Individual Experiences Research Articles

Innovative local authority public health interventions to support the mental health of children and young people

PurposeMental health champions (MHCs) and young health ambassadors (YHAs) are two innovative public health interventions. MHCs are practitioners who work in schools and other youth settings and aim to be the “go to” person for mental health in these settings. YHAs are a linked parallel network of young people, who champion mental health and advocate for youth involvement, which was co-produced with young people across all stages of development implementation. This paper aims to identify the potential benefits, barriers and facilitators of these interventions.Design/methodology/approachSemi-structured qualitative interviews (n = 19) were undertaken with a purposive sample of n = 13 MHCs, and n = 6 YHAs, between June 2021 and March 2022. Interviews were audio-recorded, transcribed, anonymised and then analysed following a thematic approach. Ethical approval was granted by Newcastle University’s Faculty of Medical Sciences Ethics Committee.FindingsThe findings are organised under five key themes: motivating factors and rewards for MHCs and YHAs; outcomes for children and young people (CYP) and others; impact on youth settings and culture; facilitators of successful implementation; and implementation challenges and opportunities.Practical implicationsThese findings are intended to be of relevance to practice and policy, particularly to those exploring the design, commissioning or implementation of similar novel and low-cost interventions, which aim to improve mental health outcomes for CYP, within the context of youth settings.Originality/valueThe interventions reported on in the present paper are novel and innovative. Little research has previously been undertaken to explore similar approaches, and the individual experiences of those involved in the delivery of these types of interventions.

Investigating feelings of imposterism in first-year medical student narratives.

Imposter phenomenon (IP), feeling as if a person does not belong, has been reported in medical students at various rates. In medical literature, this phenomenon has often been defined as a 'syndrome', but other studies have described it as a dynamic experience that can have various impacts on different people at different time points. Although studies have linked IP with other phenomena such as burnout in residents and physicians, no studies have examined its aetiology nor how these feelings are experienced by medical students. With the use of social identity theory as a framework, the authors analysed 233 reflective essays for elements of IP across eight cohorts of medical students from two institutions. Students responded to a prompt that asked: 'What was one part of your identity that you thought you would have to change in order to become a physician?' Included reflections were analysed using the framework method. Elements of IP were identified in 121 reflections (52%) and were categorised into three major themes: (1) Comparing oneself to an idealised image of a medical student, (2) Comparing oneself to an idealised image of a physician and (3) Concerns about presentation of self to others. Each theme contained two or more sub-themes. Commonly, students discussed how their own personality traits, experiences, backgrounds and identities cast doubt on their sense of belonging in medicine. The results of this study were consistent across both institutions, suggesting that imposter feelings are common among all first-year medical students. However, the extent of the impact of these feelings on their identity formation depends on the individual lived experiences of students and the context in which these feelings arise. Encouraging reflective journaling and sharing of stories from all stages of education can normalise imposter feelings during the development of the professional identity as a physician.

Self-inefficacy's impact on well-being indices in students self-identifying with cluttering characteristics

IntroductionCluttering, a fluency disorder characterized by fast and irregular speech patterns, receives relatively limited research attention. Consequently, the association between cluttering and measures of well-being remains unexplored. In contrast, stuttering, another fluency disorder, has been associated with anxiety and depression. The present study examines whether an individual's experience of cluttering characteristics is related to alterations in both positive and negative measures of well-being. To achieve this, we assessed the relationship between Self-Identified Cluttering Characteristics (SICC) and measures of well-being in a sizeable sample of 1201 university students. Our main objective was to explore the potential impact of self-inefficacy on the association between SICC and well-being. MethodsConsistent with prior research, participants identified themselves as having cluttering characteristics (SICC) or no-cluttering characteristics (SINCC) based on a verbal and written explanation of the disorder. They also completed questionnaires on psychological well-being indices and self-inefficacy. ResultsIn total, 276 respondents identified themselves as having cluttering characteristics. In regression models, both SICC and self-inefficacy were predictive of greater negative well-being, increased depressive symptoms, and heightened psychosomatic symptoms. Interestingly, ADHD diagnosis was associated with less negative well-being. Positive well-being indicators (positive future orientation and subjective happiness) were solely predicted by self-inefficacy. Supporting these findings, supplementary regressions including only 56 SICC participants who reported being treated for cluttering yielded similar results. Utilizing Hayes's PROCESS computational procedures to test moderation revealed that self-inefficacy significantly moderated the association between SICC and negative well-being (depressive symptoms) as well as the association between SICC and positive well-being (positive future orientation). ConclusionsThe findings underscore alterations in well-being among individuals who identify themselves as experiencing cluttering characteristics. Primarily, heightened negative well-being was noted in those with SICC, yet individual self-inefficacy reports mitigated this effect. Overall, SICC exacerbates negative well-being rather than diminishing positive well-being. These findings point to the importance of integrating mental health assessment and intervention into clinical practice for individuals with cluttering symptoms and the potential benefits of interventions targeting self-inefficacy to improve overall well-being in this population.

Understanding how community-dwelling persons with early dementia perceive health and community services: Informing the dementia strategy of Newfoundland and Labrador, Canada.

With an increased aging population, the number of individuals with dementia is expected to rise. The onset of dementia marks the start of negotiating access to a wide range of health and social services to find practical and emotional supports to deal with the management of changes and subsequent challenges that individual with dementia face. The toll of dementia goes beyond the health care system, affecting families and caregivers' quality of life. This places more pressure on family caregivers and health care institutions to provide services for affected individuals. It is important to understand the service needs of this population to enable them to live at home longer, contribute to society and maintain a positive quality of life. To increase understanding of how persons living at home with early dementia and their caregivers/significant others currently perceive and interact with health and community-based services and service providers. A qualitative descriptive approach was used to explore the experiences of individuals with early dementia and care providers with health and community-based services using semi-structured interviews and content analysis. Participants included 16 individuals 50years and older with mild/early dementia living at home, 22 informal caregivers of individuals with mild/early dementia, and 5 key community informants (community health nurses and social workers). Four thematic categories of barriers and two thematic categories of facilitators for access to and uptake of supportive services were identified. Five strategies to inform the development of an action plan to enhance access to, and uptake of, supportive services were determined. Early recognition of dementia through education and publicity enhanced public awareness, attention, and social inclusion with dementia-friendly neighborhoods and facilities need to be considered to achieve effective dementia-related services. Inclusion and recognition of the wishes of persons with dementia is key.

Perception of community reintegration among individuals with spinal cord injury in northwest Nigeria: a qualitative description

Purpose To explore the meaning of community reintegration and strategies for promoting community reintegration based on the lived experiences of individuals with spinal cord injury in northwest Nigeria. Material and Methods Using a qualitative description, we purposively recruited people with spinal cord injury residing in Kano, Nigeria. Eight focus groups were conducted to gather relevant information about the meaning and strategies for community reintegration, based on the lived experiences of the participants. Results A total of 64 people aged 18-60 years completed the study. Most of the participants had lived with spinal cord injury for more than five years. The individuals perceived community reintegration as a multi-dimensional concept reflected by five major themes namely: living life as usual, gainful engagement, a basket of opportunities, courage and support, and acceptance of destiny. Furthermore, the participants considered education and awareness about spinal cord injury, supportive and enabling environment, equal opportunities, care and moral support, and accessible health and rehabilitation services as critical for promoting community reintegration. Conclusion Community reintegration is a multidimensional process, and its promotion in northwest Nigeria requires a multisectoral approach.

Psychodrama as group intervention on minority stress, identity and psychosocial well-being of LGBTQ+ Italian young adults: A qualitative case study

ABSTRACT Background Growing attention is given to LGBTQ+ well-being, mainly using the minority stress model, although it’s seldom applied in group therapy research. This study aims to investigate individual experiences and identity processes related to minority stress while exploring the effectiveness of group psychodrama on LGBTQ+ well-being and stress levels. Methods Seven LGBTQ+ participants aged 19 to 27 years attended 10 weekly sessions of group psychodrama. The study utilized a qualitative exploratory case study design, where interview data underwent inductive thematic analysis and were triangulated with quantitative data concerning well-being, alexithymia, and LGBT Minority Stress. Results Participants manage their minority-contextualized identity and stigma within their narratives, indicating that group psychodrama may benefit young LGBTQ+ adults by raising awareness and resolving stressors. Conclusions The study validates the minority stress model but suggests broader theoretical integration, emphasizing the role of social identity and therapeutic impact of psychodrama in managing minority stress.

Stylet-driven Leads or Lumenless Leads for Conduction System Pacing.

Stylet-driven leads have been recently introduced for conduction system pacing, while most of the previous experience has been obtained with lumenless leads. Design and structural characteristics of both lead types are significantly different, resulting in different implant techniques and independent learning curves. Lead performance appears to be comparable, whereas data on direct comparison of clinical outcomes are scarce. Currently, there are no specific clinical scenarios favouring the use of one lead type over another and the decision should rely on the individual experience of the implanter.

Doubly disenfranchised: the experience of paternal grief following medical termination in Jérémie Szpirglas’ Pater dolorosa

ABSTRACT The term ‘disenfranchised grief’ is increasingly being used to designate grief experiences that are overlooked by wider society. In the French context, this term has overwhelmingly been applied to perinatal loss. Focusing on medical termination (IMG), a somewhat liminal category of perinatal loss, this article considers the doubly disenfranchised experience of paternal grief in such circumstances. While IMG-related grief is, in itself, disenfranchised, not least because it lacks societal recognition, paternal grief following IMG is doubly so, since the male voice is seldom heard. Taking as its focus Pater dolorosa (2019), author and journalist Jérémie Szpirglas’ narrative of medical termination, this article will consider the value of the term ‘disenfranchised grief’ in naming the experience of grief to which Szpirglas’ text attests; the capacity of the text to give voice to that experience and to offer a textual transposition of it; and the role of male grief writing following medical termination in beginning to carve out an alternative space for the sharing of a grief experience that defies established social norms. The article will therefore suggest, in line with Rita Felski’s argument, that ‘a literary text could know as much, or more, than a theory’, particularly when it comes to individual experiences of grief.

Circe, the female hero. First-person narrative and power in Madeline Miller’s Circe

Abstract This article analyzes Madeline Miller’s Circe in relation to the contemporary trend of women’s mythological retellings of marginalized female characters. Because of Circe’s first-person narrative, Miller’s book has been interpreted and marketed as empowering and feminist; however, Circe’s narrative structure rather reaffirms the ideological assumptions underlying the ‘masculine’ Bildungsroman, where the female character’s individual experience is defined by romance and she is ultimately excluded from the social scene. The dichotomy between the marketing rhetoric of empowerment and the novel’s actual narrative structure stimulates a broader reflection about the ideological implication of this novelistic trend as a whole. On the one hand, these novels exploit the well-established exemplary value of Graeco-Roman antiquity to offer a new version of the classical canon which accommodates the critiques of radical movements like feminism; on the other hand, they appropriate the progressive aura of such movements to secure a broader audience while in fact leaving power imbalances unquestioned.

“Not Offending Is Easy. The Double Life, the Secrets, the Loneliness Are the Hardest Parts I Needed Help with”: Understanding the Treatment Needs of People with Attractions to Children

People with sexual attractions to children are often subject to heavy stigmatization, and several studies have started to look at how this affects their mental health. This is likely due to a conflation with offending and sexual risk within society, which translates into academic work on the topic. In this context, little is known about how the experiences of non-offending individuals with attractions to children inform their treatment needs in non-forensic contexts. We conducted anonymous semi-structured interviews with large sample of 31 non-offending adult men who are attracted to children, recruited through online forums. The results focus on two superordinate themes central to interpersonal and intrapersonal experiences, and the effects of these on both everyday functioning (“Living with a sexual interest in children”), and perceived treatment needs (“Establishing treatment targets”). These findings hold significance for the effective design and delivery of both preventative and healthcare-related support services, particularly in relation to early intervention and assisting this population in living full lives with their sexual attractions.

B - 13 Effects of Individual and Community-Level Adverse Childhood Experiences and Current Psychopathology among Monolingual Spanish-Speaking Adult Neuropsychology Referrals

Abstract Objective The link between adverse childhood experiences (ACEs) and higher rates of psychopathology in adulthood has been well-established, though far less analogue research has examined this relationship among Latinx patients. This study assessed the relationship between ACEs and symptoms of anxiety, depression, and perceived stress among monolingual Spanish-speaking neuropsychology referrals. Method Data were culled from 27 adult neuropsychology referrals (mean age = 61.70; mean education = 8.59) neuropsychological referrals administered the ACE Questionnaire, Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Linear regression analyses examined the effect of exposure to individual (e.g., emotional, physical, sexual abuse, neglect, domestic violence) and community-level ACEs on depression, anxiety, and perceived stress symptom endorsement. Results Endorsement of more individual ACEs predicted higher levels of anxiety (R2 = 0.281; p = 0.009) and depression (R2 = 0.127; p = 0.075) symptoms, but not perceived stress levels (R2 = 0.037; p = 0.365. By contrast, endorsement of more community-level ACEs marginally predicted higher anxiety symptoms (R2 = 0.124; p = 0.071), but not depression symptoms (R2 = 0.020; p = 0.568) or perceived stress levels (R2 = 0.045; p = 0.319). Conclusions Experiencing more individual-level ACEs predicted greater anxiety and, to a lesser extent, depressive symptoms, whereas community-level ACEs did not predict similar levels of endorsement of active psychopathology among monolingual Spanish-speaking adults referred for neuropsychological evaluation. Findings emphasize the need of neuropsychologists to consider routinely assessing patient’s childhood trauma history and current psychopathology symptoms during evaluation to improve diagnostic accuracy and recommendations for Latinx patients.

Temporalities in spatial narratives about war ruins in Mostar

The spatial turn in peace and conflict studies and the geographies of peace research agendas have underscored the importance of space in (post-)conflict societies. These fields, despite recognising that space and time are inseparable dimensions, often pay more attention to the former compared to the latter. To address this gap, this article explains how space relates to temporality, a concept that delves into the lived experiences of time. More specifically, I analyse how understandings of the past, present, and future shape spatial narratives about war ruins in Mostar (Bosnia and Herzegovina), where buildings targeted during the 1990s wars remain unreconstructed. Drawing on spatial narratives gathered through walks and elite interviews, I show that temporality is a crucial element of space because lived experiences of time structure individuals' perspectives on war ruins in Mostar. Four temporalities were woven into participants’ narratives: (1) narratives shaped by trauma temporalities where war ruins remind people of wartime violence and collapse past and present; (2) narratives driven by temporalities of nostalgia and opportunities that invite reflections about the future of Mostar; (3) narratives building on a temporality of commodification that sees ruins as marketable attractions for tourists; and (4) narratives framing ruins as barriers to synchronising Mostar to a temporality of modernity, characterised by notions of progress and economic development. Through these findings, I demonstrate that temporalities are a key factor in how individuals perceive space and highlight the importance of temporalities in explaining heterogeneous attitudes toward space in areas affected by violence.

Experiences of individuals with serious mental disorders in regular employment through the Individual Placement and Support model.

This study shows the perspective, meaning and satisfaction perceived by people with Serious Mental Disorders during their experiences in regular employment. A mixed qualitative-quantitative methodology was used, applying semi-structured interview as qualitative information collection tool and the Indiana Job Satisfaction Scale as quantitative tool. The study period was from January 2021 to December 2022. A purposive sampling was performed with a sample of 24 people with Serious Mental Disorders who had obtained a job through an Individual Placement and Support (IPS) program during the study period. Semi-structured interview and the Indiana Job Satisfaction Scale were applied to this Serious Mental Disorder workers' sample. The Indiana Job Satisfaction Scale was also applied to a group of 24 workers without mental disorders in the same working conditions who served as control group. The results of the analyses of the Serious Mental Disorder workers' narratives show that perception of work experience is conditioned by individual, environmental and social predictors, as well as external factors as determining variables. Quantitative results obtained by the Indiana Job Satisfaction Scale reveal levels of job satisfaction resembling those of the rest of workers without Serious Mental Disorder. These findings reinforce the significance of employment in the recovery process for individuals with Serious Mental Disorders and emphasize the importance of understanding the subjective meaning individuals attribute to their work experiences.

A Study on the Relationship between Campus Environment and College Students’ Emotional Perception: A Case Study of Yuelu Mountain National University Science and Technology City

The campus environment directly impacts college students’ psychological and emotional well-being, influencing their behavioral performance and the development of their personalities. Investigating the complex relationship between the campus spatial environment and students’ emotions is crucial for designing urban environments that support mental health. Using Yuelu Mountain National University Science and Technology City as a case study, this research developed a framework to analyze campus environment characteristics and emotional perception. The study quantitatively assessed emotional perceptions, examined the specific contributions of different campus environment elements to individual emotions, and created an emotion prediction map to explore these relationships in depth. The results indicate that “campus greenery” and “diversity” negatively affect “disappointment” and “depression”, while “sky views” positively impact “happiness” and “sense of security”. Additionally, “diversity” positively affects “relaxation”, and “campus greenery” and “diversity” have negative effects on “disappointment” and “depression”, with “diversity” having a particularly strong positive effect on “relaxation”. The pronounced spatial clustering of emotional perceptions on campus further underscores the significant influence of the campus environment on individual emotional experiences. As the first study to explore the mechanisms underlying the emotional perceptions of Chinese college students in relation to the campus environment, this research overcomes the limitations of traditional environmental assessment indicators by identifying campus environmental elements and psychological factors that better align with the psychological needs of college students. This provides a scientific basis for optimizing campus environments based on the emotional perceptions of students, thereby supporting mental health promotion and guiding campus environment construction. Moreover, the research methodology is broadly applicable. The integration of campus environment image data and deep learning offers a significant tool for assessing campus space and environmental perception, thereby enhancing human-centered environmental assessment and prediction while more accurately reflecting architectural space perception.

Employee green behavior in laboratories of higher education institutions: a qualitative study

Purpose This study aims to explore employee green behavior in higher education institution (HEI) laboratories in the Kingdom of Bahrain. Design/methodology/approach A qualitative approach was used to explore the green behavior experiences of individuals working in HEI laboratories. In-depth interviews were conducted with nine participants selected via purposive sampling. Thematic analysis was performed on the collected data using ATLAS.ti 9 software. Findings The analysis of the collected data identified five themes related to the green behavior in HEI laboratories. These themes, ranked in descending order of frequency, are conserving, avoiding harm, transforming, influencing others and taking initiative. The conserving theme accounted for one-third of the subcodes, as did the avoiding harm theme. The final one-third of subcodes was distributed among the remaining three themes. Research limitations/implications This study conducted virtual interviews and coincidentally interviewed only female participants. The findings contribute to the existing literature on the themes of green behavior among laboratory staff in HEIs and provide valuable insights for university managers and sustainability coordinators in shaping policies to promote environmentally friendly practices and address negative practices. Originality/value Despite existing studies on environmental practices in various workplace settings, the exploration of green behavior in HEI laboratories in the Kingdom of Bahrain from the employee perspective remains limited. This study presents a significant opportunity for researchers to explore sustainability in HEI laboratories and for policymakers to develop corresponding strategies.

“Mammograms are kind of my pacifier”: The cultural context of women's preference for annual mammograms in a risk-based screening cohort

Population genetic testing and risk-based screening have the potential to shift how we determine risk and screen for breast cancer. While much attention has been paid to the experiences of individuals who may be at elevated risk for breast cancer, less is known about how those at average risk make decisions about their health. Through qualitative interviews with 30 participants, we explore how those enrolled in a risk-based screening trial who are determined to be at average risk for breast cancer make screening decisions. We consider how the social context of breast health, known as ‘pink ribbon culture,’ and the pervasiveness of annual mammography as the standard of care make risk-based screening less acceptable for many participants. Risk-based screening paradigms assume that individuals will assess their risk quantitatively based on the risk models that are used. Yet, our findings demonstrate that social and cultural factors influence decision-making surrounding breast cancer screening, an important consideration when implementing risk-based screening programs. We will begin to address a gap in knowledge about how women who are told they are average risk after risk-based screening (most of the population) and recommended to screen less than annually make screening decisions.

Why Won't Anyone Talk? Challenges Naming and Addressing Tokenism Within Health and Human Service Agencies Serving the LGBTQ+ Community.

Workplace tokenism, the use of superficial efforts to appear equitable, which often leads to burnout of marginalized groups, is pervasive, even in health and human service organizations dedicated to improving their community's health and well-being. An original research project to identify interventions addressing tokenism within Lesbian, Gay, Bisexual, Transgender, Queer plus serving health and human service agencies in New York was unable to engage staff in focus groups. A follow-up survey with 41 potential participants reported burnout as the main reason for nonparticipation. Qualitative data revealed desired aftercare for the retraumatizing nature of sharing individual experiences. Utilizing a community-based participatory research approach with an antiracism lens may mitigate challenges addressing tokenism, thereby increasing workplace inclusion of our Lesbian, Gay, Bisexual, Transgender, Queer plus community.

Lifetime Revictimization: Evidence From the Wisconsin Longitudinal Study.

Despite the documented increasing prevalence of elder abuse victimization and its devastating health effects, a life-course view of the victimization experiences of older adults has rarely been adopted in the elder abuse literature. The current study investigated lifetime links between victimization experiences by examining the indirect effect of adverse childhood experiences (ACE) on elder abuse victimization via intimate partner violence (IPV) victimization in middle adulthood, and whether this indirect association would differ by gender. Using data from the Wisconsin Longitudinal Study, we analyzed the previous and current victimization experiences of a total of 5,391 older adults in their early 70s and estimated mediational and moderated mediation models. The key results indicated that a higher ACE score was associated with exposure to IPV victimization in middle adulthood, which was in turn associated with exposure to elder abuse victimization. This indirect association was stronger for women than for men. Regarding specific types of childhood victimization, parental physical abuse, sexual abuse, and witnessing domestic violence significantly predicted elder abuse victimization via IPV victimization. Our results support the phenomenon of lifetime victimization, whereby an individual experiences reoccurring forms of victimization across the life course from childhood to late adulthood. Findings highlight the compelling need for the assessment of cumulative victimization experiences and their impact on elder abuse victims. A life-course-based, trauma-informed approach would greatly enhance prevention and intervention services for elder abuse.

Editorial for the special issue on "Prediction, Creativity, and Cultural Evolution in Music Cognition".

Music making across cultures arguably involves a blend of innovation and adherence to established norms. This integration allows listeners to recognise a range of innovative, surprising, and functional elements in music, while also associating them to a certain tradition or style. In this light, musical creativity may be seen to involve the novel recombination of shared elements and rules, which can in itself give rise to new cultural conventions. Put simply, future norms rely on past knowledge and present action; this holds for music as it does for other cultural domains. A key process permeating this temporal transition, with regards to both music making and music listening, is prediction. Recent findings suggest that as we listen to music, our brain is constantly generating predictions based on prior knowledge acquired in a given enculturation context. Those predictions, in turn, can shape our appraisal of the music, in a continual perception-action loop. This dynamic process of predicting and calibrating expectations may enable shared musical realities, that is, sets of norms that are transmitted, with some modification, either vertically between generations of a given musical culture, or horizontally between peers of the same or different cultures. As music transforms through cultural evolution, so do the predictive models in our minds and the expectancy they give rise to, influenced by cultural exposure and individual experience. Thus, creativity and prediction are both fundamental and complementary to the transmission of cultural systems, including music, across generations and societies. For these reasons, prediction, creativity and cultural evolution were the central themes in a symposium we organised in 2022. The symposium aimed to study their interplay from an interdisciplinary perspective, guided by contemporary theories and methodologies. This special issue compiles research discussed during or inspired by that symposium, concluding with potential directions for the field of music cognition in that spirit.

Focus on the less exposed: a virtual photovoice study with LGQ educators

ABSTRACT Within the classroom, many educators strive to cultivate a climate of inclusivity. However, little is known about how LGBTQ+ educators negotiate their identities and feelings of inclusion within the confines of their institutional practices. This study employed a virtual photovoice inquiry rooted in Freire’s educational approach to examine perceptions of inclusion for lesbian, gay, and queer-identifying (LGQ) educators. Four LGQ educators and staff members documented their lived experiences through photography and engaged in critical dialogue about their artwork. In this paper, the author shares two themes from the qualitative data: resiliency in the face of adversity and the pivotal role of self-identity and its development. The findings shed light on the nuanced experiences of LGQ educators while offering pathways to promote inclusivity and enhance LGBTQ±positive awareness in educational settings. In the landscape of LGBTQ+ educational research, a significant void persists, particularly in understanding the perceptions of LGBTQ+ educators and staff, which carries substantial implications for developing inclusive educational policies and practices. By providing a deeper understanding of the experiences of LGQ individuals within academia, this research catalyses the advancement of social justice and provides directions for future research within educational contexts.