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BMC Public Health Jun 2024Social desirability can negatively affect the validity of self-reported measures, including underreporting of stigmatized behaviors like alcohol consumption. The...
BACKGROUND
Social desirability can negatively affect the validity of self-reported measures, including underreporting of stigmatized behaviors like alcohol consumption. The Marlowe-Crowne Social Desirability Scale (SDS) is widely implemented and comprised of Denial and Attribution Domains (i.e., tendencies to deny undesirable traits or attribute socially desirable traits to oneself, respectively). Yet, limited psychometric research has been conducted in sub-Saharan Africa, where the prevalence of unhealthy alcohol consumption is high as well as religiosity and hierarchical social norms. To address this gap, we (a) conducted an exploratory study assessing certain psychometric properties of the 28-item SDS (Runyankole-translated) among persons with HIV (PWH) in Uganda, and (b) examined the relationship between social desirability and self-reported alcohol use.
METHODS
We pooled baseline data (N = 1153) from three studies of PWH engaged in alcohol use from 2017 to 2021. We assessed the translated scale's construct validity (via confirmatory factor analysis), internal consistency, item performance, differential item functioning by gender, concurrent validity with the DUREL religiosity index domains, and the association between social desirability and self-reported alcohol use.
RESULTS
Participants had a mean age of 40.42 years, 63% were men, and 91% had an undetectable HIV viral load. The 28-item SDS had satisfactory construct validity (Model fit indices: RMSEA = 0.07, CFI = 0.84, TLI = 0.82) and internal consistency (Denial Domain Ω = 0.82, Attribution Domain Ω = 0.69). We excluded Item 14 ("I never hesitate to help someone in trouble") from the Attribution Domain, which mitigated differential measurement error by gender and slightly improved the construct validity (Model fit indices: RMSEA = 0.06, CFI = 0.86, TLI = 0.85) and reliability (Attribution Domain Ω = 0.72) of the 27-item modified SDS. Using the 27-item SDS, we found that social desirability was weakly correlated with religiosity and inversely associated with self-reported alcohol use after adjusting for biomarker-measured alcohol use and other confounders (β = -0.05, 95% confidence interval: -0.09 to -0.01, p-value = 0.03).
CONCLUSIONS
We detected and mitigated measurement error in the 28-item Runyankole-translated SDS, and found that the modified 27-item scale had satisfactory construct validity and internal consistency in our sample. Future studies should continue to evaluate the psychometric properties of the Runyankole-translated SDS, including retranslating Item 14 and reevaluating its performance.
Topics: Humans; Psychometrics; Male; Female; Social Desirability; HIV Infections; Adult; Uganda; Middle Aged; Self Report; Alcohol Drinking; Reproducibility of Results; Surveys and Questionnaires
PubMed: 38898463
DOI: 10.1186/s12889-024-18886-z -
Medycyna Pracy Dec 2023Professionals working with trauma victims can experience both negative and positive effects following exposure to secondary trauma. The aim of the study was to determine...
BACKGROUND
Professionals working with trauma victims can experience both negative and positive effects following exposure to secondary trauma. The aim of the study was to determine the relationship between secondary traumatic stress (STS), secondary posttraumatic growth (SPTG) and cognitive coping strategies and to establish the mediating role of cognitive coping strategies in the relationship between STS and SPTG.
MATERIAL AND METHODS
A group of 500 professionals working with trauma survivors were surveyed. The , the and the was used.
RESULTS
The results indicated that 29% of professionals demonstrate a high intensity of STS, and nearly 34% exhibit a high level of SPTG. Denial and regret were positively correlated with STS; positive cognitive restructuring, resolution/acceptance and downward comparison were positively related to SPTG. Two cognitive coping strategies, i.e., positive cognitive restructuring and downward comparison, were found to act as mediators in the relationship between STS and SPTG.
CONCLUSIONS
Understanding the effects of secondary exposure to trauma and the coping responses of professionals working with trauma survivors will support the development of prevention and intervention actions aimed at protecting them from the deleterious impact of exposure to secondary trauma at work and promoting secondary posttraumatic growth. Med Pr Work Health Saf. 2023;74(6):449-60.
Topics: Humans; Coping Skills; Adaptation, Psychological; Compassion Fatigue; Stress Disorders, Post-Traumatic; Emotions
PubMed: 38160418
DOI: 10.13075/mp.5893.01432 -
Journal of the American College of... Aug 2023This scoping review aims to characterize what is known about transgender and gender diverse (TGD) individuals in emergency psychiatric settings and identify what gaps...
OBJECTIVE
This scoping review aims to characterize what is known about transgender and gender diverse (TGD) individuals in emergency psychiatric settings and identify what gaps persist in this literature.
METHODS
A search of 4 electronic databases (PubMed, Web of Science, GenderWatch, and PsycINFO) was used for data collection. Included were studies that looked at TGD individuals presenting to a psychiatric emergency department (ED) or ED with a primary mental health concern. Study screening progress was documented in a Preferred Reporting Items for Systematic reviews and Meta-Analyses flow chart. A total of 232 titles and abstracts were screened, 38 full texts were evaluated for eligibility, and 10 studies were included.
RESULTS
The studies reviewed identified mental health vulnerabilities unique to the TGD population, including service denial in health care settings, gender dysphoria, increased rates of non-suicidal self-injury, and in some studies an increase in suicidality. Societal inequities, including the risk of discrimination and residential instability, were also revealed. A subset of the studies identified best practices in caring for this population, including the use of non-judgmental, affirmative, and inclusive language, and on a structural level creating emergency environments that are confidential, inclusive, and therapeutic for these individuals.
CONCLUSIONS
There is limited information on TGD individuals in emergency psychiatric settings, and thus it is difficult to form strong conclusions. However, the current evidence available suggests possible inequities in this population. Three major themes with regards to TGD individuals in emergency psychiatric settings were identified: mental health vulnerabilities, societal inequities, and best practices in caring for this population. Overall, there is a scarcity of literature in this field, and further research on the experiences of this population is needed to inform clinical practice.
PubMed: 37547378
DOI: 10.1002/emp2.13018 -
Sensors (Basel, Switzerland) Dec 2023As threat vectors and adversarial capabilities evolve, Cloud-Assisted Connected and Autonomous Vehicles (CCAVs) are becoming more vulnerable to cyberattacks. Several...
As threat vectors and adversarial capabilities evolve, Cloud-Assisted Connected and Autonomous Vehicles (CCAVs) are becoming more vulnerable to cyberattacks. Several established threat analysis and risk assessment (TARA) methodologies are publicly available to address the evolving threat landscape. However, these methodologies inadequately capture the threat data of CCAVs, resulting in poorly defined threat boundaries or the reduced efficacy of the TARA. This is due to multiple factors, including complex hardware-software interactions, rapid technological advancements, outdated security frameworks, heterogeneous standards and protocols, and human errors in CCAV systems. To address these factors, this study begins by systematically evaluating TARA methods and applying the Spoofing, Tampering, Repudiation, Information disclosure, Denial of service, and Elevation of privileges (STRIDE) threat model and Damage, Reproducibility, Exploitability, Affected Users, and Discoverability (DREAD) risk assessment to target system architectures. This study identifies vulnerabilities, quantifies risks, and methodically examines defined data processing components. In addition, this study offers an attack tree to delineate attack vectors and provides a novel defense taxonomy against identified risks. This article demonstrates the efficacy of the TARA in systematically capturing compromised security requirements, threats, limits, and associated risks with greater precision. By doing so, we further discuss the challenges in protecting hardware-software assets against multi-staged attacks due to emerging vulnerabilities. As a result, this research informs advanced threat analyses and risk management strategies for enhanced security engineering of cyberphysical CCAV systems.
PubMed: 38203103
DOI: 10.3390/s24010241 -
Health Expectations : An International... Dec 2023With the increasing availability of information, patients are becoming more informed about radiology procedures and requesting imaging studies. This qualitative study...
BACKGROUND
With the increasing availability of information, patients are becoming more informed about radiology procedures and requesting imaging studies. This qualitative study aims to explore factors that influence general practitioners' (GPs) decisions to fulfil patient requests for imaging studies during clinical consultation.
METHODS
Semi-structured interviews were conducted with 10 GPs working across five private medical centres in Northwest Sydney. Conventional content analysis was used with emergent themes to identify GPs perspectives.
RESULTS
Six themes stood out from the interviews with GPs fulfilling patient requests for imaging studies. They included four pertaining to patient factors: patient expectations, 'therapeutic scans', 'impressive labels' and entitled. Two further themes pertained to the GP perspective and included defensive medicine, and 'new patients'. Requests are fulfilled from anxious or health-obsessed patients, with GPs worrying about litigation if they refuse. However, GPs decline requests from patients with entitlement attitudes or during first visits.
DISCUSSION
The findings suggest that GPs struggle to balance their responsibilities as gatekeepers of imaging with patients' expectations of request fulfilment. Clear guidelines on the appropriate use of diagnostic imaging and its limitations could help patients understand its proper use and ease anxiety. Additionally, education and training for GPs could help them manage patient expectations and provide appropriate care.
PATIENT CONTRIBUTIONS
Patients, service users, caregivers, people with lived experiences or members of the public were not directly involved in the design, conduct, analysis or interpretation of the study. However, our study was conducted in primary care facilities where the GPs were interviewed about patients' requests for diagnostic imaging based on their own initiatives. GPs' perspectives in managing patient expectations and healthcare utilisation were explored within the Australian Medicare system, where medical imaging and image-guided procedures come at little to no cost to the individual. The study findings contribute to a better understanding of the challenges faced by GPs in dealing with patient consumerism and requests for diagnostic imaging, as well as factors influencing request fulfilment or denial. Insights gained from this study may inform future research about delivering patient-centred care within a similar context.
Topics: Aged; Humans; General Practitioners; Attitude of Health Personnel; Australia; National Health Programs; Qualitative Research; Radiology
PubMed: 37587771
DOI: 10.1111/hex.13849 -
Journal of Psychosomatic Obstetrics and... Dec 2023"Unperceived pregnancy" names the phenomenon when a person becomes pregnant unintentionally and is not aware of being pregnant. Scientific explanations are roughly based...
"Unperceived pregnancy" names the phenomenon when a person becomes pregnant unintentionally and is not aware of being pregnant. Scientific explanations are roughly based on two hypotheses: psychological and physiological. We aim to gain a better understanding of unperceived pregnancy by studying the perspectives of people who experienced an unperceived pregnancy and obstetric professionals. Seventeen semi-structured interviews were conducted: eight with women who had experienced an unperceived pregnancy (≥30 weeks' gestation), six with midwives, and three with gynecologists. Our findings show that women's explanations for not noticing their pregnancy center around the absence of pregnancy symptoms. The failure to recognize more subtle signs of pregnancy was enforced by inattention, physical distractions, and psychological factors. In contrast, psychological explanations are dominant among obstetric professionals. Our study demonstrates a discrepancy in the explanations provided by women who had experienced an unperceived pregnancy and obstetric professionals. Potentially, this could result in people being unheard and misunderstood. We recommend that future research moves beyond a focus on "denial of pregnancy" to consider both psychological and physiological factors, and how these could potentially interrelate. This broadened approach will enhance our understanding of unperceived pregnancy and can contribute to improved counseling by obstetric professionals.
Topics: Pregnancy; Female; Humans; Midwifery; Qualitative Research
PubMed: 37086382
DOI: 10.1080/0167482X.2023.2197139 -
Personality and Individual Differences Nov 2023Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns....
Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns. Individuals with high alexithymia tend to engage in experiential avoidance and this may mediate psychological distress. However, little is known about what specific processes of experiential avoidance are involved, and the nature of the relation between alexithymia, experiential avoidance, and psychological distress remains unclear at a latent construct level. To examine this relationship at the latent construct level, a representative sample of 693 U.S. adults completed alexithymia (TAS-20, BVAQ, PAQ), general distress (DASS-21), multi-dimensional experiential avoidance (MEAQ), and general health (PROMIS-G-10) questionnaires. Structural equation modeling revealed that alexithymia significantly predicted experiential avoidance (β = 0.966, = 82.383, < .01), experiential avoidance significantly predicted general distress (β = 0.810, = 2.017, < .05), and experiential avoidance fully mediated the relationship between alexithymia and general distress (β = -0.159, = -0.398, > .05). Correlations between alexithymia and experiential avoidance subfactors revealed a strong relationship to the repression and denial subfactor. Experiential avoidance is a promising target for clinical interventions, though longitudinal research is necessary to elucidate how the relationship between alexithymia and experiential avoidance unfolds over time.
PubMed: 37637074
DOI: 10.1016/j.paid.2023.112308 -
Brain Sciences Mar 2024One significant obstacle to gaining a widespread awareness of the ongoing climate change is the nature of its manifestations in relation to our perception: climate...
One significant obstacle to gaining a widespread awareness of the ongoing climate change is the nature of its manifestations in relation to our perception: climate change effects are gradual, distributed, and sometimes seemingly contradictory. These features result in a lag in collective climate action and sometimes foster climate skepticism and climate denial. While the literature on climate change perception and belief has thoroughly explored its sociocultural and sociopolitical aspects, research on the potential contribution of psychophysiological factors remains scarce. In this perspective paper, we outline evidence and arguments for the involvement of psychophysiological systems such as thermoception, hygroreception, and interoception in modulating climate change awareness. We discuss psychophysiological mechanisms of climate change awareness in animals and humans, as well as possible sources of individual variance in climate change perception. We conclude by suggesting novel research questions which would be worthwhile to pursue in future studies.
PubMed: 38539654
DOI: 10.3390/brainsci14030266 -
The Oncologist May 2024Indolent non-Hodgkin's lymphomas (iNHL) are a heterogenous group of mostly incurable diseases with prolonged illness courses and prognostic uncertainty. Yet, studies...
BACKGROUND
Indolent non-Hodgkin's lymphomas (iNHL) are a heterogenous group of mostly incurable diseases with prolonged illness courses and prognostic uncertainty. Yet, studies evaluating coping and perception of prognosis are limited.
METHODS
We conducted a cross-sectional study of adults newly diagnosed with iNHL in the past 3 months at a single academic center. We assessed quality of life (QOL: Functional Assessment of Cancer Therapy-General), psychological symptoms (Hospital Anxiety and Depression Scale), coping (Brief-COPE), and perception of prognosis (Prognosis Awareness Impact Scale).
RESULTS
We enrolled 70.6% (48/68) of eligible patients. Patients had older age (mean = 66.9,sd = 10.5), were female (60.4%), predominantly identified as White (85.4%), and had at least received a college degree (75%). Chronic lymphocytic leukemia (39.6%) and follicular lymphoma (33.3%) were the most common diagnoses. Overall, 27.1% and 14.6% of patients reported clinically significant anxiety and PTSD symptoms, respectively. Patients highly utilized acceptance (56.2%), seeking emotional support (47.9%), and denial (47.9%) as coping strategies at diagnosis. While 66.7% of patients recalled their oncologist assessment of illness as incurable, only 35.4% reported that the illness is unlikely to be cured. Overall, 45.8% indicated that they were worried about prognosis and 31.2% reported perseverating on their prognosis. Higher emotional coping with prognosis was associated with fewer anxiety (B = -0.6, SE = 0.2, P < .001), depression (B = -0.3, SE = .1, P = .005), and PTSD (B = -1.3, SE = 0.4, P < .001) symptoms and better QOL (B = 1.7, SE = 0.4, P < .001).
DISCUSSION
Patients with iNHL report substantial psychological distress, a diversity of coping strategies, and complex cognitive understanding of their prognosis. Interventions, which address prognostic uncertainty and promote positive emotional coping with prognosis, may ameliorate psychological distress in this population.
Topics: Humans; Female; Male; Prognosis; Lymphoma, Non-Hodgkin; Adaptation, Psychological; Aged; Cross-Sectional Studies; Middle Aged; Quality of Life; Anxiety; Depression; Adult
PubMed: 37935593
DOI: 10.1093/oncolo/oyad295 -
PloS One 2024The current study characterizes a cohort of veteran claims filed with the Veterans Benefits Administration for posttraumatic stress disorder secondary to experiencing...
Military sexual trauma-related posttraumatic stress disorder service-connection: Characteristics of claimants and award denial across gender, race, and compared to combat trauma.
The current study characterizes a cohort of veteran claims filed with the Veterans Benefits Administration for posttraumatic stress disorder secondary to experiencing military sexual trauma, compares posttraumatic stress disorder service-connection award denial for military sexual trauma-related claims versus combat-related claims, and examines military sexual trauma -related award denial across gender and race. We conducted analyses on a retrospective national cohort of veteran claims submitted and rated between October 2017-May 2022, including 102,409 combat-related claims and 31,803 military sexual trauma-related claims. Descriptive statistics were calculated, logistic regressions assessed denial of service-connection across stressor type and demographics, and odds ratios were calculated as effect sizes. Military sexual trauma-related claims were submitted primarily by White women Army veterans, and had higher odds of being denied than combat claims (27.6% vs 18.2%). When controlling for age, race, and gender, men veterans had a 1.78 times higher odds of having military sexual trauma-related claims denied compared to women veterans (36.6% vs. 25.4%), and Black veterans had a 1.39 times higher odds of having military sexual trauma-related claims denied compared to White veterans (32.4% vs. 25.3%). Three-fourths of military sexual trauma-related claims were awarded in this cohort. However, there were disparities in awarding of claims for men and Black veterans, which suggest the possibility of systemic barriers for veterans from underserved backgrounds and/or veterans who may underreport military sexual trauma.
Topics: Male; United States; Humans; Female; Stress Disorders, Post-Traumatic; Retrospective Studies; Military Sexual Trauma; United States Department of Veterans Affairs; Veterans; Military Personnel; Sex Offenses
PubMed: 38206995
DOI: 10.1371/journal.pone.0280708