Early maladaptive schemas in young people who self-injure.

BACKGROUND: There is emerging evidence that early maladaptive schemas (EMS) may be a cognitive vulnerability factor in nonsuicidal self-injury (NSSI). The current study sought to examine the relationship between EMS and NSSI history, and whether this is moderated by gender, in a community youth sample. METHOD: Participants were 403 Australian secondary and university students aged between 16 and 25 years, who completed a survey of NSSI history, EMS, and general emotional distress. RESULTS: Logistic regression analysis indicated that being female, depression, and EMS scores were useful for differentiating between youth reporting NSSI history and those who did not. High levels of Defectiveness/Shame and Abandonment/Instability schema scores, and low levels of Emotional Inhibition schema scores, were associated with NSSI history. Gender did not moderate the relationships between these EMS scores and NSSI history. CONCLUSIONS: Present results suggest that aspects of the schema domain of Disconnection and Rejection are important for identifying NSSI history beyond young people's emotional distress. This provides researchers and clinicians with an opportunity to better target key EMS, especially beliefs about self-defectiveness and feelings of shame, that may be driving the regulatory function of self-injury among youth.

'Old and ill': death anxiety and coping strategies influencing health professionals' well-being and dementia care.

OBJECTIVES: This paper examined the psychological factors that influence the well-being of health professionals who work with people with dementia and the types of care (person-centred or task-oriented) provided to these patients. METHODS: The literature was reviewed to identify the factors influencing the well-being of, and types of care provided by, health professionals working with people experiencing dementia. RESULTS: Based on our review of the literature, we propose that approaches to care and the well-being of health professionals working with dementia patients are influenced by the characterisation of dementia as a terminal illness that typically occurs in older people. Drawing upon terror management theory, we argue that exposure to dementia patients is likely to promote awareness of one's own mortality and death-related anxiety. A theoretical model is presented which posits that health professionals working in dementia care draw on experiential avoidance to manage this anxiety. Both death anxiety, and coping strategies, such as experiential avoidance, used to manage this anxiety may influence health professionals' approaches to care of, and attitudes towards, dementia patients. We also suggest a bi-directional relationship between health professionals' approaches to care and well-being. CONCLUSION: Recommendations are made regarding future directions for research and implications for training of health professionals providing direct service or consultation in dementia care.

Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

BACKGROUND: Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. PURPOSE: This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. METHODS: A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. RESULTS: Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. CONCLUSION: The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning development and competence to manage culturally complex clinical issues such as end of life care, and is recommended as a framework for health care students to learn the skills required to provide culturally competent care in a range of culturally complex health care settings.

Fostering cultural inclusiveness and learning in culturally mixed business classes.

BACKGROUND: Business educators have advocated that in order to build faculty's intercultural capability, it is vital to provide them with professional development in using intercultural training resources and with "community of practice" support in adapting such resources for enhancing their students' intercultural learning. This approach has been adopted in an Australian action research project titled "Internationalisation at Home" (IaH), which involved providing faculty with professional development adapted from an established intercultural training resource - the EXCELL (Excellence in Cultural Experiential Learning and Leadership) Program. CASE DESCRIPTION: In this paper, we present two case studies of the implementation of the IaH Project in business schools at the University of Canberra and at Griffith University. Lessons learned from the first study were incorporated in the design and evaluation of the second one. Faculty leaders will describe how they engage and support colleagues in adapting components of EXCELL to foster cultural inclusiveness and facilitate students' intercultural competence development. As part of project evaluation, we hypothesised that students who participated in IaH courses would report greater levels of (1) cultural inclusiveness in their educational environment, and (2) cultural learning development, compared with students who were not enrolled in IaH courses. Research participants in the Canberra case study comprised an intervention group of 140 business undergraduates enrolled in an IaH course, and a control group of 59 non-IaH undergraduates. At Griffith, participants were 211 first year management students in the intervention group and 84 students enrolled in a non-IaH first year course. DISCUSSION AND EVALUATION: In each case study, an end-of-semester survey showed that students who had completed courses with the IaH project intervention reported significantly greater levels of perceived cultural inclusiveness in multicultural classes, and of cultural learning development, than students in the control group. Faculty's reflections on project processes and outcomes further suggest that implementing strategic, structured active learning interventions such as in the IaH Project, could bring about more productive social interactions in multicultural classes and benefit domestic and especially international students. We will discuss implications of the findings for students' intercultural learning, faculty's needs for continual professional development, and the role of institutional support in intercultural competence development.

Do adolescent delinquency and problem drinking share psychosocial risk factors? A literature review.

Despite the prevalence and damaging effects of adolescent problem drinking, relative to delinquency, far less research has focused on drinking using an integrated theoretical approach. The aim of the current research was to review existing literature on psychosocial risk factors for delinquency and problem drinking, and explore whether integrating elements of social learning theory with an established psychosocial control theory of delinquency could explain adolescent problem drinking. We reviewed 71 studies published post-1990 with particular focus on articles that empirically researched risk factors for adolescent problem drinking and delinquency in separate and concurrent studies and meta-analytic reviews. We found shared risk factors for adolescent delinquency and problem drinking that are encompassed by an extension of psychosocial control theory. The potential of an extended psychosocial control theory providing a parsimonious theoretical approach to explaining delinquency, problem drinking and other adolescent problem behaviours, along with suggestions for future investigations, is discussed.