Negative Appraisals Research Articles

Understanding College Students' Healthcare Avoidance: From Early Maladaptive Schemas, through Healthcare Institutional Betrayal and Betrayal Trauma Appraisal of Worst Healthcare Experiences.

Understanding healthcare avoidance among college students is critical. In this study, we consider two broad cognitive contributors to greater healthcare avoidance: specific early maladaptive schema and negative appraisals of students' prior worst healthcare experiences. From schema theory, we proposed college students holding greater levels of two early maladaptive schema (disconnection/rejection and impaired autonomy/performance EMS) would be more likely to appraise their problematic healthcare experience as both containing healthcare institutional betrayal (HIB) behaviors and as traumatic and betrayal-inducing; both EMS and these appraisals would predict healthcare avoidance. Using a cross-sectional survey in a large, diverse college student sample (n = 1383, 61.1% female, 18.9% African American, 7.2% Asian, 6.4% Hispanic/Latino), as predicted, both EMS were significantly related to healthcare avoidance. Furthermore, a sequential mediation model was supported, indicating students holding greater EMS of disconnection/rejection or impaired autonomy/rejection reported more HIB in their worst healthcare experience, and appraised that experience as more betraying. Taken altogether, this model accounted for 23% of the variance in students' reports of healthcare avoidance. Core beliefs formed early in life may be a foundational lens through which potentially traumatic healthcare experiences are processed in ways that can impact emerging adults' future healthcare engagement. Findings also support the importance of addressing HIB actions and repairing trauma appraisals accrued during problematic healthcare experiences to prevent healthcare avoidance by emerging adults.

A randomised controlled trial of the Learning Skills Together (LST) intervention to improve dementia family caregivers' self-efficacy with complex care.

Background Nearly two-thirds of family caregivers of persons living with Alzheimer's disease or related dementias (AD/ADRD) provide complex care, including medical care. Family caregivers typically receive little to no training on how to provide this care. Furthermore, family caregivers simultaneously grapple with the presence of behavioral and psychological symptoms of dementia (BPSD), diminished communication abilities, and comorbidities such as diabetes. We developed Learning Skills Together ( LST ), a six-week digitally delivered psychoeducational program, to facilitate family caregiver abilities to administer complex care tasks. The goal of the present study is to test the efficacy of LST and to reduce adverse outcomes associated with caregiving, such as depressive symptomology and negative appraisal of BPSD. Methods To test the efficacy of LST , we will conduct a two-arm single-site randomised controlled trial (RCT) with N = 200 family caregivers of persons living with AD/ADRD. Eligible family caregivers will be randomly assigned to participate in either the LST intervention or a structurally equivalent control condition focused on healthy living. All family caregivers will complete four surveys, including a baseline survey administered prior to randomisation, a post-intervention survey, and a three- and six-month follow-up survey to assess change in study outcomes. Between-group comparisons of each outcome will be evaluated using generalized estimating equation models. Mediation analyses will assess family caregiver self-efficacy as the intervention's mechanism of change in depressive symptomology and BPSD. We will also examine caregiver race, ethnicity, and gender as effect modifiers of the intervention. Discussion LST findings will inform the field of AD/ADRD and caregiving regarding optimally supporting family caregivers in managing complex care tasks. If efficacious, the LST intervention will support family caregivers in preserving their own mental health while providing complex care. Trial registration This study was registered on Clinical Trials.gov on May 6, 2023 (NCT05846984). https://clinicaltrials.gov/study/NCT05846984?cond=learning%20skills%20together&rank=2.

Adding Insult to Injury

Should the government censor dangerous anti-vaccination propoganda? Should it restrict the praise of terrorist groups, or speech intended to promote discriminatory attitudes? In other words, should the government curb the advocacy of dangerous ideas and actions (i.e. 'harmful advocacy'), or should the government take a more permissive approach? Strong free speech supporters argue that citizens should be free to engage in and to hear harmful advocacy, arguing that restrictions are deeply objectionable at best, and, at worst, wholly impermissible. To support their position, strong free speech supporters have offered a wide range of arguments and ideas. One of the most interesting arguments revolves around the idea that restrictions on harmful advocacy are deeply insulting to citizens. The worry, broadly understood, is that this kind of censorship is demeaning, treats citizens as though they are stupid, or as though they are children. As such, even when censorship is effective in preventing harms to citizens, it nonetheless comes at the significant political cost of failing to properly respect the citizenry at large. By contrast, so the thought goes, an alternative political scheme that prohibits censorship, or permits it only in exceptional cases, does a better job of respecting citizens as independent, rational, morally responsible agents. This alternative political system may, sometimes, be less effective at preventing speech harms. But it is a political system where citizens can stand tall and hold their heads high. In this paper, I consider and reject three versions of the worry that censorship is insulting. §1 explores the idea that censorship is insulting qua involving a negative appraisal of the citizens being interfered with. The key idea here is that censorship involves a lack of what Stephen Darwall terms ‘appraisal respect’, insofar as the government is suggesting that citizens cannot be trusted to manage their own beliefs and intentions. Drawing on the work of Thomas Nagel, §2 explores the idea that censorship diminishes the political status of citizens. Finally, §3 explores the suggestion that censorship is incompatible with a full appreciation of the thinking nature of citizens, and thus involves a lack of what Darwall would term ‘recognition respect’. The paper argues that censorship is not necessarily premised upon an insulting view of the citizenry. On the contrary, it argues that the best kind of censorship stems from a rich appreciation of the diverse range of capabilities, needs, vulnerabilities, and responsibilities of citizens, as well as the need for co-operation between citizens if societal flourishing is going to be achieved on a large scale. Granted, such a vision places an emphasis on the imperfections and liabilities of citizens – at least when compared to the rather solitary, highly intellectual creature one sometimes finds in the philosophical literature. Still, such a vision of citizens as imperfect falls well short of being genuinely insulting. To err is human. And there’s nothing insulting about being treated like a human.

Causes de plaintes après arthroplastie totale primaire de hanche en France : données assurantielles de 240 expertises de 2014 à 2017

Introduction: Total hip arthroplasty (THA) is one of the most frequent orthopedic surgery procedures, and orthopedic surgeons are among the most frequently accused of malpractice by their patients. Identifying the main reasons for malpractice claims after THA is a prior condition to reducing their frequency. The quality of the preoperative risk information given to the patient by the surgeon is crucial for these purposes. Data specific to THA are sparse in France, and we therefore conducted a retrospective study 1) to determine whether the outcome of medico-legal expert appraisal correlated with the quality and traceability of preoperative information, and 2) to identify the most frequent grounds for complaint after primary THA.Hypothesis: The quality of patient information partly determines expert appraisal.Material and Method: A retrospective study was conducted based on data from the Branchet medical professional insurance agency for malpractice claims following THA over the period 2014-2017, with 240 complete files, for 125 women and 115 men. Data comprised: type of procedure, main grounds of complaint (complications), positive or negative expert appraisal, quality of preoperative patient information, amounts of compensation accorded and fees paid, and the practitioner’s liability. We assessed correlations between information quality and liability.Results: Surgical site infection and neurologic deficit were the two main grounds for malpractice claims. In the 240 files, cases for 106 operations (44.2%) were submitted to arbitration, 95 (39.6%) were brought to court, and 39 (16.2%) were settled out of court. The practitioner was held at least partly liable in 40 files (16.7%). Information to the patient was deemed imperfect or poor for 119 files (49.6%) and good in 121 (50.4%). Mean compensation was euro 30,940 (range, euro 0 to euro 198,100).In 27 of the 40 cases of liability (67.5%), the information to the patient was deemed imperfect or poor. Twenty-six of the 40 cases (65%) were settled out of court.In case of poor information, there was a significant risk for the practitioner to be held liable: 7.5% vs 25% (p=0.003).Discussion: The present study listed the main complications underlying malpractice claims after THA: infection, neurologic complications, and limb-length discrepancy. This should enable practitioners to improve patient information so as to reduce the rate of malpractice claims or at least decrease the practitioner’s liability, as the study found a correlation between information quality and expert appraisal.Level of evidence: IV; retrospective study.

Not all uncivil behaviours are equal: exploring responses to incivility in veterinary practice using vignettes

Workplace incivility is considered a common workplace stressor, linked to a range of adverse impacts such as reduced wellbeing. However, there is a lack of research focused on how targets of incivility respond. The current study addresses that gap by examining responses to incivility within veterinary practice. Veterinarians and veterinary nurses (n = 132) evaluated six scenarios depicting two types of incivility (direct e.g. demeaning comments/indirect, for example, ignoring someone) across three instigators (clients, co-workers, senior colleagues), reporting their perception and appraisal of the uncivil behaviour depicted along with potential responses. Direct incivility was linked to responses such as reciprocation, exit, and support seeking, whereas indirect incivility was associated with affiliative and ignoring responses. Negative appraisal of incivility predicted a higher likelihood of exit, avoidance, support seeking and reporting responses. These findings suggest that incivility targets utilise a broad range of response options and adapt their response dependent on the situation.

Attachment and borderline personality disorder as the dance unfolds: A quantitative analysis of a novel paradigm

Current research on personality disorders strives to identify key behavioural and cognitive facets of patient functioning, to unravel the underlying root causes and maintenance mechanisms. This process often involves the application of social paradigms — however, these often only include momentary affective depictions rather than unfolding interactions. This constitutes a limitation in our capacity to probe core symptoms, and leaves potential findings uncovered which could help those who are in close relationships with affected individuals. Here, we deployed a novel task in which subjects interact with four unknown virtual partners in a turn-taking paradigm akin to a dance, and report on their experience with each. The virtual partners embody four combinations of low/high expressivity of positive/negative mood. Higher scores on our symptomatic measures of attachment anxiety, avoidance, and borderline personality disorder (BPD) were all linked to a general negative appraisal of all the interpersonal experiences. Moreover, the negative appraisal of the partner who displayed a high negative/low positive mood was tied with attachment anxiety and BPD symptoms. The extent to which subjects felt responsible for causing partners’ distress was most strongly linked to attachment anxiety. Finally, we provide a fully-fledged exploration of move-by-move action latencies and click distances from partners. This analysis underscored slower movement initiation from anxiously attached individuals throughout all virtual interactions. In summary, we describe a novel paradigm for second-person neuroscience, which allowed both the replication of established results and the capture of new behavioural signatures associated with attachment anxiety, and discuss its limitations.

Laughter and effective presidential leadership: A case study of Ronald Reagan as the 'great communicator'.

Former United States President Ronald Reagan's use of media and his charismatic connection with viewers earned him the moniker "the great communicator". One aspect of his charisma, the influence of elicited laughter, during a highly critical 5-minute news story by CBS reporter Leslie Stahl during the 1984 US presidential election is examined here. Two experiments examining the effects of audience laughter on perceptions of charismatic leadership are reported. In the first experiment the effects of audience laughter in response to Reagan's comments were investigated. Here, Reagan's perceived warmth as an effective leader significantly diminished when strong laughter is removed, whereas perceptions of competence remained unaffected. The second study carried out on an older cohort replicated and extended the first in a pre-registered design by considering the perception of trait charisma. Here, the presence or absence of audience laughter did not affect judgements of charisma. Additionally, the affective response before, and then after, the presentation of the news story was measured. Emotions associated with a positive appraisal all decreased after being shown the news story while emotions associated negative appraisal all increased. However, only participant anger was significantly increased when audience laughter was removed. Taken together the findings of both studies converge on the fact that subtle changes in media presentation of political leaders can have a significant effect on viewers. The findings show that even after 40 years in office the social psychological effects of presidential charisma can still influence observers.

The Role of Sensory Impairment in Cognitive Health Appraisal: A Study of Older Korean Americans Living in Subsidized Senior Housing.

We examined how the association between cognitive performance and cognitive health appraisal would be moderated by vision and/or hearing impairment. Data were collected from 315 older Korean-American residents in subsidized senior housing in Los Angeles (M age = 79.4years). Linear regression models examined the direct and interactive effects of cognitive performance, vision impairment, and hearing impairment on cognitive health appraisal. Negative appraisal of cognitive health was associated with lower cognitive performance and poorer ratings for vision and hearing. Moreover, we found a significant interaction between cognitive performance and hearing impairment (β = .13, p < .05), as well as a three-way interaction among cognitive performance, vision impairment, and hearing impairment (β = .12, p < .05). The association between objective and subjective measures of cognition was weakened when hearing was impaired. Such a pattern was further evident when both vision and hearing were impaired.

Reasons for malpractice claims after primary total hip arthroplasty in France: Insurance data from 240 claims from 2014 to 2017

IntroductionTotal hip arthroplasty (THA) is one of the most frequent orthopedic surgery procedures, and orthopedic surgeons are among the most frequently accused of malpractice by their patients. Identifying the main reasons for malpractice claims after THA is a prior condition to reducing their frequency. The quality of the preoperative risk information given to the patient by the surgeon is crucial for these purposes. Data specific to THA are sparse in France, and we therefore conducted a retrospective study (1) to determine whether the outcome of medico-legal expert appraisal correlated with the quality and traceability of preoperative information, and (2) to identify the most frequent grounds for complaint after primary THA. HypothesisThe quality of patient information partly determines expert appraisal. Material and methodA retrospective study was conducted based on data from the Branchet medical professional insurance agency for malpractice claims following THA over the period 2014–2017, with 240 complete files, for 125 women and 115 men. Data comprised: type of procedure, main grounds of complaint (complications), positive or negative expert appraisal, quality of preoperative patient information, amounts of compensation accorded and fees paid, and the practitioner's liability. We assessed correlations between information quality and liability. ResultsSurgical site infection and neurologic deficit were the two main grounds for malpractice claims. In the 240 files, cases for 106 operations (44.2%) were submitted to arbitration, 95 (39.6%) were brought to court, and 39 (16.2%) were settled out of court. The practitioner was held at least partly liable in 40 files (16.7%). Information to the patient was deemed imperfect or poor for 119 files (49.6%) and good in 121 (50.4%). Mean compensation was €30,940 (range, €0 to €198,100). In 27 of the 40 cases of liability (67.5%), the information to the patient was deemed imperfect or poor. Twenty-six of the 40 cases (65%) were settled out of court. In case of poor information, there was a significant risk for the practitioner to be held liable: 7.5 vs. 25% (p=0.003). DiscussionThe present study listed the main complications underlying malpractice claims after THA: infection, neurologic complications, and limb-length discrepancy. This should enable practitioners to improve patient information so as to reduce the rate of malpractice claims or at least decrease the practitioner's liability, as the study found a correlation between information quality and expert appraisal. Level of evidenceIV; retrospective study.

Exploring the associations between competence in dementia care and work attitudes among formal caregivers in nursing homes.

Based on the two-factor model of caregiving appraisals, this study aims to (1) investigate the relationships between competence in dementia care and job satisfaction (work attitudes in positive aspect) and turnover intention (work attitudes in negative aspect) among formal caregivers in nursing homes, and (2) examine the mediating roles of positive aspects of caregiving (caregiving appraisals in positive aspect) and caregiving burden (caregiving appraisals in negative aspect) in the above associations. A cross-sectional design was used. Structural equation modelling was employed to test the proposed model. STROBE checklist guides the reporting of this study. Using the multistage cluster sampling method, 407 formal caregivers were selected from 43 nursing homes across 7 districts/counties in China. The proposed model shows a good model fit. Competence in dementia care shows significant positive associations with increased job satisfaction and decreased turnover intention among formal caregivers in nursing homes. Caregiving burden and positive aspects of caregiving mediate the relationships between competence in dementia care and both job satisfaction and turnover intention. Furthermore, the relationship between positive aspects of caregiving and job satisfaction is stronger than that with turnover intention, but the relationship between caregiving burden and turnover intention is not stronger than that with job satisfaction. The results demonstrate that the two-factor model of caregiving appraisals effectively elucidates the associations and underlying mechanisms between competence in dementia care and formal caregivers' work attitudes. Specifically, two crucial conclusions are drawn: (1) competence in dementia care is associated with higher levels of job satisfaction and lower levels of turnover intention among formal caregivers in nursing homes; (2) caregiving burden and positive aspects of caregiving serve as parallel mediators in these associations. Policymakers and nursing homes managers should implement a series of measures aimed at formal caregivers in nursing home. Specifically, allocating more resources to enhance the competence in dementia care of formal caregivers is crucial, given its significant association with elevated job satisfaction and reduced turnover intention. Besides, positive and negative caregiving appraisals emerge as proximal factors influencing work attitudes of formal caregivers. Therefore, intervention projects focused on formal caregivers in nursing home should target enhancing positive experiences and alleviating caregiving burden. No patient or public contribution.

Predicting DSM-5 PTSD symptomatology 6 months to 2 years after burn: The role of early psychological risk factors

BackgroundMajor burn injuries may have long-term mental health consequences, such as posttraumatic stress disorder (PTSD). This study extended prior work to investigate DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn as well as the contribution of two sets of early psychological risk factors to DSM-5 PTSD symptoms: Established PTSD risk factors (prior adjustment problems, past trauma, perception of life threat, peritraumatic emotions and dissociation) and theory-derived cognitive factors (negative appraisals of the trauma and its sequelae, memory disorganization, trauma-related rumination, and thought suppression). MethodThe current study recruited a sample of 118 adult burn patients (75.4% men, mean age 41.8, mean TBSA 18.3%) consecutively admitted to a large regional burn center in Northern Taiwan, who were assessed at 6, 12, and 24 months following their burn injury. ResultsA total of 11.0%, 5.9%, and 7.6% met probable DSM-5 PTSD at 6 months, 1 year, and 2 years post-burn, respectively. The rates rose to 15.3%, 10.2%, and 11.0% using the cutoff method. After controlling for covariates, the regression model with theory-derived cognitive factors explained an additional significant 15.9%, 17.2%, and 17.7% of the variance in DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn, respectively. In contrast, the regression model with established PTSD risk factors explained an additional significant 7.2%, 14.4%, and 10.5% of the variance in DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn, respectively. Of all predictors, negative appraisals of intrusions was consistently and strongly predictive of DSM-5 PTSD symptomatology post-burn across time, followed by prior depression. ConclusionsThe results underscore the role of early cognitive risk factors in the development and persistence of DSM-5 PTSD symptomatology following burn injury.

Experimental use of self-affirmation to manage self-concept threat in a simulated intrusive thought paradigm

Introduction: Based on the commonality in cognitive clinical theories of OCD and cognitive dissonance theory regarding threat to self (Wright &amp; Riskind, 2021), this preliminary study investigated whether (1) OCD-related distress catalyzed by ego-dystonic intrusive unwanted thoughts is akin to cognitive dissonance, and (2) distress and negative appraisals of the simulated intrusive thoughts can be alleviated by a values-based self-affirmation exercise developed in the dissonance literature. Methods: Nonclinical college students (N = 93) were presented with a simulated intrusive thought induction. After rating their distress from writing the simulated intrusion, they were randomly assigned to one of four conditions: neutralization used in the clinical literature, a values-based self-affirmation task, a combination of neutralization followed by self-affirmation, or a control condition. Results: The results revealed that the group that combined a neutralizing exercise followed by a self-affirmation exercise displayed a significantly greater decrease in dissonance-like distress and negative appraisals of the simulated intrusion than the other three groups. The groups that received self-affirmation alone or neutralization alone did not appear to reduce distress on their own. The combined group and other groups did not show rebound distress. Discussion: These novel analogue study findings help to bring cognitive clinical models of OCD and cognitive dissonance theory closer together. Moreover, they introduce the possibility that self-affirmation procedures could provide useful secondary ways to augment current OCD treatment protocols.

Do perfectionism, body image concerns, and intimacy predict genitopelvic pain in the postpartum? A prospective study of new mothers.

Genitopelvic pain following childbirth is common and likely to challenge the psychological, relational, and sexual well-being of new mothers. While genitopelvic pain generally decreases during the postpartum period, personal and interpersonal characteristics may explain why genitopelvic pain persists beyond the period of physical recovery in some mothers. Body image concerns, increased stress, and relationship challenges would be particularly salient during pregnancy and the postpartum period, which could put new mothers at greater risk of sexual difficulties. Also, mothers may display a negative appraisal regarding genitopelvic pain and doubt their ability to cope with it, which may contribute to the pain. The current study aimed to examine the role of perfectionism, body image concerns, and perceived intimacy in the occurrence and change in genitopelvic pain in new mothers in postpartum. A total of 211 new mothers and their partners were recruited for a larger prospective dyadic study on the transition to parenthood. Mothers completed a single item assessing genitopelvic pain, in addition to brief validated questionnaires measuring perfectionism, body image concerns, and perceived couple intimacy during pregnancy and at 4, 8, and 12months postpartum. Five multilevel modeling analyses revealed that adaptive perfectionism, maladaptive perfectionism, and body image concerns were associated with a higher occurrence of genitopelvic pain from 4 to 12months postpartum. Mothers' and partners' perceived intimacy was not significantly related to new mothers' genitopelvic pain. None of the predictors modified the trajectory of genitopelvic pain over time. Raising awareness among health care professionals regarding the role of perfectionism and body image concerns in genitopelvic pain may help them identify new mothers at risk of chronic genitopelvic pain, while offering a new avenue of intervention. There has been little research examining the role of perfectionism, body image concerns, and intimacy in postpartum genitopelvic pain. Based on a longitudinal prospective approach, this study identified perfectionism and body image concerns as significant predictors of postpartum genitopelvic pain. However, prepregnancy genitopelvic pain, genitopelvic pain intensity, and sexual distress were not measured. Adaptive and maladaptive perfectionism and body image concerns are associated with new mothers' genitopelvic pain up to 12months postpartum.

Gender, Sexism, and Contempt in Candidate Evaluation

ABSTRACT Several recent studies have shown that the emotion of contempt, which is often linked to negative appraisals of competence and integrity, is the most important negative emotion in some electoral contests. Furthermore, gender-based stereotypes and prejudice have been shown to cause voters to evaluate female candidates in ways that seem contemptuous, i.e. as inferior and having undesirable traits. In this study, we analyze how sexism and gender-based prejudices may influence voters’ emotions (especially their levels of contempt) in response to female political candidates in general and to those who violate gender norms. We find strong differences in emotional responses between sexist and nonsexist voters.

Can Wuwei and Ziran Authorise Anticipation?: Death, Desire, and Autonomy in the Zhuangzi

The concept of anticipation, on the one hand, has received a considerable treatment in classical phenomenology, particularly in Husserl. The Zhuangzi, on the other hand, has not been explored with the help of Husserl’s concept of anticipation. Broadly construed, anticipation, due to its association with robust proclivity to seeing and conjuring up possibilities issuing from a phenomenon, shall have no place in the Zhuangzi. Against such backdrop, I argue that—albeit the Zhuangzi does not develop an explicit discourse on anticipation—a delimited form of anticipation (‘d-anticipation’), that is, one which is inspired by Husserl’s concept of anticipation evident in his genetic phenomenology, can work in concert with the thoughts articulated in the Zhuangzi. I demonstrate this via examining death, desire, and freedom evident in the Zhuangzi. That ‘d-anticipation’ can work in concert with the thoughts articulated in the Zhuangzi can be apprehended in a variety of ways. Firstly, it can be seen in our natural response to death and the way in which we handle desires. Secondly, it points to Zhuangzi’s reductionistic manner of appreciating the richness of reality. Thirdly, it offers a way in which we can live life according to our nature. Fourthly, it points to an exercise of freedom which opens up the possibility of transcending conventional standards. Fifthly, it is inherently constitutive of the process of comportment with the Dao. Finally, it is in essence constitutive of a phenomenon or circumstance. In setting out to demonstrate these contentions, I seek to show that ‘d-anticipation’ can fill in a lacuna brought about by the negative appraisal of anticipation in the Zhuangzi and can assume a pivotal role in one’s comportment with the Dao.

The association between use of social media and the development of body dysmorphic disorder and attitudes toward cosmetic surgeries: a national survey.

Body dysmorphic disorder (BDD) causes distress due to one's negative appraisal of their body image. The development of BDD has been linked to the passive use of social media and photo-editing apps. People with BDD typically pursue cosmetic surgeries to remedy their perceived flaws. The dramatic increase in the use of photo-editing apps and their well-established effects on mental health is a public health concern. To study the association between use of social media and the development of BDD and acceptance toward cosmetic surgeries (ACSS) among Saudis. An online, cross-sectional, validated survey conducted among Saudis 18 and older. Descriptive analyses were utilized for demographics and prevalence rates of main study variables. ANOVA was used to compare mean scores in BDD and ACSS among different demographic groups. Tukeys post-hoc test was done to identify the categories that were different when the ANOVA test showed a statistically significance. A p-value of <0.05 was considered statistically significant. A total of 1,483 Saudi adults completed the questionnaire. Key results showed that BDD was found in 24.4 % of the sample. The percentage of participants with BDD who spent 4-7 h per day on Instagram and Snapchat (29%) was significantly higher than those who spent only less than an hour per day on these platforms (19%) (p < 0.001). Individuals with BDD had a significantly higher risk of accepting cosmetic surgery compared to those without BDD (p < 0.001). A growing body of evidence suggests that social media may impact mental health in different ways. This study reveals that heavy use of these platforms is associated with negative appraisals about one's physical appearance, and it fosters one's tendency toward cosmetic surgery, especially among females.

The experiences and perspectives of older adult mental health professional staff teams when supporting people with young-onset dementia.

Background. The diagnosis of young-onset dementia presents significant challenges both for the person and their families, which often differ from the challenges faced with late-onset dementia. Evidence of the experience of service users and carers tends to reveal a negative appraisal of the care received, citing longer diagnosis times, poor clinician knowledge and lack of age-appropriate care. However, evidence looking into staff experiences of supporting someone with young-onset dementia is relatively scarce. The aim of this study was to explore the experiences and reflections of health and social care staff who support people with young-onset dementia within older adult mental health services, and whether their knowledge of the systems they work in could reveal the existence of barriers or facilitators to young-onset dementia care. Methods. Health and social care professionals working with people and carers with young-onset dementia across England were remotely interviewed between September and December 2021. Data were analysed using inductive thematic analysis. Findings. Sixteen staff members were interviewed. Three themes were constructed with six sub-themes. The first theme related to the perception of greater complexity around young-onset dementia support. The second theme describes staff fears around their ability to effectively support people with young-onset dementia, including the perception that young-onset dementia requires specialist input. The final theme describes systemic and structural inefficiencies which provide additional challenges for staff. Conclusions. Providing effective support for people with young-onset dementia and their families requires adjustments both within the clinician role and mental health services. Staff considered young-onset dementia support to be a specialist intervention and felt the services they work for are suited to generic mental health and dementia provision. Findings are discussed with recommendations relating to developing a standardised model of dementia care for young-onset dementia which recognises and responds to the unique experiences of young-onset dementia.

Factors Influencing Adherence to Insomnia and Obstructive Sleep Apnea Treatments among Veterans with Mild Traumatic Brain Injury

ABSTRACT Objective To understand factors influencing adherence to recommended treatment for insomnia and obstructive sleep apnea (OSA) among Veterans with mild traumatic brain injury (mTBI). Method Semi-structured interviews (n = 49) with 29 clinical stakeholders and 20 Veterans were conducted. Clinical stakeholders included Veterans Health Administration providers and policymakers involved in the management of mTBI and/or sleep disorders. Veterans included those with a clinician-confirmed mTBI with a recent history of insomnia disorder and/or OSA treatment. Themes were identified using a Descriptive and Interpretive approach. Results Barriers to sleep disorder treatment adherence included factors associated with the patient (e.g., negative appraisal of treatment benefit), intervention (e.g., side effects), health conditions (e.g., cognitive challenges), health care system (e.g., limited availability of care), and socioeconomic status (e.g., economic instability). Similarly, facilitators of adherence included patient- (e.g., positive appraisal of treatment benefit), intervention- (e.g., flexible delivery format), condition- (e.g., accommodating cognitive impairments), health care system- (e.g., access to adherence support), and socioeconomic-related factors (e.g., social support). Conclusions Interviews revealed the multi-faceted nature of factors influencing adherence to sleep disorder treatment among Veterans with mTBI. Findings can inform the development of novel interventions and care delivery models that meet the complex needs of this population.

In the face of ambiguity: intrinsic brain organization in development predicts one's bias toward positivity or negativity.

Exacerbated negativity bias, including in responses to ambiguity, represents a common phenotype of internalizing disorders. Individuals differ in their propensity toward positive or negative appraisals of ambiguity. This variability constitutes one's valence bias, a stable construct linked to mental health. Evidence suggests an initial negativity in response to ambiguity that updates via regulatory processes to support a more positive bias. Previous work implicates the amygdala and prefrontal cortex, and regions of the cingulo-opercular system, in this regulatory process. Nonetheless, the neurodevelopmental origins of valence bias remain unclear. The current study tests whether intrinsic brain organization predicts valence bias among 119 children and adolescents (6 to 17years). Using whole-brain resting-state functional connectivity, a machine-learning model predicted valence bias (r = 0.20, P = 0.03), as did a model restricted to amygdala and cingulo-opercular system features (r = 0.19, P = 0.04). Disrupting connectivity revealed additional intra-system (e.g. fronto-parietal) and inter-system (e.g. amygdala to cingulo-opercular) connectivity important for prediction. The results highlight top-down control systems and bottom-up perceptual processes that influence valence bias in development. Thus, intrinsic brain organization informs the neurodevelopmental origins of valence bias, and directs future work aimed at explicating related internalizing symptomology.

Development of an intervention for reducing infant bathing frequency.

Bathing babies less frequently and intensively in the first six months of life may prevent eczema, but this has not yet been definitively tested in a randomised controlled trial. Such a trial would require evidence-based support to help parents engage with a minimal bathing routine. The present study reports the development of this support. We adopted a four-stage design process: (i) Pregnant women and their families (n = 31) were interviewed to ascertain key barriers and facilitators towards following the minimal bathing intervention. (ii) These barriers and facilitators were mapped to behaviour change techniques, focussing on the intervention types of education, persuasion and environmental restructuring, alongside appropriate modes of delivery, and prototype intervention materials were developed. (iii) We iteratively refined these materials in a workshop with multidisciplinary experts and Patient and Public Involvement and Engagement (PPIE) representatives (n = 13) and an (iv) intervention walkthrough with families (n = 5). The design process was informed by the Behaviour Change Wheel, Theoretical framework of acceptability and the Template for intervention description and replication. Social influences and motivational factors are likely to influence both uptake and adherence to the intervention. Anticipated emotional reward from participating in research for the benefit of others was indicated to be a strong facilitator for intervention uptake. Alternatives to bathing, having fun with the baby and the night-time routine, alongside family support, were notable facilitators suggested to aid adherence to the intervention. Barriers included hygiene concerns and anticipated negative social appraisal. Barriers and facilitators were mapped to thirty-six behaviour change techniques, focussing on the intervention types of education, persuasion and environmental restructuring, all of which were embedded into the package of support. The prototype intervention materials received positive feedback from the expert workshop and study walkthrough with families. The final package of support comprises printed and digital prompts and cues, a study booklet, video, and digital tool for self-monitoring. The intervention design process incorporated the 'real world' views and experiences of families, experts and PPIE representatives, alongside criteria for designing behavioural interventions. The effectiveness of the package of support will be tested in a feasibility trial and embedded process evaluation.