Anorexia nervosa: Enhancing motivation to change with self-determination theory.

Motivational deficits (little or no motivation to change) are often reported in patients with eating disorders, particularly anorexia nervosa. The motivational approaches frequently used by French clinicians rely solely on a dichotomous view of motivation (intrinsic vs. extrinsic). In self-determination theory, certain forms of extrinsic motivation can strengthen an individual's commitment to an activity, providing they are self-determined. This theory therefore extends and enriches the dual motivational approach by highlighting potentially useful forms of extrinsic motivation and by emphasizing the importance of behavioral regulation. Empirical work is now needed to assess how clinicians can use self-determination theory to enhance motivation to change among patients with anorexia nervosa and encourage their adherence to care management plans.

Work stress and motivation in psychologists in the hospital setting: the role of primary cognitive appraisal.

The aim of this study was to explore in a hospital setting the relationships between work motivation and stress among psychologists working in hospitals. The second aim was to identify the respective roles of threat appraisal and challenge appraisal in this population. We expected work stress to have a motivational impact in the workplace, with primary cognitive appraisal (e.g., threat or challenge) playing a crucial role. The study included a large sample of 430 French psychologists recruited in French hospitals with a mean age of 33.68 ± 8.73 years. We assessed perceived work stress, work motivation, and primary cognitive appraisal. Analysis showed two main outcomes. First, perceived stress in the workplace impacts work motivation; specifically, the higher the perceived stress, the less motivation is self-determined. Second, threat cognitive appraisal has a direct and negative motivational impact, but also an indirect impact via perceived stress. However, appraisal of work as a cognitive challenge also directly and positively impacts motivation in the workplace, without indirect effects. Finally, work stress, work motivation and primary cognitive appraisals are significantly related with the workplace. These relationships support complementarity with the Transactional Model of Stress and SDT motivational approach in a theoretical and practical perspective in the workplace.

Emotional exhaustion and fear of COVID-19 in geriatric facilities during the COVID-19 pandemic.

OBJECTIVE: Since the onset of the COVID-19 pandemic, healthcare workers, especially those employed in hospital settings, have been exposed to a variety of stressors in the workplace. The aim of this study was to explore the Emotional Exhaustion (EE) of workers in geriatric facilities during the COVID-19 crisis. We accordingly sought to investigate the short-term impact of the COVID-19 pandemic in terms of the EE experienced by workers in geriatric facilities, and to examine the manner in which psychosocial conditions and fear of COVID-19 in the workplace have affected EE. METHODS: Surveys were administered in the midst of the COVID-19 crisis (October to December 2020). The study included 118 French healthcare workers with a mean age of 35.61 ± 0.73 recruited in geriatric facilities. We assessed EE, psychosocial conditions (e.g., demands at work, health and well-being, etc.) and fear of COVID-19 in the workplace. RESULTS: The analysis yielded two main outcomes. First, 34.75% workers (41) reported severe levels of EE. Second, demands at work and the fear of COVD-19 increased EE. Health and well-being were, however, demonstrated to protect against EE. DISCUSSION: Furthermore, fear of COVID-19 was shown to contribute significantly to EE healthcare workers in geriatric facilities. It is likely that Covid-19 indirectly contributes to EE by influencing demands at work.

Psychiatric comorbidities of obsessive-compulsive disorder: A series of systematic reviews and meta-analyses.

OBJECTIVE: Although there is a growing number of studies on psychiatric comorbidities of obsessive-compulsive disorder (OCD), controversy remains about the strength of associations between some disorders. We present a series of systematic reviews and meta-analyses examining four psychiatric disorders frequently associated with OCD-depression, bipolar disorder, substance abuse disorder and psychosis. METHODS: Three electronic databases were searched up to May 2017; PsycINFO, Medline, and Web of Science. Meta-analyses using random effects models were conducted. RESULTS: The meta-analyses found strong associations between all comorbidities and OCD, particularly for depression. In addition, a series of systematic reviews were conducted giving information about the characteristics of these psychiatric associations. CONCLUSION: It is probable that these disorders share common etiological factors, and thus trans-diagnostic processes must be addressed when offering treatment. Clinical implications of these findings are discussed with suggestions for further research in the area.

Future-Oriented Repetitive Thought: Pessimistic View of Future in Patients With Alzheimer Disease.

OBJECTIVE: In this study, we, for the first time, evaluated future-oriented repetitive thought in patients with Alzheimer disease (AD), that is, how they think and worry about the future. METHODS: We administered the Future-Oriented Repetitive Thought scale to 34 patients with AD and 37 control participants. This scale assessed 3 categories of future-oriented repetitive thought: (1) pessimistic repetitive future thinking (eg, "I think about the possibility of losing people or things that are important to me"), (2) repetitive thinking about future goals (eg, "I make specific plans for how to get things that I want in life"), and (3) positive indulging about the future (eg, "When I picture good things happening in my future, it is as if they were actually happening to me now"). RESULTS: Analysis demonstrated more pessimistic repetitive future thinking, but less repetitive thinking about future goals and positive indulging about the future, in patients with AD than in control participants. CONCLUSION: Our findings demonstrate a pessimistic view of future in patients with AD, which is possibly attributed to hopelessness and depression.

Selflife: A Life Skills Development Tool to Prevent Sexual Violence among Healthcare Students.

BACKGROUND: in France, 14.5% of women and 3.9% of men aged 20-69 years have experienced sexual violence. Of these, 40% will go on to develop posttraumatic stress disorder. Sexual violence is therefore a major public health issue. In the present study, we tested a life skills development tool (Selflife) designed to prevent sexual violence in a population of healthcare students. METHODS: a total of 225 French healthcare students were randomly divided into a control group using case studies (n = 114) and a group using Selflife (n = 111) to discuss the topic of sexual violence. After the session, they completed self-report questionnaires collecting sociodemographic data and probing their feelings about their participation, their life skills, and their verdict on the intervention. RESULTS: compared with controls, participants in the Selflife group reported gaining more knowledge about sexual violence, a greater sense of improving their life skills, and greater satisfaction with the intervention. CONCLUSIONS: these results suggest that, in addition to providing information about sexual violence, Selflife helped students develop their life skills, thereby empowering them to act when confronted with sexual violence. Its impact on prevalence and on the psychological and psychiatric consequences remains to be assessed.

Willingness to be vaccinated against COVID-19: the role of risk perception, trust in institutions, and affects.

Introduction: Vaccination is one of the most effective ways to stop the COVID-19 pandemic and prevent severe disease. This study aims to ascertain the determinants of COVID-19 vaccination acceptance in the French population before the vaccine was introduced (France's second lockdown) and during the roll-out of the vaccination campaign (France's third lockdown). We focus on the following as determinants of willingness to be vaccinated: risk perception, affects related to the risk, and trust in political and health institutions. Method: The study was conducted among two convenient samples including 591 and 474 participants. The results show that the timing of the crisis was important. While the intention to be vaccinated was relatively low before the vaccines were introduced, it became significantly higher when the vaccination campaign was deployed. Results: The results show that risk perception and trust in health institutions are the most relevant predictors of intention to be vaccinated. Discussion: Results are discussed in terms of the effectiveness of communication campaigns.

Trauma Exposure and Mental Health Prevalence Among First Aiders.

Introduction: First aiders are commonly exposed to different forms of traumatic event (TE) during their duties, such as Chronic Indirect Vicarious Exposure which refers to an indirect exposure to aversive details of the trauma (APA, 2013). If the psychopathological impact of TE is well documented, the mental health of first aiders remains neglected. Therefore, our main objectives are (i) to study the link between exposure to traumatic events and psychopathological outcomes and (ii) to quantify the rates of mental health disorders among first aiders. Method: Our sample comprised of 53 volunteer first aiders (21 females and 32 males) with an average age of 32.4 years (SD = 13.6 years). Traumatic event exposure and mental health were assessed through a set of validated questionnaires completed online. Results: Rates of mental health outcomes were higher than within the general population. Females showed higher scores of post-traumatic stress disorder (PTSD) than males. PTSD scores were significantly correlated with all mental issues scores, apart from tobacco use and eating disorders scores. There was a significant correlation between the number of traumatic events and the years of experience. Exposure to traumatic events only correlated with nicotine dependency. No other correlation reaches statistical significance. Discussion: The scores of all mental health outcomes were high; a surprising result, as volunteer first aiders are thought to be recruited for their strong dispositional cognitive and emotional abilities. The high levels of post-traumatic stress disorder and burnout, along with the prevalent anxiety and depression, highlight the need for greater psychosocial support. Resilience training and peer support would be useful interventions in this group.

Fear of COVID-19, emotional exhaustion, and care quality experience in nursing home staff during the COVID-19 pandemic.

BACKGROUND: Nursing home staff have been adversely impacted throughout the COVID-19 pandemic, facing difficulties in providing patient care. The aim of this study was to explore health workers' perception regarding their own care quality experience in nursing homes during the COVID-19 pandemic. Amidst the second wave of the pandemic, we investigated the relationships between fear of COVID-19 and care quality experiences in nursing homes with emotional exhaustion (EE) as a mediating role. We hypothesized that EE is associated with fear of COVID-19 and care quality experience among nursing home staff. Furthermore, we predicted that EE would mediate the relationships between fear of COVID-19 and care quality experience. METHODS: During the second wave of COVID-19 (October to December 2020), we administered surveys to a large sample of 129 French nursing home staff with a mean age of 38.47 ± 10.31 who were directly and repeatedly exposed to COVID-19. We assessed their emotional exhaustion (EE) and care quality experience in the workplace via subjective indicators using self-reported scales. RESULTS: In the context of COVID-19, low to severe emotional exhaustion levels were found among nursing home staff, and these levels were associated with care quality experience as well as fear of COVID-19. The groups with low and severe levels of EE reported the highest levels of fear of COVID-19. The groups with moderate and severe levels of EE reported the lowest levels of care quality experience. Lastly, the relationships between fear of COVID-19 and care quality experience were mediated by EE. CONCLUSIONS: The findings made by the present study focused on the role of emotional coping responses to COVID-19. EE was associated positively with fear of COVID-19 and negatively with care quality experience. Furthermore, EE was found to mediate the relationship between fear of COVID-19 and care quality experience. We discuss these findings as they relate to palliative care issues in nursing homes and the manner in which emotional exhaustion ought to be addressed among nursing home staff.

"I Will Be Healthy": Ideal Self in Patients with Alzheimer's Disease.

Background: Within the concept of the self, a distinction can be made between ideal self (i.e., what would like to become) and feared self (i.e., what would not like to become in the future). Objective: We investigated ideal self and feared self in patients with mild Alzheimer's disease (AD). We have also measured these self-related processes in relation to depression and anxiety. Methods: We invited 31 patients with mild AD and 35 control participants to decide whether they would consider the statement (e.g., I will be healthy) as a representation that they would like to acquire (i.e., ideal self) or to avoid (i.e., feared self). Results: Analysis demonstrated that more participants assigned the "I will be healthy" statement to ideal self than to feared self, and this tendency was observed in both AD participants and controls. Less depression and anxiety were observed in participants who have assigned the "I will be healthy" statement to their ideal self compared to those who assigned this statement to their feared self, and this was observed in both AD participant and control groups. Conclusion: Our study demonstrates that AD patients tend to endorse positive health traits and to integrate these traits into their ideal self. AD patients tend to endorse health-related images that are associated with hopes when projecting into their future self. This positive projection into the self may create a motivational force (e.g., aspirations and hopes) to embody the "healthy" self that AD patients desire to be.

The face of future: Face expressions during future thinking.

Future thinking, which is the ability to project oneself forward in time to pre-experience an event, is intimately associated with emotions. We investigated whether emotional future thinking can activate emotional facial expressions. We invited 43 participants to imagine future scenarios, cued by the words "happy," "sad," and "city." Future thinking was video recorded and analysed with a facial analysis software to classify whether facial expressions (i.e., happy, sad, angry, surprised, scared, disgusted, and neutral facial expression) of participants were neutral or emotional. Analysis demonstrated higher levels of happy facial expressions during future thinking cued by the word "happy" than "sad" or "city." In contrast, higher levels of sad facial expressions were observed during future thinking cued by the word "sad" than "happy" or "city." Higher levels of neutral facial expressions were observed during future thinking cued by the word "city" than "happy" or "sad." In the three conditions, the neutral facial expressions were high compared with happy and sad facial expressions. Together, emotional future thinking, at least for future scenarios cued by "happy" and "sad," seems to trigger the corresponding facial expression. Our study provides an original physiological window into the subjective emotional experience during future thinking.

High Exhaustion in Geriatric Healthcare Professionals During the COVID-19 Second Lockdown.

BACKGROUND: In a previous study, we assessed burnout in geriatric healthcare workers during the first lockdown that lasted from March to May 2020 in France, in response to the COVID-19 crisis. OBJECTIVE: We carried out a follow-up study to assess burnout in the same population during the second lockdown that was implemented at the end of October 2020. METHODS: We used an online survey to assess burnout in terms of exhaustion and disengagement in a sample of 58 geriatric healthcare workers. RESULTS: We found higher levels of exhaustion, disengagement, and burnout among geriatric healthcare workers during the second than during the first lockdown. We also found high levels of exhaustion but moderate disengagement and burnout during the second lockdown. CONCLUSION: The increased exhaustion, disengagement, and burnout during the second lockdown can be attributed to the increased workload in geriatric facilities throughout this crisis and during the second lockdown due to shortage in staff and increased number of shifts and allocated duties. The high levels of exhaustion reported among geriatric healthcare workers during the second lockdown can reflect their physical fatigue, as well as their feelings of being emotionally overextended and exhausted by their workload.

Burnout of Healthcare Workers in Acute Care Geriatric Facilities During the COVID-19 Crisis: An Online-Based Study.

BACKGROUND/OBJECTIVE: The COVID-19 crisis has been increasing the burden of healthcare workers in acute care geriatric facilities. These workers have been dealing with drastic changes in the care they provide to their residents including cancelation of group activities and communal dining and even restrictions of activities outside rooms. Healthcare workers have also been devoting more time and energy to perform COVID-related medical duties. Geriatric facilities have been facing shortages in equipment and supplies, as well as staffing shortages. Finally, healthcare workers have been facing challenges regarding their personal safety and that of their families. Consequently, we hypothesized the presence of high levels of burnout among healthcare workers during the COVID-19 crisis. METHODS: To evaluate burnout in healthcare workers in French acute care geriatric facilities, we used an online survey based on the Oldenburg Burnout Inventory. Eighty-four healthcare workers answered the survey, during April of 2020. RESULTS: Analysis demonstrated that they were experiencing medium levels of burnout, exhaustion, and disengagement. CONCLUSION: This level of burnout reflected their fatigue, loss of energy, and/or feelings of being overextended and exhausted. Considering the expected cumulative impact of various stressors, the medium level of burnout observed has come as a surprise to us and might actually be considered as relatively good news. Nevertheless, no level of burnout is negligible and has wide ranging negative consequences.

Chronic low back pain and the transdiagnostic process: How do cognitive and emotional dysregulations contribute to the intensity of risk factors and pain?

BACKGROUND AND AIMS: Based on a transdiagnostic approach, this study assesses the impact of cognitive and emotional processes (difficulties in emotional regulation, impulsiveness, rumination and somatosensory amplification) on the psychological risk factors of chronic low-back pain. METHODS: The study was carried out with 256 patients with chronic low-back pain. All the variables were assessed through a booklet of 10 validated questionnaires. Multiple regression analysis and moderation analysis were performed. RESULTS: Predictors included in multiple regression models explain 3%-42% (adjusted R2) of the variance in psychological risk factors. Moreover, analyses reveal a significant moderator effect of somatosensory amplification on the link between fear-avoidance beliefs linked to work and pain intensity (F(3;250)=12.33; p=.00), of somatosensory amplification and brooding on the link between depression and functional repercussions (FR) on everyday life (F(3;252)=13.36; p=.000; F(1;252)=12.42; p=.00), of the reflection dimension of rumination on the link between the helplessness dimension of catastrophizing and FRs on sociability (F(3;252)=37.02; p=.00). There is also a moderation analysis with a significant trend concerning the lack of emotional awareness and the difficulties in controlling impulsive behaviours. CONCLUSIONS: Our results indicate an important role of some dimensions of difficulties in emotional regulation, somatosensory amplification and rumination in the increase in negative affects and dysfunctional beliefs, and in the links between those psychological risk factors and pain/disability. IMPLICATIONS: This study identifies some cognitive and emotional dysregulations substantially involved in work-related chronic pain. This contribute to put in place psychotherapeutic protocols to tackle these deficits and dysregulations in a relevant way.

Inmates-to-staff assaults, PTSD and burnout: profiles of risk and vulnerability.

Prison employees are often confronted with critical incidents and chronic stressors that may lead to trauma or burnout symptoms. However, most of the research on clinical aspects of interpersonal violence in prisons (inmates-to-staff violence, specifically) focuses either on trauma or on burnout. The purpose of the present study is (a) to examine both burnout and posttraumatic stress among prison staff and (b) to examine the influences of inmates-to-staff violent relations on posttraumatic stress in terms of risk profile to develop PTSD. A random sample of French correctional employees has completed various self-reported questionnaires assessing burnout, posttraumatic stress, and stress as well as victimization and demographic characteristics. Correctional employees demonstrated high levels of PTSD symptoms, burnout, and stress. Violent interactions with inmates lead to experienced trauma of all types (PTSD, secondary, or vicarious trauma). Results have highlighted a prison worker's profile prone to PTSD: he or she expresses high levels of emotional exhaustion, intense levels of stress, high levels of depersonalization, and high levels of intrusion, avoidance, and hyperreactivity. This study contributes to an understanding of the literature by explaining the complex association between burnout and posttraumatic stress after interpersonal violence. These findings suggest a need to support prison workers and to address inmates-to-staff relational dynamics.