Emotional Costs Research Articles

From Agency to Responsibility: Gestalt Therapy Trainees’ Experience of Engaging in Personal Therapy

Personal therapy is a common mandatory element of counseling and psychotherapy training in the United Kingdom. Previous research has established that this practice provides trainees with a unique learning space but also is associated with financial and emotional costs. Furthermore, some argue that the practice of personal therapy is ethically questionable. At the heart of many relational modalities, such as Gestalt psychotherapy, lies the relationship between client and therapist and more research is needed to explore how trainees perceive established training methods. The current study recruited 11 trainee Gestalt practitioners and conducted one-to-one semi-structured interviews to explore their experiences of engaging in personal therapy. A number of themes emerged in reflexive thematic analysis: trainees perceived personal therapy to be associated with professional and personal gains as well as financial and emotional costs; they also viewed personal therapy to be an essential component of their training but would like to be involved in discussions around how it is shaped. We recommend that training providers and professional bodies offer such a dialogic space, and that future research and practice further considers the barriers of minority clients and trainees in particular.

Settling for a “good enough” school: contradictions of middle class reproduction in a small town in illiberal Hungary

Abstract The politics of the Orbán regime, in power in Hungary since 2010, are reshaping the possibilities for middle class reproduction and social mobility, as revealed through our analysis of parental dilemmas around school choice and future aspirations in a peripheral small town. As the main targets of re-industrialization and an important voter base for the regime, small towns are particularly relevant localities for studying the transformations of middle-class reproduction. Globally, anxieties over class reproduction pushes parents to invest more intensely in their children’s education, whereas increasingly worrying about the detrimental effects of related pressures on their child’s well-being. In small towns in the global semi-periphery, parental dilemmas around schooling appear in a particularly acute form due to the limited possibilities for social advancement, the high financial and emotional costs that mobility requires, and the racialised dimension of localised class relations. We contend that policies of the Orbán regime, such as the ‘churchification’ of education and the privileging of technical middle schools, have further reshaped local possibilities and routes of advancement. The tension between the pervasive promise of middle-class advancement through education and the locally rooted assessment of realistic employment possibilities exposes the contradictions of the current regime and helps to grasp the localised consequences of its socio-economic re-engineering. As in the studied context class is strongly racialised, we examine the strategies and dilemmas of middle class parents of the ethnic majority, and Roma parents who aspire to become middle class in a relational way, revealing how ethnicity further complicates middle class reproduction in Hungarian peripheral small towns.

Mothers’ Parenting Behaviours, Strain, Enjoyment and Subsequent Childbearing

Modern parenting is both emotionally costly and rewarding. It is also more intensive than before and requires significant time and effort, particularly from mothers. Emotional costs and benefits of children are important to fertility decisions, and they may be linked with a mother’s parenting behaviours. Using a sample of 4402 partnered first-time mothers from the UK Household Longitudinal Study waves 1 to 9 (2009–2018), this study investigated the association between mothers’ parenting behaviours, changes in the levels of reported strain or enjoyment of everyday activities and second-birth transition. A decline in enjoyment formed a negative association with second-birth risk. The frequency of participation in dinner with the child and in leisure activities with the child formed significant associations with second-birth risk but only for selected segments of the population. We discuss the possible underlying mechanisms of these associations and the socioeconomic differences within them.

Class Clash: Unpacking Conflicts of Class Affiliation in the Bodily Practices of Polish Men Under 35 Years with Working-Class Origins

The article examines conflicts of class affiliation in the bodily practices of young Polish men of working-class origin. The empirical basis of the analysis is individual in-depth interviews with biographical elements carried out in 2022 as part of a study on the bodily practices of four generations of Polish men. The article contains the state of research on practices in the context of class affiliation. The theoretical framework is based on the concept of classist phantasm and middle-class hegemony. The study shows the critical importance of working-class backgrounds in shaping and controlling the body throughout the lifespan. The piggy bank ethos is one of the key categories emerging from the analysis, and research participants remain trapped in negotiating class identity reflected in bodily practices. In negotiating their class affiliation, men experience conflict with the values of the family of origin from their early teenage years. As they study and strive for advancement, they pay a hidden emotional cost, as they must authenticate themselves as deserving of their place in the middle class. Even if they are upgrading to the middle class (as working adults), they remain in the power of the piggy bank ethos. The study’s main conclusion is that social advancement is only partly achievable. Climbing up the social ladder, the study participants still balance middle-class practices and working-class values, which become apparent in what they do about the body.

Decoding motivation in English medium instruction: situated expectancy-value theory and student performance at a Chinese transnational university

ABSTRACT This study investigates English-medium instruction (EMI) academic motivation at a Chinese transnational university, aiming to bridge identified research gaps by employing the Situated Expectancy-Value Theory (SEVT). Specifically, it explores motivational predictors of EMI academic performance and the factors influencing these predictors. A longitudinal mixed-methods approach was adopted, utilising a validated Chinese EMI Student Academic Motivation Scale administered twice (n = 156) over a semester and semi-structured interviews with a subgroup of 15 participants. Results from multiple linear regression indicated that the combination of nine motivational variables had a moderate impact on EMI academic performance, and two of the predictor variables – expectations of success and emotional cost – were statistically significant predictors. Qualitative findings from the interviews revealed four key factors that influence the development of expectations of success: past learning experience, English language ability, learner autonomy, and socialisers’ influence; additionally, three main factors were identified as affecting the development of emotional cost: English language barriers, EMI curriculum, and peer pressure. The study concludes with practical pedagogical recommendations, drawn from both quantitative and qualitative data, aimed at enhancing EMI effectiveness in similar educational contexts.

To Perform or Not to Perform: Exploring the Impact of COVID‐19 on Aotearoa New Zealand's Performing Arts Sector

ABSTRACTThis article explores narratives of how COVID‐19 impacted the performing arts sector, by drawing on interviews with creative workers in Aotearoa New Zealand. Despite the late exposure to COVID‐19 and the adoption of an elimination approach that afforded opportunities for performing arts to continue to varying extents between 2019 and 2022, cultural workers in Aotearoa New Zealand, as with their overseas counterparts, experienced significant and consequential disruption to their working conditions and lives. Taking into account the specificity of Aotearoa New Zealand's performing arts sector and the government's COVID‐19 response, the article contributes to the empirical examination of COVID‐19 experiences by teasing out narratives of impact from cultural workers. The thematic analysis demonstrates how participants presented (1) COVID‐19 as responsible for financial, emotional, and psychological costs, (2) framed opportunities arising from disrupted working conditions and wage subsidy as “silver linings,” (3) were reliant on digital technologies, and (4) constructed the return to “normal” as marked by the COVID‐19 “aftermath.” The article argues that uniting these perceptions and articulations of impact is the ongoing (re)evaluations of risks and benefits by cultural workers of working conditions that predate COVID‐19.

Aging Filipina migrants’ experiences of transnational end-of-life care and loss over time

ABSTRACT This article addresses experiences of transnational end-of-life care among aging Filipina migrants before and during COVID-19. de Leon addresses the emotional costs associated with loving and losing kin from a distance both before and during the pandemic, drawing on their autobiographical account of distant care by proxy during their aunt’s wake and funeral. Blower-Nassiri highlights the exacerbated fears and anxieties around dying, illness, and end-of-life among aging migrants, drawing on two life histories of retired nurses who recalled moments of loss and being absent for end-of-life events, such as funerals, before and during the pandemic. Together, de Leon and Blower-Nassiri provide an intimate portrait of three Filipina migrants’ experiences with end-of-life care and loss. They further address the limitations of the life course framework in their consideration of how care carries on, across generations through end-of-life practices and rituals that signal an accrual of loss over time.

“The Only Self-Defense I Have is My Wedding Band”: Doing Heterosexuality, Evading Gender Harassment, and Becoming Respectable in the Street

The field of critical heterosexualities studies invites sociologists to untether heterosexuality from biology. In this article, I leverage the findings of 113 interviews with a racially diverse sample of cis and trans women to examine how women maintain everyday dignity in the street despite widespread gender harassment and systemic, racialized sexual inequalities. Drawing on social constructionist theory and applying an intersectional framework, I examine heterosexuality as a performance, uncovering how gender identity, race, and sexual orientation intersect to shape both the costs and benefits of “doing heterosexuality” in the street. Through practices such as wearing wedding rings, holding the hands of men friends, and displaying affection for men in public places, straight, queer, cis, and trans women creatively resist heteronormativity’s regulation of their social-sexual lives and strive to enunciate sexual unavailability; communicate the existence of a protector; and signal respectability by demonstrating conformity with racialized, cisnormative ideals of gender and sexual normativity. Findings demonstrate that racialized, queer, and trans participants tend to experience greater emotional costs and fewer symbolic rewards associated with “doing heterosexuality” than white, straight-identified, and cis participants. This intersectional analysis enriches extant research on gender and sexuality, illuminating the utility of the “doing heterosexuality” framework for uncovering intersections between heterosexual accountability and gender inequality across diverse organizational and interpersonal contexts.

Hidden emotional costs of home accommodation. The lived experiences of Ukrainian refugees in Polish homes

Hidden emotional costs of home accommodation. The lived experiences of Ukrainian refugees in Polish homes

Factors That Influence Access to Medical Assistance in Dying Services: An Integrative Review.

In nearly all jurisdictions where it is permitted, Medical Assistance in Dying is situated in a healthcare system. Currently, limited evidence demonstrates how supply and demand factors influence access to Medical Assistance in Dying. The aim of this study is to synthesise empirical research from jurisdictions where Medical Assistance in Dying is legal to identify how supply and demand factors influence access for eligible adults. An integrative review was conducted. CINAHL Complete, PubMed, ProQuest, PsycINFO and Embase databases were systematically searched for studies published between January 1998 and January 2024. Records were independently assessed against inclusion and exclusion criteria. Additional studies were identified by forward and backward citation searching. All studies were assessed for quality. Findings were analysed deductively using an established conceptual framework, and a secondary narrative synthesis was undertaken. Fifty-eight studies met the inclusion criteria. Most studies (n = 32) reported results related to the supply side, 16 reported on the demand side and 10 reported on both supply and demand dimensions of access. Studies about supply showed that health service policies may obstruct access to Medical Assistance in Dying. For healthcare professionals, the practice entails an additional workload and can create tensions with colleagues. Studies of the demand for Medical Assistance in Dying focused on supporting time-critical decisions, adequate planning and caregiver support. Access to Medical Assistance in Dying requires the participation of health services and healthcare professionals but is hindered by policies that obstruct access and direct financial and indirect emotional labour costs. Innovative and inclusive models to promote high-quality, compassionate care at the end of life and access to Medical Assistance in Dying should be considered. Patients, caregivers and service users were involved in many of the studies included in this review, and their experiences and perspectives contributed to the analysis and synthesis in this review.

The tipping point: Financial and emotional costs of care for Medicare patients with cancer.

260 Background: As cancer-related health care expenses are increasing, a greater proportion of treatment costs are shifting directly to the patient, resulting in an increased financial burden for many patients. In addition to growing healthcare costs, the inflationary environment in the US has also increased the costs of daily living expenses. Although the Inflation Reduction Act (IRA) encompasses measures for negotiating prices of specific high-cost medications within Medicare Parts B and D, given the expenses associated with cancer treatment IRA negotiation provisions will likely have limited impact on patients’ financial burden. We sought to capture the financial and emotional experiences of Medicare cancer patients about their costs of care prior to the implementation of the IRA. Methods: This cross-sectional analysis used data from a nationwide survey distributed in February 2024 by Patient Advocate Foundation (PAF). Inclusion criteria included a valid email address, age >19, self-reported cancer diagnosis and Medicare coverage. Frequencies were calculated for categorical variables. Additional information about financial challenges will be collected on a subset of cancer survey respondents in May 2024. Results: A total of 331 survey respondents with cancer completed the survey. Most respondents were female (61%), age≥56 (86%), white (73%), retired (59%), married (47%), household income <$48,000 (69%), and rural location (24%). The most common cancer types were multiple myeloma (47%) and breast (26%); 25% were diagnosed < 2 years prior, 87% were receiving cancer treatment and 52% experienced financial challenges prior to diagnosis. Almost half (45%) reported a negative change in their financial situation in the past 12 months; caused by increased living (63%), food (60%), medical care (47%) and medication (39%) costs. Overwhelming/above average financial stress (40%) was reported on the day of the survey; 30% reported spending at least 25% of their monthly income on medical costs; 69% reported financial burden due to their illness. Fifty-nine percent reported that finances impacted their emotional wellbeing. Common coping strategies to alleviate financial distress included positive attitudes, family/friend support and spiritual beliefs. Conclusions: To mitigate the impact of inflation on low-income cancer patients, it is essential for policymakers, healthcare providers, and community organizations to work together to ensure access to affordable healthcare, support services, and financial assistance programs. Additionally, raising awareness about the challenges faced by this vulnerable population and advocating for policies that address their needs can help alleviate some of the burdens imposed by inflation. While the IRA is a step in the right direction, its financial impact on patients appears limited.

Potential bed-day savings and caregiver perspectives of transitioning hospital-level management of infants with bronchiolitis to the home: a mixed-methods study

ObjectiveHome management of infants admitted to hospital with bronchiolitis would alleviate pressure on hospital beds. We aim to understand the proportion of children requiring active care interventions (ie, oxygen, fluids),...

The Moderating Role of Interest in the Relationship between Perceived Task Difficulty and Invested Mental Effort

Including motivational variables such as interest in the cognitive load framework is an ongoing process. Of particular interest is the question of how motivational variables influence the investment of mental effort. In this study, we investigated how topic interest affects the investment of mental effort in simple tasks. A total of 1543 students’ judgments regarding invested mental effort, perceived task difficulty, and topic interest for 32 tasks of a chemistry test were analyzed at the task level based on item response theory parameters. Additionally, objective task difficulty was calculated. The Rasch parameters were used for correlation and moderated regression analyses. The results indicated that when perceived task difficulty was low, students invested more mental effort in solving tasks of low topic interest compared to tasks of high topic interest. With increasing perceived task difficulty, the amount of invested mental effort rose for tasks of low as well as high topic interest. However, the difference between tasks of low and high topic interest in the amount of invested mental effort decreased as perceived task difficulty increased and even vanished when perceived task difficulty roughly corresponded to students’ performance capability. These results are in line with flow theory and the expectancy-value-cost model of motivation. When solving tasks that match their performance capability, students can experience a flow situation. However, when solving rather easy tasks of low interest, students can experience motivational costs in terms of additional effort, such as an increased need for motivational self-regulation. The results of this study provide a basis for systematically investigating and better understanding the relationship between interest, task difficulty, invested mental effort, flow experience, and emotional costs.

Collateral damage: the emotional and material costs of political commitment for the followers of Mazzini and Garibaldi

ABSTRACT This article aims to cast light on the backstage of total militancy in the case of the followers of Mazzini and Garibaldi during the Risorgimento and post-Risorgimento. Political engagement is an existential commitment to a cause either in undercover conspiracy networks or in openly volunteering to fight all the way through to parliamentary activity that carries emotional and material costs. These costs can best be approached through the now rich scholarly literature on political emotions and exile, and the still under-investigated collateral effects of nineteenth-century patriotism that can be recovered from the study of the correspondence of families and friends and ego-documents. From Mazzini’s most intimate confessions to the choices made by Giovine Italia’s local leaders or by Garibaldi’s officers on the battlefield or even in the parliamentary arena, the impact of politics on the private horizon reveals the multiple layers of gain and loss, of expectation and disappointment, playing an unavoidable role in the lives of so many Italian men and women. The selected cases illustrate how disruptive political engagement proved to be when it entered the private sphere in the shape of risk, absence or punishment, and yet how fulfilling it was when it offered the ultimate reason for people leaving behind their loved ones and their professional status.

Effect of older adults willingness on telemedicine usage: an integrated approach based on technology acceptance and decomposed theory of planned behavior model

BackgroundTelemedicine, as a novel method of health management system, has demonstrated to have a significant impact on health levels. However, a challenge persists in the form of low usage rates and acceptance among older adults in China. There are accumulating evidence that willingness will affect the telemedicine usage among older adults. This study investigates factors influencing older users’ trust in adopting telemedicine technology, thereby promoting actual use.MethodsA questionnaire survey was conducted with 400 urban seniors aged 60 and above. Drawing from the Technology Acceptance Model (TAM) and the Decomposed Theory of Planned Behavior (DTPB), the author combines elements such as Perceived Usefulness, Perceived Ease of Use, Subjective Norms, Service Environment, Self-Efficacy, Behavioral Intention to Use, and Usage Behavior. The aim is to explore the interrelationships between these factors.ResultsPerceived Usefulness (PU) and Service Environment (SE) significantly and positively impact Behavioral Intention (BI) to use telemedicine, with Trust (TR) identified as a crucial mediating variable. Enhancing trust can substantially increase older adults’ intention to use telemedicine services. Furthermore, the study reveals a significant relationship between older adults’ trust in telemedicine and factors such as Perceived Usefulness (PU), Service Environment (SE), Subjective Norms (SR), as well as Emotional Risk (ER) and Cost Risk (CR), the latter two tending to decrease Trust(TR).ConclusionsThis paper constructs and validates a combined model based on TAM and DTPB, comprehensively exploring the potential factors influencing the older adults’ intention to use telemedicine. The findings suggest that telemedicine services for older adults should prioritize improving user perception and enhancing trust throughout the service process to effectively increase their willingness to use these services.

Adding brief content-related information to sensitive-content screens does not exacerbate screen- or image-related distress

ABSTRACT Content descriptions presented on sensitive-content screens reduce how often people view negative images. But does this reduction in exposure come at an emotional cost? Across two experiments, we investigated this possibility. In Experiment 1, we compared participants’ change in state anxiety when exposed to sensitive-content screens with and without brief and detailed content descriptions. State anxiety was similar for participants who saw screens with and without brief content descriptions, but we found larger increases in state anxiety for detailed content descriptions. Therefore, detailed content descriptions negatively impact how people feel when they view sensitive-content screens. In Experiment 2, we presented participants with a single sensitive-content screen, either with or without a brief content description, and gave them the opportunity to uncover it. Participants who uncovered the screen viewed the negative image and then rated their distress. Most participants uncovered the screen and, irrespective of condition, reported similar image-related distress. Taken together, brief descriptions do not negatively impact how people feel when they view sensitive-content screens or the forewarned content. Therefore, brief content descriptions do not create an emotional cost. Social media platforms should move beyond merely warning about upcoming content and provide brief content descriptions indicating what the content depicts.

MiRNAs that regulate apoptosis in breast cancer and cervical cancer.

In today's world, one of the main problems is cancer, which still has a long way to go to cure it, and it brings a lot of financial and emotional costs to the people of society and governments. Breast cancer (BC) and cervical cancer (CC), two of the most common cancers, are caused by several genetic and environmental factors in women. These two cancers' involvement rate is higher than other cancers in women. microRNAs (miRNAs) are non-coding RNA molecules with a length of 18 to 24 nucleotides, which play an important role in post-translational changes. miRNAs themselves are divided into two categories, oncomiRs and tumor suppressors. OncomiRs have a part in tumor expansion and tumor suppressors prevent tumor development and progress. miRNAs can control cellular processes by regulating various pathways including autophagy, apoptosis, and signaling. Apoptosis is a type of programmed cell death that includes intrinsic and extrinsic pathways and is different from other cell death pathways such as necrosis and ferroptosis. Apoptosis controls the growth, differentiation, and death of cells by regulating the death of damaged and old cells, and since miRNAs are one of the factors that regulate apoptosis, and divided into two categories: pro-apoptotic and anti-apoptotic. We decided in this study to investigate the relationship between miRNAs and apoptosis in the most common women's cancers, BC and CC.

Are companies ethically justified in offering nonmedical egg freezing as an employee benefit?

All over the world, many companies are including oocyte cryopreservation for nonmedical reasons, also popularly known as nonmedical egg freezing (NMEF), within their employee benefits packages. However, it is important to ask whether companies are ethically justified in offering NMEF as a benefit for their employees. The inclusion of NMEF within companies' employee benefits packages could be ethically justified in two ways. On the one hand, company-sponsored NMEF can serve as a strategy to mitigate or eliminate gender inequalities in the workplace, such as female underrepresentation in positions of authority and leadership and the so-called work/motherhood conflict. On the other hand, company-sponsored NMEF can be a means to expand women's reproductive autonomy by making egg freezing accessible to those women who are not able to afford it otherwise. This article calls into question these ethical justifications. We argue that by offering NMEF as an employee benefit, companies maintain current workplace inequalities and impose an option for women with multiple risks and externalities. Therefore, companies' offering of NMEF benefits cannot be ethically justified. Furthermore, we argue that companies that offer NMEF benefits incur fiduciary responsibilities related to the physiological, emotional, psychological, and financial costs of the use of company-sponsored NMEF.

Examining Motivational Attitudes Toward Statistics and Their Relationship to Performance in Life Science Students

A strong foundation of statistics is essential for undergraduates pursuing life science careers, but this foundation is frequently undermined by negative student attitudes toward statistics. This study explored life science students’ motivational attitudes toward statistics, and their relationship to performance, using expectancy-value theory as a guiding framework. According to expectancy-value theory, task-values—interest in a task (intrinsic value), importance of doing well on a task (attainment value), perceptions of the usefulness of a task (utility value), and negative aspects of engaging in a task (cost)—impact achievement outcomes. However, task-values may be better represented by differentiating each into more specific underlying dimensions, or facets. Using 360 undergraduate life science students enrolled in biostatistics courses across two institutions, this study assessed the fit of a task-value facets model for statistics and examined which task-value facets relate to performance on a statistics assessment. Results show that life science students distinguish among facets of attainment value (importance of achievement, personal importance), utility value (school, daily life, social, career/job), and cost (effort, emotional, opportunity) for statistics. Students’ perceptions of the emotional cost of statistics and the importance of achievement in statistics related to their statistics performance. Implications for teaching and research are discussed. Supplementary materials for this article are available online.

Impaired cognitive flexibility in major depressive disorder: Evidences from spatial-temporal ERPs analysis

BackgroundMajor Depressive Disorder (MDD) may exhibit impairments in cognitive flexibility. This study investigated whether the cognitive flexibility deficits in MDD are evident across general stimuli or specific to emotional stimuli, while exploring the underlying neuropsychological mechanism. MethodsA total of 41 MDD patients and 42 healthy controls (HCs) were recruited. Event-related potentials (ERPs) were recorded when participants performed a non-emotional and an emotional task switching paradigm (N-ETSP and ETSP), both of which assessed cognitive flexibility. Microstate and source localization analysis were applied to reflect brain activity among different brain areas during task switching. ResultsIn the N-ETSP, MDD group showed larger P3 difference wave (Pd3) amplitudes and longer P2 difference wave (Pd2) latencies. In the ETSP, MDD group displayed smaller N2 difference wave (Nd2) amplitudes and larger Pd3 amplitudes. The comparison of sLORETA images of emotional switch task and emotional repeat task showed that MDD group had increased activation in the precentral gyrus in microstate2 of the P2 time window and had reduced activation in the middle occipital gyrus in microstate3 of the N2 time window. LimitationsThe cross-sectional design failed to capture dynamic changes in cognitive flexibility in MDD. ConclusionsMDD demonstrated impaired cognitive flexibility respond to both non-emotional and emotional stimuli, with greater impairment for negative emotional stimuli. These deficits are evident in abnormal ERPs component during the early attention stage and the later task preparation stage. Furthermore, abnormal emotional switching cost in MDD appears to be related to early abnormal perceptual control in the parietal-occipital cortex.