Work Stressors,Social Support,and Burnout in Junior Doctors: Exploring Direct and Indirect Pathways

The study tested a pathway model linking different occupational stressors, different sources of social support, and burnout. A sample of 184 junior medical doctors was used. Pathway analysis suggested that doctors who experienced increased time demands, organizational constraints, and a lack of personal confidence perceived their consultants as less supportive, whereas those who experienced greater clinical responsibility perceived their supervisors as more supportive. A lack of support from coworkers was linked with a lack of support from consultants, top management, and family. The perception of consultant support was linked with lower burnout, whereas the perception of coworker support was linked with higher burnout. The present findings may inform interventions aimed to support junior doctors experiencing burnout.     

Religious Involvement Measurement Model in a National Sample of African Americans

This study examined the factor structure of a brief measure of religious involvement developed previously in research with African American women. Telephone interview methods were used with a national sample of both African American women and men (N = 2,370). Confirmatory factor analyses supported the distinction between religious beliefs and religious behaviors factors and indicated that the factor loadings were equivalent for women and men. Women reported higher levels of religious involvement than men. These results support the validity of this relatively brief instrument for assessing these two dimensions of religious involvement for both African American women and men.     

Seeking Balance: Decision Support Needs of Women Without Cancer and a Deleterious BRCA1 or BRCA2 Mutation

Recommendations for women with a deleterious BRCA1 or BRCA2 gene mutation include complex medical approaches related to cancer risk reduction and detection. Current science has not yet fully elucidated decision support needs that women face when living with medical consequences associated with known hereditary cancer risk. The purpose of this study was to describe health communication and decision support needs in healthy women with BRCA1/2 gene mutations. The original researchers completed an interpretive secondary qualitative data analysis of 23 phenomenological narratives collected between 2008 and 2010. The Ottawa Decision Support and Patient Centered Communication frameworks guided the study design and analysis. Women described a pattern wherein breast and ovarian cancer risk, health related recommendations and decisions, and personal values were prioritized over time based on life contexts. Knowing versus acting on cancer risk was not a static process but an ongoing balancing act of considering current and future personal and medical values, further compounded by the complexity of recommendations. Women shared stories of anticipatory, physical and psychosocial consequences of the decision making experience. The findings have potential to generate future research questions and guide intervention development. Importantly, findings indicate a need for ongoing, long-term, support from genetics professionals and decision support interventions, which challenges the current practice paradigm.     

Promoting spiritual well-being: a quasi-experimental test of an element of Hay and Nye’s theory of children’s spirituality

This study is one of the first tests of key implicit claims of Hay and Nye’s theory of children’s spirituality and spiritual development. Two quasi-experimental studies tested two claims: that exposure to six conditions posited as fostering relational consciousness in a programme of spiritual formation promotes spiritual well-being; that the effect of the conditions continues after exposure ends. The results for Study One revealed that length of exposure to any of the six conditions was not a significant predictor of spiritual well-being, F(3, 179)?=?1.49, p = 0.22. Study Two results indicated that as the length of time since exposure increased so did spiritual well-being, r(38)?=?0.39, p = 0.01 at the bivariate level, and F(4, 35)?=?2.4, p = 0.06 in the regression. These results reveal a possible relationship between exposure to the six conditions and spiritual well-being.     

Mother-Infant Psychotherapy Informed by Polyvagal Theory

This article illustrates the psychotherapeutic treatment of a 2-month-old male experiencing separation distress and problems in his regulatory system that were influencing the relationship with his mother. The baby was the product of a pregnancy complicated by maternal mental illness, homelessness, alcohol and drug exposure, lack of prenatal care, and a complicated delivery that required a 12-day hospital stay in the Neonatal Intensive Care Unit. The mother-infant psychotherapy was carried out over a two-year period and demonstrates the sensitive care needed when working with an overaroused and fearful baby and the critical ways that holding the mother in mind allows her in turn to hold her baby in mind. In this situation, the therapist provided an emotionally attuned interpersonal therapeutic relationship and created features of safety in the environment that helped develop new models of trust. We report here on an innovative program that provides health, mental health, onsite childcare, parenting education, and in-patient substance abuse services to mothers who are pregnant and/or parenting infants in the first three years of life. The specific purpose of the article is to discuss the mother-infant therapeutic treatment of a constitutionally challenged baby who was over aroused and fearful, and that we consider serves as an example for showing the favorable ways that holding the mother in mind free her to be emotionally available to the infant.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.