Collective narcissism and its social consequences.

This article introduces the concept of collective narcissism—an emotional investment in an unrealistic belief about the in group's greatness—aiming to explain how feelings about an ingroup shape a tendency to aggress against outgroups. The results of 5 studies indicate that collective, but not individual, narcissism predicts intergroup aggressiveness. Collective narcissism is related to high private and low public collective self-esteem and low implicit group esteem. It predicts perceived threat from outgroups, unwillingness to forgive outgroups, preference for military aggression over and above social dominance orientation, right-wing authoritarianism, and blind patriotism. The relationship between collective narcissism and aggressiveness is mediated by perceived threat from outgroups and perceived insult to the ingroup. In sum, the results indicate that collective narcissism is a form of high but ambivalent group esteem related to sensitivity to threats to the ingroup's image and retaliatory aggression

Multidimensional sexual perfectionism and female sexual function: A longitudinal investigation

Research on multidimensional sexual perfectionism differentiates four forms of sexual perfectionism: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. Self-oriented sexual perfectionism reflects perfectionistic standards people apply to themselves as sexual partners; partner-oriented sexual perfectionism reflects perfectionistic standards people apply to their sexual partner; partner-prescribed sexual perfectionism reflects people’s beliefs that their sexual partner imposes perfectionistic standards on them; and socially prescribed sexual perfectionism reflects people’s beliefs that society imposes such standards on them. Previous studies found partner-prescribed and socially prescribed sexual perfectionism to be maladaptive forms of sexual perfectionism associated with a negative sexual self-concept and problematic sexual behaviors, but only examined cross-sectional relationships. The present article presents the first longitudinal study examining whether multidimensional sexual perfectionism predicts changes in sexual self-concept and sexual function over time. A total of 366 women aged 17-69 years completed measures of multidimensional sexual perfectionism, sexual esteem, sexual anxiety, sexual problem self-blame, and female sexual function (cross-sectional data). Three to six months later, 164 of the women completed the same measures again (longitudinal data). Across analyses, partner-prescribed sexual perfectionism emerged as the most maladaptive form of sexual perfectionism. In the cross-sectional data, partner-prescribed sexual perfectionism showed positive relationships with sexual anxiety, sexual problem self-blame, and intercourse pain and negative relationships with sexual esteem, desire, arousal, lubrication, and orgasmic function. In the longitudinal data, partner-prescribed sexual perfectionism predicted increases in sexual anxiety and decreases in sexual esteem, arousal, and lubrication over time. The findings suggest that partner-prescribed sexual perfectionism contributes to women’s negative sexual self-concept and female sexual dysfunction

Assessment of cognitive self-statements during marital problem solving: A comparison of two methods

Twenty maritally distressed couples (DC) and 20 nondistressed couples (NDC) were recruited and asked to undertake 10 minutes of problem-solving discussions, which were videotaped. Each individual partner’s cognitive self-statements during the interaction were assessed using two methods: video-assisted recall (VR) and thought listing (TL). Reported cognitions from each method were content- analysed and classified into five categories: partner- referent positive, partner- referent negative, self-referent positive, self- referent negative, and other. Proportions of reported cognitions falling into each category were analysed in two separate two-way MANOVAs (marital distress/ nondistress x sex) for the VR and TL measures. Results of each MANOVA indicated a highly significant effect of marital distress on cognitions, and a significant effect of sex on the VR but not the TL measure. Discriminant analyses showed that the VR and TL methods both discriminated between DC and NDC groups. Post hoc univariate ANOVAs indicated that DC had significantly higher proportions of negative partner- referent cognitions, and lower proportions of positive partner- referent cognitions, than NDC while problem solving. The relative merits of each cognitive assessment method, and their potential use in increasing marital therapy effectiveness, are discussed

Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review

BACKGROUND: When disasters occur, there are many different occupational groups involved in rescue, recovery and support efforts. This study aimed to conduct a systematic literature review to identify social and occupational factors affecting the psychological impact of disasters on responders. METHODS: Four electronic literature databases (MEDLINE®, Embase, PsycINFO® and Web of Science) were searched and hand searches of reference lists were carried out. Papers were screened against specific inclusion criteria (e.g. published in peer-reviewed journal in English; included a quantitative measure of wellbeing; participants were disaster responders). Data was extracted from relevant papers and thematic analysis was used to develop a list of key factors affecting the wellbeing of disaster responders. RESULTS: Eighteen thousand five papers were found and 111 included in the review. The psychological impact of disasters on responders appeared associated with pre-disaster factors (occupational factors; specialised training and preparedness; life events and health), during-disaster factors (exposure; duration on site and arrival time; emotional involvement; peri-traumatic distress/dissociation; role-related stressors; perceptions of safety, threat and risk; harm to self or close others; social support; professional support) and post-disaster factors (professional support; impact on life; life events; media; coping strategies). CONCLUSIONS: There are steps that can be taken at all stages of a disaster (before, during and after) which may minimise risks to responders and enhance resilience. Preparedness (for the demands of the role and the potential psychological impact) and support (particularly from the organisation) are essential. The findings of this review could potentially be used to develop training workshops for professionals involved in disaster response. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40359-016-0120-9) contains supplementary material, which is available to authorized users

T4 Variation in National Readmission Patterns After Burn Injury

Abstract Introduction The purpose of this study was to identify risk factors and costs associated with readmission after burn injury across the United States. Methods The 2010–2014 Nationwide Readmissions Database was queried for patients admitted for burn. Multivariate logistic regression identified risk factors for 30-day readmission at index and different hospitals. Readmission cost was calculated using cost-to-charge ratios. Results Of the 94,759 patients admitted with a burn, 7.4% (n=7000) were readmitted within 30 days and of those, 29.2% (n=2047) occurred at a different hospital. Infection (29.4% [n=1990]), graft loss, wound healing, late effects, or aftercare issues (15.3% [n=1074]), and pain control and/or hydration (19.2% [n=1346]) were the most common reasons for readmission. Risk factors unique to readmission to a different hospital include: second degree burns (OR 1.23, p 7 days (OR 2.07, p<0.01), and admission to a metropolitan teaching hospital (OR 1.50, p<0.01) compared to a metropolitan non-teaching hospital. Other risk factors for readmission to a different hospital included: burn of face, head and neck (OR 1.53, p<0.01) and admission to non-metropolitan hospital (OR 1.93, p<0.01). Compared to private insurance, Medicare and Medicaid patients were more likely to get readmitted to a different hospital (OR 1.29, p<0.01 and OR 1.21, p<0.049, respectively). Overall risk factors for readmission at 30 days included: depression (OR 1.30, p<0.01), psychoses (OR 1.53, p<0.01), burn of lower limbs (OR 1.29, p<0.01), third degree burns (OR 1.31, p<0.01), leaving against medical advice (OR 3.39, p<0.01), admission to for-profit hospital (OR 1.30, p<0.01), and Charlson Comorbidity Index ≥2 (OR 1.48, p<0.01). Further risk factors are presented in Table 1. The median readmission cost was higher for patients readmitted to a different hospital $9,005 [$4,792–18,615] vs $8,697 [$5,118-$18,030], p<0.041). The median cost of readmission within 1 year was$10,959 [$5,369-$23,940]. Conclusions Previously unreported, 1 in 3 burn readmissions nationally occur at a different hospital, have unique risk factors, are costlier, and are missed by current quality metrics. For-profit hospitals have higher rates of readmissions overall. Applicability of Research to Practice A significant proportion of burn readmissions are missed by benchmarking and have unique risk factors, suggesting prevention programs, quality monitoring, and policy need to be changed

Multidimensional sexual perfectionism

Perfectionism is a multidimensional personality characteristic that can affect all areas of life. This article presents the first systematic investigation of multidimensional perfectionism in the domain of sexuality exploring the unique relationships that different forms of sexual perfectionism show with positive and negative aspects of sexuality. A sample of 272 university students (52 male, 220 female) completed measures of four forms of sexual perfectionism: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. In addition, they completed measures of sexual esteem, sexual self-efficacy, sexual optimism, sex life satisfaction (capturing positive aspects of sexuality) and sexual problem self-blame, sexual anxiety, sexual depression, and negative sexual perfectionism cognitions during sex (capturing negative aspects). Results showed unique patterns of relationships for the four forms of sexual perfectionism, suggesting that partner-prescribed and socially prescribed sexual perfectionism are maladaptive forms of sexual perfectionism associated with negative aspects of sexuality whereas self-oriented and partner-oriented sexual perfectionism emerged as ambivalent forms associated with positive and negative aspects

81 Augmented Creatinine Clearance in Severely Injured Burn Patients

Abstract Introduction Most trauma surgeons assume that serum creatinine (SCr) reflects glomerular filtration rate (GFR). However, new evidence suggests augmented renal clearance (ARC= creatinine clearance (CLCr) >130 ml/min) occurs in up to 60% of critically ill patients. ARC is associated with subtherapeutic drug concentrations, may lead to adverse clinical outcomes, and has yet to be reported in the burn population. Unfortunately, actual CLCr is usually not measured in the burn ICU and estimates of glomerular filtration rate (eGFR) have not been validated in critically ill burn ICU patients. To fill this gap, we test the hypothesis that ARC is common in burn ICU patients and is dissociated from eGFR. Methods In 15 consecutive burn ICU patients with total body surface area burns (TBSA) > 10%, 24 hr CLCr was correlated with demographics, iatrogenic factors, and clinical estimates of GFR: Cockroft-Gault (CG), modification of diet in renal disease (MDRD), and chronic kidney disease epidemiology (CKD-EPI). Univariate and multivariate logistic regression were used to identify risk factors of ARC. Values are M±SD if parametric and median [interquartile range] otherwise. Differences are assessed at p<0.05. Results The study population was 43 ± 16y, 60% males, 47% Caucasian, BMI 28.8 ± 8 kg/m2, with TBSA of 23[13–42]%. Length of stay was 26 ± 14d and overall mortality was 20% (n=3). Serum creatinine was 0.74[0.69–1.11] mg/dL and CLCr was 139 ± 66 ml/min. Urine output was 0.93 ± 0.43 cc/kg/h. In this sample of 15 patients, 67% (n=10) had ARC, 7% (n=1) had normal GFR, and 27% (n=4) were in acute renal failure. Hypertension, diabetes, age, amount of crystalloid in the first 24 hours and fluid balance were all associated with ARC on univariate analysis (all p<0.05), but TBSA, gender, race, smoking history, pressor use, weight, mechanical ventilation, admission vitals and creatinine were not. After controlling for confounders, none of these factors were independent risk factors for ARC. CKD-EPI, MDRD, and CG, underestimated CLCr by an average of 12% (p<0.031), 7% (p<0.071), and 9%, (p<0.0001), respectively. Conclusions These preliminary data are the first demonstration that ARC is common in critically-ill burn ICU patients, is independent of patient-specific and iatrogenic factors, and is not accurately detected by current clinical estimates. Applicability of Research to Practice Increased renal clearance can have adverse effects on drug concentrations, such as antibiotics and thromboprophylaxis, and ultimately clinical outcomes. More accurate estimates of CLCr are needed to minimize treatment failure in this population, and further studies are warranted to assess clinical outcomes of this phenomenon