A review of research on the prevalence,antecedents, consequences and prevention of workplace aggression in clinical medical practice

A broad-ranging review of the published research literature was undertaken on workplace aggression in clinical medical practice. Prevalence studies have found that 15–75% of survey respondents reported verbal aggression and 2–29% reported physical aggression in medical practice settings in the previous 6–24 months. In comparison, there was limited published research on the antecedents and consequences of clinician exposure to workplace aggression, and a dearth of published research on the prevention and minimization of workplace aggression in medical practice settings. Future research efforts need to investigate workplace aggression from all sources and across all medical clinician sub-populations in the diverse settings in which they work. Specific attention needs to be given to identifying key risk and protective factors for workplace aggression exposure, including in relation to clinician profiles, the settings and conditions of medical work, and the presence of key aggression prevention and minimization efforts, both individually and in combination. The impact of workplace aggression on clinician health, well-being, performance and work participation remains under-researched. Overall, a more extensive and robust evidence base is required to enable informed decision-making on reducing the likelihood and consequences of workplace aggression in clinical medical practice.     

Temporal considerations in the study of family firms: Reflections on “the study of organizational behaviour in family business”

We complement the work of Gagné et al. by discussing how an extended time dimension shapes organizational behaviour in family firms. Using insights from family dynamics, identity theory, and social identity theory, we show how early formative experiences in the family can influence commitment, conflict, and motivation in family firms. Then we examine how a family's intention to pass on the firm to later generations can impact leadership, human-resources practices, and corporate cultures.     

A puzzle about natural laws and the existence of God

The existence of natural laws, whether deterministic or indeterministic, and whether exceptionless or ceteris paribus, seems puzzling because it implies that mindless bits of matter behave in a consistent and co-ordinated way. I explain this puzzle by showing that a number of attempted solutions fail. The puzzle could be resolved if it were assumed that natural laws are a manifestation of God’s activity. This argument from natural law to God’s existence differs from its traditional counterparts in that, whereas the latter seek to explain the fact of natural laws, the former seeks to explain their possibility. The customary objections to the traditional arguments cannot be successfully adapted to counter this new argument, with one exception which has only limited effect. I rebut four claims that the theistic solution to the puzzle about natural laws is paradoxical, though I concede that one of these claims has merit. I consider four objections to the new argument but find three of them more or less unsatisfactory. The fourth, if successful, would undermine our claims to know the truth about the world.     

The Impact Message Inventory–Circumplex (IMI–C): A Replication Study of Its Circumplex Structure in a Dutch Sample

The 56-items Impact Message Inventory–Circumplex (IMI–C) has been developed to describe the interpersonal styles of target persons in terms of the 2-dimensional interpersonal circle, divided in 8 subscales (octants). The IMI–C is based on the assumption that a target person's interpersonal styles can validly be measured by assessing the internal (cognitive and emotional) reactions of the IMI–C respondent (e.g., therapists), interacting with the target person (e.g., psychotherapy patients). This replication study tested the circumplexity of a computer-delivered Dutch IMI–C. The computer-delivered Dutch IMI–C approached circumplexity in a large clinical sample (N = 812) of psychotherapy and psychiatric patients, after removing 3 items from the Submissive octant scale. These 3 items clearly disturbed the IMI–C circumplex structure. It is concluded that, even with the inevitable problem of nested data, circumplexity was approached sufficiently to justify the interpretation of the IMI–C at the octant level, provided that the 3 troublesome Submissive items are removed from the calculations of octant scores. Our replication test of the Dutch IMI–C circumplexity might be an impetus for researchers in the United States to invest in the further validation of the original American version.     

Income and neighbourhood‐level inequality predict self‐esteem and ethnic identity centrality through individual‐ and group‐based relative deprivation: A multilevel path analysis

Although income and inequality (objective measures of deprivation and the distribution of income within a defined area, respectively) predict people's self‐appraisals, the psychological mechanisms underlying these relationships are largely unknown. We address this oversight by predicting that feeling individually deprived (individual‐based relative deprivation [IRD])—a self‐focused appraisal—mediates the relationship between these two objective measures and self‐esteem. Conversely, believing that one's group is deprived (group‐based relative deprivation [GRD])—a group‐focused appraisal—mediates the relationship between these two objective measures and ethnic identity centrality. We examined these predictions in a national sample of New Zealand adults (N = 6349). As expected, income negatively correlated with IRD and GRD; in turn, IRD negatively correlated with self‐esteem, and GRD positively correlated with ethnic identity centrality. Moreover, after accounting for between‐level variability in income, neighbourhood‐level inequality had indirect effects on self‐esteem and ethnic identity centrality through IRD and GRD, respectively. Thus, income and inequality independently predicted self‐esteem and strength of ingroup identification through distinct mechanisms. Copyright © 2015 John Wiley & Sons, Ltd.     

The Medical School Curate: An Examination of Student Need

The intense and encompassing nature of medical education can be overwhelming at times. The impact that this effect has on a student can be mitigated if adequately trained, spiritually focused advisors are available and present within the campus setting. This article presents real case examples of, and recommendations for, the role of medical school chaplaincies and why those chaplaincies should be a part of the culture of medical education.     

Are community studies of psychological trauma's impact accurate? A study among Jews and Palestinians

We evaluated the accuracy of posttraumatic stress disorder (PTSD) and major depression (MD) diagnoses using brief assessment instruments conducted by phone. PTSD and MD were assessed by telephone interview in a randomly selected sample of Jewish and Palestinian residents of Jerusalem (N = 150) during a period of marked threat of terrorism and war. We utilized the PTSD Symptom Scale Interview Format (Foa, Riggs, Dancu, & Rothbaum, 1993) and the Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001). We then conducted in-depth, in-person interviews within 2 weeks, assessing PTSD and MD using the Composite International Diagnostic Interview (CIDI; Kessler et al., 2004). The prevalence of PTSD and MD diagnosis ascertained by the 2 assessment modalities was similar. Indices of classification accuracy for the phone interview, using the in-person interview as the standard, ranged from modest to high. Brief phone and in-depth in-person measures of PTSD and MD also correlated similarly with other demographic, stress, and coping factors, suggesting convergent validity. Brief phone interviews appear useful for estimating the prevalence of psychological disorders in mass casualty contexts and may have a critical role in both epidemiologic work and guiding public health interventions.     

Reliability and Validity of the Thai “Global Person Generated Index”, an Individualised Measure of Quality of Life

The “Global Person Generated Index” (GPGI) is an individualised measure of global quality of life (QoL). Individualised measures have been used within a health context, however until recently have been rarely used to explore global QoL. This paper establishes the GPGI’s validity and reliability in Thailand. Data were collected from participants in two sites in Northeast Thailand. Participants completed the Thai GPGI, the “Satisfaction with Life Scale”(SWLS), a modified “Positive and Negative Affect Scale” (PANAS) and provided demographic data. 81 participants provided data at T1. 70 participants completed data for test-retest (two week interval) reliability comparisons. Test-retest reliability correlation was 0.678 (p < 0.001) for participants reporting no change in QoL. GPGI correlated moderately with SWLS (0.381, p < 0.01) and PANAS scales (0.291 and −0.378, both p < 0.01), indicating validity. GPGI scores were related to health and correlated to a moderate degree with income (0.379, p < 0.05). GPGI scores did not show the expected differences in scores based on gender, although this may be owing to cultural issues. Areas nominated as important to QoL included family, money, house, health and employment, which mirrors items on other QoL scales and previous work with individualised measures. The Thai GPGI is reliable for group comparisons and valid. The difficulties of designing cross-cultural construct validity hypotheses are acknowledged. Areas nominated as important to QoL were diverse and largely asset based. The GPGI is recommended for use to explore global QoL and potentially useful for needs assessment and exploration of response shift.     

Thriving and Ethnic Discrimination: A Mixed‐Methods Study

Using mixed methodology, the authors examined facilitators to psychological thriving—or positive changes after adversity—in the context of ethnic discrimination among Latina/o adults. Several themes emerged from qualitative interviews (n = 10), including proving others wrong, ethnic identity, and community involvement. Quantitative analyses (n = 97) indicated that U.S. identity moderated the relationship between ethnic microaggressions and thriving such that high levels of U.S. identity were associated with lower thriving. Implications and future directions are discussed. Usando una metodología mixta, los autores examinaron los facilitadores de la prosperidad psicológica (o cambios positivos tras la adversidad) en el contexto de la discriminación étnica en personas latinas adultas. Varios temas surgieron de las entrevistas cualitativas (n = 10), entre los que se incluyen demostrar que otros estaban equivocados, la identidad étnica y la implicación de la comunidad. Los análisis cuantitativos (n = 97) indicaron que la identidad estadounidense moderó la relación entre las microagresiones étnicas y la prosperidad de tal modo que unos altos niveles de identidad estadounidense se asociaron con una baja prosperidad. Se discuten las implicaciones y direcciones futuras.     

The Diabetes Family Behavior Checklist: A Psychometric Evaluation

The Diabetes Family Behavior Checklist (DFBC) assesses supportive and non-supportive parental behavior specific to diabetes management via parent and child reports. The DFBC was administered to 133 children with type 1 diabetes (T1D) and their caregivers. Subsequent analysis verified the two-factor structure of the DFBC corresponding to positive and negative support behaviors. Internal consistency was high for DFBC scores. Moderate to strong correlations with other measures of diabetes-specific familial behaviors, adherence, and metabolic control support the validity of the DFBC. Clinical application of the DFBC is discussed.