Identifying violence among women patients attending family practices: the role of research in community change

Violence against women has serious consequences. Although victims use health facilities more frequently than others, violence is still not recognized in most services and in the larger community. This study had three aims: (1) to estimate the prevalence of violence among women patients in primary care, (2) to evaluate the feasibility of asking all women about violence, and (3) to make violence visible, and thereby initiate a process of professional and community change on the issue of violence against women. The study was carried out in a small Italian town, at the initiative of a local family doctor. We conducted a cross‐sectional survey among patients of six family practices and 444 women responded to a self‐administrated questionnaire. Five per cent of respondents experienced physical or sexual violence in the last year, and 25% had experienced it in the past. Nineteen per cent had experienced psychological violence in the last 12 months. Risk factors for current violence were: younger age, being pregnant or with young children, being separated or divorced, or lack of stable employment. Most women were in favour of being asked about violence by their doctor. The study's results were disseminated in public meetings, with good press coverage. This resulted in a dramatic increase in the visibility of victims of violence, the development of a training course for health professionals, and the creation of the first women's group in the town. Along with advocacy work, the group has prepared a booklet on violence addressing women, and is now raising funds to start an ‘anti‐violence’ telephone line. Overall, the study has become a tool for change within the health services and the community. Copyright © 2004 John Wiley & Sons, Ltd.     

Faces of Shame: Implications for Self-Esteem,Emotion Regulation,Aggression, and Well-Being

There is an increasing interest in psychological research on shame experiences and their associations with other aspects of psychological functioning and well-being, as well as with possible maladaptive outcomes. In an attempt to confirm and extend previous knowledge on this topic, we investigated the nomological network of shame experiences in a large community sample (N = 380; 66.1% females), adopting a multidimensional conceptualization of shame. Females reported higher levels of shame (in particular, bodily and behavioral shame), guilt, psychological distress, emotional reappraisal, and hostility. Males had higher levels of self-esteem, emotional suppression, and physical aggression. Shame feelings were associated with low self-esteem, hostility, and psychological distress in a consistent way across gender. Associations between characterological shame and emotional suppression, as well as between bodily shame and anger occurred only among females. Moreover, characterological and bodily shame added to the prediction of low self-esteem, hostility, and psychological distress above and beyond the influence of trait shame. Finally, among females, emotional suppression mediated the influence of characterological shame on hostility and psychological distress. These findings extend current knowledge on the nomological net surrounding shame experiences in everyday life, supporting the added value of a multidimensional conceptualization of shame feelings.     

The contribution of self-efficacy beliefs to dispositional shyness: on social-cognitive systems and the development of personality dispositions

This longitudinal research explored the impact of self-efficacy beliefs on self-reported tendencies to experience shyness in interpersonal encounters among a population of adolescents studied over a two-year period. Self-efficacy measures, taken at the initial measurement period, included indices of perceived self-efficacy for forming and maintaining social relationships, dealing effectively with parents, managing negative emotions, and expressing positive emotions towards others. Levels of self-reported shyness as well as emotional stability were assessed also at time 1, with shyness measured again at the follow-up assessment two years later. Structural equation modeling indicated that two of the four self-efficacy measures uniquely contributed to levels of shyness reported at time 1, and that perceptions of social self-efficacy uniquely contributed to shyness at time 2 even when considering the effects of time 1 shyness levels. Emotional stability did not uniquely contributed to time 2 shyness after considering the relation between shyness at the first and second measurement points. The broad implications of social-cognitive analyses for the study of personality development are discussed.     

Semantic access processing in a supra-modal deficit: a single case study

The case is presented of a semantic dementia patient, who shows a deficit selective for (i) conceptual class (living things), (ii) attribute processing (visual features) and affecting (iii) input-output modalities at the same processing stage (matching stored representation to attributes). The first experimental part aims at exploring the specific stage/process at which semantic knowledge breaks down through multi-modality tasks, devised to tap different levels within the semantic elaboration flow. The second focuses on the differences between category vs. attribute knowledge across various modalities. The core nature of the patient's deficit is investigated through a close comparison of her damage to a specific processing stage across modalities in the light of her class and attribute-specific impairment. The complex pattern of findings is discussed according to current theoretical accounts of semantic memory organization. Finally, the relevance of the adoption of a broad perspective when dealing with semantic memory impairments is highlighted.     

The link between stress,well-being,and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

Background/Objective: Prolonged stress can overwhelm coping resources, leading people to seek mental health care. Acceptance and commitment therapy (ACT) is an intervention that enhances well-being and reduces distress, assumedly by means of increasing psychological flexibility (PF). We examined the association between a total increase in PF during an intervention and decreases in stress and increases in well-being during and after the intervention. Method: The intervention was a randomized controlled trial of an ACT-based self-help intervention. Participants were 91 individuals reporting elevated levels of work-related stress. Measurements were completed at preintervention, postintervention, and 3-month follow-up. Results: Structural equation models revealed that the total increase in PF during the intervention was negatively associated with a decrease in stress (b = -0.63, SE = 0.14, p < .001) and positively associated with an increase in well-being during the intervention (b = 0.48, SE = 0.11, p < .001), but not with a decrease in stress (b = 0.03, SE = 0.27, p > .05) and well-being (b = -0.04, SE = 0.39, p > .05) following the intervention. Conclusions: Our study provides empirical support for decreasing stress and promoting well-being through ACT and emphasizes the potential of PF in promoting well-being.     

Adolescents’ regulatory emotional self-efficacy beliefs and daily affect intensity

Self-efficacy beliefs in emotion regulation were shown to foster well-being and psychosocial adaptation over time. In this study, we investigated their relationship with daily affect intensity among 199 adolescents aged 15–19. Participants completed the Regulatory Emotional Self-Efficacy Scale measuring perceived capability to manage the experience and expression of negative emotions (SE-NE) and positive emotions (SE-PO). Through Experience Sampling Method, for 1 week they also repeatedly rated their positive affect (happiness and contentment) and negative affect (anger, anxiety, sadness). Multilevel regression models revealed an additive intensifying predictive effect of SE-PO and SE-NE on happiness and contentment, and a single direct negative effect of SE-NE on sadness. Models also highlighted an interactive effect of SE-PO and SE-NE on all negative affect variables, such that only at low SE-PO levels did high SE-NE predict lower negative affect. Findings support the relation between adolescents’ regulatory emotional self-efficacy beliefs and their daily affect intensity, bringing forward suggestions for intervention.     

Exploring User-Centred Design in Practice: Some Caveats

This paper provides a nuanced perspective on the topic of user-centred design (UCD) in the human–computer interaction (HCI) field. After a brief outline of its emergence, we describe some of the central tenets of the approach, using the process model of Gulliksen et al. (Behav Inf Technol 22(6):397–409, 2003) as a well-documented exemplar. We then examine in more detail some of the difficulties one can encounter in performing user-centred design (UCD), illuminating these issues through vignettes from specific projects in which we have been involved. In this paper, we focus on issues that can arise in working with children and with people of differing mental abilities. Our argument is that, while a user-centred perspective is required at all times in the design team, the forms of participation of users in the design process needs to fit the context and can vary significantly from that presented as the prototypical UCD approach.