Influence of the typology and timing of childhood trauma in psychoticism.

PURPOSE: Child maltreatment (CM) is associated with psychosis; however little is known about the frequency, type, and timing of abuse in the personality pathology domain of psychoticism (PSY) in the DSM-5. The purpose of this study was to analyze childhood trauma typology and frequency according to gender and to identify sensitive periods of susceptibility to CM in women with high PSY. METHODS: The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the frequency, severity and timing of each type of maltreatment. The full sample consisted of 83 participants with different psychiatric diagnoses. Psychoticism was assessed with the DSM-5 Personality Inventory (PID-5). To identify the differences in CM exposure between the PSY+ (high psychoticism) and PSY- (low psychoticism) groups, the Mann-Whitney U test, the chi square test and random forest (RF) test were used. RESULTS: Comparing PSY + and PSY-, revealed gender differences in the impact of abuse, with highly frequent and severe types of abuse, in women. In women, PSY + and PSY-, were differentiated especially in non-verbal emotional abuse, peer physical bullying and parental verbal abuse. Several periods with a major peak at age seven followed by peaks at age 17 and 12 years old were identified. CONCLUSION: Increased exposure to CM occurs in women with PSY+. A sensitivity to CM exposure during early childhood and late adolescence could be a risk factor for psychoticism in women.

Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey.

BACKGROUND: Evidence on workplace bullying and harassment (WBH) in the UK has not used probability-sample surveys with robust mental health assessments. This study aimed to profile the prevalence and nature of WBH in England, identify inequalities in exposure, and quantify adjusted associations with mental health. METHODS: Data were from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional probability-sample survey of the household population in England. Criteria for inclusion in the secondary analysis were being aged 16-70 years and in paid work in the past month (n = 3838). Common mental disorders (CMDs) were assessed using the Clinical Interview Schedule-Revised and mental wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale. Analyses were weighted. We examined associations between past-year WBH and current CMD using multivariable regression modelling, adjusting for sociodemographic factors. Interaction terms tested for gender differences in associations. The study received ethical approval (ETH21220-299). RESULTS: One in ten employees (10.6%, n = 444/3838) reported past-year experience of WBH, with rates higher in women (12.2%, n = 284/2189), those of mixed, multiple, and other ethnicity (21.0%, n = 15/92), and people in debt (15.2%, n = 50/281) or living in cold homes (14.6%, n = 42/234). Most commonly identified perpetrators of WBH were line managers (53.6%, n = 244/444) or colleagues (42.8%, n = 194/444). Excessive criticism (49.3%, n = 212/444), verbal abuse (42.6%, n = 187/444), and humiliation (31.4%, n = 142/444) were the most common types. WBH was associated with all indicators of poor mental health, including CMD (adjusted odds ratio [aOR] 2.65, 95% CI 2.02-3.49), and 11 of 14 mental wellbeing indicators, including lower levels of confidence (aOR 0.57, 0.46-0.72) and closeness to others (aOR 0.57, 0.46-0.72). Patterns of association between WBH and mental health were similar in men and women. CONCLUSIONS: These findings reinforce a need for more cohesive UK legislation against WBH; guidance on recognition of bullying behaviours for employees, managers, and human resources, focusing on prevention and early intervention, and increased awareness of the impact of WBH on mental health among health service practitioners. Limitations include reliance on cross-sectional data collected before pandemic-related and other changes in workplace practices. Longitudinal data are needed to improve evidence on causality and the longevity of mental health impacts.

The Healthy Context Paradox Between Bullying and Emotional Adaptation: A Moderated Mediating Effect.

Introduction: Bullying is a significant concern for young people, with studies consistently showing a link between bullying and negative emotional consequences. However, the mechanisms that underlie this association remain unclear, particularly in terms of the classroom environment. This study aimed to explore the paradoxical phenomenon between bullying victimization and emotional adaptation among junior high school students in China, using the hypothesis of the healthy context paradox. Methods: The study involved 880 students (565 girls; Mage=14.69; SD=1.407 years), and data were collected using self-reported surveys. The findings of the study, utilizing multilevel structural equation modeling (MSEM) techniques, demonstrated a cross-level moderated effect of classroom-level bullying victimization on the relationship between individual bullying victimization and emotional adaptation. Results: Specifically, the results indicated that in classrooms with higher levels of victimization, the association between individual bullying victimization and increased depressive symptoms and State&Trait anxiety was more pronounced. These findings support the "Healthy context paradox" hypothesis in the Chinese context and provide insight into the mechanisms underlying this phenomenon. Discussion: The results suggest that the classroom environment plays a crucial role in shaping the emotional consequences of bullying and that addressing classroom victimization is crucial for promoting emotional health among young people. By understanding the mechanisms that underlie the association between bullying and emotional consequences, interventions can be developed to target the underlying factors that contribute to this paradoxical phenomenon. Overall, the study provides new insights into the complex relationship between bullying and emotional health among young people, highlighting the importance of considering the classroom environment in addressing this issue.

Negative Acts in the Courtroom: Characteristics, Distribution, and Frequency among a National Cohort of Danish Prosecutors.

Danish prosecutors report exposure to negative acts from professional counterparts in courtrooms, which is associated with an increased risk of burnout. However, knowledge of the characteristics of these acts is limited. Based on existing theoretical frameworks, this study aims to characterize these negative acts. A nation-wide survey of Danish prosecutors (response rate: 81%) yielded 687 descriptions of experiences with negative acts from professional counterparts from a career perspective. These were analyzed using theory-directed content analysis based on the Stress-as-Offense-to-Self (SOS) theory by Semmer and colleagues and Cortina and colleagues' characterization of incivility in American courtrooms. We identified a total of 15 types of behavior within the three main themes: illegitimate tasks (n = 22), illegitimate stressors (n = 68), and illegitimate behavior (n = 612). Tentative differences in the distribution of experienced negative acts from a career perspective were found for gender and seniority. Women reported negative acts more frequently than men, and assistant prosecutors reported verbal abuse more frequently than senior prosecutors, who, conversely, more often reported a perceived lack of court management. More prospective research is needed on negative acts experienced by prosecutors to assess the scope of these in Danish courtrooms and how they impact the risk of burnout.

An exploratory study of the prevalence and adverse associations of in-school traditional bullying and cyberbullying among adolescents in Connecticut.

Bullying, traditional or cyber, among adolescents, is a public health concern. In this study, we explored frequencies and correlates of different forms of bullying among Connecticut high-school students. Youth Risk Behavior Survey data from 2019 from Connecticut adolescents (N = 1814) were used. χ2 tests and survey-weighted logistic regressions examined relationships between bullying subgroups (in-school traditional bullying (ISTB) only, cyberbullying only, and both) and mental concerns, risk behaviors, academic performance, physical health, and receipt of social support, with the logistic regressions adjusted for demographics. The past-12-month frequency of having experienced only cyberbullying was 5.6%, only ISTB was 9.1%, and both forms was 8.7%. Between-group differences were observed by bullying status in terms of sex and race/ethnicity. In adjusted models, bullying status was associated with suicide attempts, suicidal ideation, self-harm, depression/dysphoria, mental health, use of alcohol, marijuana, injection drugs, tobacco, and e-vapor, gambling, driving under influence of alcohol, high-risk sexual behavior, physical fights, weapon-carrying, injuries/threats at school, feeling unsafe at school, dating violence, obesity, poor general health, insecure housing, less perceived family support, and poor academic performance. People experiencing both types of bullying were typically more likely to report adverse measures. High-school students commonly report bullying. The findings that both forms (traditional and cyber) were more robustly linked to negative experiences highlight the need for examining further relationships between types and patterns of bullying and mental health and functioning. Better understanding may help improve preventive anti-bullying interventions.

Mental Health Impact of Bullying by Ethnic Peers in Senior Housing: A Study with Older Korean American Residents in the Greater Los Angeles Area.

Using data from Korean-American residents (N = 343) in subsidized senior housing in the Los Angeles area, we examined the effect of peer bullying on mental health. About 18% of the sample had been a target of bullying, and over 31% had witnessed someone being bullied. Being a target of bullying was a significant predictor for both depressive symptoms and anxiety, whereas witnessing other residents being bullied was a significant predictor for anxiety only. Findings shed light on the adverse mental health impacts of peer bullying among ethnic minority older residents in senior housing.

Even worse for Black girls: the longitudinal association of racial bullying with the initiation of alcohol and tobacco use.

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after nine months. Two cluster randomized controlled trials were conducted in 2019 with fifth (girls: 50.0%; 10 years old: 82.0%; White: 36.8%; Black: 58.7%; Others: 4.5%) and seventh graders (girls: 49.5%; 12 years old: 78.1%; White: 33.2%; Black: 60.4%; Others: 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyzes on two subsets of students in each grade: those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After nine months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio - RR=1.36, 95%CI=1.07-1.70) and tobacco (RR=1.81, 95%CI=1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol: RR=1.45, 95%CI=1.07-1.93; tobacco: RR=2.34, 95%CI=1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies.

Traditional bullying and cyberbullying at schools in Germany: Results of the HBSC study 2022 and trends from 2009/10 to 2022.

Background: Bullying is a form of violence that is carried out repeatedly, with the intention of causing harm and with an imbalance of power between those involved. Bullying has serious negative effects on the mental health of adolescents and thus represents a significant health risk in childhood and adolescence. Methods: Based on data from the Health Behaviour in School-aged Children (HBSC) study from the survey year 2022 in Germany (N = 6,475), the prevalence of school bullying and cyberbullying among 11-, 13- and 15-year-olds in Germany was analysed. In addition, the prevalence of school bullying and cyberbullying was analysed as a trend from 2009/10 to 2022 (bullying) and from 2017/18 to 2022 (cyberbullying). Results: Around 14 % of the learners surveyed reported direct experience of bullying at school, and around 7 % reported cyberbullying experiences as bullied and/or bullying victims. Adolescents who identified as gender diverse were particularly likely to report bullying experiences. School bullying decreased over time, but remained stable between 2017/18 and 2022. Cyberbullying, on the other hand, increased in 2022 compared to 2017/18. Conclusions: Experiencing bullying at school and online is an everyday experience for many children and young people, so there is still a need for the broad implementation of effective anti-bullying measures in schools.

Children and adolescents weathering the storm: Resilience in the presence of bullying victimization, harassment, and pandemic lockdown in northern Norway.

Resilience is a concept of growing interest because it can systematically inform prevention measures and psychosocial interventions for children and adolescents. The aim of this study was to explore resilience factors among young people who are victims of bullying and harassment (age 9 to 16 years old). In 2021 the burden of the pandemic lockdown became an additional adversity. The study used a repeated cross-sectional design. Two datasets with a total of 2,211 participants from 2017 (N = 972) and 2021 (N = 1,239) were included. The strengths and difficulties questionnaire (SDQ) was applied to define the resilient and non-resilient groups, and the quality-of-life questionnaire (KINDL) was used to map resilience factors. A total of 227 participants reported that they were being bullied, and 604 participants reported harassments from their peers. We used correlation and regression analyses to identify which factors predicted the highest resistance to the negative effects of bullying and harassment. The results were that 77.2% of the participants stayed resilient when facing these maladjustments, but this dropped to 61.7% during the pandemic. The most important resilience factors before the pandemic were the school environment, emotional well-being, and good relations with their friends. The impact of these predictors changed during the pandemic. Emotional well-being increased in strength, school environment was reduced, and friends did not predict resilience anymore. The effect sizes were generally large to medium. As it is common to experience adversity at some stage in life, it is vital for families, schools, social and healthcare workers to be aware of the factors associated with resilience. The results of this study may contribute towards an evidence base for developing plans to increase the capacity of resilience among young people.

Nursing faculty members' response to bullying in the eyes of their students: A pilot study in Pangasinan.

BACKGROUND: Bullying is a pervasive issue that can occur in any setting, including among nursing students and within the nursing profession. Faculty members have a vital role in resolving bullying. OBJECTIVES: To examine the nursing faculty members' responses to incidents of bullying within two nursing institutions in Pangasinan. DESIGN: Descriptive- comparative design. SETTINGS: Two Colleges of Nursing in a city in Pangasinan, Philippines. PARTICIPANTS: Nursing students from first to fourth year BS Nursing students. METHODS: An online survey was the main tool in this study, Lynch formula was utilized to calculate the sample size. There are 458 nursing students who participated in this study. Frequency, percentage, mean, standard deviation, one-way ANOVA, and t-test were used to analyze the data. RESULTS: It was revealed that faculty members sometimes address bullying by group discussion (M = 3.26, SD = 1.27), and they almost never utilized non-intervention in bullying (M = 2.33, SD = 0.85). There is a variation in terms of group discussion with a one-way ANOVA score of F (2, 455) = 3.22, p = 0.04, when faculty members are grouped according to their degrees. Regarding the difference between the faculty members' responses to bullying when grouped according to gender, there is a significant difference between male and female for mediation (t(457) = 2.10, p = 0.04), group discussion (t(457) = 2.79, p = 0.01), victim support (t(457) = 2.54, p = 0.01), and disciplinary methods (t(457) = 2.66, p = 0.01). CONCLUSION: The study emphasizes the complex nature of tackling bullying among nursing students. It highlights the efficacy of several solutions used by faculty members, such as group discussions, mediation, victim assistance, and disciplinary measures. The findings indicate that a comprehensive understanding of the dynamics involved in addressing bullying is necessary. This understanding highlights the significance of a cooperative and compassionate strategy that includes all individuals involved in the educational setting. It is clear that a standardized approach may not be enough, and customized techniques that take into account the particular circumstances and requirements of the persons involved are essential.

The Impact of Statewide Enumerated Antibullying Laws and Local School Interventions on School Spaces, Physical Harm, and Suicide Attempts for LGBTQ Youth.

Purpose: Our goal was to evaluate the impact of enumerated antibullying laws and local interventions on school affirmation, risk of physical threat or harm, and suicide attempts for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Methods: This study used cross-sectional data from three national sources that provided outcomes and potential predictors: (1) The Trevor Project National Survey 2022: based on the LGBTQ youth report, (2) Movement Advancement Project: presence of LGBTQ enumerated antibullying state laws, and (3) School Health Profiles 2020: statewide prevalence of school-level strategies to improve student wellness reported by school personnel. Bivariate and multivariable logistic regression models calculated the relative risks (RRs) for each outcome. Results: LGBTQ youth (n = 27,697) were surveyed. Youth were less likely to identify their school as nonaffirming in states with enumerated laws (RR: 0.97, confidence interval [CI]: 0.94-0.99) and in states with higher percentages of gay/straight alliances (GSAs) (RR: 0.97, 95% CI: 0.96-0.97). Youth were less likely to report a history of physical threat or harm in states with more GSAs (RR: 0.96, 95% CI: 0.95-0.97). Enumerated state laws were associated with a lower risk of suicide attempts among LGBTQ youth (RR: 0.82, 95% CI: 0.77-0.87). Universal strategies/policies not specific to LGBTQ youth did not reduce risk of physical threat/harm or suicide attempts. Conclusions: Statewide enumerated antibullying protections and the presence of a GSA were associated with a decreased risk of poor outcomes among LGBTQ youth. Longitudinal studies are needed to assess the impact of recent legislative changes.

Implementation of a Trauma-Informed Challenging Interactions Reporting Tool to Improve our Clinical Learning Environment.

PROBLEM: Workplace mistreatment is a contributor to resident burnout; understanding and intervening against mistreatment is one key tool in mitigating burnout. While ACGME survey data alerts programs to general mistreatment trends, those data are not detailed enough to inform local interventions. Our team designed and implemented a Challenging Interactions Reporting Tool (CIRT) to characterize the experiences of our trainees at a granular level and to inform targeted interventions for improvement. APPROACH: Our CIRT was offered to 158 residents in August 2020 via REDCap. Residents submit electronic reports that are reviewed weekly by program leaders who develop action plans for each report. Reporters can identify themselves or can choose to remain anonymous. When "hot spots" for mistreatment are identified in our hospital, we implement a targeted systems-level intervention. OUTCOMES: Residents filed 275 reports between August 2020 and December 2022. Reports represented all training environments and involved all interprofessional members of clinical teams. Residents reported awareness of, use of, and satisfaction with the tool. NEXT STEPS: Our program created the CIRT as a tool to inform local interventions for improving the safety of our clinical learning environment. We continue to disseminate our tool across our hospital's GME programs and are now measuring the impact of our interventions.

Exploring the intersection of gender identity and homoparental family structure: Implications for educational, family and personal well-being in Spanish students.

This study explores the relationship among self-perceived gender, family type (heteroparental or homoparental) and socioeconomic factors concerning various educational, family and personal well-being domains. The data are derived from a large sample of 69,088 students from 465 schools (65% public; 35% private or semi-private) in Spain. Five separate multi-level generalized mixed (logistic or linear) regression models were calculated. Key findings include that non-binary students from homoparental families reported lower evaluations in multiple dimensions, suggesting the need for additional support. Likewise, students from homoparental families exhibited lower personal well-being and family relationship assessments, possibly due to perceived social stigmatization and peer bullying. This study sheds light on the complexities of gender identity and family type in educational settings, emphasizing the importance of addressing these issues for students' well-being and academic success.

Korean autistic persons facing systemic stigmatization from middle education schools: daily survival on the edge as a puppet.

Introduction: Korean autistic persons who have endured an integrated secondary education system have been exposed to school bullying, causing trauma and stigma to them. It also blocks them from entering a tertiary education system and a decent work, resulting in a lower quality of life. However, research on how it affects autistic persons has not yet been conducted in Korea. Methods: Fourteen adult autistic persons in the Republic of Korea participated in the semi-structured focused group interviews. Their conversations were analyzed through qualitative coding. Results: The interview results show the rare voice of Korean autistic people. Although interviewees experienced physical, verbal, and sexual violence against them during the secondary education period, they could not get substantial assistance from schools and society. Interviewees agreed that bullying is inherent in the secondary education system of Korea, even in Korean culture. They experienced the cause of bullying being attributed to them as victims rather than perpetrators, and impunity is given to the bullying assailants. Early analyses of this article confirm that such experiences are combined with the sociocultural climate of elitism, meritocracy, and authoritarianism in the Republic of Korea. Conclusion: The study confirmed that the autistic person's bullying experience does not come from the social inability of autistic people but the "profound" competition and discriminative atmosphere of the society. The result urges further studies on the bullying experience of East Asian autistic persons and the construction of Korean intervention strategies to prevent school violence against Koreans with disabilities, especially autistic pupils.

Face-to-face bullying in and outside of schools and cyberbullying are associated with suicidality in Kenyan high school students: a public health issue.

BACKGROUND: Childhood bullying has been classified as a major public health concern by WHO, with negative effects on the health education and social outcomes of both bullies and victims. There is no current Kenyan data on the prevalence of face-to-face bullying and cyberbullying co-occurring in the same cohort of youth and how they are associated with different aspects of suicidality and socio-demographic characteristics. This study aims to fill these gaps in the Kenyan situation so as to inform current policy and practice. METHODOLOGY: This cross-sectional study involved 2,652 students from ten secondary schools in Kenya, selected from three regions representing different levels of public funded schools and socioeconomic spaces. The outcome variable was derived from the questionnaire which asked students questions related to self-harm, suicide thoughts, plans, and attempts. Predictor variables were based on response on experience of bullying in school, out of school, at home, and cyberbullying. Other variables such as gender, age, family background, and class were also collected from the self-reported questions. Data were analyzed using SPSS version 25, with descriptive summary statistics and chi-square tests used to examine variables, and logistic regression analysis used to determine the associations between suicidality and experience of bullying. RESULTS: The mean age was 16.13 years. More than half of the participants were male, with the largest proportion living in rural areas. Face-to-face bullying was more prevalent than cyberbullying, with 82% of participants experiencing bullying and 68% experiencing it almost daily in the past six months. Both face-to-face bullying and cyberbullying were associated with suicidal thoughts, plans, and attempts. Predictors of suicidal attempts included being bullied outside of school and being a victim of group bullying, while being bullied every day and being bullied by adult men were predictors of suicidal attempts in cyberbullying. CONCLUSION: There is a high prevalence of face-to-face bullying both in and outside schools. There is also a high prevalence of cyberbullying. Both face-to-face and cyberbullying are associated with suicidality in Kenyan high school students.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies.

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Atypical brain structural connectivity and social cognition in childhood maltreatment and peer victimisation.

BACKGROUND: Childhood maltreatment (CM) is associated with neurobiological aberrations and atypical social cognition. Few studies have examined the neural effects of another common early-life interpersonal stressor, namely peer victimisation (PV). This study examines the associations between tract aberrations and childhood interpersonal stress from caregivers (CM) and peers (PV), and explores how the observed tract alterations are in turn related to affective theory of mind (ToM). METHODS: Data from 107 age-and gender-matched youths (34 CM [age = 19.9 ± 1.68; 36%male], 35 PV [age = 19.9 ± 1.65; 43%male], 38 comparison subjects [age = 20.0 ± 1.66; 42%male] were analysed using tractography and whole-brain tract-based spatial statistics (TBSS). RESULTS: At the whole-brain level using TBSS, the CM group had higher fractional anisotropy (FA) than the PV and comparison groups in a cluster of predominantly limbic and corpus callosal pathways. Segmented tractography indicated the CM group had higher FA in right uncinate fasciculus compared to both groups. They also had smaller right anterior thalamic radiation (ATR) tract volume than the comparison group and higher left ATR FA than the PV group, with these metrics associated with higher emotional abuse and enhanced affective ToM within the CM group, respectively. The PV group had lower inferior fronto-occipital fasciculus FA than the other two groups, which was related to lower affective ToM within the PV group. CONCLUSION: Findings suggest that exposure to early-life stress from caregivers and peers are differentially associated with alterations of neural pathways connecting the frontal, temporal and occipital cortices involved in cognitive and affective control, with possible links to their atypical social cognition.

Grace Under Pressure: a mixed methods impact assessment of a verbatim theatre intervention to improve healthcare workplace culture.

BACKGROUND: Healthcare workplace mistreatment has been documented globally. Poor workplace behaviour, ranging from incivility to bullying and harassment, is common in healthcare, and contributes significantly to adverse events in healthcare, poor mental health among healthcare workers, and to attrition in the healthcare workforce, particularly in junior years. Poor workplace behaviour is often normalised, and is difficult to address. Verbatim theatre, a form of research informed theatre in which plays are created from informants' exact words only, is particularly suited to facilitating workplace culture change by raising awareness about issues that are difficult to discuss. The objective of this study was to assess the impact of the verbatim theatre play 'Grace Under Pressure' on workplace culture in NSW hospitals. METHODS: The intervention was conducted in 13 hospitals from 8 Local Health Districts (LHDs) in NSW, Australia, in October and November 2019, with aggregated impact across all sites measured by a bespoke survey ('Pam McLean Centre (PMC) survey') at the conclusion of the intervention. This study was conducted in 3 Local Health Districts (one urban, one regional, one remote), with data collection conducted in November-December 2019 and December 2020. The study design was a mixed methods assessment of the play's impact using (1) validated baseline measures of psychosocial risk, analysed descriptively, (2) overall findings from the PMC survey above, analysed descriptively, (3) interviews conducted within a month of the intervention, analysed thematically and (4) interviews conducted one year later, analysed thematically. RESULTS: Half (51.5%) of the respondents (n = 149) to the baseline survey had scores indicating high risk of job strain and depressive symptoms. Of 478 respondents to the PMC survey (response rate 57%), 93% found the play important, 92% recommended others see the play, 89% considered that it stimulated thinking about workplace behaviour, and 85% that it made discussing these issues easier. Thematic analysis of interviews within one month (n = 21) showed that the play raised awareness about poor workplace behaviour and motivated behaviour change. Interviews conducted one year later (n = 6) attributed improved workplace culture to the intervention due to improved awareness, discussion and capacity to respond to challenging issues. CONCLUSIONS: Verbatim theatre is effective in raising awareness about difficult workplace behaviour in ways that motivate behaviour change, and hence can be effective in catalysing real improvements in healthcare workplace culture. Creative approaches are recommended for addressing similarly complex challenges in healthcare workforce retention.

Longitudinal relations between bullying victimization and aggression: The multiple mediation effects of anger rumination and hostile automatic thoughts.

Bullying victimization is widely accepted to be associated with aggression. However, the mechanisms underlying this relationship remain unknown. To examine the long-term impact of bullying victimization on aggression, the present study tested the potential mediating effects of both anger rumination and hostile automatic thoughts. A total of 809 undergraduates from four universities across China (74.80% female; Mage = 19.63 years, SD = 0.82 years) completed the survey on three occasions, with a 6-month delay between Time 1 and Time 2 and a 1-year interval between Time 2 and Time 3. A cross-lagged model of anger rumination and hostile automatic thoughts was developed to test whether they predicted one another, and two structural models were constructed to test their mediating roles in bullying victimization and aggression. Findings indicated that anger rumination and hostile automatic thoughts are mutually predictable; the correlation between bullying victimization and aggression is mediated independently by anger rumination and hostile automatic thoughts, and the chain mediation of bullying victimization predicting aggression first through anger rumination and then through hostile automatic thinking was established. In addition, an alternative mediation model is also significant, with hostile automatic thoughts as the primary mediator and anger rumination as the secondary mediator. These results highlight the significance of anger rumination and hostile automatic thoughts in the long-term effects of bullying victimization on aggression. Interventions designed to reduce undergraduate students' anger rumination and hostile automatic thoughts may help reduce their aggression.

Longitudinal Relationships Between Bullying Victimization and Dual Social Behaviors: The Roles of Self-Compassion and Trauma-Related Shame.

Purpose: Bullying victimization is a serious issue among college students, which might affect the development of their social behaviors. Based on the theory of stress and coping and emotion regulation theory, the present study examined the mediating role of self-compassion and trauma-related shame between bullying victimization and cyber aggression/prosocial behavior. Patients and Methods: We gathered self-reporting data on bullying victimization, self-compassion, trauma-related shame, cyber aggression, and prosocial behavior from 634 college students in China using a three-wave longitudinal design survey. Structural equation modeling was used to test temporal mediation. Results: The results showed that bullying victimization predicted cyber aggression and prosocial behavior via trauma-related shame and the chain effect of self-compassion and trauma-related shame. Moreover, self-compassion also mediated the relationship between bullying victimization and prosocial behavior. Conclusion: The study revealed the different emotional processes that underlie both bullying victimization and different social behaviors. It also contributes to more effective prevention and intervention measures for the social adaptation of bullied students.