Staff stress and challenging behaviour : the relationship between stressors, personality, coping strategies, behavioural knowledge and psychological distress in care staff

Objective: This research study investigated relationships between factors that influence the experience of psychological stress by staff working in residential services supporting adults with learning disabilities and challenging behaviours. A psychological model was developed that related the personality traits of direct care staff with their personal coping style, behavioural knowledge and emotional reaction when exposed to environmental stressors and investigated the impact on psychological distress experienced. Design: A self-report questionnaire study on sixty-nine direct care staff working in an independent sector community based service for adults with learning disabilities and severely challenging behaviours. Correlation and regression analyses were employed to examine relationships between the different factors. Method: Staff completed a battery of measures including versions of the Eysenck Personality Questionnaire (EPQ-R), Shortened Ways of Coping (Revised) Questionnaire (SWC-R), the General Health Questionnaire (GHQ), Knowledge of Behavioural Principles (KBPAC), Care Staff's Emotional Reactions to Aggressive Challenging Behaviours and Work and Client Sources of Stress Checklist. Results: Staff reported high levels of stress. A significant association was found between Neurotic personality type, the use of wishful-thinking coping strategies, a negative emotional reaction to challenging behaviours and greater levels of psychological distress. No association was found between knowledge of behavioural principles and stress. Discussion: Support was found for the proposed psychological model for staff stress. Clinical implications were discussed that have a direct influence on the way in which staff working in services for people who challenge are supported by clinical psychologists. Suggestions were made for future research in the area

Becoming a mother:Supported decision-making in context

Little is known about how women with intellectual disabilities make decisions in relation to pregnancy. Social support is important for mothers with intellectual disabilities in many areas. This study explored how the support network influenced the decision-making of women with intellectual disabilities in relation to pregnancy. The study extended previous research to include the multiple perspectives of mothers, personal and professional support network. A model of decision-making was constructed, with implications of how services approach working with mothers with intellectual disabilities. Using a grounded theory methodology, three mothers with intellectual disabilities, two of their family members and six professionals were interviewed about their experiences of decision-making in relation to pregnancy. The results suggested that the quality of a woman’s relationships were key to facilitating decision-making. The results highlighted the need for services to focus on creating supportive working relationships with mothers and other services involved in the parenting assessment process. </jats:p

Genetic and environmental factors in vascular dementia: an update of blood brain barrier dysfunction

Vascular dementia (VaD) describes a combination of both cognitive and behavioural manifestations associated with variable brain lesions of vascular origin. While vascular risk factors have been implicated in VaD, the relationship is most evident when the factors are considered together and not individually. This review will examine the significance of the integrity of blood brain barrier (BBB) tight junction (TJ) proteins - occludin and claudins in the pathophysiology of VaD. Specifically, some of the genetic contributors to VaD, namely those responsible for the integrity of the BBB, will be reviewed in detail. Moreover, environmental factors will be considered in conjunction with these genes to examine how the interaction of environmental and genetic factors contributes to one's susceptibility to VaD. © 2016 John Wiley and Sons Australia, Ltd