Search

Drawing upon the literatures in information privacy, developmental psychology, and family science, this research investigates how parental online privacy concerns can be passed on to adolescents and affect their self-disclosure on social networking sites. We propose that parental privacy concerns decrease adolescents' self-disclosure both directly (i.e., compliance) and indirectly through adolescents' privacy concerns (i.e., internalization) and that such effects are moderated by parent-child privacy dissonance, parental internet evaluative mediation, and adolescents' gender. To test the research model, we collected matched parent-child data from 726 families in China. The results show the indirect effect of parental privacy concerns on adolescents' self-disclosure via their influence on adolescents' privacy concerns. In addition, parent-child privacy dissonance weakens the effect of adolescents' privacy concerns on selfdisclosure. The extent to which parents employ internet evaluative mediation to guide adolescents' online activities reinforces the effect of parental privacy concerns on adolescents' privacy concerns. Statistical analyses further revealed that the mediating effect of adolescents' privacy concerns is weakened by parent-child privacy dissonance but strengthened by internet evaluative mediation. We also found that parental privacy concerns affect sons and daughters through different paths, especially when parents employ high internet evaluative mediation. Under high internet evaluative mediation, parental privacy concerns affect sons' self-disclosure primarily through an indirect path (via sons' privacy concerns), but influence daughters' self-disclosure both directly and indirectly via daughters' privacy concerns. We conclude by discussing theoretical contributions and practical implications. [ABSTRACT FROM AUTHOR]

The hospital is a workplace full of stressful events for healthcare workers (HCWs) due to unpredictable changes in their daily routines. Perceptions of stressful events (stress mindset) have a significant impact on an individual's health and well-being. However, few studies have reported the factors and potential counter mechanisms influencing these perceptions. This study aimed to evaluate the relationship between empathy, self-disclosure, social support, and stress mindset of HCWs, and to explore the mechanism of empathy on stress mindset. Five hundred and eight HCWs (35.2% men and 64.8% women) completed the Interpersonal Reactivity Index (IRI), the Distress Disclosure Index (DDI), the Social Support Rating Scale (SSRS), the Stress Mindset Measure (SMM), and demographic questionnaires online in China. The results showed that empathy was positively linked with stress mindset and positively correlated with self-disclosure and social support. In the multiple mediating model, selfdisclosure and social support mediated the association between empathy and stress mindset sequentially. The results imply that empathy, self-disclosure, and social support play a significant role in the formation of HCWs' stress mindset. These findings have substantial ramifications for reducing stress and creating successful government interventions to fortify stress mindset in healthcare. [ABSTRACT FROM AUTHOR]

Background: When doctors seek medical care, there is evidence that the treating doctor can struggle to provide optimal treatment. Guidelines state that doctor-patients should be treated like any other patient, but this is challenging for the treating doctor. This study set out to explore both the positive experiences general practitioners (GPs) have when caring for doctor-patients, and the challenges they confront. It sought to identify whether GPs believe they treat doctor-patients differently to other patients and if so, in what ways, for what reasons, and how this impacts their provision of care. The study also aimed to develop a model that makes sense of GPs' experiences when caring for a patient who is also a medical doctor. Method: Qualitative in-depth interviews with 26 GPs were carried out, with analysis of de-identified transcripts using pragmatic grounded theory. Evolving understandings were used to develop a model to make sense of GPs' experiences caring for their doctor-patients. Results: The core aspects of GPs' experiences of treating fellow doctors centred around concepts of respect and collegiality. These play a central role in mediating how a treating doctor experiences a consultation with a doctor-patient, influencing the quality of care provided. GPs shared that the use of medical language (and assumptions about the doctor-patient's knowledge/behaviours), testing, the exploration of sensitive issues, and the degree of shared decision-making were areas where their treatment might vary when treating a doctor-patient. Treating doctors often experience anxiety about errors and the likely scrutiny from the medical, and wider community. The decision to treat the doctor-patient differently was driven by a desire to maintain a sense of collegiality, to not offend, to meet their doctor-patient's expectations, and to appear competent. Conclusion: The professional socialisation of doctors, with its emphasis on collegiality and respect, plays a significant role in the dynamics of the therapeutic relationship when a doctor treats a doctor-patient. Current guidelines make little reference to these dynamics with the over-simplified 'keep it normal' recommendations. Treating doctors need evidence-informed training to navigate these challenges and ensure they can effectively deliver quality care to their doctor-patients. [ABSTRACT FROM AUTHOR]

Conflict‐related sexual violence (CRSV) can severely impair survivors' mental health and prompt their need for mental health care. Male survivors face gender‐related barriers to disclosing experiences of sexual violence, yet the understanding of factors impeding or promoting disclosure is limited. This knowledge gap is even more pronounced regarding male disclosure in refugee settings. The high prevalence of CRSV experiences in male refugees in European host countries points to the urgency of understanding male disclosure processes along with its barriers and facilitators, in order to provide for adequate mental health care. 10 clinical experts working with male survivors of CRSV in Germany were interviewed adopting an explorative phenomenological approach and using the Problem‐Centered Interview. Qualitative content analysis yielded five themes describing male disclosure of CRSV: 1. Experiences of CRSV commonly remain nonverbalized, 2. Disclosure of CRSV is a dialogical and iterative process, 3. The process of (non‐)disclosure is a negotiation of agency, 4. Disclosure of CRSV affects the survivor's psychoemotional state, and 5. Disclosure and recovery are interdependent processes. Additionally, seven categories describing barriers to and facilitators of male disclosure were extracted: 1. trauma characteristics, 2. survivor variables, 3. clinician variables, 4. interpreter variables, 5. interpersonal variables, 6. contextual variables, and 7. sociocultural variables. Clinical experts emphasize the effectivity of a gender‐specific communicative taboo for male refugee survivors that intersect with socio‐cultural norms. Variables characterizing survivors who are at risk of not disclosing CRSV are identified. A discussion of clinical approaches to address the taboo surrounding CRSV and to support male refugee survivors in agentic disclosure and recovery is provided. [ABSTRACT FROM AUTHOR]

Background: Although fear of cancer recurrence (FCR) is the most important factor affecting the life quality of young breast cancer patients, and it may be affected by the patient's personality, marital relationship and communication, there is a lack of research on the relationship between adult attachment, self-disclosure and FCR in patients. This study investigated the current situation of FCR in young breast cancer patients, its correlation with adult attachment and self-disclosure and its influencing factors, in order to predict the impact of adult attachment and self-disclosure of patients to spouse on FCR. Methods: A survey was conducted on 126 breast cancer patients at our hospital using the General Information Questionnaire (GIQ), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Experiences in Close Relationships inventory (ECR), and Distress Disclosure Index (DDI). The study analyzed the status of FCR among young breast cancer patients and its correlation with adult attachment and self-disclosure, along with its influencing factors. Results: Among the 126 young breast cancer patients, 50 had a FoP-Q-SF score <34 (normal group), while 76 had a FoP-Q-SF score ≥34 (FCR positive group), with an FCR incidence rate of 60.32%. Univariate analysis showed statistically significant differences between the two groups in terms of FoP-Q-SF score, ECR score, attachment anxiety score, attachment avoidance score, DDI score, age, educational level, employment status, per capita monthly income, and treatment method (p < 0.05). Correlation analysis revealed that FoP-Q-SF scores were positively correlated with attachment anxiety score, attachment avoidance score, ECR scores and negatively correlated with DDI scores (p < 0.05). Linear regression analysis indicated that age, per capita monthly income, treatment method, attachment anxiety, attachment avoidance and self-disclosure level were negative predictors of FoP-Q-SF scores in young breast cancer patients (p < 0.05). Conclusion: The incidence rate of FCR among young breast cancer patients is high. There is a positive correlation between adult attachment and the level of FCR, and a negative correlation between the level of self-disclosure and FCR. Patients with lower per capita monthly income, more complex treatment methods, higher level of attachment anxiety, higher level of attachment avoidance and lower DDI scores had higher FoP-Q-SF scores. [ABSTRACT FROM AUTHOR]

Online health communities (OHCs) are able to facilitate social support exchange among people with similar health concerns, and the relationship between self-disclosure and social support exchange has been widely discussed. Build upon the previous studies, we extend the seminal theory of reasoned action (TRA) in this research, through the adoption of an salient but understudied construct, user role, which captures user inclination toward providing or seeking social support, and further explore how it impacts OHC users' self-disclosure intention. We adopt a mixed methods approach including manual coding, machine learning algorithms, and econometric analyses, and investigate over 4 million posts over 17 years from a well-developed breast cancer OHC to uncover both direct and indirect effects of user role on OHC users' intention of future self-disclosure intention. The results reveal both the main and moderating effects of user roles regarding users' self-disclosure intention. First, user with a more clear intention of social support seeking or providing are more likely to disclose personal information. Second, the relative tendency of support provision magnifies the positive effects of attitudinal and normative factors toward future disclosure. We also discuss the findings and implications of the extended TRA framework to generate some actionable insights of OHC design. [ABSTRACT FROM AUTHOR]

This study examines the alpha-generating power of the public-report-based ESG score, which is based on ESG incident data collected by RepRisk from various public sources, and its relationship with the self-disclosure-based ESG score obtained from Refinitiv. The authors construct pure ESG factor portfolios to neutralize exposure to common style factors and isolate the pure ESG factor returns. Their results suggest that (i) the source difference is the main cause of the negative correlation between the public report ESG and the self-disclosure ESG score, (ii) the public report ESG score and its subscores produce the mixed results in terms of their adjusted factor returns across regions, and (iii) the combination of the public report ESG and the self-disclosure ESG score significantly improves the risk–return profiles of the combined ESG factor returns in the United States, European Union (EU), and Japan. [ABSTRACT FROM AUTHOR]

This study examines the development of vulnerable self-disclosure in supportive interactions from ages 13 to 29. A diverse community sample (N = 184; 85 boys 99 girls; 58% white, 29% Black, 13% other identity groups) participated in annual observed interactions with close friends and romantic partners. Participants were observed as they sought and provided support to their best friends each year from age 13 to 18, and as they sought support from their romantic partners from age 19 to 29. Random intercept cross-lagged panel models were used to parse markers of within-individual change in vulnerable self-disclosure observed annually across ages 13 to 18. A follow-up regression model also investigated cascading associations from vulnerable self-disclosure in adolescent friendships to vulnerable self-disclosure in adult romantic relationships. When adolescents sought support, they demonstrated greater-than-expected increases in self-disclosure each year when their best friends demonstrated relatively high self-disclosure. For girls in this sample, when providing support, they demonstrated greater-than-expected decreases in self-disclosure each year when their best friends demonstrated relatively high self-disclosure. Adolescents whose friends disclosed highly to them also tended to express more vulnerability with romantic partners in adulthood. Post-hoc analyses investigate the role of friendship stability and gender as potential moderators of self-disclosure development. The best friendship, a key source of emotional support, serves as a foundational context for learning appropriate use of vulnerable self-disclosure when seeking and providing emotional support, which persists across time and relationships. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore how immigrant women and men from India construct mental health and mental illness in the perinatal period. Design: Qualitative interpretive design. Methods: Data were collected by conducting in‐depth interviews with 19 participants. Photo elicitation, free listing and pile sorting were used during the interviews. Purposive sampling was used, and data were collected in 2018 and 2019. Data were analysed using thematic analysis. Finding/Results: One major theme and three subthemes were identified. 'We do not talk about it' was the major theme and the subthemes: (1) 'living peacefully and feeling happy' described the views on mental health; (2) 'that's the elephant in the room still' captures how participants felt when talking about mental illness; and (3) 'why don't we talk about it' offers reasons why the Indian community does not talk about mental health and illness. Conclusion: The findings of this study have highlighted the importance of understanding the impact of immigration and being culturally sensitive when assessing mental health in the perinatal period. Impact: The findings of this study identify some of the reasons for non‐disclosure of mental health issues by immigrants. Incorporating these findings during psychosocial assessment by health professionals in the perinatal period will help translate the cultural aspects into more effective communication. Patient or Public Contribution: Patient and public contribution to the study was provided by the Community Stakeholders Group; these were members of the immigrant community from India who had expertise in mental health. They contributed to the study design and the key terms and phrases for the free list used in interviews. [ABSTRACT FROM AUTHOR]

This study examines links between self‐disclosure and relationship quality with close friends from adolescence to adulthood. A diverse community sample of adolescents (N = 184) participated in survey and observational measures annually from ages 13 through 29, along with their close friends and romantic partners. Random intercept cross‐lagged panel modeling (RICLPM) was used to parse markers of within‐individual change from age 13 to 18. Long‐term longitudinal path models also investigated cascading associations among self‐disclosure and relationship quality, on aggregate, from adolescence to adulthood. Adolescents who reported a higher‐quality friendship in a given year demonstrated greater‐than‐expected increases in self‐disclosure the following year, and an adolescent demonstrated high self‐disclosure one year reported greater‐than‐expected increases in friendship quality the following year. Higher mean self‐disclosure in adolescence predicted higher mean self‐disclosure in adulthood. Results are interpreted as identifying high‐quality adolescent friendships as key contexts for developing intimacy‐building capacities (i.e. self‐disclosure), which sets the stage for satisfying close relationships in adulthood. [ABSTRACT FROM AUTHOR]

This study investigated the relationships between personality organization, Mental Illness Attitude (MIA), and Perspectives Toward Psychotherapy (PTP) with regard to the mediating role of Emotional Self‐Disclosure (ESD) by utilizing structural equation modeling (SEM). A sample of 266 outpatients with mental health disorders was selected using a purposive sampling method. Data collection involved the use of the Inventory of Personality Organization, The Illness Attitudes Scale, Emotional Self‐Disclosure Scale, and Attitudes Toward Seeking Professional Psychological Help‐The10‐item (ATSPPH‐SF). The results revealed that personality organization, MIA, and ESD have significant associations with PTP. Also, MIA has a positive indirect relationship with PTP through ESD as a mediator, while personality organization negatively correlated to PTP through ESD. Personality organization, MIA, and ESD collectively accounted for 72.8% of the variance in PTP. Findings demonstrated an adequately fitting model about the direct and indirect associations of personality organization and MIA with PTP about the mediating role of ESD. This model has implications for psychotherapeutic and community‐based initiatives in individuals with mental health disorders. [ABSTRACT FROM AUTHOR]

Objective: Although a significant number of professionals who provide eating disorder (ED) treatment have lived experience with an ED in the past, there is no consensus on whether these professionals should use these experiences in treatment. This review aims to evaluate current literature on recovered professionals with an ED past treating ED patients, unravelling advantages and disadvantages in treatment, the impact on professionals and their surroundings, and implications for practice. Method: A systematic literature search was conducted which included 10 articles. We analysed qualitative data through a systematic synthesis. Strength of evidence was calculated for each subtheme. Results: Three themes and 14 subthemes were divided into categories. The category 'treatment (patient‐professional interaction)' was divided into: advantages, disadvantages and other implications for treatment. Additionally, the category 'professionals themselves' included subthemes that directly impact or relate to ED professionals: recovery as a non‐linear process, the significant role of self‐care and adverse feelings of professionals. Finally, the category 'work settings' included: company culture and training, supervision and professional development. Discussion: Recovered ED professionals are a promising addition to ED treatment due to the enhanced expertise of the professional. However, attention should be paid to the risk of distorted boundaries between patient and professional. Highlights: This review aims to evaluate current literature about recovered professionals with an eating disorder past treating eating disorder patients.Advantages we found were patients feeling recognised and understood with improved perspectives, and enhanced expertise of professionals.Disadvantages were distorted boundaries, the vulnerability and risk of relapse of professionals.To work as an eating disorder professional, it is important to focus on self‐care, stimulate a safe work setting and organising supervision among colleagues. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work is to examine suicide intent disclosures to identify patterns to support an improved understanding of the impetus for suicidal behavior in late life, which may offer insight useful in aiding prevention efforts. Methods: Using restricted access data from the National Violent Death Reporting System for years 2016–2018, we conducted qualitative content analysis of included narrative descriptions of 2,969 cases in which the decedent was aged 65 years or older and disclosed their intent to die by suicide. Results: The majority of suicide intent disclosures were direct statements of intent to die by suicide (37.19%), followed by a smaller proportion of indirect (implied) statements (25.29%). When response of disclosure recipient was described, such disclosures were frequently dismissed as insincere. Uncontrolled or chronic pain was cited by 11.62% of decedents as the rationale for suicide. Conclusion: Findings from this work suggest the content of suicide intent disclosures may vary considerably but demonstrate consistent patterns. Dismissal of such disclosures is a common response, likely due to inability to assess sincerity. Given the high rate of lethality among suicide attempts in late life, any intent disclosures should be critically evaluated. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic drew attention to health disparities and racism in healthcare. The first step in addressing racial disparities in healthcare is acknowledgement that there is a problem. Palliative care teams have an obligation to recognize how racism shows up in healthcare and in turn how it affects racially marginalized patients. Clinicians must engage in self-reflection by assessing their own conscious and unconscious biases that impact the clinician/patient dyad, by understanding their social location, and by using assessments and interventions that are grounded in cultural humility and awareness of racial trauma. This paper examines racism in healthcare, the psychological impact of racism when working patients, techniques for clinicians in palliative care to address their own biases, and implications for clinical practice. It includes a composite case study of a patient navigating pain management, illustrating how racism can impact the care of BIPOC and AAPI patients. [ABSTRACT FROM AUTHOR]

Objectives: Videoconference psychotherapy (VCP) is a crucial component of many health care systems, allowing for remote delivery of services. However, little is known about the mechanisms of change within VCP. Previous research has suggested that self‐disclosure may be greater in VCP than face‐to‐face modalities and was investigated in the current study. Design: Young adults aged 18–25 years (N = 57) were randomly allocated to face‐to‐face or VCP interview conditions, with measures completed pre‐ and post‐interview. Methods: Participants completed an autobiographical memory task, requiring them to describe specific memories in response to positive and negative valence cue words. Measures included self‐reported self‐disclosure, blind observer‐rated self‐disclosure, memory specificity, and mean number of words per response. Results: No significant differences were found between conditions with regard to self‐reported self‐disclosure, capacity to recall specific memories, or words uttered per response. However, observer‐rated depth of self‐disclosure was significantly higher for participants in the face‐to‐face than VCP condition. Self‐disclosure and memory specificity were also significantly greater for negative than positive valence cue words, regardless of condition. Conclusions: The findings indicate that whilst participants may be able to draw on memories with equal ease regardless of interview modality, in VCP, emotional processing of these memories may require increased support and guidance from the therapist. [ABSTRACT FROM AUTHOR]

A worrying phenomenon has emerged recently: more people are deliberately avoiding rather than seeking information regarding acquired immunodeficiency syndrome (AIDS). This is the first study to explore behaviors related to AIDS information avoidance and the potential influential factors among older men who have sex with men (MSM). We enrolled 11 older MSM from Wuhan, the largest city in central China, from January to March 2023 using a phenomenological method. This qualitative research was conducted using face-to-face semi-structured interviews. AIDS information avoidance was commonly observed among the respondents. Behaviors related to AIDS information avoidance included avoiding AIDS-related information, ignoring known AIDS information, and avoiding medical care. The main factors associated with AIDS information avoidance included information overload, high-risk sexual behaviors, over-optimism, fear of disclosure, and age. China should provide AIDS information in a manner suitable for older MSM, pay more attention to MSM over the age of 70 years, those who are not open about their sexual orientation and those who are too optimistic, and strengthen the censorship of AIDS information. [ABSTRACT FROM AUTHOR]

HIV is recognised as a multifaceted chronic disease, bearing psychosocial consequences that potentially impact on the personal and social well-being of those living with it. Adolescents and youth bear a significant proportion of the burden of the HIV epidemic but they have low rates of disclosure of their HIV status. This study aims to determine the views of adolescents living with perinatally acquired HIV on HIV status disclosure among 361 adolescents aged 15–19 in Eswatini. A cross-sectional study was conducted on adolescents who already knew their status, and data were collected using a structured questionnaire. A majority of the participants, 55% (n = 200), were females, and 44% (n = 160) were males. A low number of adolescents (22%) had disclosed their HIV status to anyone. Adolescents who found it difficult to understand disclosure themselves had low levels of onward disclosure (27%) compared to adolescents who better understood the disclosure event. Our results revealed that adolescents' prevalence of HIV status disclosure was low. This raises concerns as some of the adolescents were in relationships with partners who were not aware of their status. However, older adolescents displayed some level of disclosure self-efficacy in that a higher proportion of them disclosed better than younger adolescents. [ABSTRACT FROM AUTHOR]

Mothers experiencing homelessness are seldom asked about past trauma that may be causal to housing instability and poor health. There are also few validated trauma-focused interventions in family shelters. To address this gap, we tested the feasibility and acceptability of the trauma-focused clinical ethnographic narrative intervention (CENI-TF) in increasing mothers' trauma disclosure, appraisal of its meaning in their lives, and help-seeking behaviors. We also present the qualitative findings to contextualize the intervention. Findings are organized under three major domains and nine subthemes that capture participants' voices and experiences. The CENI-TF has the potential to promote help-seeking behaviors and interrupt recurring cycles of trauma and housing instability in this at-risk population. [ABSTRACT FROM AUTHOR]

Chatbots have several features that may stimulate self-disclosure, such as accessibility, anonymity, convenience and their perceived non-judgmental nature. The aim of this study is to investigate if people disclose (more) intimate information to a chatbot, compared to a human, and to what extent this enhances their emotional well-being through feelings of relief. An experiment with a 2 (human vs. chatbot) by 2 (low empathetic vs. high empathetic) design was conducted (N  = 286). Results showed that there was no difference in the self-reported intimacy of self-disclosure between the human and chatbot conditions. Furthermore, people perceived less fear of judgment in the chatbot condition, but more trust in the human interactant compared to the chatbot interactant. Perceived anonymity was the only variable to directly impact self-disclosure intimacy. The finding that humans disclose equally intimate information to chatbots and humans is in line with the CASA paradigm, which states that people can react in a social manner to both computers and humans. [ABSTRACT FROM AUTHOR]

The pandemic is a major public health crisis, which may bring post-traumatic stress disorder (PTSD) as well as post-traumatic growth (PTG) to healthcare professionals. The current study aimed to assess coexistence patterns of PTSD and PTG among healthcare workers during the first outbreak of Corona Virus Disease 2019 (COVID-19). It also explored whether social support and self-disclosure could predict group membership. The questionnaire survey was conducted among Chinese front-line healthcare workers three months after the first outbreak of COVID-19, and 500 valid responses were obtained. Latent class analysis (LCA) was used to analyze the data, and logistic regression was used to examine the predicting effect of social support and self-disclosure. Four latent classes were identified: low PTSD/high PTG (Class 1, 53.2%), moderate PTSD/high PTG (Class 2, 28.0%), moderate PTSD/moderate PTG (Class 3, 6.4%), and high PTSD/high PTG (Class 4, 12.4%). None of the demographic information predicted the membership. Members with "low PTSD/high PTG" were associated with high social support and high self-disclosure of distress. Meanwhile, social support and self-disclosure differentiated those with the same moderate level of PTSD but showed higher or lower PTG. The results of this study confirmed that PTSD and PTG coexist among frontline healthcare workers, and PTG is prominent among them. Social support and self-disclosure are protective factors for low-stress and high-growth combinations. [ABSTRACT FROM AUTHOR]

Background: Approximately 15% of women in low-and middle-income countries experience common perinatal mental disorders. Yet, many women, even if diagnosed with mental health conditions, are untreated due to poor quality care, limited accessibility, limited knowledge, and stigma. This paper describes how mental health-related stigma influences pregnant women's decisions not to disclose their conditions and to seek treatment in Vietnam, all of which exacerbate inequitable access to maternal mental healthcare. Methods: A mixed-method realist study was conducted, comprising 22 in-depth interviews, four focus group discussions (total participants n = 44), and a self-administered questionnaire completed by 639 pregnant women. A parallel convergent model for mixed methods analysis was employed. Data were analyzed using the realist logic of analysis, an iterative process aimed at refining identified theories. Survey data underwent analysis using SPSS 22 and descriptive analysis. Qualitative data were analyzed using configurations of context, mechanisms, and outcomes to elucidate causal links and provide explanations for complexity. Results: Nearly half of pregnant women (43.5%) would try to hide their mental health issues and 38.3% avoid having help from a mental health professional, highlighting the substantial extent of stigma affecting health-seeking and accessing care. Four key areas highlight the role of stigma in maternal mental health: fear and stigmatizing language contribute to the concealment of mental illness, rendering it unnoticed; unconsciousness, normalization, and low literacy of maternal mental health; shame, household structure and gender roles during pregnancy; and the interplay of regulations, referral pathways, and access to mental health support services further compounds the challenges. Conclusion: Addressing mental health-related stigma could influence the decision of disclosure and health-seeking behaviors, which could in turn improve responsiveness of the local health system to the needs of pregnant women with mental health needs, by offering prompt attention, a wide range of choices, and improved communication. Potential interventions to decrease stigma and improve access to mental healthcare for pregnant women in Vietnam should target structural and organizational levels and may include improvements in screening and referrals for perinatal mental care screening, thus preventing complications. [ABSTRACT FROM AUTHOR]

Discrimination because of one's stigmatized identities and personal characteristics can thwart healthy adolescent development. Little is known about the role of disclosure, including whether adolescents talk about their discrimination experiences with close relational partners (i.e., parents, siblings, friends) and whether disclosure mitigates the negative effects of discrimination. Addressing this gap, this study investigated links between adolescents' perceptions of discrimination in multiple settings (from teachers at school, from peers at school, and online) and indicators of adolescent well-being (i.e., depressive symptoms, positive identity/values, school trouble, and school bonding), and tested whether disclosure of discrimination experiences moderated these associations. Survey data from 395 parent-adolescent dyads (33% African American/Black, Hispanic/Latinx, and White, respectively) were analyzed using mixed model ANOVAs and multiple regression. Perceived discrimination was generally associated with less positive identity/values, more trouble at school and less school bonding; however, disclosure of discrimination mitigated some of these deleterious links. Adolescents' close relationships that promote disclosure therefore represent an important context that can provide protective benefits and ensure youth garner the resources and support they need for optimal development. [ABSTRACT FROM AUTHOR]

Individuals diagnosed with Crohn's disease, a chronic lifelong condition, experience a dynamic or fluctuating process of developing symptom management behavior. However, less clear is how these individuals respond to and manage their symptoms over time. The aim of this study was to longitudinally explore the symptom management experiences of individuals with Crohn's disease in China. A longitudinal qualitative design was used. Eighteen individuals with newly diagnosed Crohn's disease were purposely selected. Semi‐structured interviews were conducted on four occasions over a 12‐month period. Interviews at each time point were transcribed and coded using conventional content analysis. Afterward, data analyses of each time point were compared longitudinally to form a holistic understanding. Three themes and eight subthemes emerged from the analysis: (1) disclosing symptoms strategically: voluntary disclosure, reluctance to disclose, no need to disclose; (2) decreasing vigilance in symptom prevention: preventing symptoms stringently, preventing symptoms discriminatively, preventing symptoms with decreased diligence; and (3) increasing autonomy in symptom treatment: actively seeking medical advice, self‐treatment and self‐observation. The participants were inclined to keep symptoms hidden from relatives and friends and showed a downward trend in actively disclosing physical discomfort to medical staff within the course of 1 year. The participants' attention to symptom prevention declined, but the enthusiasm and independence to eliminate symptoms on their own increased over time. Nurses could implement targeted interventions according to the characteristics of different periods to assist individuals with Crohn's disease in managing symptoms effectively, reducing symptom burden and improving their quality of life. [ABSTRACT FROM AUTHOR]

Individuals with concealable stigma continually decide whether, and if so, how to disclose to others. These complex decision-making processes are evident across various stigmatized sexual health contexts, including sexually transmitted diseases and infections, LGBTQ+ identities, and sexual trauma, among others. One context that has received less attention within communication scholarship is difficulty orgasming among women. Due to the stigma associated with this experience, women are often reluctant to disclose their orgasm difficulties to others, especially their sexual and/or relational partners. However, the motivations women have for, and the factors they consider prior to disclosure have yet to be identified. Building upon extant sexual health communication, concealable stigma, and disclosure research, this study used semi-structured interviews (N = 31) to examine how women disclose orgasm difficulties within their sexual and/or romantic relationships. Our findings highlight several motivations women have for (non)disclosure, and various contextual and situational factors that complicate their disclosure processes. This study contributes to our theoretical understanding of the disclosure processes model (DPM) and the disclosure of concealable (sexual health) stigma. This study also offers practical insights for improving disclosure and experiences with stigma within this context. [ABSTRACT FROM AUTHOR]

Muslims in the USA experience unfair treatment and direct exposure to discriminatory acts because of their religion. Trauma stemming from discrimination can strengthen couples' relationships as they find solace in each other, or strain relationships if couples struggle to cope with the stress. This study examined the relationship between experiencing anti-Muslim hate and couples' interactional quality. Further, the role of open communication between partners in moderating the impact of anti-Muslim hate on couple interactions was examined. The study included a sample of 129 Muslim couples. The results indicated gender disparity whereby anti-Muslim hate was linked to negative interactions in relationships for Muslim women, but this was not true for their male partners. In addition, open communication had contracting gender effects on the relationship between anti-Muslim hate and couple interactions. Increased self-disclosure buffered the adverse effects of anti-Muslim hate by reducing the likelihood of negative interactions. Among women, increased self-disclosure exacerbated the detrimental effects of anti-Muslim hate on the couples' relationship such that couples engaged in more negative interactions. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The potential risks associated with administration of psychedelic drugs call for a standardized approach to patient informed consent that addresses factors such as potentially disturbing symptoms and the danger of patient exploitation, authors of a recently published article suggest. The diverse contexts for therapeutic use of these substances and the variety of providers potentially involved in their administration necessitate strong informed consent procedures, the authors explained. The special communication was published online April 10, 2024, in JAMA Psychiatry. [ABSTRACT FROM AUTHOR]

The present study explores whether a particular style of placebo disclosure could serve as a tool to foster a renewed trust in one's own inherent resources and elicit a meaningful placebo effect. In a motor performance task, two placebo groups received inert transcutaneous electrical nerve stimulation (TENS) in each of four sessions along with information on its force‐enhancing properties. Before the final session, one of the placebo groups was informed about the placebo, which was portrayed as a means to unleash an inherent potential. Along with force, we systematically monitored task‐specific self‐efficacy to test whether this variable would be differentially modulated in the two placebo groups. Compared to two control groups, placebo groups showed higher force and self‐efficacy in the last session. No differences in self‐efficacy were observed in the placebo groups even after revealing the placebo procedure, suggesting that the disclosure was effective in 'safeguarding' individuals' self‐efficacy. These findings may have important implications, paving the way for the use of placebos that not only are ethically permissible but also support individuals' self‐efficacy. [ABSTRACT FROM AUTHOR]

Single session therapy (SST) is an increasingly popular approach to mental health treatment that aims to address clients' presenting difficulties in a single appointment. However, experiential approaches to SST are limited. In this paper I describe the theory and practice of "chairwork" – an integrative, action-focused method of intervention centred on the concept of self-multiplicity – and outline how these procedures can be coherently applied in a single-session format. A preliminary protocol for delivering single-session chairwork (SSC) or "brief dialogical psychotherapy" is presented, alongside a case illustration that demonstrates features of this approach. Finally, directions for future research and the continued development of chairwork as a psychotherapeutic modality are considered. [ABSTRACT FROM AUTHOR]

Adolescents in military families may be at elevated risk for poor mental health outcomes given their developmental stage and exposure to military life stressors. Using Structural Family Theory and a family resilience lens, we examine how the family affective environment created by the roles and rules of families manifests as balanced family cohesion and balanced family flexibility, and how this family environment is related to mental health outcomes for adolescents. Furthermore, the frequency with which adolescents disclose negative emotions to their family members (including fathers, mothers, and siblings) was posited to link family environment elements and adolescent mental health. We used structural equation modeling with 201 military families that featured a Service member father, civilian mother, and adolescent age 11–18 who had at least one sibling. Across models, balanced family cohesion was directly related to adolescent mental health. Emotional disclosure to fathers and siblings was associated with better adolescent mental health. The role of emotional disclosure as a link between family affective environment and adolescent mental health depended on the family member being disclosed to and primarily emerged among fathers. Specifically, balanced family flexibility was indirectly linked to adolescent mental health via emotional disclosure to fathers. These models fit similarly among adolescent boys and girls. Potential points of intervention to support the mental health of adolescents in military families are discussed, including bolstering balanced family cohesion within the family system and addressing barriers and needed skills to encourage adolescent emotional disclosure. Highlights: In military families, balance in family cohesion is protective for adolescent mental health. In families with more balanced cohesion, adolescents disclose negative emotion to mothers more frequently. In families with more balanced flexibility, adolescents disclose negative emotion to fathers more frequently. When adolescents disclose negative emotions to fathers or siblings more frequently, they have better overall mental health. [ABSTRACT FROM AUTHOR]

Mobile technology growth in Nepal offers promising opportunities for using mobile health (mHealth) interventions to facilitate HIV prevention efforts. However, little is known about access and utilization of communication technology and their willingness to use mHealth for HIV prevention services in Nepal. We conducted a cross-sectional respondent-driven sampling survey of 250 MSM in Kathmandu Valley of Nepal from October to December 2022. We collected information on participant characteristics, HIV risk-related behaviors, ownership, or access to and frequency of use of communication technology (phones, tablets, laptops, and computers), and willingness to use mHealth to access HIV prevention services. Descriptive, bivariate, and multivariate linear regression analyses were performed. Almost all participants had smartphones with the internet (231/250, 92.4%) and accessed the internet daily (219/250, 87.6%) on the smartphone (236/250, 94.4%). The median score for willingness to use mHealth for HIV prevention was 10 (IQR: 3 to 17). Willingness to use mHealth was higher among those participants with a high school or above education (β = 0.223, p = < 0.001), had experienced violence (β = 0.231, p = 0.006), and had moderate to severe depressive symptoms (β = 0.223, p = < 0.001). However, monthly income above NPR 20,000 (USD 150) (β= -0.153, p = 0.008), disclosure of their sexual orientation to anyone (β= -0.159, p = < 0.007), and worry about being negatively judged by health care workers (β= -0.136, p = 0.023) were less willing to use mHealth strategies. The findings from this study suggest that there is a high willingness for utilizing mHealth interventions for HIV prevention in MSM population who are at higher risk of HIV acquisition. [ABSTRACT FROM AUTHOR]

Objectives: Providing personal demographic information is routine practice in the United States, and yet, little is known about the impacts of this process. This study aims to examine the experiences and perspectives of Multiracial/ethnic adults in the United States when disclosing racial/ethnic identity. Methods: Seventeen semistructured interviews were conducted with adults identifying as Multiracial/ethnic. The Multiracial/ethnic identities of participants included Black or African American and White; Black or African American, American Indian or Alaska Native (AI/AN) and Hispanic or Latino; Black or African American and Hispanic or Latino; Black or African American and AI/AN; AI/AN and White and Asian, Native Hawaiian or Pacific Islander and White. Multiple participants reported identifying with multiple ethnic groups for any single broad category. Three identified as sexual minorities. Nine were Millennials; six were Gen X; one was Gen Z; one was Baby Boomer. Qualitative data were analyzed using staged hybrid inductive–deductive thematic analysis. Results: Disclosure of racial and ethnic identities presents a unique stressor for Multiracial/ethnic populations due to methods used to obtain data, perceived mismatch of identity and phenotype and exposure to prejudice. Social norms, constructs and movements impact the categories that a Multiracial/ethnic person indicates to external parties. Conclusions: The stress and negative feelings that Multiracial/ethnic adults face when identifying their race/ethnicity underscore the broader implications of standard demographic questions on feelings of inclusivity and visibility within a population. Patient or Public Contribution: Gathering data on individuals' racial and ethnic backgrounds is a standard practice, and yet, it can pose challenges for those who identify with multiple groups or do not see their identities reflected in the options provided. Such individuals may feel excluded or experience unfair treatment when disclosing their identity, leading to significant stress. As the frequency of this data collection increases, it is essential that the questions are posed empathetically and equitably, with a strong commitment to enhancing inclusivity throughout the process. [ABSTRACT FROM AUTHOR]

Conversational technologies such as chatbots have shown to be promising in eliciting self-disclosure in several contexts. Implementing such a technology that fosters self-disclosure can help to assess sensitive topics such as behaviours that are perceived as unaccepted by others, i.e. the exposure to unaccepted (alternative) news sources. This study tests whether a conversational (chatbot) format, compared to a traditional web-based survey, can enhance self-disclosure in the political news context by implementing a two-week longitudinal, experimental research design (n = 193). Results show that users disclose unaccepted news exposure significantly more often to a chatbot, compared to a traditional web-based survey, providing evidence for a chatbots' ability to foster the disclosure of sensitive behaviours. Unlike our hypotheses, our study also shows that social presence, intimacy, and enjoyment cannot explain self-disclosure in this context, and that self-disclosure generally decreases over time. [ABSTRACT FROM AUTHOR]

This study aimed to identify components of asexual identity development and internalisation in the context of an allonormative society, with an added focus on the intersection of gender roles and romantic identities. 99 participants between the ages of 18 and 72 (M = 27.97, SD = 10.36) completed an open-ended questionnaire which was analysed using thematic analysis. Four major themes were identified: being asexual; becoming asexual; intimate social expression; and internalisation. Findings suggest that the process of discovering asexuality and identifying with the asexual community is a common experience among asexuals, and is not dependent upon a specific sexual, romantic or gender identity. Moreover, the negative ways in which many participants understand their lack of sexual attraction may be related to allonormativity and the internalisation of negative attitudes towards asexuality. However, participants' approach to disclosure and relationships, as well as their willingness to openly express their asexuality appeared to be dependent upon their gender identities and the nature of their desired relationships. Romantic-identified participants typically sought emotional intimacy and considered their asexuality to hinder their relationships, and female participants experienced greater sexual coercion when coming out. The theoretical implications of each theme within asexual identity development and internalisation are discussed. The research outlines asexual identity development within the context of a sexualised society. Evidence suggests that while discovering and adopting an asexual identity is a common experience among asexuals, disclosure and how participants navigate their relationships may be subject to other features of identity such as gender and romantic attractions. [ABSTRACT FROM AUTHOR]

The secrecy surrounding HIV continues to be a major concern for older people living with HIV (OPWH) despite their long-term experience of HIV and the presence of other chronic diseases. Our study aims to highlight how the secrecy surrounding HIV can affect the management of the other conditions. The results of this socio-anthropological sub-study of the ANRS EP66 SEPTAVIH study, which assesses frailty in OPWH, are based on in-depth interviews conducted with 20 OPWH with multimorbidities aged 70 years and over and 9 caregivers. Based on a cross-sectional thematic analysis, this study shows that HIV infection differs from other chronic diseases due to the secrecy and stigma associated with HIV. These specific issues associated with HIV complicate the lives of OPWH, depriving them of support from loved ones and forcing them to exclude their general practitioner from their care system. This then causes OPWH with multiple chronic diseases to become socially vulnerable and isolated. Interventions that support the sharing of information on HIV among OPWH and also among caregivers need to be identified as a matter of urgency in order to improve the lives and management of OPWH with multimorbidities. Trial Registration: ClinicalTrials.gov identifier: NCT03958786. [ABSTRACT FROM AUTHOR]

Survivors of intimate partner violence (IPV) often experience violent blows to the head, face, and neck and/or strangulation that result in brain injury (BI). Researchers reviewed the de-identified forensic nursing examination records of 205 women. More than 88% of women were subjected to multiple mechanisms of injury with in excess of 60% experiencing strangulation. About 31% disclosed various symptoms consistent with BI. Women experiencing strangulation were 2.24 times more likely to report BI-related symptoms compared to those who reported no strangulation. In conclusion, women experiencing IPV are prone to BI suggesting early screening and appropriate management are warranted. [ABSTRACT FROM AUTHOR]

To examine whether different types of disclosure made by climate scientists on social media influence perceived source credibility (i.e. competence, integrity, benevolence) and likability, we conducted a 2 (self-disclosure type: personal vs political) × 3 (proportion of posts including a self-disclosure: 20% vs 50% vs 80%) × 2 (gender identity of scientist: male vs female) between-subjects experiment (N = 734). We found that people liked the scientist more for a personal than political disclosure, rated them as being more competent for a political disclosure, and liked a female scientist more than a male scientist. However, scientist's gender did not moderate the effect of disclosure type or the effect of participants' gender. Our results suggest distinct benefits when scientists deliver different types of messages on social media, although disclosure is unlikely to have substantial effects on lay judgments of scientists' credibility. [ABSTRACT FROM AUTHOR]

Despite increasing societal awareness of the challenges faced by students with disabilities, students with invisible disabilities have received relatively little attention. This study explores these students' experiences, relying on interviews with 15 participants with various invisible disabilities who recently attended Israeli higher education institutions. Drawing on the analytical perspective of identity work, we explore how participants negotiate and construct their identities as students in the physical and sociocultural environments of higher education. We show that participants largely practice identity work over two continua: between presence and absence in academic spaces; and between revealing and concealing their disabilities in the context of an institutional climate underpinned by values of individualism, competition, and performativity. Through this spatial and discursive identity work, students construct their identities as abled and capable students and foster their sense of belonging in a prevailing ableist academic culture. This study explored the strategies that students with invisible disabilities develop to negotiate higher education environments and craft their student identity. Students with invisible disabilities actively shape and develop their identities in response to academic space and academic culture by positioning themselves along two continua: between presence and absences in various academic spaces; and between disclosing and concealing their disabilities. Students with invisible disabilities negotiate presence versus absence in physical spaces—in the context of physical barriers such as low temperatures, long distances, and closed spaces coupled with strict timetables and attendance requirements. Students with invisible disabilities negotiate disclosure versus concealment of disabilities—in the context of institutional expectations and requirements constructed around the image of 'normal,' that is, able-bodied, students. [ABSTRACT FROM AUTHOR]

Pregnant athletes cannot receive proper care if they choose to conceal their pregnancy. Unfortunately, many factors may lead an athlete to conceal. Whereas the extant qualitative literature suggests scholarship and sponsorship are prominent factors in the decision to disclose, this research is limited to elite athletes. To quantitatively examine predictors of pregnancy disclosure beyond scholarship and sponsorship in National Collegiate Athletic Association Division III college athletes. Cross-sectional study. Midwestern United States. Athletes on Division III women's sports teams (N = 127). Confidence in the athletic trainer (AT), perceived training and performance changes, athletic identity, and athletic identity during pregnancy. Two separate multiple regression analyses were conducted with the 4 predictors and 2 outcomes: likelihood to disclose and time to disclosure. Confidence in the AT and athletic identity during pregnancy were significant predictors in both models, whereas the variable of perceived training and performance changes was only significant in the likelihood to disclose model. Athletic identity was not a significant predictor in either model. Results suggest Division III athletes believe they would be more likely to disclose their pregnancy and may disclose sooner if they feel that their AT can properly manage their physical, emotional, and social wellness during the pregnancy. Additionally, disclosure is promoted if they believe they will still be viewed as athletes by themselves and the people around them. These findings emphasize the importance of the role of the AT, with implications that formal education of ATs should include the holistic support of the pregnant athlete. [ABSTRACT FROM AUTHOR]

Nondisclosed sport-related concussion symptoms pose a significant risk to athletes' health and well-being. Many researchers have focused on understanding the factors affecting athletes' concussion disclosure behaviors. One of the most robust predictors of the likelihood that an athlete will disclose concussion symptoms to their coaches, athletic trainers, parents, or peers is what researchers term social norms. The extant literature regarding social norms influencing concussion disclosure behaviors is inconsistent on how the construct should be defined, conceptualized, or measured, often failing to distinguish between descriptive and injunctive social norms and their sources (direct and indirect). In this technical note, we provide an overview of these critical distinctions, their importance in assessments, and examples from the literature in which scholars have correctly operationalized these constructs in athletic populations. We conclude with a brief set of suggestions for researchers seeking to measure social norms in future research. [ABSTRACT FROM AUTHOR]

Disclosure of intimate personal stories is an essential part of many marketplace conversations. In four experiments, this research investigates whether a social media influencer's sharing of sensitive self-disclosure (i.e., personal information involving risk and vulnerability) can either enhance or diminish their persuasive impact. In Study 1, we find that the impact of sensitive self-disclosure on persuasion is contingent on the expected types of influencer-audience relationships (communal vs. exchange). An influencer's sensitive self-disclosure enhances persuasion when the expected influencer-audience relationship is communal, characterized by emotional connection and mutual care. In exchange relationships, where the audience expects a more information-oriented approach, sensitive self-disclosure diminishes the influencer's persuasive impact. Study 2 demonstrates that these effects are mediated by trust in communal relationships and by perceived violations of relationship norms in exchange relationships. Studies 3 and 4 identify the boundary conditions for these effects. Study 3 shows that extremely sensitive self-disclosure, which triggers a norm violation, reduces persuasion in a communal relationship. Study 4 reveals that solicited sensitive self-disclosure, which triggers conflicting norms, increases persuasion in an exchange relationship. This research widens the scope of persuasion literature by incorporating sensitive self-disclosure as a novel framework for understanding online influencer-audience persuasion. [ABSTRACT FROM AUTHOR]

Background: HIV/AIDS continues to be a significant contributor to illness and death, particularly in sub-Saharan Africa. In this study, we conducted a qualitative assessment to understand Client and Healthcare Provider Perspectives on Differential Service Delivery Models in Uganda. The purpose was to establish strengths and weaknesses within the services delivery models, inform policy and decision-making, and to facilitate context specific solutions. Methods: Between February and April 2023, a qualitative cross-sectional study was utilised to gather insights from a targeted selection of individuals, including People Living with HIV (PLHIV), healthcare workers, HIV focal persons, community retail pharmacists, and various stakeholders. The data collection process included eleven in-depth interviews, nine key informant interviews, and eight focus group discussions carried out across eight districts in Central Uganda. The collected data was analyzed through inductive thematic analysis with the aid of Excel. Results: The various Differentiated Service Delivery Models (DSDMs), notably Community-Client-Led Drug Distribution (CCLAD), Community Drug Distribution Point (CDDP), Community Retail Pharmacy Drug Distribution Point (CRPDDP), and the facility-based Facility Based Individual Model (FBIM), were reported to have several positive impacts. These included improved treatment adherence, efficient management of antiretroviral (ARV) supplies, reduced exposure to infectious diseases, enhanced healthcare worker hospitality, minimized travel time for ART refills, stigma reduction, and decreased waiting times. Concern was raised about the lack of improvement in HIV status disclosure, opportunistic infection treatment, adherence to seasonal appointments, and sustainability due to the overreliance of the DSDMs on donor funding, suggesting potential discontinuation without funding. Doubts about health workers' commitment surfaced. Notably, the CCLAD model displayed self-sustainability, with clients financially supporting group members to collect medicines. Conclusion: Community-based DSDMs, such as CCLAD and CDDP, improve ART refill convenience, social support, and client experiences. These models reduce travel and waiting times, lowering infection risks. Addressing challenges and enhancing facility-based models is vital. In order to maintain funding after donor funding ends, sustainability measures like cross-subsidization can be used. If well implemented, the DSDMs have the potential to produce better or comparable ART outcomes compared to the FBIM model. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a marital self-disclosure programme to alleviate the fear of cancer recurrence in patients with gastric cancer who are undergoing chemotherapy. Design: Delphi method. Methods: Data from available literature and stakeholder interviews were utilised to formulate the initial draft of a marital self-disclosure programme aimed to alleviate the fear of cancer recurring in patients with gastric cancer and undergoing chemotherapy. A panel of experts subsequently conducted a tworound modified Delphi method to finalise the programme. Results: A total of 13 experts participated in the first round of consultation, while 11 experts were involved in the second round, as two experts withdrew due to unavailability. The response rates of both rounds of expert consultation were 100 and 84.62%, respectively, and the expert authority coefficients (Cr) of the programme were 0.83 and 0.84, respectively. The coordination coefficients of the expert opinions were 0.124 (χ² = 61.214, p = 0.010) and 0.167 (χ² = 69.668, p = 0.001) for each Delphi round. The average score of the second round was (4.545 ± 0.688) to (5.000 ± 0), with a full score ratio of 0.55-1.00. The coefficient of variation (CV) ranged from 0 to 0.031. Outcomes from both rounds of consultations were considered acceptable and credible. The finalised marital self-disclosure programme for alleviating the fear of cancer recurrence in patients with gastric cancer undergoing chemotherapy consists of two parts; disclosure guidance for patients and their spouse with nine items, and the structure and themes of marital self-disclosure with 31 items. Patient or public contribution: After two rounds of expert consultations, the marital self-disclosure programme for patients with gastric cancer undergoing chemotherapy is suggested to be scientifically valid and reliable. This programme is anticipated to potentially support patients and their spouses effectively by providing a reliable intervention plan focused on alleviating the fear of cancer recurrence. [ABSTRACT FROM AUTHOR]

During psychiatric diagnostic interviews, the clinician's question usually targets specific symptom descriptions based on diagnostic categories for ICD-10/DSM- 5 (2, 3). While some patients merely answer questions, others go beyond to describe their subjective experiences in a manner that highlights the intensity and urgency of those experiences. By adopting conversation analysis as a method, this study examines diagnostic interviews conducted in an outpatient clinic in South Finland and identifies sequences that divulge patients' subjective experiences. From 10 audio-recorded diagnostic interviews, 40 segments were selected where patients replied to medically or factually oriented questions with their self-disclosures. The research focus was on the clinicians' responses to these disclosures. We present five sequential trajectories that the clinicians offered third-position utterances in response to their patients' self-disclosure of subjective experiences. These trajectories include the following: 1) the clinician transfers the topic to a new agenda question concerning a medical or factual theme; 2) the clinician presents a follow-up question that selects a topic from the patient's self-disclosure of a subjective experience that may orient either towards the medical/factual side or the experiential side of the patient's telling; 3) the clinician provides an expert interpretation of the patient's selfdisclosure of his or her subjective experience from the clinician's expert perspective; 4) the clinician gives advice that orients mainly to a treatment recommendation or to another activity; and 5) the clinician presents a formulation that focusses on the core of their patient's self-disclosure of his or her subjective experience from the patient's perspective. In addition, we present what these responsive practices invoke from the patient in the next turn. We argue that an awareness of these strategies facilitates both the diagnosis and an appropriate therapeutic relationship during the psychiatric assessment interview. Finally, we discuss the clinical significance of our results regarding the patient's agency and the clinician's more conscious patient-centred orientation in the psychiatric assessment procedure. [ABSTRACT FROM AUTHOR]

The Functional Dexterity Test (FDT) is a standardized assessment used to quantify dexterity, in-hand manipulation, related to function. Recommendations to modify the scoring have been proposed to eliminate penalties, adapt the test protocol, and change the outcome parameter. A new psychometrically sound scoring system has been used in the pediatric population; however, research in the adult population requires exploration. The purpose of this study was to test if alterations in test administration, outcome recording, and outcome parameters show predictive validity for measured outcomes for age, ethnicity, and self-identified gender. The new method of administering the FDT eliminates penalties for improper performance and uses a score of speed derived from the timed score. It was theorized that eliminating assessment of reported errors in quality of movement in the quantitative scoring may improve the test validity. Clinical Measurement. The FDT was administered to 148 healthy adults aged between 18 and 78 years. No penalties were included in the quantitative scoring. Age, self-identified gender, ethnicity, and self-reported hand dominance were recorded. Time to complete the test was measured in seconds per usual protocol. The result was recorded as time and calculated as speed. Linear regression was performed to predict FDT speed from age, hand dominance, and self-identified gender. The three predictors (age, hand dominance, and gender) associated with a linear decline in dexterity were significant (p ≤0.02). Dexterity showed a linear decline with age, and participants showed faster speeds with the dominant hand. Gender was a significant predictor of speed, with males having faster speeds by an average of 0.047 pegs per second (p = 0.01). Scores using a simplified administration and speed as an outcome showed moderate predictive validity with age, gender, and the dominant hand used in this adult population. Future research exploring relationships with activities of daily living is needed. • Assessing dexterity in adults using the FDT can be done without scoring penalties. • Similar FDT administration to youth and adults streamlines use for clinicians. • Future research could establish new normative data with the revised procedure. [ABSTRACT FROM AUTHOR]

The social media industry is highly competitive, and positive word of mouth (PWOM) plays a key role in social media influencers (SMIs), that is, ordinary individuals who self-disclose personal experiences and opinions through social media platforms, gaining more followers. However, the relationship between self-disclosure (SD) and PWOM and the mechanisms underlying this relationship in the context of SMIs remain unclear. In this study, drawing from social penetration theory and the stimulus–organism–response paradigm, we developed a conceptual model to investigate the aforementioned mechanisms from the perspective of follower-perceived social relationships (i.e., transparency and psychological closeness). A total of 461 valid questionnaires were collected from SMI followers. Structural equation modeling was conducted to evaluate hypothesized associations. The results indicated that the SD of SMIs is associated with followers’ perceptions of the transparency and psychological closeness of these SMIs. These factors are also associated with followers’ PWOM. Mediation analysis confirmed that transparency and psychological closeness mediate the relationship between SD and PWOM; perceived transparency mediates the relationship between SD and perceived psychological closeness, and perceived psychological closeness mediates the relationship between perceived transparency and PWOM. By understanding the relationships between SD and followers’ PWOM and the mechanisms underlying these relationships from the perspectives of transparency and psychological closeness, we provide theoretical insights into the literature on SD and PWOM and offer suggestions for how SMIs can modify their SD practices to elicit PWOM from their followers. [ABSTRACT FROM AUTHOR]

Adolescent disclosure to parents is a key aspect of positive parent-adolescent relationships and youth adjustment. We leveraged a study of diverse families with an adolescent with type 1 diabetes to examine how observed parental empathy during parent-adolescent conflict discussions about diabetes management was associated with observed adolescent disclosure and adolescent self-reported disclosure to parents. Adolescents with type 1 diabetes and the parent most involved in their diabetes care (N = 67 dyads) participated in the study. Parent empathy, adolescent disclosure, and parent positive affect during parent-adolescent conversations were rated by trained coders. Parents reported on their own empathy and adolescents reported on their own disclosure, parental knowledge of their diabetes management, and parental acceptance. Results indicated that observed parental empathy was associated with both observed and self-reported disclosure. This association remained after covarying other parent-adolescent relationship and parent dispositional, demographic, and diabetes variables. This study holds implications for promoting greater parental communication of empathy to encourage adolescent disclosure in the context of chronic illness management. [ABSTRACT FROM AUTHOR]

This study employs multiple methods to examine why individuals engage in relational reconnection and how self-disclosure during the re-initiation process relates to well-being during a time of acute stress. We apply Social Penetration Theory to examine individuals' motivation to reconnect with dormant contacts, which channels they selected, the extent to which partners engaged in various levels of self-disclosure during relational reconnection, and how self-disclosure related to psychosocial and relational outcomes. Participants (N = 254) were recruited from Amazon Mechanical Turk to answer a series of open- and closed-ended questions relating to the most important person they reconnected with during the early stages of the COVID-19 pandemic. Qualitative thematic analysis identified ten themes driving individuals to reconnect, including relational dormancy, health checks, and reminiscing. Quantitative results showed that depth and breadth of self-disclosure in reconnected relationships were each negatively related to depression and loneliness. Breadth and depth of self-disclosure were also each positively associated with anticipation of future interaction. The ability to re-engage with former social connections showed clear associations with people's psychological and emotional well-being during the pandemic, and the findings demonstrate the central role of continued self-disclosure during relational reconnection. [ABSTRACT FROM AUTHOR]