Post-Traumatic Stress Disappointment: Disappointment and Its Role in PTSD

Disappointment is an under-studied concept in the field of PTSD; it is nevertheless apparent in testimonies of individuals diagnosed with PTSD. Self-disappointment, disappointment with others, and disappointment with the Sublime are mentioned in the literature yet were not studied and described in the context of PTSD and spiritual recovery. This study aims to fill this gap; 50 individuals of varying backgrounds who recovered from PTSD and attributed their recovery to spirituality were interviewed. Participants underwent a variety of traumas, had different piety levels, and used different recovery methods. Findings revealed a mechanism where individuals diagnosed with PTSD experience three-dimensional disappointment (TDD) with self, others, and the Sublime, and that this disappointment breeds a sense of disconnection and helplessness. Findings suggest also that disappointment plays a significant role in both creating PTSD and intensifying the suffering from it. Implications for caregivers, therapists, and individuals with PTSD are discussed.

"The biggest disappointment": women's expectations from sex are ignored, from the perspective of infertile women

OBJECTIVE

The aim of this study is to determine the attitudes, behaviours and experiences of infertile women towards sexuality.

METHODS

This study was carried out in the infertility outpatient clinic of a state hospital in Istanbul of Turkey. Fifteen infertile women who had been receiving primary infertility treatment for at least two years and were actively continuing infertility treatment were included in the study. Data were collected by means of an detailed information form and a semi-structured interview. Content analysis was applied to the data obtained from semi-structured interviews. Consistency percentage calculation was made between the codes and themes determined by 4 researchers who are experts in their fields.

RESULTS

Results based on the interviews with the participants, 2 main themes, 6 sub-themes and 27 codes related to sub-themes were determined as 'Factors Affecting Sexual Life' and 'Overview of Sexual Health and Sexuality'. 'Disappointment' was determined as the most commonly defined code in the determined main theme and sub-themes.

CONCLUSION

It was determined that the majority of infertile women base their sexual lives on reproductive functions, experience serious sexual health problems, feel worthless, and describe their sexual life as a great disappointment.

'If there were doctors who could understand our problems, I would already be better': dissatisfactory health care and marginalisation in superdiverse neighbourhoods

How people in community settings describe their experience of disappointing health care, and their responses to such dissatisfaction, sheds light on the role of marginalisation and underlines the need for radically responsive service provision. Making the case for studying unprompted accounts of dissatisfaction with healthcare provision, this is an original analysis of 71 semi-structured interviews with healthcare users in superdiverse neighbourhoods in four European cities. Healthcare users spontaneously express disappointment with services that dismiss their concerns and fail to attend to their priorities. Analysing characteristics of these healthcare users show that no single aspect of marginalisation shapes the expression of disappointment. In response to disappointing health care, users sought out alternative services and to persuade reluctant service providers, and they withdrew from services, in order to access more suitable health care and to achieve personal vindication. Promoting normative quality standards for diverse and diversifying populations that access care from a range of public and private service providers is in tension with prioritising services that are responsive to individual priorities. Without an effort towards radically responsive service provision, the ideal of universal access on the basis of need gives way to normative service provision.

On Averting Negative Emotion: Remedying the Impact of Shifting Expectations

This paper examines how people anticipate negative emotions when faced with an uncertain outcome and try to manage their expectations. While extant research streams remain equivocal on whether managing expectations always succeeds, this research examines situations in which setting a low expectation can have an adverse emotional impact and suggests ways to alleviate this negative consequence. Using goal setting and a false-feedback paradigm, we show that, although individuals who set low goals to manage expectations can end up feeling more disappointed than those who set high goals (study 1), this negative impact can be avoided when individuals are reminded of their initial goals at feedback, or made aware of inaccuracies in forecasting their future emotion (studies 1 and 2).

"It's Not About You": Disappointment as Queer Pedagogy in Community-Engaged Service-Learning

Increasingly popular in the neoliberal university, community-engaged service-learning (CESL) courses offer rich yet contradictory opportunities for LGBTQ studies students to synthesize queer critiques of community and identity with experiences in LGBTQ communities. Much CESL scholarship has focused on the tensions between benefits to community and to students, prioritizing either radical social change or student satisfaction. Beside such debates, I propose the queer ethical, pedagogical, and political value of disappointment in the tedium and contradictions of community itself. Such queer disappointment, I contend, might enable students to cultivate the emotional and critical capacities to engage in community work on sustainable, dedramatized, and unentitled terms.

Professional Disappointment as a Cause of Burnout

Burnout is common among physicians. Chronic sources of burnout have been previously examined, but little is known about the impact of acute stressors on physician burnout. Otolaryngology residents applying for competitive fellowships provide a good example for how professional disappointment may cause burnout. As otolaryngology comprises highly successful, highly competitive individuals, a long history of success may leave otolaryngologists ill-equipped to cope with such failures. Otolaryngologists should be aware of such pitfalls, preparing appropriate coping mechanisms in cases of professional disappointment.

THE VIBRANT CHALLENGES OF CLINICALLY EFFECTIVE PSYCHOANALYTIC MINDEDNESS

In addressing the central challenges of developing and maintaining the analyst's psychoanalytic mindedness, this paper focuses on two particularly challenging core components of clinical effectiveness not so easily developed despite the rigors of the tripartite training model. The first is the analyst's receptivity to unconscious communication, which entails the analyst's curiosity, acceptance of human nature, doubt, restraint, narcissistic balance, and integrity. A brief clinical vignette illustrates this. The second factor is recognizing and managing the inherent disappointments and narcissistic challenges in working psychoanalytically. The author maintains that the ability to lose and subsequently recover one's analytic mind entails discipline, courage, and faith that only experience can provide.

Disappointment expression evokes collective guilt and collective action in intergroup conflict: the moderating role of legitimacy perceptions

Research on intergroup emotions has largely focused on the experience of emotions and surprisingly little attention has been given to the expression of emotions. Drawing on the social-functional approach to emotions, we argue that in the context of intergroup conflicts, outgroup members' expression of disappointment with one's ingroup induces the complementary emotion of collective guilt and correspondingly a collective action protesting ingroup actions against the outgroup. In Study 1 conducted immediately after the 2014 Gaza war, Jewish-Israeli participants received information about outgroup's (Palestinians) expression of emotions (disappointment, fear, or none). As predicted, outgroup's expression of disappointment increased collective guilt and willingness to participate in collective action, but only among those who saw the intergroup situation as illegitimate. Moreover, collective guilt mediated the relationship between disappointment expression and collective action, moderated, again, by legitimacy perception. In Study 2, we replicated these results in the context of racial tension between Black and White Americans in the US. We discuss the theoretical and applied implications of the findings.

Promises, Promises

Presenting a pledge to another establishes expectation in the recipient for the commitment to be fulfilled, particularly when a promise is devoid of coercion. Defaulting on a commitment may damage relationships between people and may predispose the disenchanted recipient to distrust those who proffer succeeding commitments. God's advocates who have been disappointed by God's evident under-delivery may experience a crisis of faith, exemplified in attachment distress, when disappointment intimates God has over-promised his providence, which questions the nature and, ultimately, the relevance of God.

The effects of expectation disconfirmation on appraisal, affect, and behavioral intentions

People's risk perceptions can have powerful effects on their outcomes, yet little is known about how people respond to risk information that disconfirms a prior expectation. We experimentally examined the affective, cognitive, and behavioral consequences of expectation disconfirmation in the context of risk perceptions. Participants were randomly assigned and then prompted toward either a high or low personal risk estimate regarding a fictitious health threat. All participants then received the same risk feedback, which presented either a negative disconfirmation experience (i.e., worse than expected) in the high-risk estimate condition or a positive disconfirmation experience (i.e., better than expected) in the low-risk estimate condition. Participants who experienced the negative disconfirmation reported stronger intentions to prevent the threat in the future compared to participants who experienced the positive disconfirmation. This effect was mediated by both disappointment about the risk feedback and perceptions of the severity of the threat. These findings have implications for risk communication, suggesting that the provision of objective risk information may improve or diminish the likelihood of behavior change depending on people's initial expectations and their emotional and cognitive reactions to the information.

The impact of disappointment in decision making: inter-individual differences and electrical neuroimaging

Disappointment, the emotion experienced when faced to reward prediction errors (RPEs), considerably impacts decision making (DM). Individuals tend to modify their behavior in an often unpredictable way just to avoid experiencing negative emotions. Despite its importance, disappointment remains much less studied than regret and its impact on upcoming decisions largely unexplored. Here, we adapted the Trust Game to effectively elicit, quantify, and isolate disappointment by relying on the formal definition provided by Bell's in economics. We evaluated the effects of experienced disappointment and elation on future cooperation and trust as well as the rationality and utility of the different behavioral and neural mechanisms used to cope with disappointment. All participants in our game trusted less and particularly expected less from unknown opponents as a result of disappointing outcomes in the previous trial but not necessarily after elation indicating that behavioral consequences of positive and negative RPEs are not the same. A large variance in the tolerance to disappointment was observed across subjects, with some participants needing only a small disappointment to impulsively bias their subsequent decisions. As revealed by high-density EEG recordings the most tolerant individuals - who thought twice before making a decision and earned more money - relied on different neural generators to contend with neutral and unexpected outcomes. This study thus provides some support to the idea that different neural systems underlie reflexive and reflective decisions within the same individuals as predicted by the dual-system theory of social judgment and DM.