Experience Of Negative Life Events Research Articles

Negative life events, sleep quality, and depression among older adults in Shandong Province, China: A conditional process analysis based on economic income.

Negative life events have been reported as a risk factor for depression. However, the mechanism between negative life events and depression is still unclear. This study aimed to explore the mediating role of sleep quality and the moderating role of economic income in the association between negative life events and depression among older adults aged 60 years and over. A multi-stage stratified sampling method was used to select elderly individuals over 60 years old in Shandong, China, making use of the Household Health Interview Survey (2020). In total, 3868 older adults completed the measures of negative life events, sleep quality, depression, and economic income. Negative life events positively predicted depression among the elderly (proportion of direct effect, 55.12%), and poor sleep quality could mediate this association (proportion of indirect effect, 44.87%). Economic income played a moderating role in the relationship between negative life events, sleep quality, and depression (the first and second half of the mediating effect, the direct effect of negative life events on depression). Both effects were weaker among the elderly with higher economic incomes. Negative life events had positive effects on depression in older adults. Economic income moderated the direct effect of negative life events and the mediating effect (first and second half) of sleep quality on depression. When the elderly experience negative life events, interventions for improving their sleep quality and financial support could effectively prevent depression. Geriatr Gerontol Int 2024; 24: 751-757.

Prevalence and factors associated with antenatal depressive symptoms across trimesters: a study of 110,584 pregnant women covered by a mobile app-based screening programme in Shenzhen, China

BackgroundAntenatal depression is a significant public health issue affecting pregnant women both globally and in China. Using data from a mobile app-based screening programme, this study explored the prevalence and factors associated with antenatal depressive symptoms across different trimesters in Shenzhen.MethodsA retrospective cross-sectional study was conducted on pregnant women who gave birth in any hospital in Shenzhen between July 2021 and May 2022 and underwent depression screening using an official maternal and infant health mobile app at least once during pregnancy. Depressive symptoms were evaluated using the 9-item Patient Health Questionnaire (PHQ-9), with cut-off scores of 5 and 10 for mild and high level of symptoms, respectively. The prevalence for each trimester was determined by calculating the proportion of women scoring 5 or higher. A variety of sociodemographic, obstetric, psychological, and lifestyle factors were assessed for their association with depressive symptoms. Chi-square test and multivariate logistic regression were performed to identify significant predictors.ResultsA total of 110,584 pregnant women were included in the study, with an overall prevalence of depressive symptoms of 18.0% and a prevalence of high-level symptoms of 4.2%. Depressive symptoms were most prevalent in the first trimester (10.9%) and decreased in the second (6.2%) and third trimesters (6.3%). Only a small proportion (0.4%) of women showed persistent depressive symptoms across all trimesters. Anxiety symptoms in early pregnancy emerged as the most significant predictor of depressive symptoms. Other factors linked to an increased risk throughout pregnancy include lower marital satisfaction, living with parents-in-law, experience of negative life events, as well as drinking before and during pregnancy. Factors associated with a reduced risk throughout pregnancy include multiparity and daily physical activity.ConclusionsThis large-scale study provides valuable insights into the prevalence and factors associated with antenatal depressive symptoms in Shenzhen. The findings underscore the need for targeted interventions for high-risk groups and the integration of mental health care into routine antenatal services. Continuous, dynamic monitoring of depressive symptoms for pregnant women and ensuring at-risk women receive comprehensive follow-up and appropriate psychological or psychiatric care are crucial for effectively addressing antenatal depression and improving maternal and infant health outcomes.

Exploring the complex interrelation between depressive symptoms, risk, and protective factors: A comprehensive network approach

BackgroundDepressive symptoms seem to be interrelated in a complex and self-reinforcing way. To gain a better understanding of this complexity, the inclusion of theoretically relevant constructs (such as risk and protective factors) offers a comprehensive view into the complex mechanisms underlying depression. MethodsCross-sectional data from individuals diagnosed with a major depressive disorder (N = 986) and healthy controls (N = 1049) were analyzed. Participants self-reported their depressive symptoms, as well as several risk factors and protective factors. Regularized partial correlation networks were estimated for each group and compared using a network comparison test. ResultsSymptoms of depression were more strongly connected in the network of depressed patients than in healthy controls. Among the risk factors, perceived stress, the experience of negative life events, emotional neglect, and emotional abuse were the most centrally embedded in both networks. However, the centrality of risk factors did not significantly differ between the two groups. Among the protective factors, social support, personal competence, and acceptance were the most central in both networks, where the latter was significantly more strongly associated with the symptom of self-hate in depressed patients. ConclusionThe network analysis revealed that key symptoms of depression were more strongly connected for depressed patients than for healthy controls, and that risk and protective factors play an important role, particularly perceived stress in both groups and an accepting attitude for depressed patients. However, the purpose of this study is hypothesis generating and assisting in the potential selection of non-symptom nodes for future research.

IT’S GRATEFULNESS: THE ROLE OF GRATITUDE ON ADVERSE OUTCOMES AMONG BEREAVED BLACK ADULTS

Abstract The Black population has been found to experience more bereavement than other racial/ethnic groups. Accompanying loss for Black populations is often other stressful factors such as racial trauma, childhood trauma, and comorbid depression. However, despite these hardships, one of the most prevalent strengths in the Black population is their engagement in religious faith as a means of coping. Gratitude, a major factor in Positive Psychology, shares many tenets with religious beliefs; however, the utility of gratitude has yet to be fully investigated within a Black bereaved population. This study sought to identify whether gratitude moderated the relationship between experienced negative life events (i.e., racial trauma; RT, adverse childhood experiences; ACEs) and depression in a sample of bereaved Black middle to older adults. 103 Black adults aged 45+ (33% female) were administered items assessing depression, gratitude, RT, and ACEs as part of a larger bereavement study. ACEs and RT both significantly predicted depression (p=.009, p=.008, respectively), and there was a significant conditional effect of gratitude on depression, reflecting differences in the endorsement of depression across levels of ACEs and RT. Accordingly, with the significant role of gratitude amongst the present sample, there is evidence for utilizing a strengths-based, Positive Psychology informed approach in the clinical care of Black adults experiencing bereavement, particularly in the context of impactful and racially traumatic events. Additionally, a fruitful direction for future research and policy is addressing the role of adverse traumatic events on Black bereavement.

Capability approach to evaluate real-world effectiveness of social services

Abstract Background The capability approach offers a comprehensive framework for the evaluation of conditions for wellbeing in terms of how well society promotes equal opportunities, skills, and the ability to lead a good life. The aim of this study was to utilize the capability approach to evaluate the real-world effectiveness of health social work among those with experienced negative life-events. Methods “Evidencing the effectiveness of health social work assessment and intervention” (Terva, 2021-2023) quasi-experimental data with mixed methods collected in real-world conditions across three hospital districts. The baseline data (intervention=266 and comparison=255) is collected and 6 months follow-up study is lasting until June 2023. Questionnaire data among participants included validated measures of perceived capabilities and background variables (age, gender, education, income) and among social workers (the evaluation of needs). Analysis of covariance (ANCOVA) while adjusting background variables at baseline and qualitative analyses will be applied. Results People with negative life-events perceived their capabilities as being lower than general adult population. These differences were especially reflected to live a healthy life and form satisfying social relationships. In baseline, the intervention group also demonstrated significantly lower capabilities compared to the comparison group. The detailed results of the real-world effectiveness of health social work on capabilities within and between intervention and comparison groups will be presented at the conference. Conclusions Our study is one of the first ones to utilize capability approach to examine real-world effectiveness of social services among those negative life events. Future studies should also include the commodities, converting factors and individual agency into the analyses and try to capture the dynamic process of the realization of capabilities and agency with a longer follow-up up to 24 months. Key messages • Capability Approach (CA) provides useful tool for evaluating effectiveness of social services in terms of promoting health and wellbeing of the customers. • CA could be utilized for developing more empowering and effective wellbeing policies targeted to the specific customer-centered needs.

Irritability, Negative Life Events, and the Course of Anxiety and Depressive Symptoms in a Clinical Sample of Youth: A Longitudinal Study

Irritability, the tendency to react with anger, and the experience of negative life events (NLE) have independently been associated with the emergence of anxiety and depression. Here, we investigate how irritability and cumulative effects of NLE interactively predict the course of anxiety and depression in the context of common psychiatric disorders. 432 youth with no psychiatric diagnosis, or a diagnosis of an anxiety disorder, Attention-Deficit/ Hyperactivity Disorder (ADHD), or Disruptive Mood Dysregulation Disorder (DMDD), participated in this study. At baseline, we assessed NLE, parent and youth reports of irritability and anxiety, and youth reports of depression. Symptoms were annually reassessed for up to four years. In youth without psychiatric diagnoses but with elevated baseline irritability, the presence of NLE predicted decreasing anxiety, while the absence of NLE predicted increasing anxiety. In youth with an anxiety disorder, elevated baseline irritability predicted decreasing anxiety independent of NLE, while a large cumulative effect of NLE predicted increasing depression. NLE predicted persisting mild anxiety in ADHD and persisting mild depressive symptoms in DMDD. Our findings suggest that, particularly in non-referred samples, NLE might moderate the relationship between irritability and future anxiety such that irritability/ anger in the context of NLE can positively affect the course of anxiety. Future work replicating this finding while repeatedly measuring NLE and rigorously controlling for potentially confounding effects of treatment, is warranted.

Does the contribution of modifiable risk factors on oral health inequities differ by experience of negative life events among Indigenous Australian adults?

Although the prevalence of poor self-rated oral health and experience of negative life events among Indigenous adults is high, the contribution of modifiable risk factors is unknown. We aimed to estimate the contribution of modifiable risk factors in poor self-rated oral health among Indigenous Australian adults with high and low experience of negative life events using decomposition analysis. The study utilised a cross-sectional design, with data from a large convenience study of Indigenous adults in South Australia. Participants were stratified based on a median split of negative life events in the last 12 months. The outcome was the proportion of fair/poor self-rated oral health (SROH). Independent variables included experience of racism, sex, age, geographic location, car ownership, and time since last dental visit. Of the 1011 participants, the proportion with fair poor self-rated oral health was 33.5% (95% CI 30.5 to 36.4) and the proportion who had experienced 3+ negative life events in the past 12 months was 47.3% (95% CI 43.7 to 50.9). More than half the contribution in fair/poor self-rated oral health among Indigenous adults with a higher magnitude of negative life events was from experience of racism (55.3%, p<0.001), followed by residential location (19.9%), sex (9.7%) and car ownership (9.8%). The contributions of modifiable risk factors in poor self-rated oral health among Indigenous adults with different exposures to negative life events differed substantially. Targets to reduce racism will decrease oral health inequities for both groups, however Indigenous adults who have experienced substantial negative life events require additional focus on provision of culturally safe dental care.

The association between suicidal behaviour and violence, sexual abuse, and parental substance abuse among Sami and Greenlandic adolescents: the WBYG study and the NAAHS.

For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health and societal concerns. More knowledge is needed, as suicidal behaviour predicts later death by suicide. The aim of this study was to investigate associations between suicidal thoughts and suicide attempts and negative life events, including violence, sexual abuse, and parental substance abuse, in Sami and Greenlandic adolescents, within and between groups and gender. Working samples included 442 Sami and 399 Greenlandic Inuit (15-16-year-olds), in The Norwegian Arctic Adolescent Health Study (NAAHS) and the Well-Being among Youth in Greenland (WBYG) study. Multivariable logistic regression explored associations between suicidal behaviour and violence, sexual abuse, and parental substance abuse. Across Indigenous groups, suicidal thoughts and attempts were significantly associated with violence and sexual abuse. The association between suicidal behaviour; especially suicidal thoughts, and sexual abuse was significant and strong among Sami females. Sami and Inuit adolescents with a history of childhood violence reported significantly more suicide attempts; the strongest association was found among Sami males. To Sami and Greenlandic Inuit, the experiences of negative life events, such as violence or sexual abuse are significant risk factors for suicidal behaviour. Public health programmes and prevention strategies targeting youth mental health and suicide should be culturally sensitive and sensitive to gender differences in the association between negative life events and suicidal behaviour.

Racial/ethnic discrimination, ADH1B*3, and coping-motivated drinking among Black college students.

Discrimination due to race and/or ethnicity can be a pervasive stressor for Black college students in the United States beyond general negative life events and has demonstrated associations with adverse health and alcohol outcomes. Genetics may confer individual differences in the risk of drinking to cope with discrimination-related stress. This study tested whether associations of racial/ethnic discrimination with coping drinking motives and alcohol use differ as a function of a well-documented variant in the alcohol dehydrogenase 1B gene (ADH1B*3). Cross-sectional data were obtained from 241 Black students (Mage = 20.04 [range = 18-53]; 66% female) attending a predominantly White university in the northeastern United States. Participants provided a saliva sample for genotyping and self-reported on their racial/ethnic discrimination experiences, coping drinking motives, and past-month total alcohol quantity. Path models demonstrated that associations of discrimination with alcohol quantity directly or indirectly through coping drinking motives did not differ as a function of ADH1B*3, after controlling for gender, age, negative life events, and potential confounding interactions of covariates with model predictors. Regardless of ADH1B*3, greater experience of negative life events was associated with higher coping drinking motives, which in turn were associated with greater alcohol quantity. CONCLUSIONAND SCIENTIFIC SIGNIFICANCE: Findings represent a novel investigation into gene-environment interplay in associations of alcohol use with racial/ethnic discrimination. Findings demonstrate coping-motivated drinking associated with negative life events within Black college drinkers regardless of ADH1B*3. Future research should leverage longitudinal designs to characterize associations of genetics, stressful experiences, and coping-motivated drinking over time.

The Dutch 20 Item Centrality of Event Scale

Abstract: Event centrality is defined as the extent to which a memory of a traumatic event forms a reference point for people’s identity and attribution of meaning to other experiences in their life. Event centrality is typically measured with the Centrality of Event Scale (CES; Berntsen &amp; Rubin, 2006 ). The present study’s first aim was to investigate the underlying factor structure and construct validity of the Dutch 20-item CES (CES-20) in undergraduates ( N = 1,091). The second aim was to test whether the CES-20 could prospectively predict posttraumatic stress disorder (PTSD) symptoms four months later. The data supported a one-factor structure of the CES with a high internal consistency (α = .95), which is not in line with the theoretical model of event centrality but aligns with previous empirical research. Furthermore, high construct validity was evidenced by positive and significant relations between the CES and PTSD symptoms, depressive symptoms, DSM-5 trauma A criterion, and the number of experienced negative life events. Event centrality was not a significant predictor of PTSD symptoms four months later when controlling for PTSD symptoms at time 1, which questions the prospective relation between event centrality and later PTSD symptoms for those events.

Негативные события, связанные со школьным функционированием, и их взаимосвязь с риском развития депрессии у подростков

Negative experiences experienced by adolescents can cause the risk of developing mental health disorders, social maladaptation and academic problems. The aim of the study is to identify the risk of depression in adolescents in connection with experienced negative life events. The study involved 507 students of urban and rural secondary schools aged 12–17 years (median, quartiles 14 [14; 15]), 47.5% boys, 52.5% girls. The M. Kovacs Depression Scale (Children's Depression Inventory, CDI) and the Adolescent Mental Life Events Scale (ASLEC) were used. With adolescents who showed a high level of risk of depression on the CDI scale, an additional clinical interview was conducted. It is shown that adolescents perceive most of the negative events they have experienced as significant. A significant proportion of them account for life events related to school functioning, while no significant differences were found in the groups of boys and girls. It is suggested that the events experienced by students related to school functioning, in the absence of a statistically significant relationship with the risk of depression, may still increase the risk of depression in the presence of events in the life of adolescents related to family functioning (family conflicts, physical punishment in the family) and psychological factors (criticism or punishment). The data obtained concerning the frequency of experiencing negative life events related to the school sphere and noted by respondents as significant, make it necessary to work with teachers in the context of health-preserving psychological and pedagogical support.

Double burden? Implications of indebtedness to general life satisfaction following negative life events in international comparison

While debt is not problematic per se, it can become an additional burden when people experience negative life events–like unemployment, a severe disease, divorce, or their partner’s death–which can be detrimental for individuals’ subjective wellbeing. We investigate first, a potential moderating effect of economic resources or, better yet, lack thereof in the relations between negative life events and general life satisfaction, and second, whether this moderating effect is a function of state-level policies. We expect that, on average, debt has a reinforcing effect on the negative relationship between negative life events and general life satisfaction. Moreover, we expect that country-level policies protecting individuals from the negative consequences of experiencing a negative life event or indebtedness can explain the country differences in the moderating effect of debt. We test our assumptions among the population aged 50+ applying data from the Survey of Health, Ageing and Retirement (SHARE). We apply a two-stage fixed-effects regression approach to estimate the moderation effect of debt on the relationship between negative life events and general life satisfaction within and across countries. Although we find an almost zero average moderating effect of debt across countries, we find large variance in the moderating effects between countries. This variance can be explained by debt regime, but not by the generosity of the public unemployment and the public health systems, or the level of gender equality.

Cultural and interpersonal risk factors for suicide ideation and suicide attempts among Muslim college students from 11 nations

BackgroundResearch on suicidality in low to middle-income countries is scarce. We addressed this issue by investigating suicidality in a cross-national college student samples from 11 predominantly low to middle-income majority Muslim countries. MethodsThe sample consisted of 7427 college students (56% female) who reported to be affiliated with Islam. Data on self-construal, social support, negative life-events, acceptability of suicide, suicidal ideation, and suicide attempts were collected with self-administered questionnaires. ResultsAcceptability of suicide and the experience of negative life-events were positively, and perceived social support was negatively associated with suicidal ideation. Interdependent self-construal was negatively related to the acceptability of suicide and positively associated with perceived social support, implying a negative indirect effect on suicidal ideation although its direct effect was positive. The number of negative life-events was the strongest positive predictor of ever attempting suicide. The interdependent self-construal moderated the association of negative life-events with suicide attempts. LimitationsCross-sectional and self-report nature of the study were its major limitations. Participants may have suppressed their responses about suicide because of religious and legal reasons. ConclusionRemarkable similarities across 11 country samples emerged in the linkages between cultural and interpersonal factors with suicidality. Our findings highlight the value of a nuanced approach to suicidality, that can recognize the differences in the processes associated with suicidal ideation and suicide attempts, as well as the need to consider the interplay of a broad range of personal, interpersonal, and cultural influences.

Testing the Buffering Effect of Social Relationships in a Prospective Study of Disability Onset

Social support has been proposed to be a protective factor that buffers the losses that result from the experience of negative life events. The present study uses data from a large-scale Australian panel study (the Household, Income and Labour Dynamics in Australia survey) to examine how life satisfaction changes following the onset of a disabling condition and then to test whether preevent or postevent social support moderates reactions to this event. Results show that the onset of a disabling condition is associated with a large decline in life satisfaction, but these changes are not moderated by preevent social support. Postevent social support does moderate change in response to the onset of a disability, but ambiguities in the interpretation of this association must be considered.

Does Self-Compassion Moderate the Cross-Sectional Association Between Life Stress and Depressive Symptoms?

The central aims of the present study were to evaluate bivariate and multivariate associations between components of self-compassion and depressive symptoms, and to investigate the degree to which self-compassion and its components buffer the association between life stress and depressive symptoms. In a sample of female undergraduate students, linear regression analyses were used to evaluate the Self-Compassion Scale (SCS) total and subscale scores as predictors of depressive symptoms (n = 218), and the total and subscale scores as moderators of the cross-sectional association between negative life events and depressive symptoms (n = 216). The SCS total and subscale scores, coded such that higher scores indicated higher self-compassion, were all significantly and negatively associated with depressive symptoms (p < 0.001). When depressive symptoms were simultaneously regressed on all SCS subscales, high correlations among subscales limited our ability to interpret parameter estimates. A post hoc analysis was therefore conducted in which depressive symptoms were regressed on composites of positive (self-compassion) and negative (uncompassionate behavior) subscales of the SCS. Results indicated that only uncompassionate behavior was significantly associated with unique variance in depressive symptoms. Neither the SCS total score nor any of the subscale scores significantly moderated the association between negative life events and depressive symptoms. Self-compassion, particularly uncompassionate behavior, is associated with lower levels of depressive symptoms, irrespective of the experience of negative life events. However, self-compassion does not buffer the positive cross-sectional association of negative life events with depressive symptoms.

Acute stressors and clinical characteristics differentiate death by suicide, accident, or natural causes among illicit and prescription opiate users

BackgroundOpiate misuse has reached epidemic levels. Prevention efforts depend on distinguishing opiate users from abusers. The current study compared opioid users who died by natural cases, accidents, and suicide using psychological autopsy methods. Groups were compared on substance use characteristics, treatment history, experiences of negative life events, and circumstances at the time of death. MethodsSubstance use and suicide risk were evaluated using psychological autopsy methods in 63 decedents with positive toxicology for opiates at death divided into three groups: adults dying by suicide (n = 19), accident (n = 19), and natural causes (n = 25). Groups were compared on several dependent measures, using chi-square analyses to examine categorical variables and one-way analyses of variance (ANOVA) to examine continuous variables. ResultsIndividuals who died by suicide were similar in many ways to adults who died by an accidental overdose. However, suicide completers were more likely to have struggled with severe depression, and previously attempted suicide, whereas the accidental overdose sample was more likely to display a chronic pattern of severe drug abuse. ConclusionsThe current study helps to distinguish between opiate users who are at risk for death by an accidental or intentional overdose. In the ongoing opiate crisis, clinicians must understand the risk of overdose and the nuances of accidental behaviors compared to purposeful ones. Signs of suicidal planning, relevant psychopathology, and ongoing life stress may be useful points of intervention for stopping the increasing number of deaths among opiate users.

Psychosocial correlates in treatment seeking gamblers: Differences in early age onset gamblers vs later age onset gamblers

BackgroundAge of onset is an important factor in the development and trajectory of psychiatric disorders; however, little is known regarding the age of onset in relation to disordered gambling in treatment seeking samples in the UK. Utilising a large residential treatment seeking gambler cohort, the current study examined the relationship between age of gambling onset and a range of variables thought to be associated with disordered gambling. MethodData were collected from 768 gamblers attending residential treatment for disordered gambling. Individuals were grouped per the age they started gambling as either a child (≤12), adolescent (13–15), or young adult/adult (≤16). Data were analysed using linear, backward stepwise, and multinomial logistic regressions to identify significant relationships between age of onset and variables of theoretical significance. ResultsResults indicate the younger age of gambling onset was associated with increased gambling severity. Those who began gambling at an earlier age were more likely to have abused drugs or solvents, committed an unreported crime, been verbally aggressive and experienced violent outbursts. They are less likely to report a positive childhood family environment and are more likely to have had a parent with gambling and/or alcohol problems. DiscussionGamblers who began gambling at an earlier age experience negative life events and exhibit some antisocial behaviors more than later onset gamblers, indicating that when addressing gambling behavior, it is important to consider the developmental trajectory of the disorder, rather than merely addressing current gambling behavior. However, the direction of the relationship between gambling and significant variables is in some instance unclear, indicating a need for further research to define causality.

Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study

ABSTRACTNursing students from vocational college programs contribute to over 60% of the nursing student population in China. However, there remains a lack of systematic, quantitative studies examining the prevalence of mental health problems in this population. The purpose of this study was to explore the prevalence of depression, anxiety and stress symptoms and associated factors in vocational college nursing students in Sichuan, China. A total of 554 nursing students from vocational colleges participated in this cross-sectional study. Outcomes were measured with the Depression, Anxiety and Stress Scale 21 (DASS 21). Logistic regressions analysis was performed to examine correlates of mental health problems. The prevalence rates of depression, anxiety and stress symptoms among vocational college nursing students in China were 28.7% (95% CI 24.9%–32.5%), 41.7% (95% CI 37.6%–45.9%) and 20.2% (95% CI 16.8%–23.6%). Mental health problems were elevated as compared to a reference population of Chinese college students of all majors. However, only two percent indicated to seek treatment. The most consistent correlates of mental health problems were reduced engagement in physical and other leisure activities, poor sleep quality, experience of negative life events and poor self-perceived mental health.

Trait Perceived Injustice Is Associated With Pain Intensity and Pain Behavior in Participants Undergoing an Experimental Pain Induction Procedure

Recent research has revealed robust cross-sectional and prospective associations among perceived injustice, pain, disability, and depressive symptoms in patients with chronic pain. To date, research has proceeded from the assumption that perceived injustice arises as a consequence of debilitating injury or illness. However, it is possible that perceived injustice might have trait-like characteristics, persisting even in the absence of an injustice-related eliciting event. The aim of the present study was to develop and test a measure of trait perceived injustice (Trait Injustice Experience Questionnaire [T-IEQ]). The item content of the T-IEQ was drawn from the original IEQ and adapted for relevance to a noninjury context. A sample of 118 healthy undergraduates completed the T-IEQ, measures of just world belief, and trait forgiveness prior to participating in an experimental pain procedure. Pain intensity, pain behavior, and emotional responses were recorded during the painful induction. The T-IEQ had good internal consistency and test−retest reliability. The validity of the T-IEQ was supported by significant associations with measures of just world belief and trait forgiveness. The T-IEQ was also associated with pain intensity, pain behavior, and ratings of sadness and anger. Anger mediated the relation between the T-IEQ and pain outcomes. The results of the present study suggest that individuals vary in their trait-like propensity to experience negative life events as unjust and that trait perceived injustice contributes to adverse pain outcomes. PerspectiveThe present findings suggest that perceived injustice might reflect an enduring tendency to experience negative life events as unjust. The findings also suggest that trait perceived injustice is associated with higher ratings of pain intensity and anger and more pronounced displays of pain behavior.

Integrated approach for support and care for socially/psychologically vulnerable people with disturbed behavior

Background: In recent years, a higher number of incidents has been reported by the Dutch police and local government caused by people with so called ‘disturbed behavior’. Those are people who lost control over their lives and have the potential to cause great harm to themselves or others. Often people with disturbed behavior have multiple disorders (psychiatric problems, addiction, intellectual disabilities, dementia) and experienced negative life events (debts, death of loved one, divorce). This causes them to be in a vulnerable position. However, an exact description and estimate of the number of people with disturbed behavior is not yet available. In 2015 the Dutch government appointed a taskforce “people with disturbed behavior”. This was done in reaction to some severe incidents in the Dutch society, such as the murder of a former minister of health and welfare by a person with disturbed behavior. Also, changing policies such as a reduction of inpatient care, let to more attention in society. The taskforce developed nine building blocks for an appropriate support for people who display disturbed behavior and their social network. The building blocks form an integrated approach for comprehensive care and support. The building blocks include the involvement of people with disturbed behavior themselves, prevention, early recognition, guidance to the right care, appropriate transportation and appropriate support, care and penalization. As of 2016 municipalities are supported to implement these building blocks. In October 2018 all municipalities should have an integrated approach in place. Aims and Objectives: In this workshop we will focus on the concept of people with disturbed behavior and present results form a qualitative and quantitative evaluation. The evaluations were carried out to study the number of people with disturbed behavior and the extent to which the building blocks are implemented. The quantitative evaluation aims to provide information on the number of people with disturbed behavior by combining data form police systems, local health care organizations and mental health organizations over time. The qualitative evaluation monitors the implementation of the building blocks in each municipality in the Netherlands. Whether the implementation of the building blocks lead to less reported incidents with people with disturbed behavior, remains to be seen. Format (timing, speakers, discussion, group work, etc): Three presentations will be given to introduce the concept of people with disturbed behavior and to present results from the qualitative en quantitative evaluation. We will discuss with the attendants how to perform an evaluation of such an integrated approach in regular practice. Target audience: Researchers and policy makers. Learnings/Take away: We will present an example on how to evaluate an integrated approach in a vulnerable population. We will discuss encountered issues, for example concerning data sharing, measurement of patient satisfaction and interpretation of the results. And we will share learned lessons.