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Introduction: The purpose of this review is to systematically extract and analyse global academic literature to determine the physical and psychological effects of domestic abuse and violence on South Asian women. Design: This review employs a qualitative systematic approach and thematic analysis to synthesize the narratives of affected women found in the literature. Given that domestic violence is often concealed and downplayed by various social factors, statistical reports and prevalence data offer only a limited view of the issue due to underreporting. Therefore, qualitative literature is deemed more dependable in this subjective domain as it captures and interprets the experiences and meanings within this under-studied group. Data sources: Embase, PsycINFO, Google Scholar, Web Of Science, MEDLINE, and ASSIA were searched. Review methods: All included studies were critically appraised using the CASP tool for qualitative research. Thematic analysis was conducted to develop six themes. Studies excluded did not address the research question, although intersecting population issues could be valuable topics for further research. Results: The literature indicates severe mental and physical health consequences of domestic violence and abuse, with some traits persisting long-term. The analysis underscores the significant role of resilience, suggesting that individuals can overcome traumatic social experiences without enduring lifelong labels or a deficit model. Conclusion: The findings provide support for future interventions aimed at recognizing signs of abuse and preventing severe psychological and physical consequences, particularly among South Asian women. Further research is needed to understand the impact on children and other family members affected by the victim's abuse, which falls beyond the scope of this review.
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Obsessive compulsive disorder (OCD) is a complex condition characterised by intrusive and distressing thoughts (obsessions) and repetitive behaviours or mental acts (compulsions). The symptoms of OCD cause significant distress and anxiety and can have a debilitating effect on a person's daily functioning. This article gives an overview of OCD, including its prevalence, aetiology, symptoms and treatment strategies, with the aim of enhancing nurses' understanding of the condition and its adverse effects on a person's life. The author also discusses some of the ways in which nurses in any setting can support a person with OCD.
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Trastorno Obsesivo Compulsivo , Humanos , Trastorno Obsesivo Compulsivo/enfermería , Trastorno Obsesivo Compulsivo/terapia , PrevalenciaRESUMEN
We offer an alternative conceptualization of the construct of susceptibility to emotional contagion and four related studies where two separate measures were developed and initially validated. The Contagion of Affective Phenomena Scale-General (CAPS-G) is a 5-item scale that measures the general susceptibility to the contagion of affect, and the Contagion of Affective Phenomena Scale - Emotion (CAPS-E) assesses six distinct emotions. Study 1 generated items with experts. Study 2 explored and confirmed construct validity and the factorial structure of both measures using exploratory structural equation modeling. Study 3 established test-retest reliability, concurrent validity, and discriminant validity. Study 4 found predictive validity with a sample of competitive swimmers. In four separate samples, a 21-item and 6-factor first-order structure of CAPS-E provided the best model fit. We provide initial evidence that supports the use of CAPS-E and CAPS-G as reliable and valid measures of the susceptibility to contagion of affective phenomena.
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The existence of a professional identity among sport psychology practitioners (SPPs) can increase ethical and effective practice while also leading to more satisfactory careers and advancing awareness of professional roles. There is currently no consensus regarding a sport psychology professional identity (SPPI), a definition of this construct, and the factors influencing it. As such, in the present study, we sought consensus on a definition of SPPI and aimed to identify associated factors. A multinational panel of 39 SPPs from 6 different continents participated in a 3-round Delphi study. The panelists in this study, who were recruited based on their applied and scholarly experiences, constructed a shared definition of SPPI as an individual's professional self-concept concerning their sense of belonging and fit within the sport psychology profession. Further, the panelists also constructed a list of factors supporting (n = 13; e.g., knowledge and philosophy of the profession, personal meaning) and hindering (n = 10; e.g., isolation, non-traditional roles, lack of practitioner-environment fit) the development of SPPI. Professional organizations might use these results to advance professional development and training by integrating them into curricula for qualification processes. A clear understanding of what SPPI is and the factors that foster and hinder its development can support practitioners' wellbeing and practice as well as raise public awareness of what is the sport psychology profession.
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Psicología del Deporte , Identificación Social , Humanos , Técnica Delphi , Curriculum , ConsensoRESUMEN
A clear model of professional development (PD) has the potential to enhance educational and training programs and promote effective, competent, and ethical practice. Scholars have explored facets of the PD of sport psychology practitioners (SPPs) using theoretical frameworks borrowed from counseling psychology. Yet, given the emergence of a sport-specific body of work on this topic, it appears timely to take stock of existing context-specific knowledge. In the present study, we aimed to systematically review the extant literature focused on SPP's PD to identify specific characteristics and organize this knowledge in an accessible and structured manner in the form of a process model of PD. Following the PRISMA guidelines, we identified 1147 research records in the databases SportDiscuss, PsychArticles, PsychInfo, ProQuest, and PubMed. We subsequently screened and assessed the records for eligibility (i.e., empirical studies published in English that focus on developmental characteristics of SPPs, including a clear developmental stage) reducing the sample of articles that fitted our inclusion criteria to 34 qualitative manuscripts. Finally, we critically explored these manuscripts by engaging in a reflexive thematic analysis and created four developmental phases (i.e., introduction, exploration, solidification, and fulfillment). SPPs' transition through these phases is seemingly facilitated by four processes (i.e., reflection, supervision, connections and networking with peers, and learning by doing), which also support the completion of the tasks associated with nine developmental elements (i.e., purpose, confidence and anxiety, focus, awareness, adaptability, independence, philosophy/congruence, professional identity, and the individual). We present the interaction of these developmental phases, elements, and processes in the form of a sport psychology-specific process model of PD. We discuss the implications of this model and its potential contribution to future research, supervision, and training programs. Yet, we also acknowledge how a focus on Anglophone and Western cultural contexts and a lack of methodological transparency are limitations of the extant literature.
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Psicología del Deporte , Humanos , Investigación Empírica , Aprendizaje , Psicología del Deporte/educación , Revisiones Sistemáticas como AsuntoRESUMEN
Researchers have shown that the emotions that athletes experience during sporting competition can be transferred between team members to create collective team emotional states. Nevertheless, collective emotions have not yet been investigated for sporting dyads. In this study, the emotional experiences of 68 doubles table tennis players (34 dyads) were examined at three time points: precompetition, in-competition, and postcompetition. It was found that the intensity of each emotional state differed as a function of match situation (positive/negative). Moreover, in-competition anxiety, dejection, and anger were shown to predict poorer subjective performance, and anxiety was shown to negatively impact future objective athlete performance. Most pertinently, within-dyad emotional aggregation was identified for athlete in-competition happiness and dejection and for postcompetition happiness, dejection, and anger. These findings represent the first quantitative evidence of emotional convergence in sport dyads and provide support for the social functional theory of emotion in sport.
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Rendimiento Atlético , Tenis , Ira , Ansiedad/psicología , Rendimiento Atlético/psicología , Emociones , Humanos , Tenis/psicologíaRESUMEN
Conventionally, therapeutic assessments, interventions, and treatments have focussed on death-related "losses and grief" responses. It is purported that the COVID-19 aftermath has resulted in losses that cannot always be encapsulated using this method. In search of reasoning, models and theories that explain the sweeping mass destruction that COVID-19 has caused, key concepts arise in terms of how we should deal with losses and in turn support patients in the health and social care sector, (notwithstanding formal therapeutic services). There is a crucial need to embrace ambiguous loss and disenfranchised grief into everyday terminology and be acquainted with these issues, thereby adapting how services/clinicians now embrace loss and grief work. Integral to this process is to recognize that there has been a disproportionate impact on Black and minority ethnic communities, and we now need to ensure services are "seriously culturally competent." Primary Care services/IAPT/health and social care/voluntary sector are all likely to be at the forefront of delivering these interventions and are already established gatekeepers. So, this article discusses the prognostic therapeutic response to non-death related losses and grief, not restricted to the formal echelons of therapeutic provision.
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COVID-19 , Privación del Duelo , Pesar , Humanos , Apoyo SocialRESUMEN
OBJECTIVE: To evaluate the relationship between crack/cocaine use and domestic violence perpetration from the perspective of substance users' families. A secondary retrospective cross-sectional study, with 3162 family members of crack/cocaine users seeking treatment in the Recomeço Família Programme in São Paulo/Brazil was undertaken. Family members of crack/cocaine users reported that their relatives were more involved in domestic violence such as stealing (money and objects) at home [Odds Ratio Adjusted ORA = 2.17 (CI 95% 1.87; 2.53)], the family gave money to the user to buy drugs [ORA = 1.27 (1.08; 1.48)], and having problems with the judiciary [ORA = 1.48 (CI 95% 1.28; 1.71)]. Relatives of snorted cocaine users reported that there was physical and interpersonal violence, such as fathers being assaulted [ORA = 2.50 (CI 95% 1.08; 5.82)], assaulted someone else [ORA = 1.86 (CI 95% 1.32; 2.60)], threats of violence fights, arguments when the family talk about problematic drug use [ORA = 1.50 (CI 95% 1.13; 1.96)] and threatened some family members [ORA = 1.52 (CI 95% 1.14; 2.04)]. In this sample, there was a connection between crack/cocaine use and the perpetuation of domestic violence, corroborating with important implications for public policies, substance use treatment and prevention of domestic violence interventions.
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Trastornos Relacionados con Cocaína , Cocaína Crack , Violencia Doméstica , Trastornos Relacionados con Sustancias , Brasil/epidemiología , Trastornos Relacionados con Cocaína/epidemiología , Estudios Transversales , Familia , Humanos , Estudios RetrospectivosRESUMEN
OBJECTIVE: To assess factors associated with depression among higher education students and professionals during the peak of the COVID-19 pandemic. METHOD: quantitative study with a cross-sectional design. 550 students and professionals participated. The data were collected by means of a digital questionnaire that included Patient Health Questionnaire-9 to assess depressive symptoms. RESULTS: The factors related to depression and social isolation outcomes were significantly associated with the female gender (n= 149; 37,8%; Odds Ratio OR=2,0), white (n=127; 37,2%; OR=1,60), young people (n=130; 39,4%; OR=2,0), without religion (n=70; 40,2%; OR=1,64), with financial problems (n=80; 53,0%; OR=2,40) and family problems (n=98; 47,3%; OR=1,77); who suffered violence during the quarantine (n=28; 58,3%; OR=2,33), increased the use of illicit drugs (n=16; 59,3%; OR=2,69), used sedatives without a medical prescription (n=75; 54,0%; OR=2,94), lived in conflicting relationships (n=33; 54,1%;OR=2,14), lost their job during the pandemic (n=32; 59,3%; OR=1,99) and presented symptoms of anxiety related to COVID-19 (n=155; 45,2%; OR=3,91). CONCLUSION: there is a meaningful relationship between vulnerability and adopting risk behaviors during the pandemic-imposed social isolation with depressive symptoms. We suggest that health professionals be attentive to the need to adjust their psychosocial interventions when promoting strategies when promoting strategies to mitigate the effects and risks to mental health.
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COVID-19 , Pandemias , Adolescente , Ansiedad/epidemiología , Ansiedad/etiología , Ansiedad/psicología , COVID-19/epidemiología , Estudios Transversales , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Factores de Riesgo , SARS-CoV-2 , Aislamiento Social/psicologíaRESUMEN
The aim of the present article is to outline a heuristic model that facilitates movement toward an integrated understanding of the youth sport system. We define the youth sport system as the set of interdependent persons and contexts that influence and are influenced by an athlete in youth sport. Our model builds directly from a systems perspective, and its tenets of holism, feedback loops, and roles. Specifically, we argue that the persons and contexts that surround an athlete in youth sport should be examined collectively, self-correct over time, and take on certain functions that are negotiated over time. The model extends past contributions toward integration by outlining how proximal and distal processes within youth sport can be studied in a more unified way. Looking forward, research designed to capture the nuanced ways persons and contexts influence and are influenced by one another in youth sport will be best positioned to impact theory and practice in meaningful ways.
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Deportes Juveniles , Adolescente , Atletas , HumanosRESUMEN
The objective of this study is to evaluate the prevalence of self-reported rape and its associations with other forms of violence and mental health outcomes. The Brazilian National Alcohol and Drugs Survey is a probabilistic household survey that collected data from 4,283 Brazilians aged 14 years and older in 2012. The prevalence of rape was 2.3% (n = 107) and the majority (n = 81) of rapes were reported by women. Female gender increased the chances of rape (adjusted odds ratio [AOR] = 2.7, 95% confidence interval [CI] = [1.7, 4.3]). Adults aged 35 to 46 years (AOR = 2.0, 95% CI = [1.2, 4.4]) and being without religion (AOR = 2.2, 95% CI = [1.3, 3.8]) were also associated with increased chances of rape. Participants with a history of childhood sexual abuse (CSA) were 16.5 times (95% CI = [10.1, 26.7]) more likely to report having been raped. Other outcomes related to been raped were history of child prostitution (AOR = 5.1, 95% CI = [2.1, 13.4]) and witnesses of violence during childhood (AOR = 2.4, 95% CI = [1.5, 3.8]). People without social support (AORâ 3, 95% CI = [1.8, 4.3]), victims of multiple recent negative events (AOR = 3.7, 95% CI = [2.4, 5.8]), people with depression (AOR = 2.6, 95% CI = [1.7, 3.9]), history of suicidal ideation (AOR = 3.8, 95% CI = [2.0, 7.1]), and history of suicide attempts (AOR = 2.2, 95% CI = [1.1, 4.3]) are other outcomes related to having been raped. In this sample, rape was related to gender and to other forms of violence and victimization. Self-reports of rape appear to underestimate the true prevalence as the figures obtained from the survey were low. Other methods should be used to investigate this issue.
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Abuso Sexual Infantil , Violación , Adulto , Niño , Femenino , Humanos , Salud Mental , Prevalencia , Factores de RiesgoRESUMEN
ABSTRACT Objective: To assess factors associated with depression among higher education students and professionals during the peak of the COVID-19 pandemic. Method: quantitative study with a cross-sectional design. 550 students and professionals participated. The data were collected by means of a digital questionnaire that included Patient Health Questionnaire-9 to assess depressive symptoms. Results: The factors related to depression and social isolation outcomes were significantly associated with the female gender (n= 149; 37,8%; Odds Ratio OR=2,0), white (n=127; 37,2%; OR=1,60), young people (n=130; 39,4%; OR=2,0), without religion (n=70; 40,2%; OR=1,64), with financial problems (n=80; 53,0%; OR=2,40) and family problems (n=98; 47,3%; OR=1,77); who suffered violence during the quarantine (n=28; 58,3%; OR=2,33), increased the use of illicit drugs (n=16; 59,3%; OR=2,69), used sedatives without a medical prescription (n=75; 54,0%; OR=2,94), lived in conflicting relationships (n=33; 54,1%;OR=2,14), lost their job during the pandemic (n=32; 59,3%; OR=1,99) and presented symptoms of anxiety related to COVID-19 (n=155; 45,2%; OR=3,91). Conclusion: there is a meaningful relationship between vulnerability and adopting risk behaviors during the pandemic-imposed social isolation with depressive symptoms. We suggest that health professionals be attentive to the need to adjust their psychosocial interventions when promoting strategies when promoting strategies to mitigate the effects and risks to mental health.
RESUMEN Objetivo: Evaluar los factores asociados a la depresión entre estudiantes y profesionales de nivel superior durante el pico de la pandemia de COVID-19. Método: estudio cuantitativo con delineamiento transversal. Participaron 550 estudiantes y profesionales. Los datos fueron obtenidos por medio de un cuestionario digital, que incluía el Patient Health Questionnaire-9 para evaluación de síntomas depresivos. Resultados: Los factores relacionados a la depresión y los resultados del aislamiento social fueron significativamente asociados al sexo femenino (n= 149; 37,8%; Odds Ratio OR=2,0), raza blanca (n=127; 37,2%; OR=1,60), jóvenes (n=130; 39,4%; OR=2,0), sin religión (n=70; 40,2%; OR=1,64), con problemas financieros (n=80; 53,0%; OR=2,40) y familiares (n=98; 47,3%; OR=1,77); que sufrieron violencia durante la cuarentena (n=28; 58,3%; OR=2,33), aumentaron el uso de drogas ilícitas (n=16; 59,3%; OR=2,69), consumieron sedativos sin prescripción médica (n=75; 54,0%; OR=2,94), vivieron relaciones conflictivas (n=33; 54,1%;OR=2,14), perdieron el empleo en la pandemia (n=32; 59,3%; OR=1,99) y presentaron síntomas de ansiedad relacionado al COVID-19(n=155; 45,2%; OR=3,91). Conclusión: Hay una relación significativa entre vulnerabilidad y adopción de comportamientos de riesgo durante el aislamiento social impuesto por la pandemia con síntomas depresivos. Sugerimos que los profesionales de la salud estén atentos ante la necesidad de ajustar sus intervenciones psicosociales al promover estrategias para mitigar los efectos y riesgos para la salud mental.
RESUMO Objetivo: Avaliar os fatores associados à depressão entre estudantes e profissionais de nível superior durante o pico da pandemia de COVID-19. Método: estudo quantitativo com delineamento transversal. Participaram 550 estudantes e profissionais. Os dados foram coletados por meio de um questionário digital, que incluía o Patient Health Questionnaire-9 para avaliação de sintomas depressivos. Resultados: Os fatores relacionados à depressão e os desfechos do isolamento social foram significantemente associados ao sexo feminino (n=149; 37,8%; Odds Ratio OR=2,0), raça branca (n=127; 37,2%; OR=1,60), jovens (n=130; 39,4%; OR=2,0), sem religião (n=70; 40,2%; OR=1,64), com problemas financeiros (n=80; 53,0%; OR=2,40) e familiares (n=98; 47,3%; OR=1,77), que sofreram violência durante a quarentena (n=28; 58,3%; OR=2,33), aumentaram o uso de drogas ilícitas (n=16; 59,3%; OR=2,69), consumiram sedativos sem prescrição médica (n=75; 54,0%; OR=2,94), vivenciaram relacionamentos conflituosos (n=33; 54,1%;OR=2,14), perderam o emprego na pandemia (n=32; 59,3%; OR=1,99) e apresentaram sintomas de ansiedade relacionada à COVID-19 (n=155; 45,2%; OR=3,91). Conclusão: há uma relação significativa entre vulnerabilidade e adoção de comportamentos de risco durante o isolamento social imposto pela pandemia com sintomas depressivos. Sugerimos que os profissionais de saúde estejam atentos para a necessidade de ajustar suas intervenções psicossociais ao promoverem estratégias para mitigar os efeitos e riscos à saúde mental.
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This study examined the prevalence, and associated factors, of violence against women by an intimate partner amongst 369 women who attended nursing consultations at primary care centres in Northeast Brazil. Socio-demographic variables, substance use, mental health and the forms of violence were analysed. IPV was a reality for 65.4% of the women of reproductive age seen in the centres. IPV, including psychological violence, is associated with age, education and religion, particularly amongst female cannabis users whose partners were also substance users. Primary care providers are in a position to detect, screen, counsel and treat women who experience IPV.
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Violencia de Pareja , Brasil , Estudios Transversales , Femenino , Humanos , Prevalencia , Factores de Riesgo , ViolenciaRESUMEN
Monitoring the physical load undertaken by athletes and examining the subsequent relationship with performance and injury and illness risk is common practice in high performance sport. Less attention has been paid to the psychological factors contributing to the overall load experienced and the impact upon health status and performance. This paper discusses considerations for the conceptualization and measurement of psychological load in sport. First, we outline the importance of ensuring conceptual clarity is adopted in the measurement of psychological load. Next, we discuss the challenges to measuring psychological load in a comparable manner to which physical load is currently evaluated, including use of subjective assessment, adoption of specific and global approaches, and development of measurement instrumentation, techniques, and expertise. We then offer recommendations for practitioners when undertaking assessment of psychological load in sport. We conclude with future research directions to advance the study and measurement of the construct, including the interaction between psychological and physical load, the appraisal of the load faced, and personal and social resources available to successfully cope. We also highlight the need to consider groups of athletes (e. g., transitioning athlete, long-term injured) at greater risk from threats to mental and physical health from increased psychological load.
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Atletas/psicología , Deportes/psicología , Cognición , Humanos , Fatiga MentalRESUMEN
OBJECTIVES: The aim of this study was to investigate the prevalence, consequences and factors associated with drug use among individuals over 50 years of age, from the perspective of their families, with particularly reference to cocaine use. METHODS: Cross-sectional study based on secondary data with 624 family members of substance users who sought family support in 14 units of the Recomeço Família Program in São Paulo, Brazil. RESULTS: The participants were predominately men, aged 50 to 59 years (68%); cocaine users (inhaled and/ or smoked); living alone; with a low level of education and were unemployed. They were likely to use family money to pay for their substance use, with a history of theft and aggression against strangers, and were not in treatment. Unlike other participants [≥ 60 years (31.1%)]; who were better educated and retired. In this latter group, 32.8% are alcohol users, 14.8% cocaine users (inhaled and smoked), 32.6% has physically assaulted their family, 39.7% had assaulted someone else and 18.3% had stolen objects or money from home. CONCLUSIONS: The population has peculiar characteristics of vulnerability (cocaine use and violence) that remain under investigated; not only do routes into treatment for older adults (≥ 60) but appropriate treatment packages need to be developed too.
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Cocaína Crack , Trastornos Relacionados con Sustancias , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
The aim of this study is to evaluate the associations between having parents with substance use problems, and having suffered neglect within the family, and behavioral problems (psychological and drug use) among adolescents. All the participants were enrolled on the socio-educational parole scheme, 'Assisted Freedom'. In this cross-sectional study, 150 adolescents were interviewed using the Drug Abuse Screening Test, Teen Addiction Severity Index, and Childhood Trauma Questionnaire. Ninety-five percent of the participants were male (n = 143), aged 13-17. Thirty percent of adolescents had a parent who used substances and had experienced neglect from their families. Those adolescents who were living with both parents (odds ratio adjusted (ORA) = 2.7, 95% confidence interval (CI) = 1.13-6.37), from a low-income family (ORA = 6.7, 95% CI = 1.85-24.22), experienced hallucinations (ORA = 2.8, 95% CI = 1.25-6.14), had problems controlling violent behavior (ORA = 2.6, 95% CI = 1.12-5.87), and were physically neglected (ORA = 3.0, 95% CI = 1.24-7.49) were more likely to have parents who used substances and to have experienced parental neglect. This article concludes that adolescents, who are on parole, come from families with high level of psychosocial vulnerabilities, including substance use, experience neglect by their families leading to adverse emotional and psychological states.
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Maltrato a los Niños , Adolescente , Brasil , Niño , Estudios Transversales , Emociones , Humanos , Masculino , PadresRESUMEN
Evidence points toward the impact of nurses' personal views and knowledge about religion, religiosity, and spirituality on health care. This qualitative research investigates nurses' concepts of religion, religiosity, and spirituality and how they use these concepts in practice. Thirty-four nurses were interviewed at a hospital in the state of São Paulo, Brazil. Content analysis was used to organize and code the results. Three main themes generated from the interviews were (i) religiosity/spirituality as an important dimension in life; (ii) notions of religiosity and spirituality; (iii) formal knowledge of the concept of religion, religiosity, and spirituality. The results indicate that religion, religiosity and spirituality should be incorporated into nurse training to improve the comprehension and competence of nurses in these areas of practice. It is recommended that to ensure holistic and person-centered care, there must be constant reflection on these concepts.
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Enfermeras y Enfermeros/psicología , Religión y Medicina , Adulto , Actitud del Personal de Salud , Brasil , Femenino , Humanos , Masculino , Enfermeras y Enfermeros/estadística & datos numéricos , Investigación CualitativaRESUMEN
OBJECTIVE: To describe the prevalence of substance use and the associations between adverse early life experiences, sexual behaviour and violence in sexual minority (SM) individuals. METHODS: The Brazilian National Alcohol and Drugs Survey is a probabilistic household survey performed in 2012, collecting data from 4067 Brazilians aged 14â¯years and older. RESULTS: 3.4% of the sample declared themselves as sexual minorities, 53.8% female, 66.5% single, mean age of 29.5â¯years (standard deviation 16.0â¯years). A high prevalence of alcohol dependence (15.2%) and binge drinking (22.2%) was identified in the SM group. Respondents were more likely to use crack cocaine and hallucinogens, to have been involved in child prostitution, child sexual abuse and to report suicidal ideation in the previous year. Respondents were also more likely to engage in unprotected sex compared to non-sexual minorities. Nearly one-third referred to having suffered homophobic discrimination in their lives. Respondents also reported higher rates of domestic violence (18.9%) and urban violence (18%) among the SM. CONCLUSION: The findings reinforce that violence directed at individuals in the Brazilian SM community begins early in life and persists into adulthood when compared to non-sexual minorities. This population is also more exposed to substance use disorders.
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Abuso Sexual Infantil/estadística & datos numéricos , Conducta Sexual , Minorías Sexuales y de Género/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Ideación Suicida , Adulto , Brasil/epidemiología , Niño , Femenino , Humanos , Masculino , Prevalencia , Encuestas y CuestionariosRESUMEN
Introduction: Drowning is a leading cause of accidental death. In cold-water, sudden skin cooling triggers the life-threatening cold shock response (CSR). The CSR comprises tachycardia, peripheral vasoconstriction, hypertension, inspiratory gasp, and hyperventilation with the hyperventilatory component inducing hypocapnia and increasing risk of aspirating water to the lungs. Some CSR components can be reduced by habituation (i.e., reduced response to stimulus of same magnitude) induced by 3-5 short cold-water immersions (CWI). However, high levels of acute anxiety, a plausible emotion on CWI: magnifies the CSR in unhabituated participants, reverses habituated components of the CSR and prevents/delays habituation when high levels of anxiety are experienced concurrent to immersions suggesting anxiety is integral to the CSR. Purpose: To examine the predictive relationship that prior ratings of acute anxiety have with the CSR. Secondly, to examine whether anxiety ratings correlated with components of the CSR during immersion before and after induction of habituation. Methods: Forty-eight unhabituated participants completed one (CON1) 7-min immersion in to cold water (15°C). Of that cohort, twenty-five completed four further CWIs that would ordinarily induce CSR habituation. They then completed two counter-balanced immersions where anxiety levels were increased (CWI-ANX) or were not manipulated (CON2). Acute anxiety and the cardiorespiratory responses (cardiac frequency [fc], respiratory frequency [fR], tidal volume [VT ], minute ventilation [ E]) were measured. Multiple regression was used to identify components of the CSR from the most life-threatening period of immersion (1st minute) predicted by the anxiety rating prior to immersion. Relationships between anxiety rating and CSR components during immersion were assessed by correlation. Results: Anxiety rating predicted the fc component of the CSR in unhabituated participants (CON1; p < 0.05, r = 0.536, r2= 0.190). After habituation immersions (i.e., cohort 2), anxiety rating predicted the fR component of the CSR when anxiety levels were lowered (CON2; p < 0.05, r = 0.566, r2= 0.320) but predicted the fc component of the CSR (p < 0.05, r = 0.518, r2= 0.197) when anxiety was increased suggesting different drivers of the CSR when anxiety levels were manipulated; correlation data supported these relationships. Discussion: Acute anxiety is integral to the CSR before and after habituation. We offer a new integrated model including neuroanatomical, perceptual and attentional components of the CSR to explain these data.