Psychological impacts of challenging behaviour and motivational orientation in staff supporting individuals with autistic spectrum conditions

Despite increased risk of experiencing challenging behaviour, psychological impacts on community and residential staff supporting adults with autistic spectrum conditions are under-explored. Studies examining related roles indicate protective psychological factors may help maintain staff well-being. This study investigated relationships between motivational orientation (eudaimonic or hedonic), challenging behaviour frequency and type (physical, verbal or self-injurious), and psychological impacts (anxiety, depression and life satisfaction). Participants (N=99) were recruited from six organisations providing autism-specific adult services within Scotland. A series of binary logistic regressions demonstrated weekly challenging behaviour exposure (compared to monthly or daily) significantly increased the likelihood of anxiety caseness. Increased eudaimonic motivation significantly reduced the likelihood of anxiety caseness while also predicting higher life satisfaction. Further, having high levels of eudaimonic motivation appeared to moderate the impact of weekly challenging behaviour exposure on anxiety. No motivational orientation or challenging behaviour factor significantly predicted depression. This sample also demonstrated higher anxiety, lower depression, and equivalent life satisfaction levels compared to general population norms. The results highlight the need for considering staff’s motivational orientations, their frequency of exposure to challenging behaviour, and both positive and negative psychological outcomes, if seeking to accurately quantify or improve well-being in this staff population

Metal-induced Bystander Effects: Mechanism and Implicationis.

The radiation-induced bystander effect is a phenomenon known to occur post irradiation, characterised by the induction of biological effects in unirradiated cells as a result of receiving signals from irradiated cells or their culture medium. Chemicalinduced bystander effects are poorly characterised and there are no reports of a bystander effect induced by metals. Heavy metals and in particular chromium (VI) are known to cause persistent genomic instability. For the first time, this study provides evidence that a short, low-dose exposure of human fibroblasts to chromium (VI) causes a bystander effect in human fibroblasts that persists for at least thirty days post metal treatment. The biological effects induced in these bystander cells include induction of micronuclei, nucleoplasmic bridges, cytogenetic abnormalities and DNA Crucially, this effect depends on whether the bystander cells are telomerase positive or negative. Telomerase negative human fibroblasts respond to a mediumtransmissible bystander signal from all ‘donor’ cell types; but telomerase positive cells, whether they express ectopic hTERT or physiological telomerase as is the case for the immortalized k1 thyroid carcinoma cell line and human embryonic stem cells, are resistant to a signal from other telomerase positive cells. Treatment of cells with ascorbic acid revealed that the role of oxidative stress in transmission of bystander responses is more important for telomerase positive cells than telomerase negative cells. The role of TNF-alpha was also explored. In telomerase negative cells, addition of a neutralizing antibody to TNF-alpha to conditioned medium from either cell type caused a significant reduction in bystander γ-H2AX foci. In contrast, there was a significant reduction in γ-H2AX foci in bystander telomerase positive cells exposed to conditioned medium from telomerase negative but not telomerase positive donor cells. Inhibition of p38MAP Kinase by SB203580 had no effect on bystander signalling. This study highlights novel considerations for predicting the outcome of metal exposure and the importance of the indirect biological effects of heavy metals in cancer risk assessment, which has implications for cancer therapy

Adolescent risk taking behaviour: the experiences, motivations and coping styles of young people with and without psychosis

INTRODUCTION: Adolescence can be a challenging developmental period, often characterised by experimentation, impulsivity, curiosity and uncertainty, making it a heightened potential for risk taking behaviour. Particular concern has been levied at adolescents who have psychotic experiences, given that their adjustment and global functioning is often lower than that of other young people and they may be more prone to engaging in health compromising behaviours.AIMS: The primary objectives of the study were to explore the: (1) association between personality (telic & paratelic dominance), coping styles (productive, unproductive & reference to others) and health risk behaviours, and (2) perspectives of young people who experience psychosis in terms of their personal meanings and motivations for engaging in health risk behaviours.METHOD: A multi-method study comprising of two stages was employed. The first stage was a large scale cross-sectional quantitative study of a school based population (n=407) employed to test the relations between personality, coping styles and health risk behaviours. The second stage comprised of an in-depth qualitative analysis of the perspectives of young people who experience psychosis (n=10) concerning their personal meaning and motives for risk taking. The standardised measures of the main variables were also administered to the clinical group.RESULTS: Analysis from the school based data indicated that adolescents who scored high in negativistic dominance and low in telic dominance were more likely to use the unproductive coping style and engage in health risk behaviours. Coping style was found to mediate the relationship between personality and health risk behaviours. Analysis from the accounts of young people who experience psychosis highlighted the importance of understanding the developmental and social context in which adolescent risk taking occurs. It also emphasised the importance of addressing the social and attitudinal barriers associated with the stigma surrounding psychosis, given that this presents a significant challenge to young people as they strive to rebuild their lives following a psychotic episode.CONCLUSIONS: Clinical and health promotion interventions would benefit from tailoring messages to reflect the processes linking state dominance, coping styles and health risk behaviours among young people. Interventions that promote adaptive outlets for positive risk taking and emphasise the importance of maintaining health may be more likely to reduce adolescent engagement in health compromising behaviours. Understanding normative adolescent risk taking and how it relates to developmental processes in essential for those working with young people with and without mental health problems

Developing a model of citizenship for application within health and social care contexts : a community-based participatory approach

Background Citizenship as a concept has often been understood in terms of the duties, rights, obligations, and functions a person has as a member of society. In health and social care policy and practice, the term has broader reach. This study explored what citizenship means to people with recent experience of mental illness, a long-term physical health condition, or involvement with the criminal justice, as well as to people who did not primarily identify as having experienced any of these major life disruptions. The aim was to develop an empirical model of citizenship to be applied within health and social care contexts. Methods We employed a mixed-methods, community-based participatory research approach, which included conducting ten focus groups (n=77 [A: yes participants) to generate statement items about the meaning of citizenship, and holding concept-mapping sessions with participants from the stakeholder groups (n=45) to categorise and rate each item in terms of importance and achievement. The number of statement items generated from focus groups was reduced from 703 to 110 and then to 58 following an online survey to ask participants (n=242) to rate items according to their clarity and relevance to the concept of citizenship. Multidimensional scaling and hierarchical cluster analysis were used to develop a five-cluster model of citizenship. Findings 110 statement items about the meaning of citizenship were generated from the focus groups, and were reduced to 58 following the online survey. We identified five clusters representing the personal meanings of citizenship for participants: building relationships, autonomy and acceptance, access to services and supports, values and social roles, and civic rights and responsibilities. These clusters informed the development of the empirical model of citizenship to be applied within health and social care policy and practice. Interpretation This multidimensional model of citizenship provides an empirical framework for policy makers and practitioners to set citizenship-based initiatives that contribute to the recovery and social inclusion of people who have experienced major life disruptions. This model will inform the development of a citizenship tool to facilitate discussions around citizenship

Psychotraumatology and artificial intelligence : a public health approach

Public health is increasingly becoming a central perspective of psychotraumatology. Exposure to trauma and its impact is a pervasive and critical issue worldwide and is associated with substantial costs to individuals, communities and wider societies. In this review, it is argued that there is a need to extend beyond individual–level trauma interventions that target specific populations, diagnoses and risk factors. A 'paradigm shift' towards a public health approach provides health and social care institutions with a multi-level framework that focuses on early intervention, prevention, care and treatment at a population level. It is postulated that adopting a wider systems perspective can benefit from rapid innovations in artificial intelligence (AI) technologies that will accelerate understandings of trauma and its impacts and help forge pathways to identifying protective factors which have the potential to facilitate post-traumatic growth. The importance of addressing AI bias through the co-creation of machine learning algorithms with a range of stakeholders, including those with lived experiences, is emphasised. The need to harness computational approaches to big data on trauma in a secure, private, sensitive and ethical manner in accordance with 'best practice' governance structures for public health data science is essential

Handbook of Psychosocial Interventions for Veterans and Service Members : A Guide for the Non-Military Mental Health Clinician

Review of Handbook of Psychosocial Interventions for Veterans and Service Members: A Guide for the Non-Military Mental Health Clinician. Nathan D. Ainspan, Craig J. Bryan, Walter Erich Penk

"He messaged me the other night and said you are my saviour" : An interpretative phenomenological analysis of intimate partners’ roles in supporting Veterans with mental health difficulties

Introduction: The limited research base regarding Veteran welfare has emphasized the adverse psychosocial aspects of being the intimate partner of a Veteran struggling with mental health difficulties. Despite this, previous research has identified that remaining in a romantic relationship can be a protective factor against mental health difficulties. This study aims to explore intimate partners’ views of the role they play in supporting Veterans with mental health difficulties and the personal meanings they associate with this role. Methods: Six female partners of male Veterans were recruited using purposive sampling. Qualitative data were collected using semi-structured one-on-one interviews. Interpretative phenomenological analysis was used to gain an in-depth understanding of the lived experiences of partners of Veterans living with mental health difficulties. Results: Three superordinate themes were identified: 1) the multi-faceted nature of support, 2) vicarious psychosocial consequences of the caring role, and 3) reconstruction of a Veteran’s identity after transition. Discussion: Intimate partners of Veterans described how they supported Veterans experiencing mental health difficulties, as well as detailing the challenges they faced. Future research topics are considered, and recommendations for further support for intimate partners are outlined

Understanding the motivations behind the "iron sport" among Greek competitive bodybuilders using interpretive phenomenological analysis

Bodybuilding has generated debate and controversy, with research having largely focused on pathologizing the sport. This study aimed to gain insight from the accounts of bodybuilders regarding their personal meanings, experiences, and motivations for engaging in the sport within Greece. Semi-structured interviews with six 'elite' competitive bodybuilders were conducted. The themes to have emerged using interpretative phenomenological analysis were: the need to stand out vs toll of being different, self-affirmation through challenges and personal sacrifices, the importance of the mind in bodybuilding, and the impacts of a transformational body. Suggestions for future research and theoretical implications of these findings are outlined

The importance of adaptive coping, peer support, psychological input and team resilience among fire and rescue service workers in maintaining wellbeing throughout the Covid-19 pandemic : a cross sectional survey

Background Frontline railway workers have provided an essential service throughout the COVID-19 pandemic. Although railway workers are known to be at risk of developing traumatic stress-related conditions, little is known about the effects of COVID-19 on the mental wellbeing of railway workers in the UK. We tested two hypotheses: (1) increased scores in COVID-19-related risk factors will predict decreased mental wellbeing and (2) protective factors will mediate the relationship between COVID-19-related risk factors and mental wellbeing. Methods The study consisted of a cross-sectional online survey exploring the effects ofCOVID-19 on the mental wellbeing of railway workers (n=906) in the UK, using data collected during third lockdown (between Dec 1, 2020, and March 24,2021). The survey, advertised on social media and internal platforms of the Associated Society of Locomotive Engineers and Firemen, included measures of COVID-19-related risk factors (COVID-19 Perceived Risk Scale, COVID-19 Stress Measure, COVID-19 Burnout Scale, and PTSD Checklist–Civilian Version) and protective factors (brief resilience coping, team resilience, general help-seeking questionnaire) associated with mental wellbeing (Warwick Edinburgh Mental Wellbeing Scale–Short Form). We analysed responses via multiple regression and parallel mediation analyses. Open-ended questions, exploring railway workers' views of risks and protective factors for their mental wellbeing, were analysed using content analysis. The institutional ethics committee granted ethical approval and participants gave informed consent. Findings COVID-19 related risk factors negatively predicted wellbeing (r2=0·50, F=273·556 [3 variables, n=813], p<00001). Protective factors significantly mediated the relationship between wellbeing and burnout (indirect effect [IE] –0·0252, 95% CI –0·0364 to–0·0152), stress (IE –0·0252, –0·0364 to –0·0152), post-traumatic stress disorder (IE –0·0311, –0·0493 to –0·0145), and risk perception (IE –0·0244,–0·0411 to –0·0089). Content analysis found self-reported mental health decline throughout the COVID-19 pandemic, perceived loss of workplace supports, need for psychological support, and concerns for the future. Interpretation These findings emphasise the importance of adaptive coping and team-based resilience in alleviating the negative impact that COVID-19 has on railway workers' mental wellbeing and in preventing burnout. Work-based supports and access to psychological input for railway workers who need it is highlighted. Building a resilient railway workforce moving forward requires attention to staff mental wellbeing and to ensuring that support systems are robust and accessible

Concept mapping in context as a means of understanding how people with lived experience of mental health problems make sense of citizenship

People with lived experience of mental health problems (MHPs) are often marginalised and have difficulty achieving community inclusion. Citizenship provides a means of understanding what is necessary for marginalised individuals and groups to gain a sense of belonging within their communities. Developing a model of citizenship provides a basis for understanding the components of community integration and social inclusion that are often underdeveloped for people who experience MHPs. Concept mapping was used to produce visual representations and maps of ideas of how people with lived experience of MHPs made sense of the concept of citizenship within the Scottish context. A mixed methods participatory methodology was adopted, consisting of the following steps: (1) preparation (including recruiting peer researchers and identifying key stakeholder groups, (2) generating statement items through focus groups (n =77) with key stakeholder groups, (3) structuring through participants sorting and rating statement items, (4) visual representation of statement items through computation of concept maps, using multidimensional scaling and cluster analysis, (5) interpreting conceptual maps of citizenship, and (6) utilisation of a conceptual model. Reflecting on adopting a concept mapping approach, it encourages the expression of the conceptualisation of citizenship to be entirely grounded in the language of the participants; and yields a graphic outcome which displays all major domains of citizenship and their inter-relationships. It entails cognitive processes that involve decision-making about the relationship between fairly abstract concepts and an ability to sort and make connections between these. Consideration as to how this method could be adapted to incorporate other forms of media such as art and photography, when working with participants with, for example, developmental and/or cognitive challenges, is an exciting area that warrants further investigation. It is essential that the conceptual model of citizenship is contextualised through drawing upon the personal accounts and experiences of participants within their given communities