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Purpose: The aim of this study was to understand the experience of social alienation in elderly lung cancer patients, to explore its causes, and to propose targeted intervention strategies., Methods: From July to August 2023, 16 elderly lung cancer patients attending the respiratory department of a tertiary hospital in Changsha City, Hunan Province, were selected for semi-structured interviews using a purposive sampling method. The Colaizzi 7-step method was used to analyze the data., Results: A total of four themes were distilled: the experience of social alienation in elderly lung cancer patients (pessimistic feelings, inferiority complex, and heavy psychological burden), subjective causes (disease-included shame, avoidant social behavior, and stigmatized labels), objective causes (isolated social states, and reduced amount of socialization), and rehabilitation support., Conclusion: The causes of social alienation in elderly lung cancer patients include multiple aspects of personal, family, and social support, and symptom management and psychological guidance should be strengthened for this population to construct a hospital-society-family triple-linkage care program to help patients recover., Competing Interests: Conflict of interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier B.V.)

Background: Social alienation refers to the state of feeling isolated, helpless, and unsatisfied due to maintaining distance from others or avoiding social interaction and activities. This phenomenon is caused by a lack of social skills, social anxiety, physical health problems, and other reasons. Older maintenance hemodialysis patients are exposed to a higher risk of social alienation. However, previous studies have been performed using the total score of the scale, which does not allow the identification of the characteristics of various patient groups with different levels of social alienation. In contrast, latent profile analysis can classify individuals into different categories based on continuous observational indicators, which improves accuracy and provides a more objective assessment by accounting for the uncertainty of variables. Given the concealed nature of social alienation and the differences in characteristics and treatment measures between different profiles, developing a predictive model for social alienation in older maintenance hemodialysis patients holds significance., Objective: To explore the latent profile analysis of social alienation in older maintenance hemodialysis patients and to develop and validate a predictive model for social alienation in this population., Methods: A total of 350 older maintenance hemodialysis patients were selected as the study subjects using convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, the Generalized Alienation Scale, and the Self-Perceived Burden Scale. Based on the results of the Generalized Alienation Scale, a latent profile analysis was performed, followed by univariate analysis and multinomial logistic regression to develop a predictive model. The effectiveness of the predictive model was evaluated in terms of its authenticity, reliability, and predictive ability., Results: Three hundred nineteen valid questionnaires were collected. The social alienation of older maintenance hemodialysis patients based on latent profile analysis were divided into three profiles, which were named the low/medium/high-symptom groups, comprising 21%, 38.9%, and 40.1% of participants, respectively. Based on male, monthly social activity hours, Age-Adjusted Charlson Comorbidity Index, dialysis age, and Self-Perceived Burden Scale, a predictive model of social alienation for older maintenance hemodialysis patients was developed, and the Hosmer-Lemeshow tests showed no statistical significance (P > 0.05). The model has high predictive efficiency in authenticity, reliability and predictability., Conclusion: Older maintenance hemodialysis patients exhibited moderate to high levels of social alienation. The latent profile analysis based method was used to divide patients into low/medium/high-symptom profiles, and the predictive model demonstrates excellent authenticity, reliability, and predictability., (© 2024. The Author(s).)

Parental Alienation Syndrome (PAS) is a term addressed to describe negative, psychopathological feelings, thinking and behaviours, including hostility and fear, exhibited by children who have been alienated from one parent by the other parent. Despite its relevance in the clinical psychology field, theoretical and empirical contributions to understanding and deepening the many facets of this concept are still few. In particular, literature aimed at disentangling the alienating parent's psychological characteristics is scarce and fragmented. Our contribution encompasses a narrative review of scientific literature since the term PAS was coined in 1987 by Gardner, to delineate narcissistic proneness in alienating parents. Namely, considering the narcissistic drift the western society is going toward, we hypothesised that narcissism has a pivotal role in parents' alienating behaviours against the alienated ones. Firstly, the elements that emerged from our literature search confirmed our theoretical hypothesis, in terms of the likely role of narcissism/narcissistic marked traits in alienating parents. In the second section, we contextualised the phenomenon in a psychodynamic/psychoanalytic theoretical framework. Finally, based on previous findings/considerations, the developmental trajectories of children with PAS have been traced. An improved theoretical knowledge of this phenomenon, also in terms of the psychopathology associated with its genesis, means to refine the diagnostic and treatment tools to prevent it.

This study aimed to investigate the relations among perceived chronic social adversity, hope and suicidal ideation among Chinese college students. 535 college students completed the Perceived Chronic Social Adversity Questionnaire (PCSAQ), the Suicidal Ideation Scale (SIS), and the Revised Adult Dispositional Hope Scale (RADHS). The results showed that perceived chronic social adversity was positively associated with suicidal ideation, and hope was negatively associated with suicidal ideation. The results also confirmed that hope negatively moderated the relationship between perceived chronic social adversity and suicidal ideation. Further study showed that there was a significant positive relation between perceived chronic social adversity and suicidal ideation under the low hope level, however, there was a non-significant relation between perceived chronic social adversity and suicidal ideation under the high hope level., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Children with strabismus may face difficulties interacting with their peers in elementary school. This study investigates the psychosocial effect of different types of strabismus on Saudi children's selection of a playmate., Methods: Photographs of orthotropic children were digitally modified to simulate various magnitudes of strabismus. Orthotropic children with normal visual acuity viewed 18 sets of paired photographs and were asked to choose a playmate from each pair. Parents were asked to fill out a questionnaire on their socioeconomic background and to determine whether surgery should be indicated in strabismic patients for psychosocial reasons. Parents were also asked to rate their perception of seven personal characteristics of two images of the same child (one orthotropic and one strabismic)., Results: Two hundred and thirty-three children, aged 3-15 years (mean age: 9.94 [3.6] years), were studied. Children aged ≤6 years were significantly more likely not to distinguish between orthotropic children and those with strabismus ( P < 0.001). Out of 233 participants, 69.6% were significantly in favor of orthotropic faces as opposed to 30.4% ( P < 0.0001). Children perceived esotropia as less disturbing than exotropia and hypertropia ( P < 0.001). Smaller magnitudes of strabismus were significantly preferred over larger angles ( P < 0.001). Parents judged strabismic faces more negatively than orthotropic faces on all seven characteristics. Almost 88.4% of the adults thought that strabismic patients should undergo surgery for correction., Conclusions: Our findings suggest that children with apparent strabismus are perceived negatively and might be subjected to social alienation at a young age. Therefore, there is a need for strategies to address negative social bias toward children with strabismus and to enhance their peer acceptance in our society., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Middle East African Journal of Ophthalmology.)

Aim: To analyze the concept of cultural alienation BACKGROUND: Culturally diverse populations are increasing nationwide. However, many culturally diverse clients have experienced cultural alienation., Design: Rodgerian's method of concept analysis DATA SOURCE: Literature in CINAHL, PubMed, PsycINFO, JSTOR, Scopus, LGBT Life, and Oxford Bibliographic databases were searched. Inclusion criteria were full text, peer-reviewed, English language, and published within 5 years., Review Methods: Articles were read in their entirety and reread to determine more contextual data. Antecedents, attributes, and consequences were extracted., Results: Fifteen studies were included. Antecedents included: identification with racial, ethnic, sexual minority, disability, chronic illness, and threat to way of life. Attributes were traditional, different, negotiator, preserving, and sustaining. Consequences resulted in sociocultural deprivation, resistance, mistrust, distrust, loss of identity, and racism., Conclusions: Nurses, health care providers, and communities can better support and engage their clients by working together to create an inclusive environment, in which exists a safe space to work, play, and heal. Findings highlight the need to examine one's own assumptions, inquire about the client's cultural care needs, tailor communication at the client's level, acknowledge individual strengths, provide empathetic support, and promote autonomy., (© 2020 Wiley Periodicals LLC.)

Socially withdrawn children are more likely to be heterosexually inactive in early adulthood. This study aimed to test a three-mediator model. We hypothesized that social withdrawal during childhood would hinder a sense of social competence in early adolescence, limiting other-gender friendships in mid-adolescence, in turn limiting involvement in romantic relationships in late adolescence, and thus favoring a later transition into sexual activity. This mediation model was tested on a sample of 332 participants assessed annually between the ages of 12 and 22. Structural equation modeling revealed a significant indirect effect of social withdrawal on late transition into heterosexual activity through the three tested mediators. The direct effect of social withdrawal on late transition into heterosexual activity was also significant, suggesting a partial mediation.

Ehlers and Clark's (2000) cognitive model of posttraumatic stress disorder (PTSD) highlights the importance of negative appraisals in maintaining posttraumatic stress. Recent research suggests that alienation appraisals, defined as feeling disconnected from the self and others, mediate the association between traumatic experiences and subsequent PTSD symptoms. To our knowledge, no systematic review has yet explored the relation between alienation appraisals and PTSD symptoms in trauma-exposed adults, despite the important clinical implications posed by this association. A systematic search of the SCOPUS, Web of Science, PsycInfo, MEDLINE, CINAHL Plus, and PILOTS databases resulted in 470 studies, nine of which met full inclusion criteria. Studies were quality-assessed for risk of bias using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) quality assessment tool. A random-effects meta-analysis for the association between alienation appraisals and PTSD symptoms showed a large total effect size, r = .57, 95% CI [.46, .66], z = 8.41, p < .001. This large effect suggests that as alienation appraisals increase, PTSD symptoms increase. Although a strong positive association was found between alienation and PTSD symptoms, the mechanism of this association remains unclear. Limitations of the research included significant heterogeneity across studies and the fact that data were correlational. Future research to explore why alienation appraisals are significant in posttraumatic stress may further help to inform therapeutic approaches to targeting alienation appraisals in trauma survivors. Recommendations are made for the clinical assessment of alienation appraisals when exploring the impact of the traumatic experience on the survivor., (© 2020 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.)

Psychological Sense of Community (PSOC) represents a formative conceptual offering of Community Psychology to the social sciences. Nearly five decades ago, PSOC offered a window into the influence of ecological factors to understanding the emotional and behavioral well-being of members of disenfranchised and underserved segments of the population, especially members of minority and low-income subgroups. Our discipline's founders viewed PSOC as one promising vehicle for pursuing the desired paradigmatic shift from individual to systemically focused interventions to achieve intended outcomes of the emerging community mental health movement. This Commentary reflects the authors' shared thoughts to the adoption of PSOC by conservative spokespersons to explain the resistance of some to the diversification of the population and growing voice of progressive advocates., (© 2020 Wiley Periodicals LLC.)

This study examines Adolphe Quêtelet's conception of deviance. It investigates how he identified social marginalities and what actions he recommended governments to undertake. To get a close understanding of his views, this paper examines three cases of "monstrosities," namely mental alienation, drunkenness, and criminality. My main thesis is that Quêtelet provided scientific authority to a conception of deviance as sickness, immorality, and cost thus encouraging legislators to use statistics for containing social marginalities. The case of alienation shows that Quêtelet viewed insanity as a pathology of civilization to be understood through phrenology. The case of drunkenness demonstrates how Quêtelet conflated the notion of statistical mean with moral decency. The case of criminality illustrates Quêtelet's major concern with the cost of criminals for the state. While advocating for the perfectibility of mankind, Quêtelet urged governments to take actions against what he considered the monstrosities of society., (© 2019 Wiley Periodicals, Inc.)

Introduction: A growing body of evidence has demonstrated the importance of mentalization for adolescents' psychosocial functioning; however, further research is needed to understand links between mentalization and other socio-cognitive factors. The aim of this quantitative, cross-sectional study was to investigate the relationship between a teen's capacity to mentalize and three attachment-related factors: parent-teen trust, parent-teen communication, and parent-teen alienation., Methods: In an online survey, 82 (mainly) Australian adolescents (57 female; 23 male; 2 non-binary; mean age 17.09 years) completed: i) The Children's Eyes Test, which measured mentalization; and ii) The Inventory of Parent and Peer Attachment-45, which measured trust, communication quality, and alienation., Results: In teens' relationships with both mothers and fathers, trust and communication quality were significantly positively correlated (p = .001) when controlling for age and gender. Both were significantly negatively correlated with alienation (p = .001) with control variables included. Capacity to mentalize did not correlate with trust, communication quality, or alienation in relationships with either mothers or fathers (p ≤ .05)., Conclusions: Possible reasons are proposed for why no relationship was found between mentalization and trust, communication quality, or alienation. Implications for future research are discussed., Competing Interests: The authors have declared that no competing interests exist.

Boys and young men more frequently live out aspects of their psychic and social alienation online. This paper explores some of the risks and dangers that can arise from retreats into the two-dimensional world of cyberspace. It focuses more specifically on videogaming called MOBA, multi-player online battle arena games, in which players point and shoot at others. A case example emphasizes the clinical problems emerging from violent fantasies that seek a false form of containment in cyberspace. Themes of destructive fantasizing are further amplified through images of apocalypse, which are often prevalent in combat arena videogames. Textual sources from the Book of Revelation offer possible understanding for various elements of destructiveness as it appears in vulnerable male psyches. Therapeutic contact that combines a relational, containing approach and a broadly spiritual and soulful perspective can provide a path to healing such violent splits within the psyches of boys and young men., (© 2020, The Society of Analytical Psychology.)

Objectives: Pathological social withdrawal (PSW) has become a public health concern, especially in Asia. However, few studies have investigated the presence of PSW and its characteristics in Taiwan. In this study, we aimed to discover whether individuals in Taiwan display PSW behaviours, the demographic characteristics and psychiatric history of those meeting criteria for PSW and the associated psychological risks., Methods: An online self-report survey collected participants' demographic characteristics, social behaviours and their psychiatric history, along with information on adherence to cultural norms and mental health., Results: Among 1,046 valid respondents, 9% reported behaviours consistent with PSW for at least 6 months, commensurate with other online surveys in Asian countries. Around 20% of these also reported current or past psychiatric disorders, although this was lower than previous findings (50%-80%). Participants with PSW reported poorer mental health and lower confidence in social/academic/work skills than unaffected participants., Conclusion: This study identified for the first time the presence of PSW in Taiwan. Except the lower rates of psychiatric comorbidity (which could be explained by sociocultural factors and sampling methods), data were consistent with previous findings. We also extended our understanding of possible psychological risk factors associated with this pathological condition.

Background: With the increasing prevalence of obesity and the risk of increased dependency among the elderly, it becomes important to characterize the link between obesity and frailty. The relationship between obesity and social deprivation would be bidirectional, with each influencing the other., Objectives: Main objective was to study the relationship between frailty as defined by Fried and obesity (Body Mass Index (BMI) and abdominal obesity). Secondary objective was to assess the relationship between frailty and social deprivation., Materials and Methods: This was a cross-sectional study, with data collected between January 2014 and December 2015 using a senior periodic health prevention examination form used in the 4 sites of the health examination center, in Rhone, among non-institutionalized seniors (≥ 65 years). Frailty was defined according to Fried's criteria. Obesity was defined by a BMI ≥ 30 kg / m2 and a waist circumference > 88 cm for women and >102 cm for men. We studied the association between obesity according to BMI ≥ 30kg / m2 on the one hand and abdominal obesity on the other hand with frailty according to Fried. The analyzes were adjusted for gender, age, education level, not being in a relationship and social deprivation quantified by the assessment score of deprivation and health inequalities (EPICES score)., Results: 1593 senior health prevention examination forms were studied. According to BMI, senior women were almost twice as likely to be frail when obese (RR = 1.92, 95% CI [1.06 - 3.45], p = 0.018). The results were similar for abdominal obesity in women aged 65-74 years (RR = 2.12, 95% CI [1.03-4.35], p = 0.029). There was no relationship in men for both types of obesity. Seniors who were socially deprived were 2.7 times more likely to be frail than non-deprived seniors (adjusted RR = 2.76, 95% CI [1.808 - 4.203], p <0.001)., Conclusions: Obesity (BMI ≥ 30kg / m2 and high waist circumference) was associated with increased frailty among older, non-institutionalized women who came for a periodic health prevention examination. Screening and prevention of obesity in the elderly appears to be a major public health issue, and remains a priority target for action., Competing Interests: None.

Objective: identify and analyze aspects related to social vulnerability of a group of teenagers of a public all-day school with regard to harmful and abusive use of psychoactive drugs., Methods: a strategic social study, with a qualitative approach, was carried out with 49 teenagers of a public all-day secondary school. Focus groups were carried out between 2016 and 2017, and the resulting material was transcribed and analyzed by means of thematic content analysis, resulting in the following categories: The family I come from; Birds of a feather; If I'm studying, how can I work?; Drugs: a non-parallel universe., Results: social vulnerability was associated with unequal income distribution, fragile social relations affected by the harmful use of drugs and vulnerability of public all-day schools. Final considerations: all-day schools did not appear as an effective tool to break away with the context of social vulnerability regarding the use of drugs.

Introduction: The 'Hikikomori' syndrome (HS) consists of prolonged and severe social withdrawal. It has been studied first in Japan and recently has increasingly drawn the attention of researchers and clinicians all over the world. It is unclear whether it exists in other cultural contexts than Asia. The existing systematic reviews did not provide a quantitative synthesis on its prevalence. In addition, a summary of the co-occurring rates of psychiatric disorders is lacking. To provide a more comprehensive understanding of the clinical picture, it seems important to investigate which psychiatric disorders listed in the classification systems are most frequently associated with this psychological condition affecting young people. This paper describes a systematic review and meta-analysis protocol summarising worldwide prevalence of the HS in general population and clinical samples with psychiatric disorders. The review will also assess the co-occurrence between HS and each psychiatric disorder defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) in any clinical samples with psychiatric disorders., Methods and Analysis: A systematic review will be conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies will be included if they use youth aged 12-35 years, recruited from general population or population with psychiatric disorders, if they use international criteria to diagnose HS. No restriction about design or language will be applied. The search will be conducted during the first week of November 2019 by two independent reviewers through the databases Scopus, PubMed, PsycINFO, Web of Science, by examining study references, by looking for conference proceedings/dissertations/theses, by contacting study corresponding authors. Random-effect meta-analysis will be performed by computing effect sizes as logit event rates. Study quality will be assessed through the Newcastle-Ottawa Scale., Ethics and Dissemination: The current review does not require ethics approval. The results will be disseminated through conference presentations and publications in peer-reviewed journals., Prospero Registration Number: CRD 42018098747., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

A woman's social behaviour reportedly varies across the menstrual cycle. In this study, we estimated changes in sensitivity to social exclusion across the menstrual cycle and scrutinized the related role of progesterone. Forty-nine naturally cycling women played a virtual ball-tossing game (Cyberball) to manipulate social inclusion. All participants underwent inclusion and exclusion conditions during the late follicular and the luteal phase. We assessed salivary progesterone concentrations at each cycle phase. After each Cyberball session we measured positive/negative mood using the Multidimensional Mood State Questionnaire (MDMQ). Multilevel analyses indicated that women showed worse mood following exclusion as compared to inclusion conditions (p = 0.014). Notably, this exclusion effect was more pronounced during the luteal phase than the late follicular phase (p = 0.029). As expected, progesterone concentrations were higher during the luteal phase as compared to the late follicular phase, but interestingly, progesterone concentrations were negatively associated with exclusion effects. When accounting for mediation via progesterone, direct cycle-phase related differences in social exclusion effects even increased as compared to the model without mediator. These findings suggest that progesterone may function as buffer against negative feelings that result from being socially excluded. The relevance of these findings for Premenstrual Dysphoric Disorder (PMDD) are discussed, and we conclude that social exclusion may represent an important research domain criterion (RDoC) of relevance for PMDD, with progesterone pointing to new potential pharmacological targets., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: The purpose of this study was to determine the mediating role that work alienation has in the effect of loneliness at the workplace on nurses' job performance., Background: The literature includes no research on the relationship between nurses' workplace loneliness, work alienation and job performance. The study used work alienation as a mediating variable, which adds to the originality of the study. This study was carried out to contribute to relevant field research., Methods: The study used a cross-sectional research design and surveyed 138 nurses working in a public hospital in Turkey. The data were analysed using descriptive statistical methods, Pearson correlation analysis and the PROCESS macro Model 4 in the regression analysis., Results: Workplace loneliness has a negative effect on job performance. This negative effect is magnified when work alienation is used as a mediating variable., Conclusion: Nurses' loneliness at the workplace and work alienation leads to a decline in their job performance., Implications for Nursing Management: Nursing managers should take into consideration that nurses' feelings of workplace loneliness and alienation can reduce the nurses' job performance. When managers create formal and informal support networks, it can reduce nurses' negative feelings of loneliness and alienation. Thus, helping nurses to perform better at work., (© 2018 John Wiley & Sons Ltd.)

Aim: To explore and understand the experience of concealed pregnancy and develop a framework for practitioners., Background: Numerous cases of concealed pregnancy resulting in serious outcomes including maternal and perinatal death, newborn abandonment, and neonaticide are reported internationally. Historically concealed pregnancy is associated with oppressive religious cultures where premarital pregnancy was shunned. Concealed pregnancy has traditionally been viewed through a biomedical lens and associated with mental illness but this assertion remains unsubstantiated by robust evidence., Design: A Glaserian grounded theory study was undertaken., Data Sources: Thirty women were interviewed, between 2014 - 2016, on up to three occasions (46 interviews) and 22 cases of public interest were included as data., Methods: The constant comparative method and theoretical sampling which are the analytical strategies of grounded theory were used to analyse the data and generate the typology., Results: Concealed pregnancy is a fearful, life-altering, and traumatic experience. Women with a history of controlling and oppressive relationships characterized by fear respond to a crisis pregnancy by keeping it secret. Many women's relationships were characterized by emotional, mental, sexual, or physical violence. Fear for one's survival is common, may render women unable to access care or support and can be so extreme that a woman may end her own life or give birth alone., Conclusions: This typology of concealed pregnancy is intended to aid understanding the fear, trauma, and complexities associated with concealed pregnancy which is vital if practitioners are to provide sensitive, responsive and non-judgemental care., (© 2018 John Wiley & Sons Ltd.)

Background: Despite research examining the relationship between discrimination and alcohol use and delinquency among adolescents, little is understood about the mechanism behind the relationship., Objectives: On the basis of Strain Theory, the current study examined a new theoretical model in which feelings of alienation (from the self, peers, and Israeli society) mediate the relationship between discrimination and alcohol use and delinquency., Methods: A one-year follow-up study was conducted with 146 at-risk youth from the Former Soviet Union and Ethiopia in Israel (63% male), from disadvantaged low socioeconomic neighborhoods. At Time 1 (T1), adolescents were asked about their experiences of discrimination, feelings of alienation, and levels of problem alcohol use (past month/ever drunkenness, past month binge drinking, and regular daily drinking). At time 2 (T2), the participants were again asked as to their experiences of alienation, alcohol use, and delinquency., Results: Perceived discrimination at T1 significantly predicted feelings of alienation at T2, when controlling for the relationship with alienation at T1. Feelings of alienation (from the self and Israeli society) fully mediated the relationship between discrimination and alcohol use. However, there was a direct relationship between discrimination and delinquency., Conclusions: Findings emphasize the negative impact of discrimination on adolescents. They suggest that during the critical developmental period of adolescence, feelings of discrimination may be internalized into negative emotions which may lead to involvement in deviant behaviors. Results suggest a need to help adolescents process and make sense of the discriminatory experiences they perceive.

The migration is considered for a long time as a risk for mental health, to which are exposed both migrants and their descendants. Indeed, the risk of developing schizophrenia, particularly, is multiplied by 2 to 3. Today, it is offending in the 'jihadist' terrorism that bruises in countries of immigration, including France. In fact, the majority of the perpetrators of deadly attacks come from the immigrant minority. We will show that the main common factor to both phenomenons is not migration but the social exclusion which is, unfortunately often linked to it. We will also show that this exclusion is as much the fact of the host society which advocates the cultural assimilation of immigrants as that of the migrant community, trapped by its cultural defector status and its conflict of loyalty. We conclude that migration is above all an opportunity for mutual enrichment if you advocate the integration, therefore, interculturality, that is an exchange reciprocal customs and values., (© 2018 L’Encéphale, Paris.)

Purpose: We aimed to study the relationship between the mentalizing ability and stigma in patients with epilepsy., Methods: Patients with epilepsy were administered the following battery of tests: Mini-International Neuropsychiatric Interview (MINI) form, Reading the Mind in the Eyes Test (Eyes Test), Stigma Scale of Epilepsy (SSE), Internalized Stigma of Mental Illness (ISMI) Scale, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI)., Results: Assessment of an association between the Eyes Test score, ISMI Scale total score, and subscale scores revealed a negative significant correlation of Eyes Test scores with approval of stereotypes, perceived discrimination, stigma resistance, and total score. Eyes Test score and BDI scores appears to be significant predictor of internalized stigma among the clinical variables that were studied. A positive significant correlation was detected between BDI score and alienation, perceived discrimination, and total score., Conclusion: The presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: First-responder employees, including firefighters, police, and medical examiners, are at risk for the development of depression and posttraumatic stress disorder (PTSD) as a result of exposure to workplace trauma. However, pathways linking workplace trauma exposure to mental health symptoms are not well understood. In the context of social-cognitive models of depression/PTSD, we examined the role of negative cognitions as mediators of the cross-sectional and longitudinal relationship of workplace trauma exposure to symptoms of depression/PTSD in medical examiner (ME) employees., Method: 259 ME personnel were recruited from 8 sites nationwide and completed an online questionnaire assessing potential trauma exposure (i.e., exposure to disturbing cases and contact with distressed families of the deceased), negative cognitions, and symptoms of depression and PTSD, and 151 completed similar assessments 3 months later., Results: Longitudinal analyses indicated that increases in negative cognitions, and, in particular, thoughts about alienation predicted increases in depressive symptoms from Time 1 to Time 2. In cross-sectional analyses, but not longitudinal analyses, negative cognitions mediated the relationship of case exposure to symptoms of both depression and PTSD. Negative cognition also mediated the relationship of contact with distressed families to depressive symptoms. The strongest effects were for negative cognitions about being alienated from others., Conclusion: The results of this study support social-cognitive models of the development of posttraumatic distress in the workplace and have implications for the development of interventions to prevent and treat mental health symptoms in first responders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Perceived discrimination has been found to be a predictor of immigrant adolescent involvement in alcohol use, yet the psychological mechanism behind this relationship has not been well explored. Drawing on strain theory and the motivational model of alcohol use, the current study aimed to develop and test a concept of emotional alienation. In the proposed model, it is when experiences of discrimination are internalized into painful feelings of detachment, anger, rejection, and failure that the immigrant adolescent may turn to alcohol use. The study involved 365 at-risk immigrant adolescents, aged 15-19 (62% male, mean age 17.1) from the Former Soviet Union and Ethiopia in Israel, from low SES neighborhoods and community centers for youth at risk. The young people self-reported on experiences of discrimination, daily alcohol use, heavy episodic drinking (HED), and drunkenness, together with a new questionnaire examining emotional alienation developed for the study. Findings showed that experiences of alienation fully mediated the relationship between discrimination and problematic alcohol use (drunkenness and HED). In particular, feelings of self-detachment, failure, and rejection were strongly related to alcohol use. Results suggest an importance of understanding the way in which negative reactions from the host society may be internalized into destructive feelings of failure, shame, and rejection, which may lead a young person to involvement in alcohol use.

This study examined the effectiveness of LET's CONNECT (LC), a community mentorship program for youths who report peer social problems, which is based on a positive youth development framework. Participants were 218 youths (66.5% girls), aged 12 to 15 years, who were recruited from an urban medical emergency department and screened positive for bullying victimization, bullying perpetration, and/or low social connectedness. Youths were randomized to LC (n = 106) or the control condition (n = 112). Six-month outcomes were assessed with self-report measures of youth social connectedness, community connectedness, thwarted belongingness, depression, self-esteem, and suicidal ideation. LC was associated with a significant increase in only one of these outcomes, social connectedness (effect size = 0.4). It was associated consistently with trend-level positive changes for thwarted belongingness (decreased), depression (decreased), community connectedness, and self-esteem (effect sizes = 0.2). There was no effect on suicidal ideation (effect size = 0.0), and although not a primary outcome, eight youths in the LC condition and seven youths in the control condition engaged in suicidal behavior between baseline and follow-up. Although LC effect sizes are consistent with those from previous studies of community mentorship, there were multiple challenges to LC implementation that affected dosage and intervention fidelity, and that may account for the lack of stronger positive effects., (© 2018 Wiley Periodicals, Inc.)

A growing body of evidence suggests that social exclusion impairs people's capacity for active deliberation and logical reasoning. Building on this finding and on the postulate from the dual-process theory that analytical thinking is essential in order to make good judgements and decisions, we hypothesized that social exclusion will alter judgement and choice behaviour. We tested this hypothesis in three experiments in which social exclusion was manipulated using the Cyberball paradigm, an online ball-tossing game in which participants either received the ball a fair number of times or were excluded by the other two players. We focused on a range of tasks designed to be sensitive to participants' ability to engage in analytical thinking and careful deliberation, including the cognitive reflection test (Experiment 1) and a set of anchoring, intertemporal preference, disjunction, and confidence tasks (experiments 2 and 3). Our results unanimously failed to support the hypothesis that social exclusion influences people's judgements and decision-making. We discuss the implications of our findings for social exclusion theory., (© 2018 The British Psychological Society.)

Objective: To analyze publications of qualitative studies that addressed the phenomenon of violence in indigenous population., Method: Meta-synthesis of studies published in the period of 2006 to 2016, with search in the Ebsco Host, Cuiden Plus, Science Direct, Springer, and Web of Science databases., Results: A new reinterpretation of the findings was generated from the codes and categories of the primary articles. Five categories emerged: living violence, factors associated with patterns of violence, consequences of violence, interaction dynamics in situations of violence, and how to deal with violence., Conclusions: Indigenous people experience different types of violence at an early age; experienced in the family. This makes it an emerging social problem that must be taken care of urgently and represents an area of opportunity for the nursing professionals whose central focus is human care.

This article considers how the global "academic pipeline problem" constrains immigrant, low-income, and ethnic minority students' pathways to higher education, and how some students build pathways to college and career identities. After aligning theories of social capital, alienation/belonging, and challenge and their integration in Bridging Multiple Worlds Theory, we summarize six longitudinal studies based on this theory from a 23-year university-community partnership serving low-income, primarily U.S. Mexican immigrant youth. Spanning from childhood to early adulthood, the studies revealed two overarching findings: First, students built pathways to college and career identities while experiencing capital, alienation/belonging, and challenges across their evolving cultural worlds. Second, by "giving back" to families, peers, schools, and communities, students became cultural brokers and later, institutional agents, transforming institutional cultures. Findings highlight the value of integrating interdisciplinary theories, research evidence, and educational systems serving diverse communities to open individual pathways and academic pipelines in multicultural societies., (© 2018 Wiley Periodicals, Inc.)

A 'chilly' environment limits women's advancement through the educational pipeline leading to jobs in science and technology. However, we know relatively little about the environment women encounter after making it through the educational pipeline. Do technology companies create environments that may dampen women's interest at the juncture when they are launching their careers? Using original observational data from 84 recruiting sessions hosted by technology companies at a prominent university on the US West Coast, we find that company representatives often engage in behaviors that are known to create a chilly environment for women. Through gender-imbalanced presenter roles, geek culture references, overt use of gender stereotypes, and other gendered speech and actions, representatives may puncture the pipeline, lessening the interest of women at the point of recruitment into technology careers.

Objective: to understand how nurses of mental health care for psychiatric patients with clinical comorbidities., Method: qualitative study based on the referential of historical and dialectical materialism. Interviews with nurses were conducted using semi-structured script. Sample determined in snowball. The interviews were recorded and transcribed in full. The data were analyzed through content analysis, including: organization and exhaustive reading of the material, exploration, grouping data into thematic units, processing of results, and interpretation., Results: the role of nurses is marked by the dialectic between knowing and not knowing, a movement that revealed two categories: clinic of psychiatric nursing, and alienation and subordination of nurse in the care process., Final Considerations: the development of the nursing clinic, based on the therapeutic relationship, favors integral care towards the patient, whereas alienation/subordination distances the nurse from care and impairs care.

Studies on stress and its impacts on animals are very important in many fields of science, including animal science, because various stresses influence animal production and animal welfare. In particular, the social stresses within animal groups have profound impact on animals, with the potential to induce abnormal behaviors and health problems. In humans, social stress induces several health problems, including psychiatric disorders. In animal stress models, social defeat models are well characterized and used in various research fields, particularly in studies concerning mental disorders. Recently, we have focused on behavior, nutrition and metabolism in rodent models of social defeat to elucidate how social stresses affect animals. In this review, recent significant progress in studies related to animal social defeat models are described. In the field of animal science, these stress models may contribute to advances in the development of functional foods and in the management of animal welfare., (© 2017 The Authors. Animal Science Journal published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Animal Science.)

Within the theoretical framework of attachment theory, the author examined associations between adolescents' procrastination and their attachment relationships with both mothers and fathers, and explored the potential mediation role of self-worth in these associations. Participants were 384 Chinese adolescents (49.6% boys, average age 15.13 years) from public schools in Shanghai, China. They completed self-report measures of 3 dimensions of parental attachment (i.e., trust, communication, and alienation), general self-worth, and procrastination. The results indicated that both paternal and maternal trust and paternal communication were negatively associated with higher levels of procrastination whereas both paternal and maternal alienation were positively associated with procrastination. In addition, self-worth mediated the associations among 3 dimensions of parental attachment and procrastination. The findings highlighted the importance of parental attachment-based intervention strategies to reduce procrastination among adolescents.

Objective: Focusing on temporal associations between momentary (or state) loneliness, appraisal of social company, and being alone in daily life may help elucidate mechanisms that contribute to the development of prolonged (or trait) loneliness and major depressive disorder (MDD). We aim to examine if (a) a self-reinforcing loop between loneliness, negative appraisals of social company, and being alone in daily life may contribute to trait loneliness; (b) this possible self-reinforcing loop may also contribute to the development of MDD, by testing differences in temporal relationships between these social elements in participants who did or did not develop MDD during follow-up; and (c) any of these social elements at baseline predicted a MDD at follow-up., Methods: A female general population sample (n = 417) participated in an experience sampling method (ESM) study. Time-lagged analyses between loneliness, appraisal of social company, and being alone were examined at baseline, and their associations with the development of MDD during 20 months follow-up were investigated., Results: State loneliness was followed by an increase in negative appraisals of social company and a higher frequency of being alone. Further, negative appraisals of social company were associated with a higher frequency of being alone afterward. Only the latter was significant in the transition to MDD group. Trait loneliness predicted MDD during follow-up., Conclusions: Avoiding social contact after appraising company more negatively may contribute to the development of MDD.

This study aimed to untangle the mixed effects of language brokering by examining a contextual factor (i.e., parent-child alienation) and a personal attribute (i.e., resilience) that may relate to adolescents' feelings during translating (i.e., sense of burden and efficacy) and that may moderate the association between such feelings and adolescent depressive symptoms. Participants included 557 adolescent language brokers (M age  = 12.96) in Mexican-American families. Results showed that adolescents with a strong sense of alienation from parents or low resilience (a) experienced more burden or less efficacy in translating and (b) were more susceptible to the detrimental effects of feeling a sense of burden and the beneficial effects of experiencing a sense of efficacy, as measured by depressive symptoms., (© 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.)

My aim is to discuss the immediate effects of extreme trauma and to speculate on its long term effects. The formulations associated with the Post Traumatic Stress Syndrome generate an overly medicalized view of trauma, grossly underestimating its devastating impact. Catastrophic traumatic experience rips a hole in the representational continuity of psychic life; neither representations nor narrations are generated. Instead, a representational emptiness occurs, such that what has taken place cannot be shared or transmitted. The cathartic word becomes a robotic mocking of the interchange between human beings. There is no internalization, no ability to make the experience subjective. The resulting deep splitting in the psyche is characteristic of extreme traumatism, and its balance or perpetual working through is elaborated in this paper.

Alienation, i. e. disorders of the inner experience of integrity, continuity, and agency, represents a feature of both psychotic and non-psychotic disorders. Thereby, ego disturbances are thought to be specific for schizophrenia. Depersonalisation, in contrast, has been reported in schizophrenia as well as a neurotic, probably distinct syndrome. The differentiation of psychotic vs. non-psychotic alienation is often all but trivial. The present paper provides an overview of the historical roots and the psychopathological conceptualizations of alienation. Clinically relevant features of psychotic alienation are highlighted. Experience of passivity, loss of authenticity and disturbances of striving and volition appear as psychotic characteristics., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Hallucinations that involve shifts in the subjectively experienced location of the self, have been termed "out-of-body experiences" (OBEs). Early psychiatric accounts cast OBEs as a specific instance of depersonalisation and derealisation disorder (DPD-DR). However, during feelings of alienation and lack of body realism in DPD-DR the self is experienced within the physical body. Deliberate forms of "disembodiment" enable humans to imagine another's visuo-spatial perspective taking (VPT), thus, if a strong relationship between deliberate and spontaneous forms of disembodiment could be revealed, then uncontrolled OBEs could be "the other side of the coin" of a uniquely human capacity., Methods: We present a narrative review of behavioural and neuroimaging work emphasising methodological and theoretical aspects of OBE and VPT research and a potential relationship., Results: Results regarding a direct behavioural relationship between VPT and OBE are mixed and we discuss reasons by pointing out the importance of using realistic tasks and recruiting genuine OBEers instead of general DPD-DR patients. Furthermore, we review neuroimaging evidence showing overlapping neural substrates between VPT and OBE, providing a strong argument for a relationship between the two processes., Conclusions: We conclude that OBE should be regarded as a necessary implication of VPT ability in humans, or even as a necessary and potentially sufficient condition for the evolution of VPT.

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon., (© 2015 John Wiley & Sons Ltd.)

Research suggests a two factor structure for negative symptoms in patients with psychotic disorders: social amotivation (SA) and expressive deficits (ED). Applying this two-factor structure in clinical settings may provide valuable information with regard to outcomes and to target treatments. We aimed to investigate 1) whether the factor structure is also supported in chronically ill patients with a psychotic disorder and 2) what the relationship is between these factors and functioning (overall functioning and living situation), depressive symptoms and quality of life. 1157 Patients with a psychotic disorder and a duration of illness of 5 years or more were included in the analysis (data selected from the Pharmacotherapy Monitoring Outcome Survey; PHAMOUS). A confirmatory factor analysis was performed using items of the Positive and Negative Syndrome Scale that were previously identified to reflect negative symptoms (N1-4, N6, G5, G7, G13, G16). Subsequently, regression analysis was performed on outcomes. The results confirmed the distinction between SA (N2, N4, G16) and ED (N1, N3, N6, G5, G7, G13) in chronically ill patients. Both factors were related to worse overall functioning as measured with the Health of the Nation Outcome Scales, ED was uniquely associated with residential living status. Higher scores for SA were associated with more depressive symptoms and worse quality of life. Thus, SA is most strongly related to level of social-emotional functioning, while ED are more related to living situation and thereby are indicative of level of everyday functioning. This subdivision may be useful for research purposes and be a valuable additional tool in clinical practice and treatment development.

The interpersonal theory of suicide (ITS) posits that suicidal ideation is interpersonal in nature. More specifically, in the ITS, perceived burdensomeness and thwarted belongingness are dynamic cognitive-affective interpersonal states that engender suicidal ideation. However, intrapersonal (i.e., within the self) existential protective factors for suicidal ideation, such as the ability to make meaning from stressful life events, remain relatively unexplored. The authors examined the degree to which interpersonal and intrapersonal variables contribute to the variance of suicidal ideation in college students (n = 165). Results indicated that students' meaning made of stress was negatively and uniquely associated with suicidal ideation after controlling for ITS interpersonal contributions.

War and other forms of armed conflict have profound adverse effects on population health. It is important to document these effects to inform the general public and policy makers about the consequences of armed conflict, provide services to meet the needs of affected populations, protect human rights and document violations of international humanitarian law, and help to prevent future armed conflict. Documentation can be accomplished with surveillance, epidemiological surveys, and rapid assessment. Challenges include inadequate or absent data systems, social breakdown, forced migration, reporting biases, and the fog of war. The adverse effects of the Iraq War on population health demonstrate how the effects of armed conflict on population health can be documented. We recommend the establishment of an independent mechanism, operated by the United Nations or a multilateral organization, to investigate and document the effects of armed conflict on population health.

The discourse on the failings of the National Health System often cites lack of compassion as an important factor. This has resulted in proposals to enact rules which aimed at enforcing compassion in healthcare workers so as to improve the quality of healthcare and avoid future scandals. This paper argues that compassion cannot be enforced by any rule. Moreover, the contractual nature of the current doctor-patient relationship does not foster it. Experience from other service industries shows that attempts to enforce compassion in workers are futile. Rather than improving service, these attempts result in a culture of perfunctoriness and cynicism., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Objective: Three cases of rampage killings at German schools by adult outsiders were identified and analyzed. The cases took place between 1913 and 1983. To what extent do psychiatric aspects play a role and are there risk factors that can be identified und used for prevention?, Method: For the identification of risk factors the warning behavior typology was utilized which covers eight behavioral factors., Results: Severe mental problems were found in all three cases. The factors of the warning behavior typology were present in different relevance: Pathway (100 %), Fixation (100 %), Identification (33 %), novel aggression (33 %), energy burst (33 %), Leakage (66 %), last resort (66 %), directly communicated threat (0 %)., Conclusions: The prevention of such cases seems to be most promising installing a regional and interdisciplinary threat management model. The field of threat management offers a scientific frame with evidence based tools and methods.

In the experience of Saint Alban, therapeutic work is a major focus of institutional psychotherapy. What is the place today of work in the therapeutic projects led by caregivers? The principle of reality concerning our society clashes with the importance which the caregiving team attaches to work as a principle of reintegration. New opportunities for sociability and integration must be designed and bridges must be co-constructed by nurses and patients towards associations and activities in the community., (Copyright © 2015. Published by Elsevier Masson SAS.)

If being a poumista means considering that people disalienate themselves by revolutionising the world, being a poumista psychiatrist consists in taking into consideration psychological alienation and social alienation. Hence the importance of hospital committees and clubs, to give back to patients the status of a subject and to understand the question of hierarchy. The caregiver in psychiatry must bear in mind that one of the essential dimensions of their work is to "make do with" schizophrenic patients and that they must engage in everyday acts., (Copyright © 2015. Published by Elsevier Masson SAS.)

Pervasive refusal syndrome is described as a condition comprising varying degrees of refusal across several domains; social withdrawal; resistance to treatment and is potentially life threatening with no detectable organic cause. Female predominance, refusal to eat with low weight, body image distortion, depressive features, premorbid personality issues similar to eating disorders have been noted, with 67% cases having complete recovery. In this paper, we describe what is probably the first case reported from India, of a child, who presented with neuropsychiatric symptoms, and treated with electroconvulsive therapy along with medications, but, sadly had a fatal outcome., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objectives: This study examined the relationship between patients' object relations and interpersonal process in psychotherapy. Namely, we tested the hypothesis that the quality of patients' object relations is positively associated with both patient- and therapist-rated alliance quality., Design: Psychotherapy was administered naturalistically, with quantitative data collection before and during treatment., Methods: Participants included 73 adult outpatients and 23 therapists at two mental health clinics. Using the Bell Object Relations and Reality Testing Inventory, we measured four dimensions of patients' object relations at baseline-alienation, insecure attachment, egocentricity, and social incompetence. Using the Working Alliance Inventory, we measured alliance from patient and therapist perspectives. Control variables included time, patient demographics, symptom severity, and clinic. We employed hierarchical linear modelling to analyse data with a nested structure, with 138 sessions at Level 1, 73 patients at Level 2, and 23 therapists at Level 3., Results: Patient alienation and insecure attachment were associated with lower patient-rated alliance, while egocentricity was associated with higher patient-rated alliance. Patients' object relations were not significantly associated with therapist-rated alliance. On average, patients perceived the alliance more positively than their therapists, with a weak positive correlation between the alliance perspectives., Conclusions: The results suggest that object relation dimensions may be important patient characteristics for forecasting therapeutic relationship quality. They also call for more attention to differences between alliance rating perspectives., Practitioner Points: Treatment may benefit from more attention to the quality of patients' object relations. If patients present with high levels of alienation and insecure attachment, therapists may need to pay especially close attention to the therapeutic alliance, and prudently address any ruptures in its quality. When monitoring the alliance quality, it is important to consider that patients and therapists may have different perspectives. Therapists relying solely on their own perceptions are at risk of missing alliance difficulties, and patients' object relations may be uniquely predictive of their own sense of the alliance. Therefore, it may be helpful to ask patients in session and through standardized measures for feedback on how they perceive the goals and tasks of treatment and the emotional bond with their therapist. Again, any alliance tensions could then be addressed directly as a means to maintaining engagement in the service of better outcome., (© 2014 The British Psychological Society.)

The effects of acute stress on the peripheral circadian system are not well understood in vivo. Here, we show that sub-acute stress caused by restraint or social defeat potently altered clock gene expression in the peripheral tissues of mice. In these peripheral tissues, as well as the hippocampus and cortex, stressful stimuli induced time-of-day-dependent phase-advances or -delays in rhythmic clock gene expression patterns; however, such changes were not observed in the suprachiasmatic nucleus, i.e. the central circadian clock. Moreover, several days of stress exposure at the beginning of the light period abolished circadian oscillations and caused internal desynchronisation of peripheral clocks. Stress-induced changes in circadian rhythmicity showed habituation and disappeared with long-term exposure to repeated stress. These findings suggest that sub-acute physical/psychological stress potently entrains peripheral clocks and causes transient dysregulation of circadian clocks in vivo.

Abnormal hoarding of random items in the home associated with severe self-neglect and neglect of one's environment, Diogenes syndrome is transnosographic. It can affect all social classes, people without any diagnosed mental health condition or patients with psychosis or dementia, over 60s and young people. It is conveyed by self-exclusion at home, a "poor precarity" which leads to a loss of the ability to trust others and ask for help.

Self-neglect in housing has attracted growing interest from health and social care professionals over recent years. A complex issue, lying somewhere between a psychopathology and a lifestyle choice, between a private disorder and one which has consequences on the immediate environment, its clinical approach requires us to reconsider our practices to bring into being the message potential in the housing of the person presenting self-neglect.