Depression as a mediator of negative cognitive style and hopelessness in stress generation

Embracing Emotional Pain: A Case Study of Adolescent Suicidality and Spirituality

BACKGROUND

Suicidality continues to be the second leading cause of adolescent death. Nurses are in a prime position to address the emotional pain associated with adolescent suicidality but report skepticism and discomfort. Moreover, spirituality is identified as a protective factor against suicidality, yet a gap exists related to exploring spirituality within the context of the emotional pain associated with adolescent suicidality. Building awareness of adolescents' spirituality and emotional pain associated with suicidality is essential to address nurse skepticism and discomfort.

AIMS

The purpose of this study was to explore young adults' experiences of suicide attempt(s) during adolescence in the context of spirituality using a case study application of participant narratives to Minton and Antonen's B.L.E.S.S. acronym.

METHOD

A multiple-case study design was used to provide an alternative perspective for understanding adolescent suicidality from a spiritual context. Reed's theory of self-transcendence and the B.L.E.S.S. acronym guided the analysis and interpretation. Convenience online sampling resulted in six adult participants who provided email narratives of their adolescent experiences. Email data collection was guided by Fritz and Vandermause. Analysis of participant narratives followed the protocol of Baxter and Jack.

RESULTS

Participant's narratives revealed self-transcendence that paralleled the five truths about emotional pain and spirituality inherent in the B.L.E.S.S. acronym.

CONCLUSION

This case study provides nurses a guide for counteracting the barriers of skepticism and stigma to promote help-seeking behavior associated with adolescent suicidality. Further research is needed for the application of the B.L.E.S.S. acronym with other population samples.

Alexithymia, Burnout, and Hopelessness in a Large Sample of Healthcare Workers during the Third Wave of COVID-19 in Italy

In the present study, we aimed to assess the frequency of and the relationships between alexithymia, burnout, and hopelessness in a large sample of healthcare workers (HCWs) during the third wave of COVID-19 in Italy. Alexithymia was evaluated by the Italian version of the 20-item Toronto Alexithymia Scale (TAS-20) and its subscales Difficulty in Identifying Feelings (DIF), Difficulty in Describing Feelings (DDF), and Externally Oriented Thinking (EOT), burnout was measured with the scales emotional exhaustion (EE), depersonalisation (DP), and personal accomplishment (PA) of the Maslach Burnout Test (MBI), hopelessness was measured using the Beck Hopelessness Scale (BHS), and irritability (IRR), depression (DEP), and anxiety (ANX) were evaluated with the Italian version of the Irritability' Depression' Anxiety Scale (IDA). This cross-sectional study recruited a sample of 1445 HCWs from a large urban healthcare facility in Italy from 1 May to 31 June 2021. The comparison between individuals that were positive (n = 214, 14.8%) or not for alexithymia (n = 1231, 85.2%), controlling for age, gender, and working seniority, revealed that positive subjects showed higher scores on BHS, EE, DP IRR, DEP, ANX, DIF, DDF, and EOT and lower on PA than the not positive ones (p < 0.001). In the linear regression model, higher working seniority as well as higher EE, IRR, DEP, ANX, and DDF scores and lower PA were associated with higher hopelessness. In conclusion, increased hopelessness was associated with higher burnout and alexithymia. Comprehensive strategies should be implemented to support HCWs' mental health and mitigate the negative consequences of alexithymia, burnout, and hopelessness.

Self-Reported Cognitive Biases Are Equally Present in Patients Diagnosed With Psychotic Versus Nonpsychotic Disorders

We investigated the relation between subjective cognitive biases measured with the Dutch Davos Assessment of Cognitive Biases (DACOBS-NL) and (1) the presence of a psychotic versus nonpsychotic psychiatric disorder, (2) the current dose of antipsychotic medication and current psychotic symptoms, and (3) the Personality Inventory for the DSM-5 (PID-5) Psychoticism personality trait. Results showed that DACOBS-NL subjective cognitive biases (1) were equally present in patients diagnosed with nonpsychotic disorders compared with patients with a psychotic disorder, (2) could not be explained by the current dose of antipsychotic medication, nor by current psychotic symptoms, and (3) significantly correlated with all PID-5 Personality domains. Moreover, in predicting membership of the psychotic versus nonpsychotic psychiatric disorder group, the addition of the PID-5 domains in step 2 rendered the contribution of the DACOBS-NL subjective cognitive biases in step 1 nonsignificant. Further research is needed to clarify the interplay between cognitive biases and aberrant salience in the prediction of psychotic disorders.

Evidence for the role of corticotropin-releasing factor in major depressive disorder

Major depressive disorder (MDD) is a devastating disease affecting over 300 million people worldwide, and costing an estimated 380 billion Euros in lost productivity and health care in the European Union alone. Although a wealth of research has been directed toward understanding and treating MDD, still no therapy has proved to be consistently and reliably effective in interrupting the symptoms of this disease. Recent clinical and preclinical studies, using genetic screening and transgenic rodents, respectively, suggest a major role of the CRF1 gene, and the central expression of CRF1 receptor protein in determining an individual's risk of developing MDD. This gene is widely expressed in brain tissue, and regulates an organism's immediate and long-term responses to social and environmental stressors, which are primary contributors to MDD. This review presents the current state of knowledge on CRF physiology, and how it may influence the occurrence of symptoms associated with MDD. Additionally, this review presents findings from multiple laboratories that were presented as part of a symposium on this topic at the annual 2014 meeting of the International Behavioral Neuroscience Society (IBNS). The ideas and data presented in this review demonstrate the great progress that has been made over the past few decades in our understanding of MDD, and provide a pathway forward toward developing novel treatments and detection methods for this disorder.