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Introduction: Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Methods: Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. Results: At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Discussion: Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD.
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Background: During the COVID-19 pandemic, health-care workers (HCWs) may have been confronted with situations that may culminate in moral injury (MI). MI is the psychological distress that may result from perpetrating or witnessing actions that violate one's moral codes. Literature suggests that MI can be associated with mental health problems.Objective: We aimed to meta-analytically review the literature to investigate whether MI is associated with symptoms of posttraumatic stress disorder (PTSD), anxiety, depression, burnout, and suicidal ideation among active HCWs during the COVID-19 pandemic.Method: We searched eight databases for studies conducted after the onset of the COVID-19 pandemic up to 18 July 2023, and performed random-effects meta-analyses to examine the relationship between MI and various mental health outcomes.Results: We retrieved 33 studies from 13 countries, representing 31,849 individuals, and pooled 79 effect sizes. We found a positive association between MI and all investigated mental health problems (rs = .30-.41, all ps < .0001). Between-studies heterogeneity was significant. A higher percentage of nurses in the samples was associated with a stronger relationship between MI and depressive and anxiety symptoms. Samples with a higher percentage of HCWs providing direct care to patients with COVID-19 exhibited a smaller effect between MI and depressive and anxiety symptoms. We observed a stronger effect between MI and PTSD symptoms in US samples compared to non-US samples.Conclusion: We found that higher MI is moderately associated with symptoms of PTSD, anxiety, depression, burnout, and suicidal ideation among HCWs during the COVID-19 pandemic. Our findings carry limitations due to the array of MI scales employed, several of which were not specifically designed for HCWs, but underscore the need to mitigate the effect of potentially morally injurious events on the mental health of HCWs.
We conducted the first meta-analysis of moral injury and mental health among healthcare workers.Moral injury is moderately associated with symptoms of PTSD, depression, anxiety, burnout, and suicidal ideation.There was a stronger association between MI and anxiety and depressive symptoms for samples with more nurses.
Assuntos
COVID-19 , Princípios Morais , Angústia Psicológica , Transtornos de Estresse Pós-Traumáticos , Humanos , Ansiedade/epidemiologia , COVID-19/epidemiologia , Saúde Mental , Pandemias , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Depressão/epidemiologia , Esgotamento Profissional/epidemiologia , Ideação SuicidaRESUMO
A literatura científica é escassa no que se refere aos aspectos subjetivos que influenciam as relações de orientador, orientando e parecerista, no processo de elaboração da produção teórica nos cursos de pós-graduação lato sensu. Considerando essas relações como determinantes para que o sujeito complete ou não sua pós-graduação, o intuito do texto é trazer à luz a alguns aspectos identificados a partir da literatura disponível, além de efetuar uma leitura socionômica do fenômeno referido. Com isso, pretendemos instrumentalizar os atores em questão para que logrem cuidar deste processo, a partir de uma perspectiva relacional, a fim de diminuir a ocorrência de desistências de entrega de monografias, e, dessa maneira, incrementar ainda mais o conhecimento científico e socionômico...
There is very little academic literature available regarding the subjective aspects that influence how mentors, in their relationship with students, advise and review them while writing their theoretical dissertations for post-gradual courses in general. As this relationship is crucial in determining whether students will complete their post-graduate training, the aim of this study is to shed light on some aspects of this relationship through reflecting on the available academic literature, as well as to explore this phenomenon from a socionomic perspective. By this, we intend to provide tools for those involved, in order to be able and better manage this process using a relational perspective, to reduce the number of abandoned dissertations, and to thus further enhance scientific and socionomic knowledge...