeking, and to examine the extent to which these categories (or "types") of help-seeking behavior are associated with their perceptions of causal factors for emotional distress. The data for this study were drawn from interviews conducted as part of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11-12 years. Ideal-type analysis, a qualitative form of person-centered analysis, was used to construct a typology of adolescent help-seeking. Participants' help-seeking "type" was then compared with their perceived cause for emotional distress "type." We developed four distinct categories of help-seeking: (1) guided by others who have taken notice; (2) skeptical with unmet needs; (3) motivated and solution focused; and (4) preference for self-regulation. Simultaneously, we identified principal associations between perceived cause of emotional distress-(1) perceived lack of control; (2) unfair treatment; (3) others: their actions and judgements as the catalyst; (4) concern for self and others; and (5) self as cause-and help-seeking approaches. "Perceived lack of control" was most likely to be associated with "others who have taken notice"; "Unfair treatment" with "skeptical with unmet needs"; "others: their actions and judgements as the catalyst" with "motivated and solution focused"; "concern for self and others' with 'guided by others who have taken notice"; finally, "self as cause" was most likely to be associated with "preference for self-regulation." This study demonstrates meaningful and distinct categories of adolescent help-seeking and offers empirical evidence to support the assertion that perceived cause for emotional distress may influence the help-seeking approaches of adolescents.

Metamodern Spell Casting

Metamodern Spell Casting

Beliefs About Pain in Pediatric Inflammatory and Noninflammatory Chronic Musculoskeletal Conditions: A Scoping Review.

The Common Sense Self-Regulatory Model posits that beliefs about pain influence coping behaviors and subsequent physical and mental health outcomes in children/young people with chronic musculoskeletal conditions. It was unclear how and what beliefs had been investigated in this population, and whether there were similarities and differences in beliefs held about pain by those experiencing inflammatory versus noninflammatory musculoskeletal conditions. This scoping review addressed this gap. A systematic search was conducted using four databases (MEDLINE, PsycINFO, Embase, and CINAHL) in November 2021. Primary studies exploring key stakeholders' (including children, parents, and/or healthcare professionals) beliefs about pain underlying pediatric chronic musculoskeletal conditions were synthesized. Eighteen articles were identified. Cross-sectional designs were predominantly used to explore beliefs (n = 6). The majority used questionnaires to assess beliefs (n = 12). Beliefs common across musculoskeletal conditions were that children/young people felt their pain was not understood by others, and pain affected their physical functioning. Differences included children/young people and parents thinking they had some ability to control pain, and causal beliefs relating to underlying disease activity. These pain beliefs were more likely to be held in relation to inflammatory diagnoses. In contrast, children/young people and parents were more likely to view pain as uncontrollable, with more uncertainty regarding underlying causes, relating to noninflammatory diagnoses. Methods used to explore pain beliefs were inconsistent. Studies identified similarities and differences which appear to be closely related to the underlying diagnosis. Findings justify further exploration to identify potentially modifiable targets to improve pain outcomes in this population.

Beliefs about mental health in incarcerated males: a qualitative interview study.

Beliefs about mental health are shaped by the sociocultural context. Prisons have unique environmental and social features, and the prevalence of mental health problems in incarcerated populations is exceptionally high. These features make prisons especially interesting settings for exploring health beliefs. The aim of this study was to explore the conceptualizations of mental health and coping preferences in a prison environment. Individual in-depth interviews were conducted with fifteen incarcerated males from three prisons in Northern Norway. The design draws on central elements from Grounded Theory. Mental health was perceived as distinct from mental illness by many of the participants. They coped with the prison environment by focusing on the things that gave them a sense of meaning and autonomy - this also formed their conceptualization of mental health. Furthermore, social interaction and activities were perceived as important to enhance and maintain mental well-being, however there were institutional barriers to using these coping strategies. The prison environment was integrated in the participants conceptualizations of mental health problems, and psychosocial stressors were emphasized in causal attributions. Biological and dispositional factors were less frequently mentioned. The participants preferred non-medical management for mental health problems and most displayed a reserved attitude towards psychotropic medications. The exception was attention-deficit hyperactivity disorder, for which they held neurobiological causal beliefs, together with a corresponding preference for medication as treatment. The main finding was a firm integration of the prison context in in the participants' beliefs about mental health. We theorize that fusion of prison conditions and mental health beliefs were brought on by the processes of prisonization, observing mental distress in peers and attempts to protect self-esteem by externalizing the causes for mental health problems. Access to activities, social time, and "someone to talk to" were perceived to be crucial for improving and preserving mental health.

Age-related differences in temporal binding and the influence of action body parts.

If voluntary action is followed by an effect with a short time delay, the time interval between action and effect is often perceived to be shorter than it actually is. This perceptual time compression is termed intentional binding or temporal binding. We investigated age-related changes in adulthood considering temporal binding and its dependence on action body parts (i.e., hand vs. foot). This experiment included 17 young adults (mean age: 21.71 ± 3.14 years) and 27 older adults (mean age: 74.41 ± 3.38 years). Participants performed a button press task using their index fingers (hand condition) or toes (foot condition). The results showed that older participants exhibited a strong time compression comparable to young participants in the voluntary condition. Older participants also showed a strong time compression in involuntary action, which was induced by a mechanical device, differently from young participants. In line with previous research, the present age-related differences in time compression considering involuntary action suggest that causal belief significantly influences event perception rather than the associated intention of action or sensory afferents. The present results also suggest that the nature of action body parts has no significant influence on temporal binding, independent of age group.

Emotional reactions to climate change: a comparison across France, Germany, Norway, and the United Kingdom.

We present a study of emotional reactions to climate change utilizing representative samples from France, Germany, Norway, and the United Kingdom (UK). Drawing on appraisal theories of emotion, we examine relations between appraisals, emotions, and behavioral intentions in the context of climate change. We compare the four countries concerning emotional differences and commonalities and relate our findings to pertinent models of cultural values. Five distinct emotions were measured: worry, hope, fear, outrage, and guilt. In addition, the survey asked respondents to appraise a set of climate-related statements, such as the causality of climate change, or the efficacy of mitigation efforts. Also, a set of climate-relevant actions, such as willingness to reduce energy consumption or support for climate policies, was assessed. Findings show that appraisals of human causation and moral concern were associated with worry and outrage, and appraisals of efficacy and technological solutions were associated with hope. Worry and outrage are associated with intentions to reduce one's energy consumption, whereas hope and guilt are related to support for policies such as tax and price increases. A country comparison shows that French respondents score high on outrage and worry and tend to engage in individual behaviors to mitigate climate change, whereas Norwegian respondents score high on hope and show a tendency to support policies of cost increase. Generally, worry is the most and guilt the least intense emotion. Moral concerns and perceived collective efficacy of one's country in addressing climate change are relatively strong in France, while beliefs in human causation and in negative impacts of climate change prevail in Germany, and confidence in technological solutions are prevalent in Norway. In sum, findings reveal typical patterns of emotional responses in the four countries and confirm systematic associations between emotions and appraisals as well as between emotions and behaviors. Relating these findings to models of cultural values reveals that Norway, endorsing secular and egalitarian values, is characterized by hope and confidence in technological solutions, whereas France and Germany, emphasizing relatively more hierarchical and traditional values, are rather characterized by fear, outrage, and support for behavioral restrictions imposed by climate change policies.

Lifestyle causal beliefs are associated with higher personal and perceived stigma regarding depressive disorders: results from a representative population survey

BackgroundDepression is a prevalent and severe disorder associated with considerable stigma. This stigma contributes to the suffering and impedes help seeking behaviour of those affected. Stigma can be influenced by causal beliefs about depression and personal contact with people suffering from depression. The aim of this study was to investigate (1) the associations between beliefs about the aetiology of depression and personal / perceived stigma, as well as (2) a possible moderating effect of personal contact with people with depression on these associations.MethodsStigma, causal beliefs, and contact with depression were assessed in a representative online survey among German adults (N = 5,000). Multiple regression analyses were performed with contact levels (unaffected vs. personally affected (diagnosed) vs. personally affected (undiagnosed) vs. affected by relatives with depression vs. persons who treat depression) and causal beliefs (biogenetic vs. psychosocial vs. lifestyle) as predictor variables for personal and perceived stigma as dependent variables.ResultsHigher personal stigma was associated with lifestyle causal beliefs (p < .001, f² = 0.07), lower personal stigma with biogenetic (p = .006, f² = 0.01) and psychosocial (p < .001, f² = 0.02) causal beliefs. A positive interaction between psychosocial beliefs and the contact group “relatives” (p = .039) further suggests that this contact group does not benefit so strongly from psychosocial causal beliefs regarding personal stigma. Higher perceived stigma was associated with psychosocial (p < .001, f² = 0.01) and lifestyle (p < .011, f² = 0.01) causal beliefs. Regarding contact levels, the “unaffected” had significantly higher personal stigma scores than each of the other contact groups (p < .001). The contact group “affected (diagnosed)” had significantly higher perceived stigma scores than “unaffected”.ConclusionsThe available data show that anti-stigma campaigns should clearly communicate, that depression is not caused by an unfavorable lifestyle. In general, psychosocial or biological explanatory models should be explained. Especially for the target group “relatives of depressive patients”, who can be an important support for patients, education about biogenetic explanatory models should be provided. However, it is important to note that causal beliefs are only one of many factors that impact on stigma.

The Brain Is Not Working (Thluak Rian a Ttuan Lo): Perceptions of Mental Illness in a Resettled Chin Community

For decades, violent conflict has caused forced displacement throughout Myanmar. Chin people, largely from the northwestern Chin state in Myanmar, have been subjected to this violence resulting in displacement and resettlement with refugee status for thousands of Chin people. Scholars have often endeavored to understand the psychological outcomes of displacement and resettlement, with empirical work often dedicated to the onset of posttraumatic stress, depression, anxiety, and other Western-defined constructs of mental illness being correlated with traumatic experiences. These endeavors fail to center cultural explanations of mental illness among specific cultural groups like the Chin. Therefore, we used a community-collaborative, grounded theory approach to interview Chin people ( N = 20) resettled in the midwestern United States. Grounded theory analyses led to identification of two categories reflecting participants’ explanatory models of mental illness: (a) The Brain is Not working and (b) Causal Beliefs of The Brain not Working. The first category has one subcategory (Symptoms of the Brain not Working) and the second category is separated into three subcategories: (a) Going Crazy, Being Born Like that, and Thinking too Much as Causes, (b) Religion as an Explanation, and (c) “Control Your Heart”: Personal Responsibility and the Onset of Illness. These are discussed in light of the need to better understand cultural models of illness for Chin people with refugee status in contexts of resettlement. Specific attention is afforded to potential importance of this idiom of distress.

Causal Beliefs About and Perceptions of Illness in Persons Experiencing Schizophrenia and in Close Relatives of Such Individuals: An Exploratory Study.

The cause to which persons experiencing schizophrenia attribute their illness influences emotional and adjustment variables. This is also true for close relatives (CRs), who are important players in the affected individual's environment and whose mood can influence the person's day-to-day life or treatment adherence. Recent literature has highlighted a need to further explore the impact of causal beliefs on different aspects of recovery as well as on stigma. The objective of this study was to explore causal beliefs about the illness and their relationship to other illness perceptions and stigma among persons experiencing schizophrenia and their CRs. Twenty French individuals experiencing schizophrenia and 27 CRs of individuals with schizophrenia answered the Brief Illness Perception Questionnaire, which investigates probable causes of an illness and other illness perceptions, and the Stigma Scale. A semi-structured interview was used to collect information about diagnosis, treatment, and access to psychoeducation. The individuals with schizophrenia identified fewer causal attributions than the CRs. They were more likely to endorse psychosocial stress and family environment as probable causes, while CRs mostly favored genetic explanations. We found significant relationships between causal attributions and most negative perceptions of the illness, including components of stigma, in both samples. Among CRs, having received family psychoeducation was strongly correlated with viewing substance abuse as a probable cause. Relationships between causal beliefs about illness and perceptions of illness both in individuals experiencing schizophrenia and in CRs of such individuals should be explored further with harmonized and detailed tools. Assessing causal beliefs about schizophrenia as a framework for psychiatric clinical practice could prove useful for all those involved in the recovery process.

Beliefs around the causes of inequities and intergroup attitudes among health professional students before and after a course related to Indigenous Peoples and colonialism

BackgroundAddressing the Truth and Reconciliation Calls to Action on including anti-racism and cultural competency education is acknowledged within many health professional programs. However, little is known about the effects of a course related to Indigenous Peoples and colonialism on learners’ beliefs about the causes of inequities and intergroup attitudes.MethodsA total of 335 learners across three course cohorts (in 2019, 2020, 2022) of health professional programs (e.g., Dentistry/Dental Hygiene, Medicine, Nursing, and Pharmacy) at a Canadian university completed a survey prior to and 3 months following an educational intervention. The survey assessed gender, age, cultural identity, political ideology, and health professional program along with learners’ causal beliefs, blaming attitudes, support for social action and perceived professional responsibility to address inequities. Pre-post changes were assessed using mixed measures (Cohort x Time of measurement) analyses of variance, and demographic predictors of change were determined using multiple regression analyses. Pearson correlations were conducted to assess the relationship between the main outcome variables.ResultsOnly one cohort of learners reported change following the intervention, indicating greater awareness of the effects of historical aspects of colonialism on Indigenous Peoples inequities, but unexpectedly, expressed stronger blaming attitudes and less support for government social action and policy at the end of the course. When controlling for demographic variables, the strongest predictors of blaming attitudes towards Indigenous Peoples and lower support for government action were gender and health professional program. There was a negative correlation between historical factors and blaming attitudes suggesting that learners who were less willing to recognize the role of historical factors on health inequities were more likely to express blaming attitudes. Further, stronger support for government action or policies to address such inequities was associated with greater recognition of the causal effects of historical factors, and learners were less likely to express blaming attitudes.ConclusionThe findings with respect to blaming attitudes and lower support for government social action and policies suggested that educational interventions can have unexpected negative effects. As such, implementation of content to address the Truth and Reconciliation Commissions Calls to Action should be accompanied by rigorous research and evaluation that explore how attitudes are transformed across the health professional education journey to monitor intended and unintended effects.

Teachers’ beliefs about educational quality: Examining the power of school settings through survey experiments

This study aims to characterize teachers' beliefs on determinants of educational quality and the influence of school settings. A factorial survey experiment with a probabilistic sample of 1285 Chilean primary school teachers is used to identify the causal attributions of the quality of teacher–student relations and learning methodologies in schools. Results indicate that teachers believe that decisional power and income satisfaction are the most important determinants of relational quality, while planning preparation and a multidisciplinary team of professionals are the most crucial for the quality of learning methodologies. Moreover, schools' characteristics affect teachers’ causal beliefs about educational quality.

Psychological distress and the belief that oral behaviours put a strain on the masticatory system in relation to the self-report of awake bruxism: Four scenarios.

It is assumed that other factors than masticatory muscle activity awareness could drive the self-report of awake bruxism. To investigate the extent to which the report of awake bruxism is associated with psychological distress, and with the belief that oral behaviours put a strain on the masticatory system among TMD-pain patients. The study sample consisted of 1830 adult patients with reported function-dependent TMD pain. Awake bruxism was assessed through six items of the Oral Behaviors Checklist. Psychological distress was assessed by means of somatic symptoms, depression and anxiety. Causal attribution belief was measured with the question 'Do you think these behaviours put a strain on your jaws, jaw muscles, and/or teeth?' Mean age of all participants was 42.8 (±15.2) years, 78.2% being female. Controlled for sex, positive, yet weak, correlations were found between awake bruxism and somatic symptom severity (rs = 0.258; p < .001), depression (rs = 0.272; p < .001) and anxiety (rs = 0.314; p < .001): patients with the highest scores reported approximately twice as much awake bruxism compared to those with minimal scores. Controlled for age and sex, a positive, moderate correlation was found between awake bruxism and causal attribution belief (rs = 0.538; p < .001). Patients who believed that performing awake oral behaviours put 'very much' a strain on the masticatory system reported four times more awake bruxism than patients who did not believe that these behaviours are harmful. Based on the results and relevant scientific literature, the theoretical background mechanisms of our findings are discussed in four scenarios that are either in favour of the use of self-report of awake bruxism being a representation of masticatory muscle activity awareness, or against it.

A cognitive pathway to punishment insensitivity

Individuals differ in their sensitivity to the adverse consequences of their actions, leading some to persist in maladaptive behaviors. Two pathways have been identified for this insensitivity: a motivational pathway based on excessive reward valuation and a behavioral pathway based on autonomous stimulus-response mechanisms. Here, we identify a third, cognitive pathway based on differences in punishment knowledge and use of that knowledge to suppress behavior. We show that distinct phenotypes of punishment sensitivity emerge from differences in what people learn about their actions. Exposed to identical punishment contingencies, some people (sensitive phenotype) form correct causal beliefs that they use to guide their behavior, successfully obtaining rewards and avoiding punishment, whereas others form incorrect but internally coherent causal beliefs that lead them to earn punishment they do not like. Incorrect causal beliefs were not inherently problematic because we show that many individuals benefit from information about why they are being punished, revaluing their actions and changing their behavior to avoid further punishment (unaware phenotype). However, one condition where incorrect causal beliefs were problematic was when punishment is infrequent. Under this condition, more individuals show punishment insensitivity and detrimental patterns of behavior that resist experience and information-driven updating, even when punishment is severe (compulsive phenotype). For these individuals, rare punishment acted as a "trap," inoculating maladaptive behavioral preferences against cognitive and behavioral updating.

Explanatory Models of (Mental) Health Among Sub-Saharan African Migrants in Belgium: A Qualitative Study of Healthcare Professionals' Perceptions and Practices.

Culturally differing approaches to the distinction between physical and mental health contribute to cultural differences in explanatory models of what we call "mental" health in a Western context. For this reason, we use "(mental) health" in this study when referring to these models or differences in understanding. This interpretative, interview-based qualitative study focuses on Belgian mental health professionals' perceptions of the (mental) health explanatory models held by their patients of sub-Saharan African (SSA) descent. The study goals were threefold: first, to assess professionals' perceptions of the explanatory models of their patients of SSA descent; second, to examine how these perceptions influence treatment practices; and third, to investigate the role of the professionals' cultural backgrounds, comparing the results between professionals with and without an SSA background. Twenty-two in-depth interviews with mental health professionals were thematically analyzed, with ten of the participants of SSA descent. Results show that all professionals perceived differences between Western and SSA explanatory models of (mental) health. Causal beliefs were mentioned as the most important difference, including their influence on coping strategies and health-seeking behavior among patients of SSA descent. Professionals' perceptions and familiarity with SSA explanatory models of (mental) health affected their treatment practices. Language and conceptual interpretation difficulties were encountered less frequently by professionals of SSA descent. Those with a Western background applied "culturally sensitive" practices, while professionals of SSA descent implemented an integrated approach. These results contribute to ongoing discussions about what is considered "cultural competency."

Adversity versus fate, genetics, and the environment: Causal beliefs and attitudes toward intellectual disability

ABSTRACT The present study investigated the role of demographic and personal factors concerning the attitudes toward intellectual disability. Our sample consisted of 482 Romanians aged 18 to 74. We measured the overall attitudes toward intellectual disability, as well as some specific dimensions, i.e., integration or segregation, social distance, private rights, and subtle derogatory changes. Our results suggested that the most significant predictor of the overall positive attitude toward intellectual disability, as well as for the subtle derogatory beliefs and integration/segregation dimensions, was the perceived environmental causal belief about intellectual disability. Next, the biomedical causal was the most significant predictor for the social distance dimension. Finally, the perceived fate-related causal belief was the most significant predictor for the private rights dimension. We discuss our findings concerning their role in designing targeted public awareness programs.

Reward-related self-agency is disturbed in depression and anxiety.

The sense of agency, or the belief in action causality, is an elusive construct that impacts day-to-day experience and decision-making. Despite its relevance in a range of neuropsychiatric disorders, it is widely under-studied and remains difficult to measure objectively in patient populations. We developed and tested a novel cognitive measure of reward-dependent agency perception in an in-person and online cohort. The in-person cohort consisted of 52 healthy control subjects and 20 subjects with depression and anxiety disorders (DA), including major depressive disorder and generalized anxiety disorder. The online sample consisted of 254 participants. The task consisted of an effort implementation for monetary rewards with computerized visual feedback interference and trial-by-trial ratings of self versus other agency. All subjects across both cohorts demonstrated higher self-agency after receiving positive-win feedback, compared to negative-loss feedback when the level of computer inference was kept constant. Patients with DA showed reduced positive feedback-dependent agency compared to healthy controls. Finally, in our online sample, we found that higher self-agency following negative-loss feedback was associated with worse anhedonia symptoms. Together this work suggests how positive and negative environmental information impacts the sense of self-agency in healthy subjects, and how it is perturbed in patients with depression and anxiety.

Leaving the stigma to the patients? Frequency of crisis experiences among mental health professionals in Berlin and Brandenburg and how they cope with it

Background Although mental health professionals’ mental health problems are gaining increased attention, there is little systematic research on this topic. Aims This study investigated the frequency of crisis experiences among mental health professionals and examined how they approach these experiences in terms of their personal and social identities. Methods An online survey was conducted among mental health professionals in 18 psychiatric hospital departments in the German federal states of Berlin and Brandenburg (N = 215), containing questions about personal crisis experiences, help sought, service use, meaningfulness of lived experiences, causal beliefs of mental illness and psychotherapeutic orientation. Social identification was assessed via semantic differential scales derived from preliminary interview studies. To investigate relationships between the variables, explorative correlation analyses were calculated. Results Results showed a high frequency rate of crisis experiences, substantial rates of suicidal ideation and incapacity to work and high service use. Most participants regarded their experiences as meaningful for their personal identity. Meaningfulness was positively related to a psychosocial causation model of mental illness, to psychodynamic psychotherapeutic orientation and to a high degree of disidentification with users and crisis experienced colleagues. Conclusion The (paradoxical) disintegration of personal and social identity of may be understood as a strategy to avoid stigmatization. A more challenging coping style among professionals is discussed.