Do mortality cues increase state autonomy? The moderating roles of trait autonomy, flexibility, and curiosity.

This study tested the effects of deep and subtle mortality cues on state autonomy, in addition to the moderating roles of trait autonomy, psychological flexibility, and curiosity. Australian undergraduate students (N = 442) self-reported on moderator variables before being randomly allocated to receive either deep mortality cues, subtle mortality cues, or a control task, and finally reported their state autonomy for life goals. Trait autonomy did not moderate the effect of mortality cues on state autonomy. However, for individuals high on psychological flexibility, any mortality cues led to increased state autonomy compared to the control. For individuals high on curiosity, there was some evidence that only deep mortality cues led to increased state autonomy. These findings help clarify the nature of growth outcomes (in terms of more authentic, autonomous motivation for life goals), and the personal characteristics that facilitate growth-oriented processing of death awareness.

Connecting DSM-5 and ICD-11 trait domains with schema therapy and dialectical behavior therapy constructs.

The DSM-5 Section III alternative model of personality disorder (AMPD) and the International Classification of Diseases - 11th Edition's (ICD-11) personality disorder classification allow clinicians to identify individual trait domains in which people score highly. However, how these domains relate to constructs associated with efficacious treatment approaches is unclear. The current study aimed to determine whether constructs from two evidence-based treatments (schema therapy [ST] and dialectical behavior therapy [DBT]) were associated with maladaptive personality traits in a way consistent with underlying theories. We examined associations between ST constructs, DBT skill use and maladaptive coping styles, and personality traits in a sample of 525 adults. Bivariate intercorrelations and a series of multiple regression analyses were conducted to investigate the associations. As hypothesized, maladaptive coping was strongly associated with all trait domains. Surprisingly, poor DBT-skill use was only associated with negative affectivity, detachment, and disinhibition trait domains. Specific schema domains were associated with each personality trait domain, supporting trait domain-schema domain specificity. The current study highlights the potential clinical utility of the AMPD and ICD-11 trait models and ultimately contributes to the dearth of evidence on their likely usefulness for treatment selection, planning, and applications.

Living Authentically in the Face of Death: Predictors of Autonomous Motivation Among Individuals Exposed to Chronic Mortality Cues Compared to a Matched Community Sample.

Despite research demonstrating positive outcomes of conscious death reflection, very little research directly examines a core proposition of existential psychologists-that death reflection provides an opportunity for more authentic living. The current study compared individuals chronically exposed to genuine mortality cues (funeral/cemetery workers, n = 107) to a matched control sample (n = 121) on autonomous motivation. It also assessed the moderating role of six constructs implicated in growth-oriented processing of death reflection: psychological flexibility, curiosity, neutral death acceptance, death anxiety, approach-oriented coping, and avoidant coping. Funeral/cemetery workers were significantly higher on autonomous motivation, and death-related work was found to have a more positive association with autonomous motivation for those higher on flexibility and lower on death anxiety. This has implications for both understanding which individuals are most likely to experience growth motivations when confronting death, and potential avenues for facilitating these motivations to enhance well-being.

The Indonesian Mental Health Act: psychiatrists' views on the act and its implementation.

In 2014, the Indonesian government passed the Mental Health Act (MHA) to address the country's complex mental health situation. The implementation of the MHA has been slow, and little is known about how the MHA is perceived by mental healthcare providers within local settings. This study aimed to obtain insight into psychiatrists' views on the MHA, including on how it affected their clinical practice and on challenges of translating the MHA into practice. The study was conducted in Bali, and 27 psychiatrists (15 men and 12 women) participated in a semi-structured interview. Thematic analysis indicated four overarching themes: raising the profile of mental health, developing a shared understanding of mental illness, integrating psychiatric practice with other services and views on implementation of the MHA into practice. Overall, the psychiatrists viewed the MHA as a step in the right direction to improve mental health services and to create awareness at local and national levels. However, there was consensus that the meaning of the MHA's concepts of mental problems and disorders were not compatible with psychiatric everyday practice or their patients' understandings. As a result, many assumed that the MHA was targeted at government and policy officials. Furthermore, there was a perceived lack of clarity on issues relating to collaborating with other services and unequal access to resources among regencies that impacted on their clinical practice in a negative way. Moreover, a few psychiatrists raised concerns that local beliefs and practices were not acknowledged in the MHA. According to the participants, mental health remained a highly political issue and without national support, mental health would remain a low priority. In conclusion, insights into providers' perspectives contribute to developing an evidence-base that can inform the implementation process of the MHA in Indonesia, and possibly elsewhere, into local level guidelines and regulations.

A systematic review of the clinical utility of the DSM-5 section III alternative model of personality disorder.

Empirical controversy remains regarding the representation and diagnosis of personality disorders, as either distinct categories or as a dimensional continuum of psychopathology. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the Personality and Personality Disorders Work Group presented an alternative model of personality disorder (AMPD) that elicits a hybrid diagnosis. This attempt to combat the various limitations associated with primarily categorical or dimensional approaches was met with criticism regarding the AMPD's indeterminate clinical utility. To seek clarity, the current mixed-methods systematic review aimed to determine the clinical utility of the AMPD within a clinical population. An electronic screening of six databases, in addition to the application of explicit exclusion criteria, revealed 20 studies of relevance. Study characteristics and individual assessments of methodological quality were tabulated. The convergent, narrative synthesis of results was largely in support of the AMPD's clinical utility. Future exploration of the AMPD's communicative value between clinicians and their patients' families, the feasibility of the model's application, and the model's ability to translate into treatment modalities is required to both consolidate the current findings and to support a transition to a hybrid diagnosis of personality psychopathology. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The voluntary control of piloerection.

Autonomic nervous systems in the human body are named for their operation outside of conscious control. One rare exception is voluntarily generated piloerection (VGP)-the conscious ability to induce goosebumps-whose physiological study, to our knowledge, is confined to three single-individual case studies. Very little is known about the physiological nature and emotional correlates of this ability. The current manuscript assesses physiological, emotional, and personality phenomena associated with VGP in a sample of thirty-two individuals. Physiological descriptions obtained from the sample are consistent with previous reports, including stereotypical patterns of sensation and action. Most participants also reported that their VGP accompanies psychological states associated with affective states (e.g., awe) and experience (e.g., listening to music), and higher than typical openness to new experiences. These preliminary findings suggest that this rare and unusual physiological ability interacts with emotional and personality factors, and thus merits further study.

Nuanced aesthetic emotions: emotion differentiation is related to knowledge of the arts and curiosity.

The ability to distinguish between emotions is considered indicative of well-being, but does emotion differentiation (ED) in an aesthetic context also reflect deeper and more knowledgeable aesthetic experiences? Here we examine whether positive and negative ED in response to artistic stimuli reflects higher fluency in an aesthetic domain. Particularly, we test whether knowledge of the arts and curiosity are associated with more fine-grained positive and negative aesthetic experiences. A sample of 214 people rated their positive and negative feelings in response to various artworks including positive and negative themes. Positive ED was associated with the embracing sub-trait of curiosity that reflects engagement and enjoyment of novelty and complexity, but was unrelated to artistic knowledge and perceived comprehension. Negative ED was associated with higher curiosity and particularly more knowledge of the arts. This relationship was mediated by appraised comprehension suggesting that deeper engagement with art, by those with more art knowledge, is associated with more fine-grained emotional experiences. This finding extends ED beyond well-being research and suggests that more nuanced emotional experiences are more likely for those with expertise in the arts and motivation for exploration.

Aesthetic Emotions and Aesthetic People: Openness Predicts Sensitivity to Novelty in the Experiences of Interest and Pleasure.

There is a stable relationship between the Openness/Intellect domain of personality and aesthetic engagement. However, neither of these are simple constructs and while the relationship exists, process based evidence explaining the relationship is still lacking. This research sought to clarify the relationship by evaluating the influence of the Openness and Intellect aspects on several different aesthetic emotions. Two studies looked at the between- and within-person differences in arousal and the emotions of interest, pleasure and confusion in response to visual art. The results suggest that Openness, as opposed to Intellect, was predictive of greater arousal, interest and pleasure, while both aspects explained less confusion. Differences in Openness were associated with within-person emotion appraisal contingencies, particularly greater novelty-interest and novelty-pleasure relationships. Those higher in Openness were particularly influenced by novelty in artworks. For pleasure this relationship suggested a different qualitative structure of appraisals. The appraisal of novelty is part of the experience of pleasure for those high in Openness, but not those low in Openness. This research supports the utility of studying Openness and Intellect as separate aspects of the broad domain and clarifies the relationship between Openness and aesthetic states in terms of within-person appraisal processes.

Attachment as a partial mediator of the relationship between emotional abuse and schizotypy.

Developmental theories highlight the salience of attachment theory in explaining vulnerability towards psychosis. At the same time there is increasing recognition that psychosis is associated with childhood trauma variables. This study explored the interaction between attachment and several trauma variables in relation to schizotypy levels in a non-clinical sample. 283 non-clinical participants completed online measures of schizotypy, attachment, childhood abuse and neglect. When five types of abuse/neglect were entered into a linear regression analysis emotional abuse was the sole independent predictor of schizotypy. Age, attachment anxiety and avoidance were independent predictors after the effects of emotional abuse were controlled for. The overall model was significant, explaining 34% of the variation in schizotypy. Moderation analysis indicated that the effect of emotional abuse was not conditional upon attachment. Parallel mediation analysis indicated small but significant indirect effects of emotional abuse on schizotypy through attachment avoidance (13%) and attachment anxiety (8%). We conclude that emotional abuse contributes to vulnerability towards psychosis both directly and indirectly through attachment insecurity.

Cultural considerations in the treatment of mental illness among sexually abused children and adolescents: the case of Bali, Indonesia.

Childhood and adolescence sexual abuse can have long-lasting and devastating effects on personal and interpersonal growth and development. Sexually abused children tend to exhibit higher rates of poor school performance, aggressive behavior, PTSD (posttraumatic stress disorder), or depressive symptomatology, as well as social and relational deficits (e.g., age-inappropriate sexual behaviors). The trauma following such abuse can further affect neurodevelopment and physiology, aggravating mental or physical problems in adulthood. Early symptom recognition and appropriate interventional applications are important factors in successfully treating or even preventing the development of mental disorders in such cohorts. A central element of effective treatment is the selection of treatment targets. Cultural considerations are rarely or peripherally considered in sexual abuse treatment strategies. Western-trained psychiatrists and clinical psychologists tend to overlook or underestimate such factors in cross-cultural settings, resulting in interventional efforts that may interfere with traditional approaches to healing, and potentially contributing to a transgenerational cycle of trauma. By using Bali (Indonesia) as a focal culture, in this article we discuss the effects of cultural elements and showcase their potential contribution and systematic implementation into a holistic and sensitive interventional model for the treatment of mental illness in childhood and adolescence sexual traumatization.

Treating the untreated: applying a community-based, culturally sensitive psychiatric intervention to confined and physically restrained mentally ill individuals in Bali, Indonesia.

This study identified, mapped and treated the clinical features of mentally ill people, who had been isolated and restrained by family and community members as a result of a functional failure of the traditional medical, hospital-based mental health model currently practiced in Indonesia. A 10-month epidemiological population survey was carried out in Karangasem regency of Bali, Indonesia. A total of 404,591 individuals were clinically interviewed, of which 895 individuals with mental health problems were identified, with 23 satisfying criteria of physical restraint and confinement. Of the latter, twenty were males; age range was 19-69 years, all diagnosed by the researchers with schizophrenia-spectrum disorder (ICD-10 diagnostic criteria). Duration of restraint ranged from 3 months to 30 years (mean = 8.1 years, SD = 8.3 years). Through the application of a holistic intervention model, all patients exhibited a remarkable recovery within 19 months of treatment. We conclude that the development of a community-based, culturally sensitive and respectful mental health model can serve as an optimum promoter of positive mental health outcomes.

A spiritual-hypnosis assisted treatment of children with PTSD after the 2002 Bali terrorist attack.

The aim of this study was to assess the effectiveness of a spiritual-hypnosis assisted therapy (SHAT) for treatment of posttraumatic stress disorder (PTSD) in children. All children, age 6-12 years (N=226; 52.7% females), who experienced the terrorist bomb blasts in Bali in 2002, and subsequently were diagnosed with PTSD were studied, through a longitudinal, quasi-experimental (pre-post test), single-blind, randomized control design. Of them, 48 received group SHAT (treatment group), and 178 did not receive any therapy (control group). Statistically significant results showed that SHAT produced a 77.1% improvement rate, at a two-year follow up, compared to 24% in the control group, while at the same time, the mean PTSD symptom score differences were significantly lower in the former group. We conclude that the method of spiritual-hypnosis is highly effective, economic, and easily implemented, and has a potential for therapy of PTSD in other cultures or other catastrophic life-threatening events.

"I intend to donate but ...": non-donors' views of blood donation in the UK.

Although only 6% of the eligible United Kingdom population regularly donate blood, reasons for low donation rates remain poorly understood. In a grounded theory investigation, blood donors (n = 23) and non-donors (n = 27) completed a questionnaire that included 15 open-ended items. Semi-structured interviews were conducted with sub-samples of donors (n = 5) and non-donors (n = 7). Analysis of open-ended responses and interview transcripts identified five themes. Three themes, namely pro-social views, helping behaviour and awareness had similar relevance for donors and non-donors. Two themes, anxiety and practical difficulties, were used by non-donors to account for non-donation despite intentions to donate. Although non-donors' anxieties may be difficult to overcome, perceived practical difficulties provide scope for intervention. The removal of perceived barriers to donation offers one way of increasing donation rates.

Predicting parents' decisions on MMR immunisation: a mixed method investigation.

BACKGROUND: Increasing uptake rates for MMR vaccination requires an understanding of factors leading parents to decide for and against vaccination, particularly in the light of recent developments. OBJECTIVE: We investigated factors relevant to immunising and non-immunising parents and the extent to which these factors predicted their decisions. METHODS: The study was conducted in Edinburgh, UK. A two-stage mixed method design was used. Delphi technique elicited parents' views of factors relevant to MMR immunisation. Twenty-six factors identified as relevant were incorporated into a final questionnaire. Using cluster sampling, the final questionnaire was distributed to parents recruited through a group of local nurseries. 110 parents participated: eighty (72.7%) had had their child MMR vaccinated, thirty (27.3%) had refused the vaccine. The factors in the final questionnaire were analysed against vaccination status using a direct binary logistic regression model. RESULTS: Four factors significantly predicted vaccination status, (prediction toward 'yes vaccination'). These were the influence of current research (OR=0.18, 95% CI=0.07-0.51), the helpfulness of leaflets and information packs (OR=3.27, 95% CI=1.38-7.75), the importance of eradication of rubella (OR=2.42, 95% CI=1.01-5.78), and the importance attached to the risk of adverse reactions (OR=0.65, 95% CI=0.48-0.87). CONCLUSIONS: Differences between immunising and non-immunising parents lie in the importance attached to four relevant factors. Excluding risk of adverse reactions, these factors have not been previously identified as salient and require to be explored further. Health advice to parents should highlight the identified importance attached to eradicating rubella and explicitly reflect research findings.