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BMC Psychology Apr 2024The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions...
BACKGROUND
The increasing costs of nurses' occupational-stress, conflicts, and violence within healthcare services have raised international interest. Yet, research/interventions should consider that perceived stress and conflicts- but also potential resources- within the wards can crossover the healthcare settings, impacting nurses' private lives and viceversa, potentially creating vicious circles exacerbating stress, conflicts/violence or, conversely, virtuous circles of psychological/relational wellbeing. Based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model, and responding to the need to go in-depth into this complex dynamic, this study aims to explore potential vicious circles featured by the negative effects of the interplay (main/mediating effects) between perceived stressors in nursing linked to interpersonal conflicts (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families), work-family inter-role conflicts (Work-Family/Family-Work-Conflicts), and work-related stress (Effort-Reward-Imbalance) on nurses' psychological/relational health (Anxiety, Depression, Somatization, Interpersonal-Sensitivity, Hostility). The potential moderating role of work-resources (Job-Control, Social-Support, Job-Satisfaction) in breaking vicious circles/promoting virtuous circles was also explored.
METHOD
The STROBE Checklist was used to report this cross-sectional multi-centre study. Overall, 265 nurses completed self-report questionnaires. Main/mediating/moderating hypotheses were tested by using Correlational-Analyses and Hayes-PROCESS-tool.
RESULTS
Data confirmed the hypothesized detrimental vicious circles (main/mediating effects), impairing nurses' psychological health conditions at individual level (Anxiety, Depression, Somatization), but also at relational level (Hostility and Interpersonal-Sensitivity). The moderating role of all work resources was fully supported.
CONCLUSION
Findings could be used to implement interventions/practices to effectively prevent the maintenance/exacerbation of vicious circles and promote psychological/relational wellbeing in healthcare settings and beyond.
Topics: Humans; Role Conflict; Cross-Sectional Studies; Job Satisfaction; Interpersonal Relations; Mental Health; Surveys and Questionnaires; Stress, Psychological
PubMed: 38600606
DOI: 10.1186/s40359-024-01676-y -
Neuroscience Letters May 2024Concussion can lead to various symptoms such as balance problems, memory impairments, dizziness, and/or headaches. It has been previously suggested that during...
Concussion can lead to various symptoms such as balance problems, memory impairments, dizziness, and/or headaches. It has been previously suggested that during self-motion relevant tasks, individuals with concussion may rely heavily on visual information to compensate for potentially less reliable vestibular inputs and/or problems with multisensory integration. As such, concussed individuals may also be more sensitive to other visually-driven sensations such as visually induced motion sickness (VIMS). To investigate whether concussed individuals are at elevated risk of experiencing VIMS, we exposed participants with concussion (n = 16) and healthy controls (n = 15) to a virtual scene depicting visual self-motion down a grocery store aisle at different speeds. Participants with concussion were further separated into symptomatic and asymptomatic groups. VIMS was measured with the SSQ before and after stimulus exposure, and visual dependence, self-reported dizziness, and somatization were recorded at baseline. Results showed that concussed participants who were symptomatic demonstrated significantly higher SSQ scores after stimulus presentation compared to healthy controls and those who were asymptomatic. Visual dependence was positively correlated with the level of VIMS in healthy controls and participants with concussion. Our results suggest that the presence of concussion symptoms at time of testing significantly increased the risk and severity of VIMS. This finding is of relevance with regards to the use of visual display devices such as Virtual Reality applications in the assessment and rehabilitation of individuals with concussion.
Topics: Humans; Motion Sickness; Brain Concussion; Male; Female; Adult; Young Adult; Photic Stimulation; Visual Perception
PubMed: 38599370
DOI: 10.1016/j.neulet.2024.137767 -
Canadian Journal of Psychiatry. Revue... Jul 2024
Topics: Humans; Nervous System Diseases
PubMed: 38584382
DOI: 10.1177/07067437241245957 -
European Journal of Psychotraumatology 2024Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe... (Observational Study)
Observational Study
Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment - results of an observational single-centre pilot study.
Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before () and at the end of treatment (). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. A total of = 50 patients with CPTSD were included in the study, of whom = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (-3.9 points; < .001; = .36), as well as a significant reduction of psychological distress ( < .001; = .55) and functional impairment ( < .001; = .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust ( = -.34, = .026) and decreased epistemic credulity ( = .37, = .017), which together with lower age ( = .43, = .012) and lower depression levels at baseline ( = .35, = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process.
Topics: Humans; Stress Disorders, Post-Traumatic; Pilot Projects; Inpatients; Psychotherapy; Surveys and Questionnaires
PubMed: 38577992
DOI: 10.1080/20008066.2024.2333221 -
Radiology Case Reports Jun 2024Ewing sarcoma is the second most frequent primary bone tumour of childhood and adolescence. The aim of this report is to describe the imaging, pathology, clinical...
Ewing sarcoma is the second most frequent primary bone tumour of childhood and adolescence. The aim of this report is to describe the imaging, pathology, clinical findings, and treatment of a primary intradural extramedullary Ewing sarcoma with a unique intracranial metastatic component in a pediatric patient. A 14-year-old girl with a history of mood disorders presented to the emergency department with a 3-week history of neck torticollis, cervical pain, paresis, and paresthesia of the upper and lower extremities on the left side. Initially, non-organic causes such as somatization or conversion disorder were suspected. She returned 3 months later when her symptoms worsened. MRI of the head and spine was performed, and demonstrated the presence of a suprasellar, retro-chiasmatic mass lesion. There was also diffuse leptomeningeal enhancement, another well-defined intradural extramedullary lesion the sacral region and several multifocal cauda equina soft tissue nodules. The patient first underwent surgery. The patient was also treated with a combination of chemotherapy (vincristine, doxorubicin and cyclophosphamide alternating with ifosfamide and etoposide (VDC/IE)) and radiation as per the Children's Oncology Group AEWS1221 protocol. Most recent imaging conducted 22 months after the initial mass discovery revealed improvement of the suprasellar mass lesion with residual stable appearance of the prominence and enhancement of the pituitary stalk and tuber cinereum. There was interval improvement of the spinal lesions with no convincing residual. Clinically, at almost three years since initial imaging findings, and 25 months since completing treatment, she is stable from an oncology perspective.
PubMed: 38572274
DOI: 10.1016/j.radcr.2024.02.101 -
Global Mental Health (Cambridge,... 2024Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional...
Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional survey with Syrian refugee adults in Leipzig, Germany in 2021/2022. Outcomes included PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7) and somatic symptom (SSS-8). Descriptive, regression and effect modification analyses assessed associations between selected predictor variables and mental health service access. The sampling strategy means findings are applicable only to Syrian refugees in Leipzig. Of the 513 respondents, 18.3% had moderate/severe anxiety symptoms, 28.7% had moderate/severe depression symptoms, and 25.3% had PTSD symptoms. A total of 52.8% reported past year mental health problems, and 48.9% of those participants sought care for these problems. The most common reasons for not accessing mental healthcare services were wanting to handle the problem themselves and uncertainty about where to access services. Adjusted Poisson regression models ( = 259) found significant associations between current mental health symptoms and mental healthcare service access (RR: 1.47, 95% CI: 1.02-2.15, = 0.041) but significance levels were not reached between somatization and trust in physicians with mental healthcare service access. Syrian refugees in Leipzig likely experience high unmet mental health needs. Community-based interventions for refugee mental health and de-stigmatization activities are needed to address these unmet needs in Leipzig.
PubMed: 38572249
DOI: 10.1017/gmh.2024.16 -
La Clinica Terapeutica 2024Many patients affected by FM present different comorbidities, but to date no case of FM in patients with CRMO has been reported in literature. Several studies show the...
BACKGROUND
Many patients affected by FM present different comorbidities, but to date no case of FM in patients with CRMO has been reported in literature. Several studies show the importance of psychosomatic assessment in FM, but only one reported the presence of allostatic overload.
CASE PRESENTATION
In April 2022, a 21-year-old female patient, a third-year medical student, came to our clinic to be assessed and treated for FM. She presents with a diagnosis of CRMO made in 2014 and a diagnosis of FM made in 2019.
RESULTS
At the psychiatric evaluation she presented symptoms of anxiety, depression, insomnia and reported widespread pain with the presence of almost daily headaches. From the psychosomatic point of view using DCPR-revised she presented diagnostic criteria for allostatic overload, related to study and periodic flare-ups of painful symptoms due to CRMO, persistent somatization, with musculoskeletal and gastroenterological symptoms, demoralization and type A behaviour.
CONCLUSION
This case shows how useful a psychosomatic assessment of the patient can be for offering insights into what stressors at the origin of allostatic overload may be present in different FM patients.
Topics: Female; Humans; Young Adult; Adult; Fibromyalgia; Osteomyelitis; Psychophysiologic Disorders; Pain; Projective Techniques
PubMed: 38571464
DOI: 10.7417/CT.2024.5038 -
Psychiatry Investigation Mar 2024The primary objective of this study was to examine the associations among emotion regulation strategies, interoceptive awareness, and psychological distress...
OBJECTIVE
The primary objective of this study was to examine the associations among emotion regulation strategies, interoceptive awareness, and psychological distress measures-namely, depression, anxiety, and somatization. Additionally, we aimed to explore the predictive power of various facets of interoceptive awareness in determining the severity of symptoms for each mental disorder.
METHODS
A cohort of 130 outpatients diagnosed with depression/anxiety disorder were recruited, and 20 subjects exhibiting incomplete responses were excluded from the dataset, leading to a final sample size of 110 outpatients. The clinical symptoms were measured by Patient Health Questionnaire-9, State-Trait Anxiety Inventory Form Y, and Symptom Checklist-90-Revised, and the usage of emotion-regulation strategies and interoceptive awareness was assessed with Emotion Regulation Questionnaire and Multidimensional Assessment of Interoceptive Awareness (MAIA), respectively. A hierarchical regression analysis was performed to examine whether emotion-regulation strategies and interoceptive awareness explain the statistically significant variance in each of the symptoms.
RESULTS
In the depression model, cognitive reappraisal, accept, and attention regulation showed significant associations, while in the anxiety model, cognitive reappraisal, attention regulation, trust, and notice emerged as significant factors. Lastly, cognitive reappraisal and attention regulation were found to be significant contributors to the final model for somatization.
CONCLUSION
The inclusion of MAIA subscales improved the predictive ability of the regression model, highlighting the independent association between interoceptive awareness-particularly attention regulation-and clinical symptoms of anxiety and depression. Additionally, the study underscores the relevance of considering the specific pathological context when implementing interventions, as evidenced by the positive associations between the accept subscale and depression and between the notice subscale and anxiety, respectively.
PubMed: 38569583
DOI: 10.30773/pi.2023.0221 -
Journal of Psychosomatic Research May 2024Using the large Rome Foundation Global Epidemiology Survey dataset, the aim of this study was to evaluate the construct and convergent validity and internal consistency...
OBJECTIVE
Using the large Rome Foundation Global Epidemiology Survey dataset, the aim of this study was to evaluate the construct and convergent validity and internal consistency of the PHQ-4 across both gastrointestinal and non-gastrointestinal condition cohorts. Another aim was to provide descriptive information about the PHQ-4 including means, confidence intervals and percentage of caseness using a large representative sample.
METHODS
A cross-sectional survey was conducted in 26 countries. Confirmatory factor and internal consistency analyses were conducted across subsamples of patients with gastrointestinal conditions (i.e., disorders of gut-brain interaction [DGBI; any DGBI, individual DGBI, and DGBI region], gastroesophageal reflux disease (GERD), coeliac disease, diverticulitis, inflammatory bowel disease (IBD), cancer anywhere in the gastrointestinal tract, peptic ulcer) and those without a gastrointestinal condition. Convergent validity was also assessed via a series of Pearson's correlation coefficients with PROMIS (physical and mental quality of life), and PHQ-12 (somatisation).
RESULTS
Based on 54,127 participants (50.9% male; mean age 44.34 years) confirmatory factor analysis indicated acceptable to excellent model fits for the PHQ-4 across all subsamples and individual DGBI and DGBI region (Comparative Fit Index >0.950, Tucker-Lewis Index >0.950, Root Mean Squared Error of Approximation <0.05, and Standardised Root Mean Square Residual <0.05). The PHQ-4 was found to demonstrate convergent validity (Pearson's correlation coefficients >±0.4), and good internal consistency (Cronbach's α > 0.75).
CONCLUSIONS
This study provides evidence that the PHQ-4 is a valid and reliable tool for assessing mental health symptomology in both gastrointestinal and non-gastrointestinal cohorts.
Topics: Humans; Male; Cross-Sectional Studies; Female; Adult; Gastrointestinal Diseases; Middle Aged; Reproducibility of Results; Patient Health Questionnaire; Psychometrics; Quality of Life; Factor Analysis, Statistical; Aged
PubMed: 38569449
DOI: 10.1016/j.jpsychores.2024.111654 -
Inquiry : a Journal of Medical Care... 2024The main objective of the present study was to investigate factors related to seafarers' mental health. A sample of seafarers from 12 countries participated in the...
The main objective of the present study was to investigate factors related to seafarers' mental health. A sample of seafarers from 12 countries participated in the study. A list of stressors was used to assess both perception of exposure to these stressors and their subjective significance. The Symptom Checklist (SCL-90) was used to assess seafarers' mental health on 5 of 9 subscales: Depression, Anxiety, Hostility, Interpersonal Sensitivity, and Somatisation. Three significant findings emerged from the analyses. The first was that 3 types of stressors contribute significantly to mental health problems: (1) environmental factors (eg, vibration), (2) social problems (eg, bullying, homesickness, working alone), and (3) health problems (eg, physical injuries, viruses, and the illnesses). The second finding was that both stress and mental health issues determine seafarers' motivation for their work and their consideration regarding leaving the maritime industry. The third finding was that factors contributing to seafarers' consideration of leaving the industry were mainly related to social stressors such as isolation from family and friends, cultural differences at work, demands from supervisors, and bullying. Factors such as bad weather, working shifts, length of employment contract or a ban on disembarkment in ports were found to be relatively less important for seafarers as factors toward considering leaving the industry. The implications of these findings are discussed.
Topics: Humans; Mental Health; Intention; Loneliness; Employment
PubMed: 38529893
DOI: 10.1177/00469580241229617