Basic psychological needs, more than mindfulness and resilience, relate to medical student stress: A case for shifting the focus of wellness curricula.

PURPOSE: Medical student distress is an increasing concern in medical education. Addressing this issue requires a comprehensive understanding of what factors influence learners' stress in medical school. Grounded in Self-Determination Theory (SDT), this study explores the relative association between medical students' mindfulness, resilience, basic psychological needs, and perceived stress. Materials and methods: Of all year 1-4 medical students at our institution, 197 (49%) completed an online survey, measuring satisfaction and frustration of their basic psychological needs (autonomy, competence, relatedness), mindfulness, resilience, and perceived stress. Variables were assessed in relation to perceived stress, controlling for students' gender and year. RESULTS: Higher mindfulness, resilience, and need satisfaction were associated with lower perceived stress. Conversely, need frustration was associated with higher perceived stress. When students' need frustration was included in the model, the association between mindfulness, resilience, and perceived stress weakened. Third years reported more autonomy frustration than all other years. Compared to males, females in second and fourth year reported higher stress, lower mindfulness and resilience, and less competence fulfilment. CONCLUSIONS: Findings of this study suggest that, while mindfulness and resilience are important qualities for medical student well-being, their stress-protective benefits may diminish when students' basic psychological needs are frustrated in medical school. Addressing potentially need-thwarting aspects of the learning environment is therefore recommended, to help reduce student stress and promote their well-being. Preliminary suggestions on how this might be achieved are discussed, from an SDT perspective.

A family-based eating disorder day treatment program for youth: examining the clinical and statistical significance of short-term treatment outcomes.

This article describes an innovative family-based day treatment program (DTP) for youth with moderate to severe eating disorders. A sample of 65 youth completed a battery of psychological measures pre- and post-treatment and 6 months after program completion. Treatment outcomes were assessed in three main domains: (a) medical stabilization, (b) normalization of eating behavior, and (c) improved psychological functioning. Overall, patients demonstrated statistically significant and clinically meaningful improvements on all outcome measures. Findings indicate that a comprehensive DTP can successfully facilitate positive outcomes in youth with eating disorders and that these improvements can be maintained 6 months post-treatment.

The role of family, religiosity, and behavior in adolescent gambling.

Predictors of adolescent gambling behavior were examined in a sample of 436 males and females (ages 13-16). A biopsychosocial model was used to identify key variables that differentiate between non-gambling and gambling adolescents. Logistic regression found that, as compared to adolescent male non-gamblers, adolescent male gamblers were older, had more conflict in their family, were more likely to have used drugs, and have peers that gamble. Compared to adolescent female non-gamblers, adolescent female gamblers had more attention and thought problems, and scored higher on rule-breaking. For both males and females, religiosity was a protective factor against involvement in gambling. Some of the results are consistent with previous research, while some of these findings are unique to this study. These results shed light on factors to consider when developing programs to combat the negative impacts of gambling on adolescents.

Racial Composition of Couples in Battered Spouse Syndrome Cases: A Look at Juror Perceptions and Decisions.

This study manipulated the race of the defendant (wife) and the victim (husband)-White/White, White/Black, Black/Black, and Black/White-in a murder case involving a history of intimate partner violence (IPV) to examine the potential prejudicial impact of race on juror decision-making. A total of 244 jury-eligible American community members read a trial transcript of a murder case in which the defendant claimed self-defense using evidence of battered spouse syndrome. Participants provided a verdict, responsibility attributions, and their perceptions of the scenario. Findings revealed that the Black defendant (wife) was more likely to be found not guilty by reason of self-defense, and female jurors were overall more likely to acquit the defendant (wife) than were men. These results contribute to the scarce literature on the influence of race on perceptions of legal proceedings involving IPV.

Juror decision making in not criminally responsible on account of mental disorder trials: Effects of defendant gender and mental illness type.

This study sought to examine the potential impact of defendant gender and mental illness type on Canadian juror decision making by manipulating the gender (man, woman) and mental illness (substance abuse disorder, schizophrenia, bipolar, depression) of the defendant in a second-degree murder case involving an insanity plea. Participants read a trial transcript that included definitions of second-degree murder and the not criminally on account of mental disorder (NCRMD) defense. Participants then provided a verdict (guilty or NCRMD) and completed various scales measuring attributional judgments, perceptions of the defendant, and perceived dangerousness. Contrary to expectations, NCRMD was chosen over a guilty verdict in the majority of cases. Findings also indicated that participant decisions and perceptions regarding defendants diagnosed with substance abuse disorder differed from the other mental illness groups. The gender of the defendant had an influence on participants' perceptions of internal attributions, and the perceived stability of criminal behaviors. Results suggest that perceptions of mental illness influence verdicts in NCRMD cases, and that defendant gender plays a role in participants' perceptions of defendants. These findings contribute to the scarce literature on mental illness in the Canadian court system. Future research should examine the interaction between juror gender, defendant gender, and mental illness in insanity cases.

Defendant mental illness and juror decision-making: A comparison of sample types.

Two studies were conducted with separate student and community samples to explore the effect of sample types and the influence of defendant mental illness on juror decision-making. Following the completion of a pre-trial questionnaire in which jurors' attitudes towards mental illness were assessed, participants were provided with a robbery trial transcript, wherein the mental illness of the defendant was manipulated. Participants then answered a questionnaire to assess their knowledge of the scenario, their verdict, verdict confidence, and sentencing decision. Limited relationships were found between the variables in both Study 1 and Study 2. Neither attitude ratings nor mental illness type had a significant effect on juror decisions. Samples differed in terms of the paths through which juror decisions were achieved. Findings suggest that sample type may be particularly relevant for this topic of study, and that future research is required on legal proceedings for cases involving a defendant with a mental illness.

Canadian mock juror attitudes and decisions in domestic violence cases involving asian and white interracial and intraracial couples.

This study manipulated the race of the defendant and the victim (White/White, White/Asian, Asian/Asian, and Asian/White) in a domestic violence case to examine the potential prejudicial impact of race on juror decision making. A total of 181 undergraduate students read a trial transcript involving an allegation of spousal abuse in which defendant and victim race were manipulated using photographs. They then provided a verdict and confidence rating, a sentence, and responsibility attributions, and completed various scales measuring attitudes toward wife abuse and women. Findings revealed that female jurors were harsher toward the defendant than were male jurors. When controlling for attitudes toward Asians, jurors found the defendant guilty more often in cases involving interracial couples, as compared to same-race couples. Path analyses revealed various factors and attitudes involved in domestic violence trial outcomes. Findings contribute to the scarce literature on legal proceedings involving Asians, particularly in domestic violence cases. Outcomes also provide a model for relevant factors and characteristics of jurors in domestic violence cases. Roadblocks inherent in jury research are also discussed.