Fear Of Negative Consequences Research Articles

Psychological safety during a large-scale simulation-based learning event

Psychological safety (PS) is currently endorsed as best practice in simulated learning environments. PS refers to the belief that a student can express their ideas and concerns without fear of negative consequences. Students who participate in simulation-based scenarios often experience psychological distress during such events if they are immersed in an environment that is not psychologically safe. This phenomenon has been researched in the field of nursing during both the briefing and debriefing phases of simulation. The aim of this study was to determine the level of PS of emergency care students at a large-scale simulation rescue training exercise. A quantitative survey design was used on student participants at an annual rescue training exercise in 2021. Students who participated in a high-fidelity rescue event scored a mean PS score of 48.76. Reluctance to take interpersonal risks and fear of making mistakes in a team setting were identified as areas of concern. When PS is understood and improved, the learning experience for students will be enhanced and they will be able to participate without fear of humiliation.

Effect of enhanced informed consent on veteran hesitancy to disclose suicidal ideation and related risk factors.

The concealment of suicidal ideation (SI) constitutes a significant barrier to reducing veteran deaths by suicide and is associated with fear of negative consequences (e.g., involuntary hospitalization). This study examined whether augmenting informed consent with psychoeducation aimed to help patients achieve a more realistic risk appraisal of consequences associated with disclosure of SI, decreased hesitancy to disclose SI, and related risk behaviors among U.S. veterans. Participants (N = 133) were recruited from combat veteran social media groups and were randomly assigned to a video simulated treatment-as-usual informed consent (control) or to one of two psychoeducation-enhanced informed consent conditions (psychoed, psychoed + trust). Compared with the control group, participants in both psychoeducation and enhanced informed consent conditions reported lower hesitancy to disclose SI, firearm access, and problems with drugs/thoughts of harming others, as well as greater trust and respect for the simulated clinician. These findings suggest that brief psychoeducation regarding common factors that affect hesitancy to disclose SI may be beneficial for increasing trust in providers during the informed consent process and decreasing concealment of SI and firearm access among veterans.

The Development and Validation of a Measure of Mental Health, Help-Seeking Beliefs in Arabic-Speaking Refugees.

Despite reporting elevated rates of posttraumatic stress disorder (PTSD), refugees are less likely than other groups to seek psychological treatment. Relatively little attention has been paid to the role of negative help-seeking beliefs in influencing treatment uptake. The current study sought to develop and psychometrically validate a novel measure indexing negative help-seeking beliefs for refugees (Help-Seeking Beliefs Scale [HSBS]). In this study, 262 Arabic-speaking refugee participants completed an online survey consisting of the HSBS along with measures indexing similar constructs (self-stigma of PTSD and help-seeking, perceived stigma, negative help-seeking attitudes, and help-seeking intentions). Factor analysis revealed a three-factor structure aligning with key themes identified in the literature: (a) Fear of Negative Consequences, (b) Inappropriateness, and (c) Perceived Necessity. The scale demonstrated excellent internal consistency, convergent validity, and predicted reduced help-seeking intentions. Results support the utility of a novel measure capturing a prominent help-seeking barrier in a population with high psychopathology and low treatment uptake.

Human trafficking risk factors, health impacts, and opportunities for intervention in Uganda: a qualitative analysis

BackgroundHuman trafficking is a global public health issue that is associated with serious short- and long-term morbidity. To address and prevent human trafficking, vulnerabilities to human trafficking and forces sustaining it need to be better understood among specific subpopulations. We aimed to explore risk and protective factors for human trafficking, the health impact of exploitation, and barriers and facilitators of seeking help throughout the human trafficking trajectory among forced labor and sex trafficking victims in Kampala, Uganda.MethodsBetween March and November 2020, in-depth, semi-structured qualitative interviews were conducted with 108 victims of forced labor and sex trafficking who had completed a human trafficking survey conducted by the Uganda Youth Development Link (UYDEL). Participants who experienced various forms of exploitation were purposively invited for qualitative interviews and a convenience sample was interviewed. Interviews explored personal history, trafficking recruitment, experiences of exploitation and abuse, and experiences seeking help. Interviews were analyzed using a combination of deductive and inductive thematic analysis. Themes and subthemes were organized using an adapted conceptual framework of human trafficking.ResultsPoverty and an abusive home life, frequently triggered by the death of a caretaker, underpinned vulnerability to human trafficking recruitment. Limited education, lack of social support, and survival needs pushed victims into exploitative situations. Victims of human trafficking were systematically exploited and exposed to dangerous working conditions. Victims suffered from sexually transmitted diseases, incontinence, traumatic fistulae, musculoskeletal injuries, and mental health symptoms. Lack of awareness of resources, fear of negative consequences, restrictions on movement, and dependence on the trafficker and exploitation income prevented victims from seeking help. The police and healthcare workers were the few professionals that they interacted with, but these interactions were oftentimes negative experiences.ConclusionsTo address and prevent human trafficking, localized interventions are needed at all stages of the human trafficking trajectory. Health impacts of human trafficking are severe. As some of the few professionals trafficking victims interact with, police and healthcare workers are important targets for anti-trafficking training. Improved understanding of human trafficking drivers and barriers and facilitators to seeking help can inform the design of necessary interventions.

Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children

Face masks were recognized as one of the most effective ways to prevent the spread of the COVID-19 virus in adults. These benefits were extended to children and adolescents. However, the fear of negative consequences from wearing a face mask during physical exercise led to cancellations of physical education lessons. This further decreased the amount of physical activity available to children and adolescents during the pandemic. However, there is little published data on the potential adverse effects of wearing the most effective and partially mandatory FFP2/N95 face masks during PE or physical activity (PA) in this age. Even though the pandemic has been declared as passed by the WHO, the rise of a new pandemic and thus the use of face masks for limiting its spread is inevitable, so we need to be better prepared for alternative options to lockdown and limitation of PA in such a scenario. Twenty healthy children aged 8–10 years performed two identical cardiopulmonary exercise tests as an incremental step test on a treadmill within an interval of 2 weeks, one time without wearing a protective mask and one time wearing an FFP2 mask. The cardiopulmonary exercise parameter and especially the end-expiratory gas exchange for oxygen and carbon dioxide (petO2 and petCO2) were documented for each step, at rest and 1 min after reaching physical exhaustion. Twelve boys (mean age 8.5 ± 1.4 years) and 8 girls (mean age 8.8 ± 1.4 years) showed no adverse events until maximal exertion. The mean parameters measured at peak exercise did not differ significantly between both examinations (mean peak VO2 = 42.7 ± 9.5 vs 47.8 ± 12.9 ml/min/kg, p = 0.097, mean O2pulse 7.84 ± 1.9 ml/min vs. 6.89 ± 1.8, p = 0.064, mean VE/VCO2slope 33.4 ± 5.9 vs. 34.0 ± 5.3, p = 0.689). The only significant difference was the respiratory exchange rate (RER, 1.01 ± 0.08 vs 0.95 ± 0.08, p = 0.004). The measured respiratory gases (end-tidal O2 and CO2) decreased and respectively increased significantly in almost every step when wearing an FFP2 mask. However, these levels were well below hypercapnia and above hypoxia.Conclusion: In this study, no significant differences in the cardiorespiratory function at peak exercise could be discerned when wearing an FFP2/N95 face mask. While the end-tidal values for CO2 increased significantly and the end-tidal values for O2 decreased significantly, these values did never reach levels of hypercapnia or hypoxia. Furthermore, the children terminated the exercise at a lower RER and heart rate (HR) suggesting a subconscious awareness of the higher strain. Since the detrimental effects of limiting sports during the pandemic are well documented, stopping PE lessons altogether because of the minor physiological effects of wearing these masks instead of simply stopping pushing children to perform at their best seems premature and should be reconsidered in the future.What is Known:• Wearing a face mask has an influence on psychological, social, and physiological functions in adults.• Because of the observed effects of wearing face masks in adults, physical activity in children was limited during the pandemic.What is New:• Wearing an FFP2/N95 mask during physical activity did not lead to hypercapnia or hypoxia in children in this study.• Even though end-tidal CO2 values were significantly higher and end-tidal O2 values significantly lower when wearing an FFP2/N95 face mask, no pathological values were reached.

The Impact of Psychological Safety on Leader Decision-Making: An Empirical Analysis of the Relationship

Psychological safety is a critical factor in shaping the work environment, as it affects employees' willingness to take risks, share ideas, and engage in open communication. Its impact on leadership decision-making is of particular interest, as decision-making plays a crucial role in organizational success. This research paper aims to investigate the relationship between psychological safety and leader decision- making through an empirical analysis. By utilizing secondary research data, this study seeks to explore the influence of psychological safety on leadership decision-making and highlight its implications for organizational effectiveness and employee well-being. To begin, it is important to understand what psychological safety entails. Psychological safety refers to the perception of individuals that they can speak up, take risks, and express their thoughts and ideas without fear of negative consequences. It creates an environment where employees feel psychologically secure, fostering trust, collaboration, and innovation. This paper aims to delve into how psychological safety affects the work environment and why it is crucial for organizational success.

The Role of Psychological Safety in Team Communication: Implications for Human Resource Practices

In the fast-paced environment of contemporary workplaces, characterized by a focus on innovation and collaboration, effective team communication stands out as a critical factor for organizational success. At the heart of such communication dynamics lies the concept of psychological safety—a shared belief within teams that encourages individuals to express themselves without fear of negative consequences. Recognized as a fundamental element for high-performing teams, psychological safety is now undergoing a paradigm shift in human resource (HR) practices, which traditionally concentrated on recruitment, training, and performance management. As organizations navigate the complexities of the global market, understanding and fostering psychological safety within teams have become imperative. This paper explores the multifaceted dimensions of psychological safety in team communication and its implications for contemporary HR practices. The groundwork for psychological safety was laid by Edgar Schein, whose seminal research emphasized the importance of trust and mutual respect in organizational settings. Drawing from social psychology theories, Schein highlighted psychological safety as a facilitator for authentic expression and constructive dialogue. Amy Edmondson's subsequent research further underscored the pivotal role of psychological safety, particularly in fostering open communication, learning, and innovation within teams. Psychological safety, defined as the perceived safety of interpersonal interaction, influences team communication and performance significantly. Various factors such as role-based characteristics, organizational trust, and empowering leadership contribute to its establishment. Trust moderates the relationship between work locus of control and psychological safety. Training interventions and individualized attention from managers have also been identified as means to enhance psychological safety, especially in interprofessional teams where it is crucial for effective communication and decision-making. Within psychologically safe teams, members feel empowered to voice opinions, share ideas, and challenge norms without fear of reprisal. This openness fosters a culture of constructive feedback and continuous improvement, driving innovation and problem-solving initiatives. Vulnerability, as advocated by Brené Brown, plays a crucial role in this context, facilitating authentic engagement and deeper relationships among team members. With the rise of remote work and virtual collaboration, the importance of psychological safety becomes even more pronounced. HR practices must adapt to foster psychological safety in virtual teams, leveraging technology to promote inclusivity and mitigate communication barriers.

Adherence to limiting weight-bearing activity in patients with diabetic foot ulcers: A qualitative study.

Patients with diabetic foot ulcers are advised to limit weight-bearing activity for ulcers to heal. Patients often disregard this advice although the reasons are not yet fully understood. This study explored (1) patients' experiences of receiving the advice and (2) factors influencing adherence to the advice. Semi-structured interviews were conducted with 14 patients with diabetic foot ulcers. Interviews were transcribed and analysed using inductive thematic analysis. Advice regarding limiting weight-bearing activity was described by patients as directive, generic and conflicting with other priorities. Rapport, empathy and rationale supported receptivity to the advice. Barriers and facilitators to limiting weight-bearing activity included demands of daily living, enjoyment of exercise, sick/disabled identity and burden, depression, neuropathy/pain, health benefits, fear of negative consequences, positive feedback, practical support, weather and active/passive role in recovery. It is important that healthcare professionals pay attention to how limiting weight-bearing activity advice is communicated. We propose a more person-centred approach in which advice is tailored to individuals' specific needs with discussion around patient priorities and constraints.

How Dark Is It? An Investigation of Dark Money Operations in U.S. Nonprofit Political Advocacy Organizations

Abstract Claims of dark money influence on U.S. political activity are heard from both left- and right-leaning media, both accusing the other side of undue influence from high net worth political donors on American politics. This article explores the issues of donor control, transparency, and publicness of economic policy advocacy organizations. The study focuses on social welfare nonprofit organizations active in economic policy advocacy, utilizing tax filings to compose an index of transparency based on observed characteristics such as; website verbiage, board size, staffing, fundraising spending, relations to other organizations, and other indicators. All of these variables measure legal behavior, yet as L.H. Mayer describes, some organizations appear to be stretching the boundaries of the rules so egregiously as to be in violation of legal rules, with “little fear of negative consequences” (2018, 194). Organizational tactics can reflect a disinterest in public engagement, or worse, a deliberate attempt to keep the organization’s operations opaque. It is impossible to observe, with current policy, the identity of the donors. Given an index as proposed in this article, however, observers can rank organizations on a scale indicating transparent or opaque characteristics.

PSYCHOLOGICAL SAFETY AND TEAM MEMBER EFFECTIVENESS OF MINORITIZED STUDENTS IN ENGINEERING EDUCATION

Higher psychological safety (i.e., a common feeling among team members to take interpersonal risks without any fear of negative consequences) is related to increased learning in teams, yet there is no comprehensive study in engineering education to see how individual and team-average psychological safety are related to students’ team experience, and particularly how that relationship differs based on gender, race/ethnicity, citizenship status, previous programming skills, attended semester, and students’ GPA. This study addresses these questions using multi-linear regression and multi-level modeling. Individual psychological safety was significantly related to racial/ethnic identifications of Asian, “Black, African-American” (a single choice as presented to students), and Hispanic/Latino, being an international student, attended semester, and GPA. Team member effectiveness was significantly related to GPA, previous programming skills, attended semester, a racial identification of Black, African-American, and team-average psychological safety. The results of this study help engineering instructors understand what is happening in teams and add to our knowledge about the team experiences of minoritized students.

Barriers and facilitators to deprescribing of cardiovascular medications: a systematic review

ObjectiveTo synthesise the current knowledge on barriers and facilitators to deprescribing cardiovascular medications (CVMs) at the levels of patients, informal caregivers and healthcare providers (HCPs).Design/settingWe conducted a systematic review of...

Experiences of South African caregivers disclosing to their children living with HIV: Qualitative investigations.

Awareness of Human Immunodeficiency Virus (HIV) status improves health outcomes in children living with HIV, yet caregivers often delay disclosure. This qualitative investigation explored, through observation, how 30 caregivers responded to a HIV Disclosure study conducted between 2017 and 2020 at Chris Hani Baragwanath Academic Hospital, Soweto, South Africa. Caregivers were assisted in disclosing to their children, aged 7-13 years; followed by a sub-sample of caregivers providing in-depth interviews to elaborate on findings.1) Barriers to disclosure included: caregivers being ill equipped, the fear of negative consequences and children considered lacking emotional or cognitive readiness. 2) Deflecting diagnosis from their children and the need for medication, motivated caregivers to disclosure. 3) Apprehension was evident during disclosure; however, overall disclosure was a positive experience with the support of the healthcare providers. These results highlight the significant role healthcare providers' play in supporting caregivers through the disclosure process.

“I wish I knew about these programs before!” A brief report exploring barriers to financial assistance reported by gynecological oncology patients

Purpose Despite widespread reports of cancer-related financial hardship, hospital financial assistance programs are underutilized. Approach Rapid qualitative research. Sample Gynecologic oncology patients with recurrent or metastatic disease, under 65 years old, and Comprehensive Score for Financial Toxicity of 26 or under. Methods Semi-structured interviews to elicit (1) financial assistance awareness/knowledge, (2) barriers to accessing assistance, and (3) suggestions for improving access. We analyzed the transcripts using thematic analysis: open coding, consensus building/codebook, and identification of salient themes. Findings We interviewed 25 patients and identified four barriers and three suggestions for improving access. Barriers: lack of awareness, perceptions of ineligibility, fear of negative consequences, and being overwhelmed. Suggestions: simplifying financial processes, providing individualized assistance, and being more proactive by intervening earlier. Conclusion Increase access by reducing stigma, misconceptions, and more proactively engaging at-risk patients. Implications for psychosocial providers Patients may be too afraid or overwhelmed to ask for help. A more proactive, psychosocial approach is needed.

Deprescribing practices, habits and attitudes of geriatricians and geriatricians-in-training across Europe: a large web-based survey

Key summary pointsAimTo explore current deprescribing attitudes and practices among geriatricians and geriatricians-in-training across Europe.FindingsFunctional decline, adverse drug reactions and adherence to guidelines/checklists for managing polypharmacy were the most important reasons for deprescribing. The most important barriers for deprescribing were patients’ unwillingness, fear of negative consequences, lack of time, and poor communication between multiple prescribers. Only one in four respondents thought education in medical school had sufficiently prepared them for deprescribing in clinical practice.MessageThere is a need for improved inter-professional communication, better education and evidence-based recommendations to improve future person-centered prescribing and resultant deprescribing practices.

Barriers to accessing sterile injecting equipment for people who inject drugs: An integrative review.

The global prevalence of hepatitis C virus infection is estimated to be 71 million, with an estimated 6.1 million of those having recently injected drugs. The recognised measures to prevent hepatitis C transmission in people who inject drugs are needle and syringe programmes. As people who inject drugs are at considerable risk of hepatitis C transmission, understanding the barriers they encounter when accessing needle and syringe programmes is important to support the hepatitis C elimination goal. This integrative review aimed to synthesise research exploring the barriers to accessing sterile injecting equipment faced by people who inject drugs. An integrative review was conducted guided by the PRISMA 2020 checklist, based on a systematic literature search using the following databases: CINAHL, MEDLINE, PsycINFO, Embase, psychology & behavioural sciences collection, and Emcare, as well as Google Scholar. The search returned seven studies which met the criteria, and four key themes were identified: stigma; experienced and internalised, purchase experience, practical issues, and fear of negative consequences. Participants reported barriers such as the location of the services, and concerns around confidentiality when accessing services. In addition to this, the fear of arrest and the involvement of social services proved to discourage access to these services. People who inject drugs face many challenges when accessing sterile injecting equipment, such as stigma, purchase experience, practical issues and fears and concerns. To support the World Health Organisation Hepatitis C virus elimination plan, these barriers must be tackled to maximise the provision and reduce hepatitis C transmission and reinfection rates. Since the level of research on this topic is limited, further studies are strongly needed. Patient and public involvement were not used for this review.

Risqué business? Interpersonal anxiety and humor in the #MeToo era.

Interpersonal anxiety (i.e., the fear of negative consequences from interacting with someone) may be more prominent in post-#MeToo organizations when interacting with someone of a different gender. Initial exchanges may particularly trigger this anxiety, obfuscating key organizational decisions such as hiring. Given humor's positive, intrapersonal stress-reduction effects, we propose that humor also reduces interpersonal anxiety. In three mixed-methods experiments with hiring managers, we examined the effects of applicant and evaluator gender (i.e., same-/mixed-gender dyad), positive applicant humor (i.e., a pun), and context (i.e., gender salience) in job interviews. Results showed that mixed-gender (vs. same-gender) interactions elicited more interpersonal anxiety, particularly when gender was more salient; mixed-gender interactions also predicted downstream attitudinal outcomes (e.g., social attraction and willingness to hire) and hiring decisions (e.g., selection and rejection) via interpersonal anxiety. Although humor reduced interpersonal anxiety and its consequences for female applicants, the opposite was true for male applicants when gender was salient, because it signaled some of the same expectations that initially triggered the interpersonal anxiety: the potential for harmful sexual behavior. In sum, we integrated diversity and humor theories to examine interpersonal anxiety in same- and mixed-gender interactions and then tested the extent to which humor relieved it. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Factors influencing the behavior of bystanders to workplace bullying in healthcare-A qualitative descriptive interview study.

Workplace bullying is a severe problem that affects individuals, organizations, and society. Although there is a growing research interest in bystanders of workplace bullying, the rationale underlying bystanders' behavior in healthcare settings requires further investigation. The aim of the current study is to explore factors that influence the behavior of bystanders to workplace bullying in the healthcare sector. Qualitative semistructured interviews were conducted with 32 staff members in the healthcare sector in Sweden. Data were collected between March 2019 and September 2020 and were analyzed with thematic analysis. The participants experienced that bystanders of bullying, both colleagues and managers, were in many situations acting in a passive way. Organizational factors such as dysfunctional organizational culture and deficiencies in management affected how actively the bystanders could intervene. Additionally, a fear of negative consequences, lack of awareness of what was going on, bullying behavior being excused, and the bystander not being a member of the dominant group were social factors contributing to bystanders' passive behavior. For bystander intervention to be successful, the organization must consider bullying as a serious issue, take action, and show support for both the target and the bystander.

Experiences of Sexual Harassment among Nurses in a Tertiary Hospital

Introduction: Sexual harassment among nurses is a major issue of work place, health and safety that seriously affects patient care. It is more common among nurses. The aim of this study was to identify experiences of sexual harassment among nurses in a tertiary hospital.
 Method: A descriptive cross-sectional design was used to find out the experience of sexual harassment among nurses. Two hundred and twenty-three, nurses working in a tertiary hospital were selected using purposive sampling technique. Data were collected through structured, self-administered questionnaire. Ethical approval was obtained from Institutional Review Committee Institute of Medicine Kathmandu. Data were analyzed using Statistical Package for Social Science (version 16)
 Results: The mean age of the nurses was 29.6 (SD ± 7.4) years and 57.0% were married. Most of the nurses (85.2%) performed as roster basis in all shifts (rotation; morning, evening and night) duty and 15.2% of the nurses were from emergency ward. Median duration of work experience was 4.17 years (range= 6months to 31 years). Total 18.5% nurses had experienced some kinds of sexual harassment in their workplace. More than half (53.8%) each were harassed by doctors and visitors; 46.2% of the nurses were harassed in emergency/ general ward/ operation theatre; 30.8% were harassed at bed side; 38.5% were harassed in the evening shift and 66.7% were harassed when they are working alone. Likewise, 28.2% reported the incident of sexual harassment; 90.9% reported verbally and 89.7% suggested that hospital need to develop policy against sexual harassment. Nurses with night shift duty (100.0%), PCL/ B. Sc level of education (20.0%), unmarried (21.8%), staff nurse (201.7%), slim body (21.3%), fierce nature (33.3%) and beautiful looks (29.8%) were more frequently victimized but that was not statistically significant.
 Conclusions: Workplace sexual harassment is frequent among nurses working at tertiary hospital. However, reporting rate is very low due to fear of negative consequences and lack of knowledge about how and where to report. Proper policy, law and reporting mechanism should be developed to combat sexual harassment among nurses.

Barriers and facilitators of successful deprescribing as described by older patients living with frailty, their informal carers and clinicians: a qualitative interview study.

ObjectiveTo explore the barriers/facilitators to deprescribing in primary care in England from the perspectives of clinicians, patients living with frailty who reside at home, and their informal carers, drawing on the Theoretical Domains Framework to identify behavioural components associated with barriers/facilitators of the process.DesignExploratory qualitative study.SettingGeneral practice (primary care) in England.Participants9 patients aged 65+ living with frailty who attended a consultation to reduce or stop a medicine/s. 3 informal carers of patients living with frailty. 14 primary care clinicians including general practitioners, practice pharmacists and advanced nurse practitioners.MethodsQualitative semistructured interviews took place with patients living with frailty, their informal carers and clinicians. Patients (n=9) and informal carers (n=3) were interviewed two times: immediately after deprescribing and 5/6 weeks later. Clinicians (n=14) were interviewed once. In total, 38 interviews were undertaken. Framework analysis was applied to manage and analyse the data.Results6 themes associated with facilitators and barriers to deprescribing were generated, respectively, with each supported by between two and three subthemes. Identified facilitators of deprescribing with patients living with frailty included shared decision-making, gradual introduction of the topic, clear communication of the topic to the patient and multidisciplinary working. Identified barriers of deprescribing included consultation constraints, patients' fear of negative consequences and inaccessible terminology and information.ConclusionsThis paper offers timely insight into the barriers and facilitators to deprescribing for patients living with frailty within the context of primary care in England. As deprescribing continues to grow in national and international significance, it is important that future deprescribing interventions acknowledge the current barriers and facilitators and their associated behavioural components experienced by clinicians, patients living with frailty and their informal carers to improve the safety and effectiveness of the process.

Assessing attack-related fear in headache disorders-Structure and psychometric properties of the Fear of Attacks in Migraine Inventory.

This study aimed to develop a self-report questionnaire for the assessment of attack-related fear in migraine, and to determine its factor structure as well as its psychometric properties by the primary analysis of a cross-sectional survey's data. High fear of attacks in migraine increases the burden of disease and is assumed to have a negative impact on the course of the disease. Little is known about the structure and dimensionality of attack-related fear, and a valid instrument for the comprehensive assessment is lacking. Based on a literature search and interviews with persons with migraine as well as with experienced practitioners, a 46-item self-report questionnaire, the Fear of Attacks in Migraine Inventory (FAMI) was developed. A cross-sectional online survey comprising an assessment of diagnostic criteria of migraine and a battery of questionnaires including the FAMI was conducted (N=387 persons with migraine, 364/387 [94.1%] women, M=40.9 [SD= 13.1] years, migraine without aura: 153/387 [39.5%], migraine with aura: 85/387 [22.0%], and chronic migraine: 149/387 [38.5%]). Item selection led to 29 items for the FAMI. Exploratory factor analysis resulted in three clearly interpretable factors (fear of negative consequences; attention and anticipation; fear-avoidance); a confirmatory factor analysis yielded an acceptable to good model fit (χ2 (3)=1328.84, p=0.001, χ2 /df=3.55, RMSEA=0.085, SRMR=0.073, CFI=0.98, and TLI=0.97). Reliability was good (fear-avoidance, ω=0.85; attention and anticipation, ω=0.88) to excellent (fear of negative consequences, ω=0.91). Correlational analyses confirmed the convergent validity of the FAMI. The FAMI appears suitable and promising for the assessment of attack-related fear in migraine research and clinical care.