How do power and hierarchy influence staff safety in maternity services?

Background There are considerable tensions for healthcare staff between their employee allegiance and contracts, patient safety, and their responsibilities to codes of conduct within professional registration, and the NHS Constitution. Aims The research aim was to identify how power and hierarchy influence staff safety in maternity services and this was achieved by reviewing research papers concerned with personal narratives of staff experiences and perspectives of employment in their profession. Methods This systematic narrative review was based on the approach of a narrative synthesis, with papers coded using Nvivo software. Findings Power and hierarchy influence staff safety in maternity services by creating challenges to staff safety, which appear to essentially derive from poor communication. The workplace adversity described by participants seems to be linked with 1) psychological vulnerability 1.1) anxiety about the job, and 1.2) dysfunctional relationships, alongside 2) working conditions 2.1) poor organisational and structural conditions 2.2) institutional normalisation of dysfunctional relationships and 2.3) interpersonal elements feeding into an obstructive culture. Conclusion The negative influences of the cultural concepts of power and hierarchy on staff safety are significant within maternity services. Disconfirmation findings, those which stood out as different from the rest, evidenced the possibilities that healthy, psychologically safe working conditions could offer for healthcare staff in improving their prevailing culture.

The study of the features of the psychological component of gestational dominance as an indicator of the formation of dysfunctional relationships in the ‟mother-child” system in women of different age categories

The article provides an analysis of the work on the problem of the specifics of the formation of the psychological component of gestational dominance (PCGD) in women with the peculiarities of the psycho-emotional state and residence of the pregnancy period. It is assumed that the features of the PCGD may be an indicator of the formation of dysfunctional relationships in the "mother-child" system and reflect the characteristics of maternal ontogenesis. Sample included pregnant women with different age categories. The method was Pregnancy attitude test of Igor’ Dobryakov. The author's approach of quantitative analysis was used in the processing of the results. It is concluded that there are significant differences in each of the types of relationships that form during pregnancy in women of different age groups, namely, in relation to pregnancy, mother, childbirth, to breastfeeding, to close significant in the face of their own mother, established by correlational analysis.

Listening to voices: understanding and self-management of auditory verbal hallucinations in young adults

AimsAuditory Verbal Hallucinations (AVH) are a hallmark of psychosis, but affect many other clinical populations. Patients’ understanding and self-management of AVH may differ between diagnostic groups, change over time, and influence clinical outcomes.We aimed to explore patients’ understanding and self-management of AVH in a young adult clinical population.Method35 participants reporting frequent AVH were purposively sampled from a youth mental health service, to capture experiences across psychosis and non-psychosis diagnoses. Diary and photo-elicitation methodologies were used – participants were asked to complete diaries documenting experiences of AVH, and to take photographs representing these experiences. In-depth, unstructured interviews were held, using participant-produced materials as a topic guide. Conventional content analysis was conducted, deriving results from the data in the form of themes.ResultThree themes emerged: (1)Searching for answers, forming identities – voice-hearers sought to explain their experiences, resulting in the construction of identities for voices, and descriptions of relationships with them. These identities were drawn from participants’ life-stories (e.g., reflecting trauma), and belief-systems (e.g., reflecting supernatural beliefs, or mental illness). Some described this process as active / volitional. Participants described re-defining their own identities in relation to those constructed for AVH (e.g. as diseased, 'chosen', or persecuted), others considered AVH explicitly as aspects of, or changes in, their personality.(2)Coping strategies and goals – patients’ self-management strategies were diverse, reflecting the diverse negative experiences of AVH. Strategies were related to a smaller number of goals, e.g. distraction, soothing overwhelming emotions, 'reality-checking', and retaining agency.(3)Outlook – participants formed an overall outlook reflecting their self-efficacy in managing AVH. Resignation and hopelessness in connection with disabling AVH are contrasted with outlooks of “acceptance” or integration, which were described as positive, ideal, or mature.ConclusionTrans-diagnostic commonalities in understanding and self-management of AVH are highlighted - answer-seeking and identity-formation processes; a diversity of coping strategies and goals; and striving to accept the symptom. Descriptions of “voices-as-self”, and dysfunctional relationships with AVH, could represent specific features of voice-hearing in personality disorder, whereas certain supernatural/paranormal identities and explanations were clearly delusional. However, no aspect of identity-formation was completely unique to psychosis or non-psychosis diagnostic groups. The identity-formation process, coping strategies, and outlooks can be seen as a framework both for individual therapies and further research.

Domestic violence at the time of the COVID-19 pandemic in Bosnia and Herzegovina

The subject of this paper is domestic violence during the COVID-19 pandemic in Bosnia and Herzegovina. This paper aims to determine the type and scope of sanctions in Bosnia and Herzegovina for domestic violence before and during the pandemic, patterns of victimization during the COVID-19 pandemic, and to determine and compare data on the scope of domestic violence before and during the pandemic. The data was collected from the state institutions and non-governmental organizations that provide assistance and protection to victims of violence. The most commonly imposed sanction for domestic violence was a suspended sentence. During the pandemic, combined forms of violence were most commonly reported, with various manifestations of physical, psychological, or economic violence, even femicide. The crisis has led to an increase in the scope of violence in families where dysfunctional relationships were previously recorded, but also to the appearance of the first forms of violence in families where violence had not occurred before. There has been a significant increase in violence reported to NGOs, and these figures do not match those of the state institutions.

Rational psychotherapy of neuroses: dynamic changes in psychological response of men and women

The paper presents the results of a study of dynamic changes in the severity of depression, it’s somatic manifestations, basic beliefs and dysfunctional attitudes in the course of treatment which included rational psychotherapy. The study sample consisted of 48 men and women with different forms of prediagnosed neurotic disorder aged 25-44 years (M = 32.6, SD = 5.3 (43.7% men)). Methods: Beck Depression Inventory (BDI, N.V. Tarabrina, 2001), Beck Anxiety Inventory (BAI, N.V. Tarabrina, 2001), Janoff-Bulman The World Assumptions Questionnaire (M.A. Padun, A.V. Kotelnikova, 2007), A. Beck, A. Weissman Dysfunctional Attitudes Scale (DAS, M.L. Zakharova, 2013). Statistical analysis included Kruskal-Wallis H-test and one-way ANOVA with post-hoc analysis. As a result of the study, it was possible to identify gender differences in the dynamics of cognitive-affective manifestations of depression, somatic manifestations of depression and dysfunctional relationships. It has been found that women demonstrate greater progress in stabilizing their emotional state and developing the skills to recognize their dysfunctional thoughts. At the same time, men are distinguished by a more pronounced dynamics of change in beliefs about their own value, the ability to manage events and luck.

Generational Trauma and the Crisis of Après-Coup In Alison Bechdel’s Graphic Memoirs

This essay suggests that Bechdel’s two autographic memoirs are indicative of the potential that exists in graphic narrative to provoke new dialogues with regard to how we approach, how we interpret, and how we interact with generational and familial trauma that stems from dysfunctional relationships with parental figures. Specifically, it examines how Bechdel’s Are You My Mother? builds upon the juxtapositions of the father-daughter bond in Fun Home by shifting the focus towards Bechdel’s traumatic relationship with her mother. This chapter argues that by explicitly weaving the narrative around a backdrop of psychology and psychoanalysis (D. W. Winnicott, Freud, Jung, and Lacan), Bechdel intentionally situates the “reader in the position of the analyst” (as quoted in The Paris Review). Drawing on Bechdel’s theory-rich content, this essay examines the figure of the mother as a shifting entity that mutates and molds itself onto substitute transitional objects and experiences, including Bechdel’s therapists and romantic attachments. Alternating among transcribed audio dialogues, diary entries, counseling sessions, dreams, letters, photographs, and memories, Are You My Mother? is an illustration of the Freudian concept of “afterwardness,” or, as Lacan coined it, après-coup—a retroactive understanding and re-visitation of earlier trauma.

Early Family Relationships Predict Children’s Emotion Regulation and Defense Mechanisms

Early family relationships have been suggested to influence the development of children’s affect regulation, involving both emotion regulation and defense mechanisms. However, we lack research on the specific family predictors for these two forms of affect regulation, which have been conceptualized to differ in their functions and accessibility to consciousness. Accordingly, we examine how the (a) quality and (b) timing of family relationships during infancy predict child’s later emotion regulation and defense mechanisms. Parents ( N = 703) reported autonomy and intimacy in marital and parenting relationships at the child’s ages of 2 and 12 months, and the child’s use of emotion regulation and immature and neurotic defenses at 7 to 8 years. As hypothesized, the results showed that functional early family relationships predicted children’s efficient emotion regulation, whereas dysfunctional relationships predicted reliance on defense mechanisms in middle childhood. Further, results showed a timing effect for neurotic defenses, partially confirming our hypothesis of early infancy being an especially important period for the development of defense mechanisms. The findings are discussed from the viewpoints of attachment and family dynamics, emotional self-awareness, and sense of security.

Assessing Conflict Management in the Couple

Weak management of interpersonal conflicts can lead to dysfunctional relationships with relevant consequences for couple and family well-being. Our purpose was to devise a single dimension scale to assess conflict management in romantic relationships. We focused on five relevant conflict aspects: competition, collaboration, avoidance, accommodating attitude, and compromise. Study 1 ( N = 405) confirmed the existence of a single latent dimension, which was defined as the Conflict Management Scale (CMS), and consists of 8 items unbiased by gender. In Study 2 ( N = 205), the CMS convergent validity with attachment, empathic self-efficacy, satisfaction, and decision-making in the couple was analyzed. In Study 3 ( N = 120), the CMS was administered to 60 heterosexual couples in order to further examine the validity of the newly developed single dimension scale. Results showed that the CMS might be considered a valid and handy tool for planning couple and family therapies.

A theology of sin related to poverty

This article is a literature study and seeks to explore the correlation between sin and poverty. It is an important subject since it helps researchers and policy makers to understand what lies at the root of the persisting cycle of poverty within contemporary society globally, and particularly in Africa. The point of departure for this investigation is based on Myers’ (2007:88) assumption: ‘without a strong theology of sin, comprehensive explanations of poverty are hard to come by’. It is argued that sin entails the violation of God’s standard of loving Him and caring for others, which applies at a personal as well as societal level. It will be demonstrated that poverty as a situation of dire needs or a lack of means for survival is caused mainly by oppression and economic exploitation. These conditions express dysfunctional relationships, which portrays the lack of love. The virtue of love is therefore a key factor that provides correctives for the relationship between sin and poverty.