Acute stress symptoms 1-2 weeks after stroke predict the subsequent development of post-traumatic stress symptoms: A prospective cohort study.

OBJECTIVE: To date no research has examined the potential influence of acute stress symptoms (ASD) on subsequent development of post-traumatic stress disorder (PTSD) symptoms in stroke survivors. Our objective was to examine whether acute stress symptoms measured 1-2 weeks post-stroke predicted the presence of post-traumatic stress symptoms measured 6-12 weeks later. DESIGN: Prospective within-groups study. METHODS: Fifty four participants who completed a measure of acute stress disorder at 1-2 weeks following stroke (time 1) and 31 of these participants completed a measure of posttraumatic stress disorder 6-12 weeks later (time 2). Participants also completed measures of stroke severity, functional impairment, cognitive impairment, depression, anxiety, pre-morbid intelligence and pain across both time points. RESULTS: Some 22% met the criteria for ASD at baseline and of those, 62.5% went on to meet the criteria for PTSD at follow-up. Meanwhile two of the seven participants (28.6%) who met the criteria for PTSD at Time 2, did not meet the ASD criteria at Time 1 (so that PTSD developed subsequently). A hierarchical multiple regression analysis indicated that the presence of acute stress symptoms at baseline was predictive of post-traumatic stress symptoms at follow-up (R2 = .26, p < .01). Less severe stroke was correlated with higher levels of post-traumatic stress symptoms at Time 2 (rho = .42, p < .01). CONCLUSIONS: The results highlight the importance of early assessment and identification of acute stress symptoms in stroke survivors as a risk factor for subsequent PTSD. Both ASD and PTSD were prevalent and the presence of both disorders should be assessed.

Coping with Covid-19: stress, control and coping among pregnant women in Ireland during the Covid-19 pandemic.

BACKGROUND: The aim of the current study is to investigate the relationship between perceived control, coping and psychological distress among pregnant women in Ireland during the Covid-19 pandemic. It is hypothesised that lower levels of perceived control, greater use of avoidant coping and greater Covid-19 related pregnancy concern will be associated with psychological distress. In addition, it is hypothesised that the relationship between Covid-19 related pregnancy concern and psychological distress will be moderated by perceived control and avoidant coping. METHOD: The study is cross-sectional, utilizing an online questionnaire, which was completed by 761 women in January 2021. The questionnaire includes measures of perceived control, coping style, perceived stress, anxiety and depression. RESULTS: Correlation analyses found that lower levels of perceived control were associated with higher levels of avoidant coping and psychological distress. There was also a significant positive relationship between avoidant coping and psychological distress. Using multiple regression, perceived control, avoidant coping and Covid-19 related pregnancy concern were found to predict 51% of the variance in psychological distress. However, in the moderation analysis, perceived control and avoidant coping were not found to moderate the relationship between Covid-19 related pregnancy concern and psychological distress. CONCLUSION: The results from this study suggest that pregnant women in Ireland are experiencing increased levels of psychological distress during the Covid-19 pandemic. The findings also suggest that perceptions of control and avoidant coping are associated with psychological distress in this group and could be used as intervention targets.

Military personnels' experience of deployment: An exploration of psychological trauma, protective influences, and resilience.

BACKGROUND: Military personnel are at a heightened risk of being exposed to potentially traumatic incidents in the line of duty. Evidence would suggest that the risk of developing psychological trauma and/or PTSD after a traumatic event is predicted by the interaction of pre-trauma, peri-trauma and post-trauma risk and protective factors. OBJECTIVE: This research will explore military personnels' experience of potentially traumatic events while deployed. In particular, the research aims to gain an understanding of both protective and risk factors which influence personnels' experience of potentially traumatic events. METHOD: One to one, semi-structured interviews were conducted with 12 members of the Irish Defence Forces. We conducted a thematic analysis in line with the recommendations provided by Braun & Clarke 2006. RESULTS: There was a wide variety of potentially traumatic events experienced by participants, ranging from stressful naval migrant rescues to armed standoffs. Aside from more pointed events, chronic stress was reported to negatively affect personal resilience while factors such as positive mindset and a belief in the mission had a galvanizing effect. Both the family back home and the "military family" were reported to provide sources of comfort and support, while at times being a source of significant stress. The organisational context of the military, including training and formal psychological supports was viewed with mixed opinions by our participants. CONCLUSIONS: The findings of this research illuminate the unique stress and strains faced by Irish military personnel at pre, peri and post deployment. The results highlight the need for effective predeployment resilience building programmes to equip personnel with the tools to deal with traumatic events. This foundational work provides the basis for further research into the military peacekeeper and humanitarian domain. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

PROTOCOL: Mental disorder, psychological problems and terrorist behaviour: A systematic review.

This is the protocol for a Campbell systematic review. The objectives are as follows: the first objective of the review (Objective 1-Prevalence) is to present a synthesis of the reported prevalence rates of mental health difficulties in terrorist samples. Where sufficient data is available, the synthesis will be sensitive to the heterogeneity of the terrorism phenomenon by exploring the rates of mental health difficulties for different forms of terrorism and for different terrorist roles (e.g., bombing, logistics, finance, etc.). The second objective (Objective 2-Temporality) will synthesise the extent to which mental health difficulties pre-date involvement in terrorism within prevalence studies. Finally, the third objective (Objective 3-Risk) aims to further establish temporality by examining the extent to which the presence of mental disorder is associated with terrorist involvement by comparing terrorist and non-terrorist samples.

Mental disorder, psychological problems and terrorist behaviour: A systematic review and meta-analysis.

Background: The link between mental health difficulties and terrorist behaviour has been the subject of debate for the last 50 years. Studies that report prevalence rates of mental health difficulties in terrorist samples or compare rates for those involved and not involved in terrorism, can inform this debate and the work of those responsible for countering violent extremism. Objectives: To synthesise the prevalence rates of mental health difficulties in terrorist samples (Objective 1-Prevalence) and prevalence of mental health disorders pre-dating involvement in terrorism (Objective 2-Temporality). The review also synthesises the extent to which mental health difficulties are associated with terrorist involvement compared to non-terrorist samples (Objective 3-Risk Factor). Search Methods: Searches were conducted between April and June 2022, capturing research until December 2021. We contacted expert networks, hand-searched specialist journals, harvested records from published reviews, and examined references lists for included papers to identify additional studies. Selection Criteria: Studies needed to empirically examine mental health difficulties and terrorism. To be included under Objective 1 (Prevalence) and Objective 2 (Temporality), studies had to adopt cross-sectional, cohort, or case-control design and report prevalence rates of mental health difficulties in terrorist samples, with studies under Objective 2 also needing to report prevalence of difficulties before detection or involvement in terrorism. For Objective 3 (Risk Factor) studies where there was variability in terrorist behaviour (involved vs. not involved) were included. Data Collection and Analysis: Captured records were screened in DisillterSR by two authors. Risk of bias was assessed using Joanna Briggs Institute checklists, and random-effects meta-analysis conducted in Comprehensive Meta-Analysis software. Results: Fifty-six papers reporting on 73 different terrorist samples (i.e., studies) (n = 13,648) were identified. All were eligible for Objective 1. Of the 73 studies, 10 were eligible for Objective 2 (Temporality) and nine were eligible for Objective 3 (Risk Factor). For Objective 1, the life-time prevalence rate of diagnosed mental disorder in terrorist samples (k = 18) was 17.4% [95% confidence interval (CI) = 11.1%-26.3%]. When collapsing all studies reporting psychological problems, disorder, and suspected disorder into one meta-analyses (k = 37), the pooled prevalence rate was 25.5% (95% CI = 20.2%-31.6%). When isolating studies reporting data for any mental health difficulty that emerged before either engagement in terrorism or detection for terrorist offences (Objective 2: Temporality), the life-time prevalence rate was 27.8% (95% CI = 20.9%-35.9%). For Objective 3 (Risk Factor), it was not appropriate to calculate a pooled effect size due the differences in comparison samples. Odds ratios for these studies ranged from 0.68 (95% CI = 0.38-1.22) to 3.13 (95% CI = 1.87-5.23). All studies were assessed as having high-risk of bias which, in part, reflects challenges conducting terrorism research. Author's Conclusions: This review does not support the assertion that terrorist samples are characterised by higher rates of mental health difficulties than would be expected in the general population. Findings have implications for future research in terms of design and reporting. There are also implications for practice with regards the inclusion of mental health difficulties as indicators of risk.

Pre-deployment programmes for building resilience in military and frontline emergency service personnel.

BACKGROUND: Military personnel and frontline emergency workers may be exposed to events that have the potential to precipitate negative mental health outcomes such as depression, symptoms of post-traumatic stress and even post-traumatic stress disorder (PTSD). Programmes have been designed to build psychological resilience before staff are deployed into the field. This review presents a synthesis of the literature on these "pre-deployment resilience-building programmes". OBJECTIVES: The objective of this review was to assess the effectiveness of programmes that seek to build resilience to potentially traumatic events among military and frontline emergency service personnel prior to their deployment. These resilience programmes were compared to other interventions, treatment as usual or no intervention. SEARCH METHODS: Studies were identified through searches of electronic databases including Ovid MEDLINE, Embase, PsycINFO, Web of Science and Google Scholar. The initial search took place in January 2019, with an updated search completed at the end of September 2020. SELECTION CRITERIA: Only studies that used a randomised controlled trial (RCT)/cluster-RCT methodology were included. The programmes being evaluated must have sought to build resilience prior to exposure to trauma. Study participants must have been 18 years or older and be military personnel or frontline emergency workers. DATA COLLECTION AND ANALYSIS: Studies that met the inclusion criteria were assembled. Data extracted included methods, participants' details, intervention details, comparator details, and information on outcomes. The primary outcomes of interest were resilience, symptoms of post-traumatic stress and PTSD. Secondary outcomes of interest included acute stress disorder, depression, social support, coping skills, emotional flexibility, self-efficacy, social functioning, subjective levels of aggression, quality of sleep, quality of life and stress. Assessment of risk of bias was also completed. A total of 28 studies were included in a narrative synthesis of results. MAIN RESULTS: All 28 included studies compared an experimental resilience building intervention versus a control or no intervention. There was a wide range of therapeutic modalities used, including cognitive behavioural therapy (CBT) informed programmes, biofeedback based programmes, stress-management programmes, mindfulness and relaxation programmes, neuropsychological-based programmes, and psychoeducational-informed programmes. The main outcomes are specified here, secondary outcomes such as depression, social support, coping skills, self-efficacy, subjective levels of aggression and stress are reported in text. No studies reported on the following pre-specified outcomes; acute stress disorder, emotional flexibility, social functioning, quality of sleep and quality of life. Resilience Eight studies reported resilience as an outcome. We narratively synthesised the data from these studies and our findings show that five of these interventions had success in building resilience in their respective samples. Two of the studies that reported significant results utilised a CBT approach to build resilience, while the other three successful programmes were mindfulness-based interventions. Symptoms of post-traumatic stress Our narrative synthesis of results included eight studies. Two of the eight studies produced significant reductions in symptoms of post traumatic stress compared to controls. These interventions used neuropsychological and biofeedback intervention models respectively. PTSD caseness Four studies reported PTSD caseness as an outcome. Our narrative synthesis of results suggests that evidence is mixed as to the effectiveness of these interventions in reducing clinical diagnosis of PTSD. One study of a neuropsychology-orientated Attention Bias Modification Training (AMBT) programme had success in reducing both symptoms of post-traumatic stress and numbers of participants receiving a diagnosis of PTSD. A stress-management programme reported that, when baseline differences in rates of pre-deployment mental health issues were controlled for, participants in the control condition were at 6.9 times the risk of a diagnosis of PTSD when compared to the intervention group. Given the diversity of intervention designs and theoretical orientations used (which included stress-management, neuropsychological and psychoeducational programmes), a definitive statement on the efficacy of pre-deployment programmes at reducing symptoms of post-traumatic stress and PTSD cannot be confidently offered. AUTHORS' CONCLUSIONS: While a number of evaluations of relevant programmes have been published, the quality of these evaluations limits our ability to determine if resilience-building programmes 'work' in terms of preventing negative outcomes such as depression, symptoms of post-traumatic stress and diagnoses of PTSD. Based on our findings we recommend that future research should: a) report pre-/post-means and standard deviation scores for scales used within respective studies, b) take the form of large, RCTs with protocols published in advance, and c) seek to measure defined psychological facets such as resilience, PTSD and stress, and measure these concepts using established psychometric tools. This will provide more certainty in future assessments of the evidence base. From a clinical implications point of view, overall there is mixed evidence that the interventions included in this review are effective at safe guarding military personnel or frontline emergency workers from experiencing negative mental health outcomes, including PTSD, following exposure to potentially traumatic events. Based on this, practitioners seeking to build resilience in their personnel need to be aware of the limitations of the evidence base. Practitioners should have modest expectations in relation to the efficacy of resilience-building programmes as a prophylactic approach to employment-related critical incident traumas.

Building a Predictive Model of Social-Emotional Adjustment: Exploring the Relationship between Parenting Self-Efficacy, Parenting Behaviour and Psychological Distress in Mothers of Young Children in Ireland.

The purpose of this study was to generate greater understanding of social-emotional difficulties in infants and toddlers in an Irish context. This study compared rates of reported social-emotional difficulties in young children in clinical and non-clinical samples and probed a predictive model of social-emotional adjustment. Data were collected from a cross-sectional sample of 72 mothers of young children aged between 12 and 48 months. Mothers were recruited from waiting lists for child Early Intervention services (clinical sample) and community mother-toddler groups (non-clinical sample). Mothers completed a questionnaire battery which assessed parenting self-efficacy, parenting behaviour, psychological distress and child social-emotional adjustment. The results indicated that 55.5% of young children in the clinical sample and 15% in the non-clinical sample had significant social-emotional problems. Similarly, 55.5% of young children in the clinical sample and 30% in the non-clinical sample had significant delays in the acquisition of social-emotional competencies. Two hierarchical multiple regressions were carried out with social-emotional problems and social-emotional competencies as the respective criterion variables. Clinical or non-clinical group membership, parenting satisfaction and maternal psychological distress were found to be significant predictors of child social-emotional problems in a model which explained 59% of the variance. Task-specific self-efficacy was the only significant predictor of child social-emotional competencies in a model which explained 21% of the variance. The significant rates of social-emotional problems in young children in the current study and the potential negative impact on child health and wellbeing, suggest that the early assessment of social-emotional adjustment should be incorporated into routine clinical assessment for young children. For services to effectively meet the needs of children with social-emotional difficulties and their families, consideration of maternal factors is also necessary.

Counter-narratives for the prevention of violent radicalisation: A systematic review of targeted interventions.

Background: In the field of terrorism research, the violent radicalisation of individuals towards perpetrating acts of terror has been the subject of academic enquiry for some time. One core focus by social scientists has been the role of narratives in this process. Narratives have the ability to present a socially constructed version of reality which serves the interest of the narrator(s). In the context of terrorism, by depicting violence as a viable antidote to individual vulnerabilities, the narratives purported for propagandistic purposes have the potential to thwart perceptions of instrumentality (a key characteristic of violent radicalisation). In order to prevent this from happening, researchers and counter-terrorism practitioners have increasingly sought to explore the potential for counter-narratives; targeted interventions that challenge the rationalisation(s) of violence purported in dominant narratives which, in turn, reconstructs the story. However, there is overwhelming consensus in both government and academic spheres that the concept of the counter-narrative is underdeveloped and, to date, there has been no synthesis of its effectiveness at targeting violent radicalisation-related outcomes. Objectives: The objective of this review was to provide a synthesis of the effectiveness of counter-narratives in reducing the risk of violent radicalisation. Search Methods: After a scoping exercise, the literature was identified through four search stages, including key-word searches of 12 databases, hand searches of reference lists of conceptual papers or books on the topic of counter-narratives, as well as direct contact with experts and professional agencies in the field. Selection Criteria: Studies adopting an experimental or quasiexperimental design where at least one of the independent variables involved comparing a counter-narrative to a control (or comparison exposure) were included in the review. Data Collection and Analysis: Accounting for duplicates, a total of 2,063 records were identified across two searches. Nineteen studies across 15 publications met the inclusion criteria. These studies were largely of moderate quality and 12 used randomised control trial designs with varying types of controls. The publication years ranged from 2000 to 2018, with the majority of studies published after 2015. The studies represented a range of geographical locations, but the region most heavily represented was North America. In most cases, the dominant narrative(s) "to-be-countered" comprised of hostile social constructions of an adversary or "out-group". The majority of studies challenged these dominant narratives through the use of stereotype-challenging, prosocial, or moral "exemplars". Other techniques included the use of alternative accounts, inoculation and persuasion. Results: In terms of risk factors for violent radicalisation, there was some disparity on intervention effectiveness. Overall, when pooling all outcomes, the intervention showed a small effect. However, the observed effects varied across different risk factors. Certain approaches (such as counter-stereotypical exemplars) were effective at targeting realistic threat perceptions, in-group favouritism and out-group hostility. However, there was no clear reduction in symbolic threat perceptions or implicit bias. Finally, there was a sparse yet discouraging evidence on the effectiveness of counter-narrative interventions at targeting primary outcomes related to violent radicalisation, such as intent to act violently. Authors' Conclusions: The review contributes to existing literature on violent radicalisation-prevention, highlighting the care and complexity needed to design and evaluate narrative-based interventions which directly counter existing, dominant narratives. The authors note the challenges of conducting high-quality research in the area, but nonetheless encourage researchers to strive for experimental rigour within these confines.

The identification of needs and development of best practice guidance for the psychological support of frontline healthcare workers during and after COVID-19: A protocol for the FLoWS project.

Recent estimates suggest that up to 34% of frontline workers in healthcare (FLWs) at the forefront of the COVID-19 pandemic response are reporting elevated symptoms of psychological distress due to resource constraints, ineffective treatments, and concerns about self-contamination. However, little systematic research has been carried out to assess the mental health needs of FLWs in Europe, or the extent of psychological suffering in FLWs within different European countries of varying outbreak severity. Accordingly, this project will employ a mixed-methods approach over three work packages to develop best-practice guidelines for alleviating psychological distress in FLWs during the different phases of the pandemic. Work package 1 will identify the point and long-term prevalence of psychological distress symptoms in a sample of Irish and Italian FLWs, and the predictors of these symptoms. Work package 2 will perform a qualitative needs assessment on a sample of Irish and Italian FLWs to identify sources of stress and resilience, barriers to psychological care, and optimal strategies for alleviating psychological distress in relation to the COVID-19 pandemic. Work package 3 will synthesise the findings from the preceding work packages to draft best practice guidelines, which will be co-created by a multidisciplinary panel of experts using the Delphi method. The guidelines will provide clinicians with a framework for alleviating psychological distress in FLWs, with particular relevance to the COVID-19 pandemic, but may also have relevance for future pandemics and other public health emergencies.

Coming-Out Experiences of Irish Gay Fathers Who Have Been Heterosexually Married: An Interpretative Phenomenological Analysis.

This study explores how Irish gay fathers, who married heterosexually in a heteronormative culture, assumed a settled gay identity in the Republic of Ireland. A purposive sample of nine men reflected on their experiences of marriage and separation, assuming a gay identity, and social and familial connectivity. Interpretative phenomenological analysis (IPA) indicated the suppression of gay sexual desires before marriage as a result of cultural homophobia. The coming-out process continued during the participants' marriage. Extramarital same-gender sexual desires and/or transgressions co-occurred with existential conflict (remorse) and resulted in marital separation. The marital and family loss was experienced as traumatic, and suicidal ideation occurred for most. All the men assumed an openly gay identity after separating. Many established a family-orientated same-gender repartnership. Results highlight the individuality and significance of the marital and family loss for those who separate after coming out as gay.

The female spouse: A process of separation when a husband 'comes out' as gay.

This study investigated the stories of heterosexual women who experienced a husband coming out as gay and a consequential marital separation. Interpretative phenomenological analysis (IPA) was used. Loss, anger, spousal empathy and concerns regarding societal prejudice were reported. Additional stress was experienced when others minimised the experience due to the gay sexual orientation of their husband. Experiencing positive communication with their husband during and after the disclosure aided the resolution of the emotional injury experienced by them. They all eventually 'let go' of their husband. This involved a process of reconceptualising the self as separated. Findings indicate the importance of supporting women to re-focus on their needs during and following marital dissolution. The importance of non-judgemental support for marital loss, rather than a focus on the gay sexual orientation of the spouse, was highlighted.

An exploration of the link between adult attachment and problematic Facebook use.

BACKGROUND: Previous studies have reported on positive and negative psychological outcomes associated with the use of social networking sites (SNSs). Research efforts linking Facebook use with depression and low self-esteem have indicated that it might be the manner in which people engage with the site that makes its use problematic for some people. The aim of the current study was to test a theoretical model of problematic Facebook use, using adult attachment style as the predictor variable of interest. METHOD: A cross-sectional design was employed wherein adult Facebook users (n = 717) completed measures of psychological distress, self-esteem, and adult attachment, in addition to measures of problematic Facebook use (i.e. social comparison, self-disclosures, impression management, & intrusive Facebook use). Data were analysed using hierarchical multiple regression and mediation analyses. RESULTS: The results of this study indicated that attachment anxiety was predictive of all facets of problematic Facebook use, and that attachment avoidance was predictive of impression management, and social consequences of intrusive Facebook use. Further analyses confirmed the mediating influences of psychological distress and self-esteem on these relationships. CONCLUSIONS: Users of Facebook with higher levels of attachment insecurity may be gravitating towards the site in order to fulfil their attachment needs. This tendency is likely to be particularly prevalent for those individuals with low self-esteem who are experiencing psychological distress.

Habit Strength and Adherence to Oral Contraceptives: the Role of Time- and Place-Based Cues.

PURPOSE: Non-adherence to the oral contraceptive pill (OCP) has been reported by almost half of OCP users. As the efficacy of the OCP requires daily adherence, poor adherence often leads to unplanned pregnancies in women who depend on this method of contraception. This study aims to investigate the association between habit strength and time- and place-based cues in the context of adherence to the OCP. METHODS: A cross-sectional questionnaire of 245 current OCP users with a mean age of 22.41 years (SD = 4.78) and a range of 18-52 years was conducted. The Self-Report Behavioural Automaticity Index was employed to measure habit strength. The Medication Adherence Report Scale was used and modified to refer to OCP non-adherence specifically. Additional measures were employed to assess the use of time- and place-based cues. Data were analysed using correlational analyses. RESULTS: Stronger habit strength was associated with better adherence to the OCP (r = - 0.25, p < .001). Having a fixed time of day to take the OCP was associated with habit strength and OCP adherence. Having a fixed place to store the OCP was associated with habit strength but not with OCP adherence. CONCLUSIONS: Time- and place-based cues are likely to be an important part of any intervention design to support adherence and strengthen the habit of taking the OCP. It is recommended that future replications include longitudinal study designs and analyses.

Conscientiousness and adherence to the oral contraceptive pill: a cross-sectional analysis of the facets of conscientiousness.

We examine the association between a six-facet model of conscientiousness and adherence to the Oral Contraceptive Pill (OCP), to investigate if these 6 facets can account for variation in adherence to the OCP. Cross-sectional data were collected from an opportunity sample of 243 female participants who were current users of the OCP, via online survey. Data were analysed using correlation and standard regression. The 60-item Chernyshenko Conscientiousness Scale (CCS), the 10-item IPIP Conscientiousness (IPIP C) subscale and the 5-item OCP Medication Adherence Report Scale (MARS) were employed. Both the total CCS (ρ = -0.26, p < 0.01) and the IPIP C scale (ρ = -0.22, p < 0.01) were associated with MARS. All facets measured by the CCS had small to medium-sized statistically significant correlations (r > -0.18 and r < -0.23, p < 0.05) with OCP adherence with the exception of traditionalism. Within a multivariable model, the six facets accounted for 7.1% of variance (p < 0.01) in adherence to the OCP. No one facet made a significant unique contribution to the model. These findings replicate and extend previous links between conscientiousness and OCP adherence. Further research should be conducted to establish the reliability of these findings in a general population of OCP users. Future interventions should focus on the development of interventions which take conscientiousness into consideration.

Attributional style and depressive symptoms in a male prison sample.

The reformulated learned helplessness model proposes that people who tend to make internal, stable, and global attributions in response to uncontrollable aversive events are more likely to develop depression. The present study sought to investigate the nature of the relationship between attributional style and depression in a male prison sample. One hundred and one adult male prisoners from four medium security prisons in Ireland completed the Attributional Style Questionnaire and measures of depression (BDI-II) and anxiety (BAI). Severity of self-reported depressive symptoms in the present sample was comparable to other prison and clinical samples, but higher than community samples. Participants were more severely affected by depressive symptoms than anxiety. The original attributional dimensions (i.e. internal, stable, and global) predicted a significant amount of variance in depression, but the model was not significant after controlling for anxiety. A subsequent regression model, comprising attributional dimensions for both negative events and positive events including a measure of 'uncontrollability', accounted for 35% of the variance in depression and the model retained significance while controlling for anxiety. An attributional model of depression may be relevant to the prison population and could provide a valid insight into the development and treatment of depressive symptoms in prisoners. The findings are interpreted in relation to previous research and implications for theory, clinical practice, and rehabilitation are discussed.

Impact of daylight saving time on road traffic collision risk: a systematic review.

BACKGROUND: Bills have been put forward in the UK and Republic of Ireland proposing a move to Central European Time (CET). Proponents argue that such a change will have benefits for road safety, with daylight being shifted from the morning, when collision risk is lower, to the evening, when risk is higher. Studies examining the impact of daylight saving time (DST) on road traffic collision risk can help inform the debate on the potential road safety benefits of a move to CET. The objective of this systematic review was to examine the impact of DST on collision risk. METHODS: Major electronic databases were searched, with no restrictions as to date of publication (the last search was performed in January 2017). Access to unpublished reports was requested through an international expert group. Studies that provided a quantitative analysis of the effect of DST on road safety-related outcomes were included. The primary outcomes of interest were road traffic collisions, injuries and fatalities. FINDINGS: Twenty-four studies met the inclusion criteria. Seventeen examined the short-term impact of transitions around DST and 12 examined long-term effects. Findings from the short-term studies were inconsistent. The long-term findings suggested a positive effect of DST. However, this cannot be attributed solely to DST, as a range of road collision risk factors vary over time. INTERPRETATION: The evidence from this review cannot support or refute the assertion that a permanent shift in light from morning to evening will have a road safety benefit.

Cognitive Impairment in Patients with Chronic Neuropathic or Radicular Pain: An Interaction of Pain and Age.

A growing body of empirical research has confirmed an association between chronic pain and cognitive dysfunction. The aim of the present study was to determine whether cognitive function is affected in patients with a diagnosis of chronic neuropathic or radicular pain relative to healthy control participants matched by age, gender, and years of education. We also examined the interaction of pain with age in terms of cognitive performance. Some limitations of previous clinical research investigating the effects of chronic pain on cognitive function include differences in the pain and cognitive scale materials used, and the heterogeneity of patient participants, both in terms of their demographics and pathological conditions. To address these potential confounds, we have used a relatively homogenous patient group and included both experimental and statistical controls. We have also specifically investigated the interaction effect of pain and age on cognitive performance. Patients (n = 38) and controls (n = 38) were administered a battery of cognitive tests measuring IQ, spatial and verbal memory, attention, and executive function. Educational level, depressive symptoms, and state anxiety were assessed as were medication usage, caffeine, and nicotine consumption to control for possible confounding effects. Both the level of depressive symptoms and the state anxiety score were higher in chronic pain patients than in matched control participants. Chronic pain patients had a lower estimated IQ than controls, and showed impairments on measures of spatial and verbal memory. Attentional responding was altered in the patient group, possibly indicative of impaired inhibitory control. There were significant interactions between chronic pain condition and age on a number of cognitive outcome variables, such that older patients with chronic pain were more impaired than both age-matched controls and younger patients with chronic pain. Chronic pain did not appear to predict performance on the Wisconsin Card Sorting Task, which was used a measure of executive function. This study supports and extends previous research indicating that chronic pain is associated with impaired memory and attention. Perspective: Compared to healthy control participants, patients with chronic neuropathic or radicular pain showed cognitive deficits which were most pronounced in older pain patients.

What about me? The loss of self through the experience of traumatic childbirth.

BACKGROUND AND OBJECTIVE: birth trauma has become an increasingly recognised maternal mental health issue and has important implications for both mother and infant. The importance of subjective birth experience in the development of birth trauma has been identified and may mediate the lack of theoretical consistency in this area. The current study aims to explore the subjective experience of birth trauma among first time mothers in Ireland. It aims to separate the potential effects of peripartum depression (PPD) from this in limiting this qualitative investigation to women who reported birth trauma, without PPD. DESIGN: mixed methods: Quantitative methods facilitated the recruitment of participants, the selection of a homogenous sample and addressed previous methodological flaws in birth trauma research. Interpretative Phenomenological Analysis (IPA) was used to explore the subjective experience of traumatic childbirth. PARTICIPANTS: seven, first- time mothers who reported a traumatic childbirth, without significant symptoms of PPD participated. MEASUREMENT AND FINDINGS: screening measures of birth trauma and PPD were completed by participants. A semi-structured interview was then conducted with each participant about their childbirth experience. Interviews were transcribed and analysed using IPA. The primary superordinate theme recounted how the identity and individuality of women is ignored and discounted, throughout the process of childbirth. Identity is challenged and altered as a result of women's incompatibility with the maternity system. CONCLUSIONS: this study supports the existence of birth trauma in an Irish context and highlights the subjective experience of women as central to the development of birth trauma. IMPLICATIONS FOR PRACTICE: acknowledgement and inclusion of the mother as an individual throughout the process of childbirth may be protective in limiting the experience of birth trauma.

Risk assessment and the prevention of radicalization from nonviolence into terrorism.

This article considers the challenges associated with completing risk assessments in countering violent extremism. In particular, it is concerned with risk assessment of those who come to the attention of government and nongovernment organizations as being potentially on a trajectory toward terrorism and where there is an obligation to consider the potential future risk that they may pose. Risk assessment in this context is fraught with difficulty, primarily due to the variable nature of terrorism, the low base-rate problem, and the dearth of strong evidence on relevant risk and resilience factors. Statistically, this will lead to poor predictive value. Ethically, it can lead to the labeling of an individual who is not on a trajectory toward violence as being "at risk" of engaging in terrorism and the imposing of unnecessary risk management actions. The article argues that actuarial approaches to risk assessment in this context cannot work. However, it further argues that approaches that help assessors to process and synthesize information in a structured way are of value and are in line with good practice in the broader field of violence risk assessment. (PsycINFO Database Record