The federal government offers Earned Income Tax Credit (EITC) to working low and middle-income families. Lack of knowledge and distrust in government results in a large proportion of qualified families not claiming EITC. This is especially true for minority groups, including immigrants. The study objectives were: (1) to examine whether a community derived EITC outreach campaign targeting EITC eligible residents of Arab-American descent in Southeast Detroit, Michigan, U.S.A., resulted in increased knowledge of EITC; (2) to study the prospective relationship between EITC knowledge and financial hardship; and (3) to study the relationship between risks (financial hardship) and protective (exercise) factors and self-rated health. In 2021, a total of 215 women attending Women, Infants, and Children (WIC) centers in Southeast Detroit, Michigan, were recruited. Participants filled out a survey at baseline, and after 6 and 12 months, respectively. The survey contained questions on sociodemographics, financial stressors, exercise, health, and knowledge of EITC. The 1-year retention rate was 48

AIM:To examine whether self-reported thriving at work is associated with biomarkers of stress, inflammation, neuroplasticity and neurodegeneration in nurses. DESIGN:A cross-sectional study. METHODS:An online questionnaire measuring thriving at work was administered to nurses in a teaching hospital in Michigan, U.S. over 5 weeks in 2024. A subsample of 100 questionnaire respondents provided blood samples for biomarker analysis. Multiple regression was used to identify self-reported and biomarker predictors of nurse thriving. Cluster analysis was used to distinguish between nurses with high and low levels of thriving based on a combination of self-report and biomarker data. RESULTS:Higher self-reports of individual and work-related resources predicted higher thriving. Cortisol, a stress hormone, was significantly and inversely associated with thriving. No blood-based biomarkers of inflammation or neuroplasticity predicted thriving. Neurofilament light chain, a marker of neurodegeneration, was not a direct predictor but modified the effects of interpersonal and work resources on thriving. CONCLUSION:Biological markers do play a role in nurses' thriving at work and may contribute important complementary information to that provided by nurse self-reports. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Nurses thrive in a work situation characterised by positive reports of individual, interpersonal and work resources and lower levels of stress. Efforts to enhance thriving could positively impact nurses' well-being and conditions for providing high-quality patient care. IMPACT:This study addressed the question of whether self-reported thriving at work among nurses is reflected in biomarkers of stress, inflammation, and neurocognitive health. A profile of high self-reported work-related resources and low cortisol distinguished higher levels of nurses' thriving from lower levels. Organisational efforts to enhance nurses' thriving can positively impact nurses' health, their work environment, and patient care. REPORTING METHOD:We followed the STROBE checklist in reporting this study. PATIENT OR PUBLIC CONTRIBUTION:No Patient or public contribution.

The current longitudinal study aimed to examine two forms of parental mentalization, parenting reflectivity and mind‐mindedness, as predictors of children's attachment security and social–emotional development at 2 years old. Participants included 88 racially and socioeconomically diverse women and their toddlers. Results showed prenatal parenting reflectivity significantly predicted toddler attachment security. Mothers' use of appropriate mind‐related comments did not significantly predict toddler attachment security, social–emotional competence or social–emotional problems cross‐sectionally above and beyond prenatal or 2‐year parenting reflectivity. A mediation analysis, however, revealed an indirect relationship between prenatal parenting reflectivity and toddler attachment security via appropriate mind‐related comments. The results of the present study indicate that early parenting reflectivity may serve as an important predictor of later attachment security and social–emotional development and that prenatal parenting reflectivity may serve as a precursor to parents' use of mind‐minded comments with their children.

OBJECTIVE:Adolescent girls and mothers are vulnerable to poor body image outcomes, which are often reinforced through fat talk, a self-disparaging body-related conversation. Depression may exacerbate this risk, particularly among those engaging in fat talk. This study examined the associations, among mother-daughter dyads, between fat talk and restrictive, emotional, and external disordered eating, eating disorder symptoms, and body dissatisfaction, as well as whether depression moderated these associations. METHOD:104 mother-daughter dyads completed online measures. Adolescent daughters (M = 15.73 years old; SD = 2.51) and their mothers (M = 43.17 years old; SD = 8.58) were primarily white/Caucasian. RESULTS:Actor effects of fat talk significantly predicted all body image outcomes. Partner effects emerged only for daughters' fat talk predicting mothers' body dissatisfaction. Depression moderated the association between fat talk and restrictive eating but did not moderate other associations. However, depression did independently predict poorer body image outcomes. DISCUSSION:Findings highlight the importance of studying mother-daughter dyads and capturing how psychopathology contributes to subclinical eating disordered behaviors, informing risk identification for eating disorder development.

Burnout is an occupational challenge to the health, performance, and retention of healthcare personnel. The objective of this cross-sectional study was to further our understanding of the association between burnout, work, coping, and cognitive impairment as it relates to neuroendocrine, inflammatory, and neuroplastic disease mechanisms. One hundred hospital-based registered nurses responded to a validated survey addressing employment and work characteristics, coping, and cognitive impairment, and a one-item, burnout scale. In addition, they all provided blood samples. Nineteen percent of the nurses reported symptoms of evolving burnout and an additional 12% reported established burnout. Severity of burnout was inversely associated with self-rated energy (p<.001), ability to concentrate (p<.001), and positively associated with stressed at work (p<.001), but not with workplace cognitive impairment. The anti-inflammatory and pro-energetic biomarker interleukin-10 was elevated in respondents in the combined two highest burnout categories (mean 2.81, S.E.M. 0.26 pg/mL) vs. a median of 2.09 pg/mL in the no-burnout category (p<.02). When biomarkers in blood were regressed on severity of burnout, concentration of the anabolic hormone dehydroepiandro­sterone­­-sulfate (standardized beta -.73, p=.007) and the neuronal strain biomarker neurofilament light chain (-.79, p=.01) inversely predicted burnout. In contrast, the ability to cope with a tough situation at work was positively associated with burnout (.75, p=.02). The study not only confirms the association between burnout and self-reported individual and work-related adverse outcomes but, importantly, burnout-relevant neuroendocrine, inflammatory, and neuronal biomarkers. Nurses suffering from burnout might exhibit dysfunctional coping resulting in decreased recognition of low energy, which accelerates the burnout process. It is proposed that assessment of biological disease mechanisms should play a larger role in both scholarly and clinical burnout work. ### Competing Interest Statement The authors have declared no competing interest.

AIM:To develop and evaluate a questionnaire for measuring factors that contribute to thriving at work among nurses. DESIGN:A cross-sectional study. METHODS:An online questionnaire was administered in March 2024 to nurses in a community teaching hospital in Michigan, US. Questionnaire content was based on a literature search and was pilot tested among nursing professionals within the hospital system. Questionnaire factor structure was examined with exploratory and confirmatory factor analyses with split-half sample validation. RESULTS:Based on exploratory and confirmatory factor analysis, a three-factor solution presented the best model, with factors comprised of 15 items measuring individual resources (3 items), work resources (6 items) and interpersonal aspects of the nursing work environment (6 items). Reliability estimates for all three factors exceeded 0.80, indicating good internal homogeneity. The questionnaire also demonstrated acceptable split-half validity and reliability. CONCLUSION:The questionnaire presented here provides a potentially useful tool for measuring and evaluating thriving at work among nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:A better understanding of factors that enhance nurse thriving would lay the foundation for targeted interventions aimed at improving the nursing work environment and nurse well-being. Enhancing nurse thriving could have a potentially positive impact on patient care. IMPACT:This study addressed the need to understand factors that contribute to thriving in nursing work. The questionnaire that was developed revealed a three-factor solution measuring individual nurse resources, work environment resources and work interpersonal resources. By measuring thriving among nurses, hospitals and other healthcare organisations are taking an important first step in identifying interventions to enhance the nursing work environment, nurse well-being and potentially the quality of patient care. REPORTING METHOD:We followed the STROBE checklist in reporting this study. No patient or public contribution.

Interventions that can be efficiently and effectively delivered to a larger number of people are needed to address the unmet need for mental health services. By emphasizing the use of lower intensity interventions, stepped-care models have the potential to address this need. However, definitions about what stepped care is and guidelines for its use are limited. Therefore, this study sought to clarify the current state of stepped care in clinical practice. Participants included licensed mental health professionals in the United States (N = 171; Mage = 43.6; 85.4% women; 88.9% White). They completed a survey assessing their use of, beliefs about, and training in stepped care, as well as barriers to its use. Providers generally agreed with the model, with cognitive-behavioral orientation predicting greater agreement. The majority of participants endorsed the use of lower intensity methods, monitoring progress, and using multiple methods, but few reported considering a patient's severity in deciding which treatment modalities to use. While formal training in lower intensity methods was somewhat uncommon, participants who received training in a greater number of lower intensity methods endorsed more stepped practices. Barriers to stepped care included patient-, provider-, and organizational-level factors. Overall, the results highlight that broad changes to health care delivery systems and provider training are needed to increase effective use of stepped care and maximize its potential benefits.

The relationship between antisocial personality traits and the expression of somatic symptoms has been the subject of several theoretical and empirical investigations. The present study sought to advance the understanding of the relationship between these variables by testing two moderation models. It was hypothesized that the relationship between antisocial traits and somatization would be moderated by alcohol use, such that the presence of alcohol dependence would strengthen the relationship between antisocial traits and somatization. It was also hypothesized that gender would play a moderating role in the relationship between ASPD and somatization, such that the relationship would be stronger among women than among men. These models were tested in a sample of 787 criminal offenders. Gender did not emerge as a significant moderator in the relationship between antisocial traits and somatization. Although substance use did significantly moderate the relationship between antisocial traits and somatization, the direction of the effect ran counter to expectations: among participants reporting a history of alcohol dependency, the relationship between antisocial features and somatization was diminished. The implications of these findings are discussed.

AIM:To examine the relationships between nurses' exposure to workplace violence and self-reports of workplace cognitive failure. DESIGN:A cross-sectional study. METHODS:An online questionnaire was administered in April 2023 to nurses in Michigan, US. Structural equation modelling was used to examine effects of physical and non-physical workplace violence (occupational stressors) and work efficiency and competence development (occupational protective factors) on workplace cognitive failure. RESULTS:Physical violence was a significant predictor of the action subscale of cognitive failure. There were no direct effects of non-physical violence, workplace efficiency, or competence development on any of the workplace cognitive failure dimensions. Both types of violence and efficiency had significant indirect effects on workplace cognitive failure via work-related exhaustion. Work-related exhaustion predicted significantly higher scores for workplace cognitive failure. CONCLUSION:Workplace violence and work efficiency exhibited primarily indirect effects on workplace cognitive failure among nurses via work-related exhaustion. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Nurses experiencing workplace violence may be at increased risk for workplace cognitive failure, especially if they are also experiencing work-related exhaustion. Workplaces that nurses perceive as more efficient can help to mitigate the effects of violence on nurses' cognitive failure. IMPACT:This study addressed the possible effects of workplace violence as well as work efficiency and competence development on nurses' cognitive failure at work. Analyses revealed primarily indirect effects of workplace violence, and indirect protective effects of work efficiency, on nurses' cognitive failure via work-related exhaustion. This research has implications for healthcare organizations and suggests that efforts made by healthcare workplaces to prevent violence and work-related exhaustion, and to enhance work efficiency, may help to mitigate workplace cognitive failure among nurses. REPORTING METHOD:We have followed the STROBE checklist in reporting this study. PATIENT OR PUBLIC CONTRIBUTION:No Patient or public contribution.

The federal government offers earned income tax credit (EITC) to working low and middle-income families. Lack of knowledge and distrust in government result in a large proportion of qualified families does not uptake (‘claim”) EITC. The study objectives were to (1) determine whether a community derived EITC outreach campaign resulted in improved knowledge of EITC, and (2) examine the relationship between financial stress and self-rated health. A total of 215 women attending Women, Infants, and Children (WIC) centers in southeast Detroit, Michigan, were recruited in 2021. Participants filled out a survey at baseline, and after 6 and 12 months, respectively. The 1-year retention rate was 48% (n = 104). The survey contained questions on sociodemographics, financial stressors, exercise, health, and knowledge of EITC. At baseline, knowledge about EITC was low (mean 1.1 [SE 0.3] on a 0–10 visual analogue scale) but increased significantly during the first six months (2.9 [0.3]; p < .01). Approximately 38% of respondents worried about not having sufficient funds to pay for rent/mortgage at baseline, and almost 28% worried about not being able to buy nutritious meals for their families. Worry about paying for meals at the 6-month mid-point assessment was significantly related to self-rated health at 12 months (p = 0.013). Self-rated health at 12 months was significantly lower (-0.74; 95% confidence interval − 1.40, − 0.16) among those worrying vs not worrying about paying for meals. The model explained 5.6% (r2 = 0.056) of the variance in self-rated health at 12-months. The study shows that knowledge about EITC is limited among qualified households. A community engaged EITC outreach campaign increased knowledge substantially. Financial strain is related to worsening self-rated health. EITC is an underused bipartisan, pro-employment supported federal program to address near-poverty and poverty among underserved families.

Ideational slippage—characterized by incorrect word usage and strained logic during dialogue—is common in aging and, at greater frequency, is an indicator of pre-clinical cognitive decline. Performance-based assessment of ideational slippage may be useful in the study of cognitive aging and Alzheimer’s-disease-related pathology. In this preliminary study, we examine the association between corpus callosum volume and a performance-based assessment of ideational slippage in middle-aged and older adults (age 61–79 years). Ideational slippage was indexed from cognitive special scores using the Rorschach Inkblot Method (RIM), which are validated indices of deviant verbalization and logical inaccuracy (Sum6, WSum6). Among middle-aged and older adults, smaller splenium volume was associated with greater ideational slippage (ηp2 = 0.48), independent of processing speed and fluid intelligence. The observed negative associations are consistent with visuospatial perception and cognitive functions of the splenium. The effect was strongest with the splenium, and volumes of the genu and total white matter had small effects that were not statistically significant. Conclusions: Results are discussed with future application of RIM special scores for the assessment of pre-clinical cognitive decline and, based on observed effect sizes, power analyses are reported to inform future study planning.

Social anxiety disorder (SAD) is highly prevalent with significant lifetime impacts, especially when left untreated. Cognitive behavioral therapy is the current gold standard treatment with successful patient outcomes. Cognitive behavioral group therapy (CBGT) is one form that provides unique benefits to participants including normalization of symptoms and social support, as well as providing increased access to treatment at a lower per-session cost. Research on this mode of treatment has been ongoing for over 20 years, but we still have much to learn about its overall efficacy. The goals of this critical review were to summarize and evaluate the most current research, including an analysis of the overall methodological design quality, and provide recommendations for the enhancement of future studies based on best practices. Recent studies included some best practice design elements used in measuring efficacy such as the use of comparison groups, masking procedures, fidelity assessments, and consideration of clinical significance in outcomes. However, many gaps exist such as a lack of consensus around measures and therapy manuals, as well as baseline competencies of facilitators. Future studies should consider incorporating additional best practice elements aligning with study goals to strengthen designs and provide the field with even more confidence in this mode of treatment.

EDITORIAL article Front. Psychol., 31 August 2023Sec. Psychology for Clinical Settings Volume 14 - 2023 | https://doi.org/10.3389/fpsyg.2023.1275034

There is growing evidence that the COVID-19 pandemic has had a severe impact on the nursing profession worldwide. Occupational strain has disrupted nurses’ emotional wellbeing and may have led to negative coping behaviors, such as increased substance use, which could impair cognitive functioning. The aim of this study was to examine whether increased substance use in a sample of U.S. nurses during the pandemic was related to greater workplace cognitive failure. An online questionnaire was administered in May 2020 to Michigan nurses statewide via three nursing organizations (n = 695 respondents). A path model was used to test the direct effects of reported increased substance use on workplace cognitive failure and via parallel psychological mediators. The model had excellent fit to the observed data, with statistically significant, unique mediating effects of greater symptoms of anxiety (b = 0.236, z = 2.22, p = 0.027), posttraumatic stress disorder (b = 0.507, z = 4.62, p < 0.001) and secondary trauma (b = 1.10, z = 2.82, p = 0.005). Importantly, the direct effect of increased substance use on workplace cognitive failure was not statistically significant independent of the mediators (b = 0.133, z = 0.56, p = 0.576; 95% confidence interval: −0.33, 0.60). These results point to the importance of further delineating the mechanistic pathways linking adverse stress to workplace cognitive failure. As we emerge from the pandemic, healthcare systems should focus resources on supporting cognitive health by addressing the psychological and emotional welfare of nurses, many of whom may be struggling with residual trauma and increased substance use.

Anticoagulation, the body's mechanism to prevent blood clotting, is an internal biomarker of an individual's response to stress. Research has indicated that understanding the causes, processes, and consequences of anticoagulation can provide important insight into the experience of individuals facing emotional and occupational strain. Unfortunately, despite their importance, the mechanisms and implications of anticoagulation are unfamiliar to many researchers and practitioners working with trauma-exposed professionals. This paper provides an accessible primer on the topic of anticoagulation, including an overview of the biological process, the research connecting these processes with emotional and occupational functioning, as well as some potential methods for assessment.

Numerous studies provide evidence of the physical and emotional strain experienced by nurses during the COVID-19 pandemic. However, little is known regarding the impact of this occupational strain on nurses’ cognitive function at work. The aim of this study was to identify factors associated with workplace cognitive failure in a sample of U.S. nurses during the COVID-19 pandemic. An online questionnaire was administered in May 2020 to Michigan nurses statewide via three nursing organizations (n = 695 respondents). Path analysis was conducted to test the parallel effects of frequency of contact with COVID patients and personal protective equipment (PPE) supply on workplace cognitive failure scores. Mediation effects of stress, sleep quality, secondary trauma, and work-related exhaustion were examined for each exposure. Results revealed significant indirect effects of all mediators except sleep quality of contact with COVID patients (cumulative indirect effect = 1.30, z = 6.33, p < 0.001) and PPE (cumulative indirect effect = −2.10, z = −5.22, p < 0.001) on cognitive failure. However, 58% of the PPE effect was direct. To reduce the risk of cognitive failure, healthcare organizations need to provide nurses with protective equipment and work environments that allow nurses to strengthen their resilience to extreme working conditions.

Purpose This paper aims to evaluate trends in research and clinical practice that may contribute to the limited utility of assessment and treatment modalities designed to capture and address psychopathy. It identifies a lack of consistency between the academic understanding of psychopathy and how the construct is applied in clinical contexts. The authors provide clarity and direction for a more effective application of the psychopathy construct in practical contexts. Design/methodology/approach This review first examines the etiology of important limitations to psychopathy research and practical application, and proposes the adoption of the most recent empirical conceptualization of the construct into practical contexts. It then evaluates the current functionality of psychopathy in practical contexts. The review ultimately proposes a method for designing intervention practices based on the model used in the development of dialectical behavior therapy (DBT) for borderline personality disorder, which will improve the practical utility of the construct. Findings The present review provides evidence that a multifaceted and dimensional perspective of psychopathy will improve the practical utility of the construct and help move the field forward. It suggests that considering independent components of the psychopathy construct along a continuous scale, as with DBT, will contribute to improvements in assessments and treatments that target psychopathy. Practical implications The current review applies relevant research to a model for developing an intervention modality particularly in forensic or correctional settings where individuals high in psychopathy are often seen. The implications outlined provide a framework that could impact practice and assessment in forensic contexts moving forward. Originality/value Previous research has not concisely outlined problems concerning the link between psychopathy research and how the construct is applied in practical settings. Few researchers have proposed plausible solutions that could improve the utility of the construct in such settings.

Identifying performance-based assessments of emotion regulation is needed for the study of myriad mood and neurological disorders. Color and form responses on the Rorschach Inkblot Method are valid measures of emotion response control, but have not been studied in relation to known neural correlations of emotion regulation. A discrepancy of color (CF + C) greater than form (FC) responses suggests low cognitive control over emotional responses. This preliminary report explores the discrepancy between form-color responses as a correlate of regional cortical thickness. A sample of community-dwelling adults were administered the Rorschach Inkblot Method and participated in a structural MRI scan. Greater middle frontal cortex thickness was associated with a positive discrepancy score [(CF + C) - FC], indicating less emotion response control (rs  = 0.48, p < 0.05); a moderate, non-significant correlation was also observed with insula cortex (rs  = 0.42, p = 0.07).The results provide evidence in support of the Rorschach Inkblot Method as a valid behavioral measure of emotion response control. More specifically, these results support the use of color-related variables included in contemporary evidence-based Rorschach methods. The results are discussed with implications for the study of emotion regulation in mood disorders and sensitivity analyses based on the observed effect sizes are reported to inform future study planning.

The COVID-19 outbreak has affected healthcare across all levels. Older adults and those with chronic illness are at greatest risk for infection complications and mortality, which presents significant psychological distress for residential healthcare workers. The concept of selfobject needs, consisting of Mirroring, Idealizing, and Twinship, may be relevant in explaining psychological distress. This study seeks to enhance our understanding of the needs of healthcare workers responsible for elderly patients and evaluate the role of psychosocial support through selfobject needs to mitigate the effects of trauma during the pandemic. Participants (N = 103) employed in residential healthcare facilities in the metropolitan Detroit, MI (USA) region completed an online survey during the peak initial infection. Assessments included standardized measures of trauma-related symptoms, depression, anxiety, and general distress symptoms, as well as a validated measure of selfobject needs. Residential healthcare workers reported mental health symptoms across domains, including clinical elevations in symptoms of trauma, depression, and anxiety. Selfobject needs and mental health outcomes were positively correlated, indicating that greater unmet relational need was associated with greater severity of symptoms. Greater trauma symptom severity as a proxy index of current experience during the pandemic predicted high depressive symptoms, and greater Mirroring need worsened the effect. These results suggest that interventions targeting selfobject needs, specifically Mirroring, may be effective at mitigating acute mental health symptoms among healthcare workers during a distressing event.