Subsequent Experience Research Articles

From pain to violence and from violence to healing

This article will describe the author's childhood during the Holocaust and postHolocaust years, his subsequent refugee experience in the UK which was both formative and deformative, and his adolescence and adulthood which revealed his susceptibility to further traumatisation. It will include insights and theories derived from thirty years of therapeutic work with Holocaust survivors and survivors of recent social and personal traumatisation, as well as forty years of work as a general practitioner (GP). This article introduces novel theories of psychic organisation including the concept of the psychic guardian function and the deformative effects of trauma. Finally, this article acknowledges how working with trauma survivors has generated unexpected healing in this wounded healer.

Personality Traits Characterizing a New Type of Depression Lead to Stress Generation in Japanese University Students

Japanese psychiatrists have proposed a new type of depression characterized by passing blame and irritability, which worsens on working days. This new type of depression is assumed to be closely associated with two personality traits: Interpersonal sensitivity, which reflects the tendency to be excessively concerned about or overreact to others’ negative evaluations, and privileged self, which reflects the tendency to pursue own pleasures at the expense of maintaining harmony with others. Although a previous longitudinal study showed that these traits can lead to interpersonal stress generation among university students, it did not control for the influence of baseline negative events, nor use a scale that separately assessed negative dependent events caused by the participants’ behaviors and negative independent events occurring outside the participants’ control. The current study addressed these limitations and investigated whether interpersonal sensitivity and privileged self led to stress generation and increased depressive symptoms. Undergraduate and graduate students in Japan (N = 265) responded to self-report measures twice at an interval of four weeks. The results indicated that privileged self was related to an increase in subsequent experiences of negative dependent and independent events after controlling for either category of events experienced at the baseline. These findings suggest that privileged self can lead to stress generation or the perception that surrounding circumstances are worse than they are. Furthermore, privileged self was associated with an increase in subsequent depressive symptoms via experiences of negative interpersonal dependent events.

Exploring the Psychosocial Impacts on COVID-19 Survivors: A Qualitative Study of Life after COVID-19 Diagnosis and Quarantine in South Korea

COVID-19 infection and subsequent quarantine experiences during the pandemic may have profoundly affected many aspects of life among COVID-19 survivors. However, limited research has explored the changes these survivors experienced once they returned to their daily lives. This study aimed to explore COVID-19 survivors’ psychosocial impacts and their lives following infection and social quarantine during the initial phase of the pandemic in South Korea. Semistructured telephone interviews were conducted in June 2021, involving 15 COVID-19 survivors. All participants contracted COVID-19 between February 2020 and April 2021 in South Korea. This study used a qualitative methodology from phenomelogical perspectives to explore and understand the participants’ shared lived experiences. Thematic analysis identified four overarching themes and 12 subthemes among Korean COVID-19 survivors: (a) self-concept transformation; (b) changed relationship dynamics; (c) life perspective shifts; and (d) health awareness evolution. Recognizing the life changes experienced by COVID-19 survivors can inform the development of targeted peer support services and person-centered education. Focusing on health awareness and empowerment, these initiatives can promote personal growth, facilitate positive changes, and alleviate traumatic experiences for future survivors of diverse infectious diseases. Future research could investigate the long-term impact of COVID-19 on individuals’ lives and explore the mechanisms underlying these effects.

EFFECT OF A COVID-19-RELATED LOCKDOWN ON MIDDLE-AGED AND OLDER FAMILY CAREGIVERS IN SINGAPORE

Abstract Lockdowns, while limiting COVID-19 transmission, can affect care provision by family caregivers and their caregiving experience. We assessed, among 1094 family caregivers aged 50-79 years in Singapore, the (1) perceived effect of nationwide lockdown on their care provision, (2) correlates of different perceptions, and (3) association of the perceptions with negative and positive caregiving experiences. Caregivers reported whether their care provision became harder, easier, or remained the same during versus before the lockdown. Multinomial logistic regression assessed the association of caregiver, care-recipient, and caregiving-context characteristics with their perceptions. Linear regression models examined the association of their perceptions with subsequent negative and positive caregiving experiences. Care provision became harder for 36%, easier for 18% and remained the same for 46% caregivers. Care provision becoming harder (versus same) was more likely for caregivers who were male, Chinese, in worse health, caring for care-recipients with functional limitations, without caregiving support from cohabiting family before the lockdown, and with caregiving support from non-cohabiting family before the lockdown. Care provision becoming easier (versus same) was less likely among caregivers who were of higher age, unemployed, socially isolated and whose care-recipients had functional limitations. Caregivers for whom care provision became harder were worse off in negative caregiving experiences. A nationwide lockdown did not make care provision harder for all caregivers. However, those for whom it did had greater negative caregiving experiences. Heterogeneity of the effect of lockdowns and offering flexibility to non-cohabiting family who support caregiving should be considerations when implementing such disruptions.

Patient Perspectives on Intimate Relationship Outcomes After Labiaplasty: A Preliminary Qualitative Analysis.

The popularity of labiaplasty has increased over the last decade and patients consistently report high levels of satisfaction with outcomes. Specifically, patients generally experience improved sexual satisfaction, but there is very limited research on the impacts on intimate relationships more broadly, even though these experiences are often crucial to women's lives. The aim of this study was to conduct an in-depth qualitative exploration of the impacts of labiaplasty on intimate relationship quality. Qualitative semistructured telephone interviews were conducted with adult women (n = 15), who had undergone labiaplasty between 1 and 72 months previously (mean [standard deviation], 28.1 [24.3] months). Participants were asked about any perceived changes to their intimate relationships and how labiaplasty may have influenced those changes (if any). Thematic analysis of the transcribed interview data was performed. The results showed that most women reported greater confidence engaging in new relationships, and partaking in subsequent sexual experiences was also commonly reported. However, other women reported no changes to their intimate relationship quality after labiaplasty. Over half of the women reported concerns that their current or a future partner may perceive their postsurgery genital appearance as not "natural." The current study adds some novel depth and nuance to the impacts of labiaplasty on intimate relationship quality. Although most women experience improved sexual confidence in their intimate relationships, a proportion may also experience concerns around their partner's reactions to the surgery.

Beyond the first choice: The impact of being an alternate choice on social integration and feedback seeking.

Existing work on newcomer adjustment and socialization typically assumes that selected employees are the first choice for a role or job. However, this is not always the case. To address this oversight, we introduce and examine the phenomenon of alternate choices: Employees who are selected for a role but perceive or discover that they were not the first choice. Drawing on social identity theory, we contend that alternate choices seek less feedback directly from others due to experiencing less social integration and examine whether leader inclusion offsets these effects. Our studies cycling between experimental and field survey designs support the proposed theory. Taken together, we illuminate how selection processes and decisions made before role entry can impact employees' subsequent work experiences and behavior after they enter the role, providing insights for theory and research on socialization, feedback seeking, and inclusion at work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Engaging in online peer-led group reflective practice through the share your research ideas project: students’ and tutors’ reflective accounts

ABSTRACT This paper presents the retrospective reflective accounts of three master’s alumni and their tutor who openly shared their thoughts on their experience of engaging in online peer-led group reflective practice through the ‘Share Your Research Ideas’ (SYRI) project. This project ran at the University of Manchester during the second half of the academic year 2019–2020, a time of the COVID-19 pandemic. It consisted of a series of online seminar sessions, which offered a space for students to reflect individually and in groups upon their experience of undertaking educational research. The contribution of this reflective piece is threefold, it aims to: 1) illustrate how the ‘Peer-Led Group Reflective Practice’ (PLGRP) pedagogical approach can be monitored and facilitated in an online learning environment, 2) identify the influence of such a pedagogical approach on those students who engaged in the project and, 3) show how reflective conversations between tutor and students over time as well as the learnings obtained from them can inform course design and shape subsequent learning experience. Thus, our goals are to document how the reflective conversations undertaken during and after the SYRI project contributed to significant student experience and life-long learning and to draw implications for future practice.

The influence of internship training experience on Kenyan and Ugandan doctors’ career intentions and decisions: a qualitative study

ABSTRACT Background Medical internship is a key period for doctors’ individual career planning and also a transition period for the broader labour market. Objectives We aimed to understand the complex set of factors influencing the career intentions and decisions of junior doctors, post-internship in Kenya and Uganda. Methods We conducted semi-structured interviews with 54 junior medical officers and 14 consultants to understand doctors’ internship experiences and subsequent employment experiences. We analysed the data using a mix of a direct content approach, informed by an internship experience and career intentions framework developed primarily from high-income country literature, alongside a more inductive thematic analysis. Results Echoing the internship experience and career intentions framework, we found that clinical exposure during internship, work–life balance, aspects of workplace culture such as relationships with consultants and other team members, and concerns over future job security and professional development all influenced Kenyan and Ugandan doctors’ career preferences. Additionally, we added a new category to the framework to reflect our finding that interns might want to ‘fill a health system gap’ when they choose their future careers, based on what they witness as interns. However, often career intentions did not match career and employment decisions due to specific contextual factors, most importantly a shortage of job opportunities. Conclusion We have shown how internship experiences shape medical doctors’ career intentions in Kenya and Uganda and highlighted the importance of job availability and context in influencing doctors’ career choices.

The evolution of consumer restaurant selection: Changes in restaurant and food delivery application attributes over time

Restaurants and food delivery applications (FDA) work together in consumption episodes, but how their interplay evolves remains unanswered. Applying this interplay to two time-lag intervals, this study explores the attributes driving shifts in the relationship between restaurants and FDA platforms’ satisfaction–behavioral intention linkage. The findings indicate that these attributes are dynamic and evolve during consumption episodes. While attribute weights depend on subsequent consumption experiences, satisfaction judgments do not entirely coincide with weight changes. Although the FDA satisfaction–restaurant behavioral intention linkage is stable over time, the restaurant satisfaction–FDA behavioral intention linkage rises sharply. Finally, the temporal effect of the satisfaction–intention mechanism increases significantly within the restaurant context but decreases slightly within the FDA context.

The Association Between the Selection and Effectiveness of Emotion-Regulation Strategies and Psychopathological Features: A Daily Life Study

Emotion dysregulation is central to psychopathological conditions, including borderline personality disorder (BPD) and depression. However, the nature of emotion-regulation (ER) difficulties in the daily life of people with BPD or depressive features is still unclear. Therefore, in this study, we aimed to disentangle two different ER subprocesses in daily life, (a) selection of ER strategies and (b) the effectiveness of implementing strategies, in terms of their associations with subsequent emotional experience. We analyzed data from a three-wave, longitudinal, experience-sampling study of young adults with varying levels of psychopathological features ( N = 202). BPD features were uniquely linked to the use but not altered effectiveness of several putatively adaptive and maladaptive ER strategies. Depressive features were uniquely associated with the use of putatively maladaptive strategies. These findings suggest that ER deficits in people with more BPD or depressive features may be primarily located in strategy selection rather than the implementation of those strategies.

Enhancing pharmacy student injection training with the CARD™ system

Abstract Background Immunization stress-related responses (ISRR) such as fear, pain and fainting contribute to negative immunization experiences and non-compliance in about 20% of un-immunized people. We introduced the CARD™ (Comfort, Ask, Relax, Distract) system - the first vaccine delivery framework demonstrated to reduce ISRR - to 240 second year pharmacy students undergoing mandatory immunization injection training and subsequent elective practical experience delivering immunizations in 2022 at the University of Toronto, Canada. Objectives The objective was to explore pharmacy students’ perceptions and behaviours following CARD™ education within the injections training course and then after participating as immunizers at influenza pop-up clinics. Results Eighteen pharmacy students participated after the injections training course and 19 participated after the pop-up clinics. Students reported CARD™ was aligned with client needs and preferences and national professional standards. They believed it was important to address ISRR and had higher confidence in their ability to support clients during immunization. Students reported deeper understanding of CARD™ after practical experience, including inviting client participation rather than imposing coping strategies. Conclusions We are the first group to incorporate evidence-based education about reducing ISRR to training curricula of pharmacy students. We demonstrated that students value education about CARD™ and that including a practical component is important to implementation fidelity. This information is relevant for injection training programs across disciplines and countries. Key messages • Incorporating CARD™ in injections training and experiences is acceptable to pharmacy students. • Reducing ISRR promotes more positive experiences for clients and immunizers.

“I was able to take it back”: Seeking VBAC after experiencing dehumanizing maternity care in a primary cesarean

In this article, we present findings from a qualitative narrative analysis that examined the pregnancy, primary cesarean, and subsequent birth experiences of women in the United States. Using a maximal variation sampling strategy, we recruited participants via social media and networking to participate in semistructured interviews. Twenty-five women from diverse backgrounds and geographic locations across the U.S. participated, eight self-identified as racialized and seventeen as non-Hispanic, White. Data were analyzed iteratively using Clandinin and Connelly's approach to Narrative Inquiry. Across their narratives, participants described their experiences of maternity care that were either generally negative (dehumanizing care) or positive (humanized care). They further described how their experiences of dehumanizing or humanized care impacted their decision-making for subsequent births, mental health, relationships with the healthcare system, early parenting birth satisfaction, and family planning. Findings suggest that regardless of ultimate mode of birth, what was most important to women was how they are treated by their maternity care team. We suggest practice changes that may improve the experience of maternity care for primary cesarean and subsequent births, especially among those made marginal by systems of oppression.

Virtual group psychotherapy for chronic pain: exploring the impact of the virtual medium on participants' experiences.

Virtual psychotherapy for chronic pain (CP) has been shown to be feasible, efficacious, and acceptable; however, little is known about how virtual delivery of group psychotherapy affects participants' experiences. This study aimed to explore the impact of a virtual medium during the coronavirus disease 2019 (COVID-19) pandemic on social interactions and therapeutic processes in the context of group psychotherapy for CP management. This qualitative, interview-based study collected data on 18 individuals who participated in virtual group psychotherapy in a tertiary care pain management unit. Results of the thematic analysis showed 4 themes. First, the ability to participate and connect was modified by not meeting in person. Connections also occurred differently as the usual patterns of interactions changed. Participants described important shifts in how emotions are communicated and subsequent experience of empathy. Finally, the commonality of chronic pain experience was identified as a central driver of connection between participants. Mixed impacts of the virtual medium on group psychotherapy dynamics and processes were found. Future research could explore ways to mitigate the negative impacts.

Online Learning in a High-Performance Sport Environment—A Mixed-Method Study

This study investigated a high-performance rugby academy program in New Zealand during the COVID-19 lockdown period in 2020. Unsurprisingly, this challenged academy staff who were abruptly charged with conceptualizing and implementing the program in innovative ways including a move to online learning and the adoption of online learning tools. A mixed-method sequential exploratory design was employed to explore the managers, coaches, and learners’ experiences. Phase 1 explored three coaches and two academy managers conceptualization and subsequent experiences of the online program. Phase 2 explored 44 academy players’ experiences of the online learning program. Our findings reveal that an explicit focus on player well-being and connection online appeared to increase a “sense of community” within and across both cohorts through enhanced communication, participation, and interaction. The challenges encountered included: accessibility, the amount, flow, and direction of information, “app fatigue,” and online technologies that were not fit-for-purpose. Our discussion reinforces that purposeful design and constant reflection is requisite to the successful and sustainable implementation of online coaching environments. We conclude with five fundamental lessons learned from COVID-19 that are worthy of consideration in the purposeful design of future online high-performance sporting programmes.

Mitigated liability of origin: a more salient category triggered by M&A as an establishment mode

PurposeThis paper aims to explore how the establishment modes used by emerging economy multinational corporations (EE-MNCs) influence their subsequent experiences of liability of origin (LOO) in developed economies based on the causal-model theory of categorization.Design/methodology/approachTaking Chinese listed firms' direct investments in developed economies as the sample, this paper utilizes Heckman (1979)'s self-selection model to examine the effect of establishment modes. Besides, when checking the robustness, subsample analyses and 2SLS regressions are used to rule out the alternative explanation associated with LOO mitigation.FindingsEE-MNCs that enter a developed economy by greenfield investment experience heightened LOO while entries using M&A are associated with the mitigated liability. When EEMNCs enter a more institutionally distant developed country, the establishment modes will be more determinant of their subsequent experiences of this liability. Moreover, the effect of establishment modes can recede when EE-MNCs have established their presence in a developed country for a longer time.Originality/valueThis paper utilizes the causal-model theory of categorization to articulate the underlying mechanisms through which the country-of-origin cue is weakened by the cue transmitted by M&A. It further considers the context-saliency of the cue of M&A and clarifies boundary conditions for the effectiveness of this establishment mode to mitigate LOO.

Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings.

Psychedelic drug experiences are shaped by current-moment contextual factors, commonly categorized as internal (set) and external (setting). Potential influences of past environments, however, have received little attention. To investigate how previous environmental stimuli shaped the experiences of patients receiving ketamine for treatment-resistant depression (TRD), and develop the concept of "imprinting" to account for such time-lagged effects across diverse hallucinogenic drugs. Recordings of treatment sessions and phenomenological interviews from 26 participants of a clinical trial investigating serial intravenous ketamine infusions for TRD, conducted from January 2021 to August 2022, were retrospectively reviewed. A broad literature search was undertaken to identify potentially underrecognized examples of imprinting with both serotonergic and atypical psychedelics, as well as analogous cognitive processes and neural mechanisms. In naturalistic single-subject experiments of a 28-year-old female and a 34-year-old male, subjective ketamine experiences were significantly altered by varying exposures to particular forms of digital media in the days preceding treatments. Higher levels of media exposure reduced the mystical/emotional qualities of subsequent psychedelic ketamine experiences, overpowering standard intention-setting practices and altering therapeutic outcomes. Qualitative data from 24 additional patients yielded eight further spontaneous reports of past environmental exposures manifesting as visual hallucinations during ketamine experiences. We identified similar examples of imprinting with diverse psychoactive drugs in past publications, including in the first-ever report of ketamine in human subjects, as well as analogous processes known to underly dreaming. Past environmental exposures can significantly influence the phenomenology and therapeutic outcomes of psychedelic experiences, yet are underrecognized and understudied. To facilitate future research, we propose expanding the contextual model of psychedelic drug actions to incorporate imprinting, a novel concept that may aid clinicians, patients, and researchers to better understand psychedelic drug effects. ClinicalTrials.gov, identifier NCT04701866.

Dynamics of solar energy entrepreneurship in rural Bihar, India

Access to energy provides numerous opportunities to enhance well-being and alleviate poverty. In rural and energy-poor areas, alternative technology solutions such as solar off-grid products, storage systems and energy-efficient devices can complement the unreliable electric grid to fulfil energy needs. Localized entrepreneurship in rural areas can play a significant role in increasing energy access. However, studies on the dynamics of rural entrepreneurship and low-cost energy access in poor households are scarce. This paper explores the local entrepreneurs' perception of social, economic, and technological factors that impact entrepreneurship dynamics in rural poor communities of India, and to identify strategies to help further improve the existing institutional support. A community-based system dynamics (CBSD) approach was used to engage community members to understand their perspective of entrepreneurial development. The study participants were twelve local rural retailers in the state of Bihar in India who were previously trained and employed in a decentralized solar project, and have since become solar entrepreneurs. Participants were engaged in group model-building sessions to develop a causal loop diagram (CLD). Based on the basic structure identified in CLD, a simulation model was developed and calibrated using data from solar project operations and surveys of solar users and entrepreneurs. Results indicate that training and subsequent experience in the project and business helped reinforce the entrepreneur's skills. Repair service and sales of energy products contributed in building trust and awareness in the community, thereby increasing demand for solar and energy-efficient products. The simulation-based scenario analysis shows the positive impact of better business practices, bulk procurement, and continued repair services on the income of the solar entrepreneurs. Findings from this study can inform subsequent energy entrepreneurial development in rural Bihar.

Brief mindful yoga intervention fails to prevent depression-related outcomes after a dysphoric affect induction

Objectives This study was designed to test whether a brief mindful yoga intervention can prevent depression-related responses to dysphoric events. Methods One-hundred-75 undergraduate participants were assigned to one of four conditions in a single-session study. Three conditions received a dysphoric affect induction. Before the induction, participants completed a 20-minute intervention consisting of (a) mindful yoga, (b) stretching, or (c) relaxation control. The fourth condition consisted of a neutral affect induction to examine the validity of the dysphoric affect induction. We hypothesized that compared to relaxation control and stretching, mindful yoga participants would show less: (H1) state depressed affect; (H2) rumination; and (H3) attentional bias toward depression-related words. Results Validity checks indicated that the dysphoric affect induction led to greater state depressed affect and rumination, but not attentional bias. Compared to relaxation control, mindful yoga did not show less state depression, rumination, or attentional bias. The stretching group showed less depression and rumination. Conclusions The results do not provide support for mindful yoga in preventing depression-related reactivity. It may be that when given in a brief, one-time dose, stretching is the better choice for preventing negative outcomes from a subsequent dysphoric experience.

Deployment Expereinces and Psychological Determinants of Moral Injury in Nigerian Military Veterans

Although there is research consensus that military deployment increases exposure to morally injurious events, little is known about factors that predict moral injury (MI) in veterans, especially in Nigeria. This study examined deployment experiences (combat experiences, number of deployments, duration of deployments) and psychological factors (attribution, early childhood experiences) as determinants of moral injury in Nigerian military veterans. The research was a cross-sectional survey that purposively sampled 148 veterans in three randomly selected military barracks across North-East, Nigeria. To ascertain whether military deployment experiences and psychological factors predict MI in veterans, a series of hierarchical multiple regression were carried out at .01 and .05 level. Findings indicated that, when the demographic and military characteristics were considered, only age (β = -.19, SE = .16, p =.05) and marital status (β = .250, SE = 3.19, p <.01) made significant independent contribution to MI. Also, combat exposure significantly predicted MI in model 2. (β = .296, SE = .23, p< .05). When five early childhood experiences were considered, only physical abuse (β = .60, SE = .53, p <.001) and emotional abuse (β = -.30, SE = .35, p <.01) emerged as significant predictors of MI. These results illustrates the significant influence of early traumatic events, including experiencing physical and emotional abuse and subsequent combat experiences with MI in Nigerian military veterans. The findings underscore the need for policies that mitigate early traumatic experiences as well as predeployment psychological training to prepare military veterans against developing moral injury.

Проблемы квалификации преступлений, совершенных в состоянии аффекта

A significant role in the qualification of crimes under Articles 107 and 113 of the Criminal Code of the Russian Federation is played by the emotional state of the offender at the time of the assault. The article provides clear definitions and basic criteria of affect as a psychological and criminal-legal category. For an unmistakable and accurate determination of the mental state of the subject of the privileged corpus delicti, it is necessary to apply psychological knowledge about the causes and mechanisms of the occurrence and course of affect in criminal law. Psychological knowledge indicates a narrowing of consciousness and thought processes, a weakening of volitional regulation of behavior in a state of passion and, most importantly, emphasizes the connection of the response of the guilty with the unlawful behavior of the victim, explaining this by psychophysiological features, subsequent experiences of the guilty about the act committed in a state of passion in the form of regret for what happened. For a comprehensive investigation and accurate qualification of each individual crime in court proceedings, it is the first interrogations, witness statements and collected documents that are important. To confirm the state of affect, it is important for a forensic expert to carefully delve into the details preceding the commission of a crime (the presence of a traumatic situation) during the initial interrogation. The main thing is not to waste time, long breaks in time from the moment of the crime to the examination of the perpetrator reduce the likelihood of establishing the actual condition of the person, therefore psychologists and law enforcement officers should work together.