Injustice and Embitterment: Crucial Stressors in Psychosomatic Patients.

OBJECTIVE: "Disorders specifically associated with stress" are receiving increasing attention in clinical practice, research, and modern classification systems of mental disorders. This includes not only reactions to "extremely threatening or horrific events" as it is characteristic for "post-traumatic stress disorders" but also a variety of day-to-day experiences. Examples are experiences of injustice, humiliation, or breach of trust which can have dire psychological consequences such as feelings of embitterment, a strong and crippling emotion. This study investigated the frequency of feelings of injustice and concomitant embitterment across different areas of daily life of psychosomatic patients. METHODS: In an observational archival study, 200 inpatients of a department of behavioral medicine filled in the "Differential Life Burden Scale, DLB-Scale" and the "Post-Traumatic Embitterment Scale, PTED-Scale" which asks for experiences of injustice and embitterment. RESULTS: More than half of all patients (58.5%) reported about very or extremely unjust and unfair life events and 51.5% additionally about feelings of embitterment. This was primarily associated with complaints about problems in the family and the workplace and was accompanied by an impairment of well-being. CONCLUSIONS: The findings indicate that experiences of injustice and embitterment are frequently seen in psychosomatic inpatients and should get special attention.

The Opium Wars of China in the Nineteenth Century and America in the Twenty-First.

The Opium Wars of 1839-1843 and 1856-1860 revealed the devastating effects of narcotic addiction on the health of the body politic of China. The defeated Qing dynasty lost effective sovereignty to the British, leaving it helpless against more than 100 years of exploitation by the European powers, the United States, and Japan. Today we see the same risk posed by prescription narcotics and illegal opioids imported from China that can be seen as retribution for the "Century of Humiliation" nearly two centuries ago.

Prevalence and Impact of Revenge Pornography on a Sample of Portuguese Women.

Victims of revenge pornography (RP) suffer long-term psychological, personal, and social consequences, given that the spread of explicit content may continue to disturb them throughout their lives. However, there is a scarcity of studies on this phenomenon in Portugal. The present study aims to identify the prevalence of RP and analyze its impact on self-esteem, humiliation, depression, and anxiety, and compare victims and non-victims of RP on these same variables. The sample comprises 274 Portuguese women aged between 18 and 82. The data was collected through an online protocol consisting of a sociodemographic questionnaire, the Rosenberg Self-Esteem Scale, the Humiliation Inventory, and the Brief Symptoms Inventory. From the total sample, 45 (16.4%) participants reported at least one experience of RP. RP victims reported higher levels of humiliation, anxiety, and depression and lower levels of self-esteem than non-victims. However, only humiliation distinguished RP victims and non-victims. RP is a growing phenomenon enhanced by the intensified use of technology. Along with this phenomenon comes the impact on victims, which has long-term consequences. This study contributes to the scientific community since the scientific study of RP and its impact on victims is still incipient.

Social anxiety and accumulation of status loss events: The role of adulthood experiences.

OBJECTIVES: The association between social anxiety (SA) and early-life status loss events (SLEs) is well documented. However, such an association in adulthood is yet to be examined. METHODS: Two studies (N = 166 and N = 431) were conducted to address this question. Adult participants filled out questionnaires regarding SLEs accumulation during childhood, adolescence, and adulthood, along with depression and SA severity measures. RESULTS: SA was associated with SLEs in adulthood over and above SLEs in childhood and adolescence, and depression. CONCLUSION: The adaptive role of SA in adulthood in the face of concrete and relevant status threats is discussed.

The Role of Witnesses in Humiliation: Why Does the Presence of an Audience Facilitate Humiliation Among Victims of Devaluation?

We examined the role that witnesses play in triggering humiliation. We hypothesized that witnesses trigger humiliation because they intensify the two core appraisals underlying humiliation: unfairness and internalization of a devaluation of the self. However, we further propose that witnesses are not a defining characteristic of humiliating situations. Results of a preliminary study using an event-recall method confirmed that witnesses were as characteristic of humiliating episodes as of those that elicited shame or anger. In Experiments 1 and 2, we manipulated the presence (vs. absence) of witnesses when a professor devalued participants and the hostile tone of this devaluation. As hypothesized, in both experiments, witnesses indirectly increased humiliation via the appraisal of unfairness. Results of Experiment 2 revealed that the presence of witnesses also interacted with hostility, enhancing humiliation. As expected, this moderating effect occurred via the other key appraisal of humiliation (i.e., internalization).

Workplace Assessment Scale: Pilot Validation Study.

First responders, such as police officers, paramedics, and firefighters are at an increased risk of experiencing negative mental health outcomes compared to the general population. This predisposition can partially be attributed to common occupational stressors, which may provoke strong feelings of betrayal and humiliation. The Workplace Assessment Scale (WAS) was developed as there is currently no appropriate measure to assess such feelings in the first responder population. Initial development of the WAS included a Betrayal Subscale and the Humiliation Subscale, each comprised of 5 Likert scale questions which ask participants to report the frequency at which they experience specific feelings associated with their workplace. This pilot validation study was conducted to determine if there is preliminary evidence to support a large-scale validation study. To determine this, we assessed the internal structure and the convergent, concurrent, and predictive validity of the WAS. Based on 21/22 (95%) participant responses, a factor analysis did not support the two-factor model we anticipated, with only one factor and seven items retained from the original version of the scale. However, the internal consistency of the remaining items was strong. The validity analysis found moderate convergent validity and weak predictive validity based on correlations between the WAS and other psychometric scales. Minimal concurrent validity was noted. Additional research is needed for further analysis and validation of the WAS.

Satisfaction and Perceived Coercion in Voluntary Hospitalisations: Impact of Past Coercive Experiences.

Coercion in psychiatry is associated with several detrimental effects, including in the long term. The effect of past experience of coercion on the perception of subsequent hospitalisations remains less studied. The present study aimed to assess the impact of past experience of coercion on the perception of coercion and satisfaction with subsequent voluntary hospitalisations. A total of 140 patients who were hospitalised on a voluntary basis were included. Fifty-three patients experienced coercion before this hospitalisation and 87 did not. Patients were assessed for treatment satisfaction and perceived coercion. Health status was also evaluated by both patients and carers. Past experience of coercion was the independent variable. Perceived coercion and satisfaction scores were used as different dependent variables in a series of regression models. Results suggested a long-term detrimental impact of past experience of coercion on some aspects of satisfaction and perceived coercion in subsequent voluntary hospitalisations even when controlling for self and carers-rated health status. Overall, this study suggests that special attention should be paid to patients who are voluntarily admitted to hospital but have a history of coercion, as they may still be impacted by their past coercive experiences. Ways to increase satisfaction and reduce perceived coercion of these patients are discussed.

Embitterment - Conception of a Potential Moderator to Dysfunctional and Aggressive Behaviour in Children and Adolescents.

Embitterment is an emotion which is known to everybody in reaction to injustice, humiliation, and breach of trust. Children and adolescents have an understanding of justice/injustice and fairness, violations of injustice, humiliation, and breach of trust are also stressors at a young age. In this conceptual paper it is argued that embitterment is also seen in children and adolescents, and that parents, educators and therapists should recognize this emotion. This could possibly help to early identify children at risk for severe dysfunctional and aggressive behaviours, when preventive interventions are still possible. The article concludes with concepts on how to diagnose and treat children with embitterment.

Social Construction and Evolutionary Perspectives on Gender Differences in Post-traumatic Distress: The Case of Status Loss Events.

Women report greater post-traumatic distress (PTD) than men following physically threatening events. However, gender differences in PTD following social stressors such as status losses are understudied. Whereas the social construction account points to a general sensitivity in women following any type of stressor, the evolutionary account suggests enhanced sensitivity to status losses in men, especially following inter-males aggressions. These propositions were examined in two studies (Study 1, N = 211; Study 2, N = 436). Participants were asked to recall a status loss and to fill out measures assessing PTD and depression severity. In line with the evolutionary account, men, as compared to women, displayed enhanced PTD following status loss. Status losses conducted by men against men were associated with greater PTD than were instances involving other target-aggressor pairings. Finally, age was negatively associated with PTD in men but not in women. The examination of evolutionary challenges modifies the standard view linking the female gender to enhanced sensitivity to trauma. Thus, the pattern of enhanced sensitivity to stressful events appears to be affected by gender- and development-specific adaptive challenges.

From autistic pragmatic language problems to a negative attitude toward human nature-a serial multiple mediation model.

It has recently been found that individuals high in autistic traits tend to believe that they are usually not treated fairly. In the present study, it is assumed that such a lowered personal belief in a just world is based on cumulative humiliation experiences that stem from autistic pragmatic language problems (e.g., communicating in a monotonous voice, not being "in tune" with others during conversations). Furthermore, the less individuals believe that they receive fair treatment, the more they may develop a negative attitude toward human nature (i.e., believing that humans are generally untrustworthy, unfair, and unhelpful). The serial multiple mediation model reflecting these assumptions received initial empirical support in a nonclinical sample (N = 344). Implications for professional health care are addressed.

Everyday dehumanization: Negative contact, humiliation, and the lived experience of being treated as 'less than human'.

Developing work on the nature and consequences of negative intergroup contact, this study explores its potential role in sustaining everyday experiences of dehumanization; that is, experiences in which participants report feeling deprived of full human status. As a case study, we explore domestic service relations in a neighbourhood of Pietermaritzburg, South Africa, analysing interviews (n = 22) conducted with Black domestic workers and their families (n = 64 participants in total) about their day-to-day interactions with Indian employers. Drawing on thematic analysis of accounts of paid domestic labour and food-sharing practices, we argue that negative contact experiences may cumulatively engender a sense of dehumanization and associated feelings of humiliation: a response marked by intertwined constructions of shame and injustice. Implications for understanding wider problems of intergroup conflict and political solidarity are discussed and avenues for future research proposed.

"morrer de vergonha": uma investigação psicanalítica sobre vergonha, humilhação e abjeção na migração de retorno / "die of shame": a psychoanalytic investigation of shame, humiliation and abjection in return migration

RESUMO: A migração de retorno se tornou apenas recentemente objeto de pesquisas no campo da saúde mental. A experiência do migrante de retorno em sua comunidade de origem o expõe aos olhares de alteridade que apontam para a fragilidade tanto de seus ideais egóicos como daqueles partilhados com o grupo cultural, particularmente quando o retorno se faz "com as mãos abanando". Com duas vinhetas clínicas tiradas de uma pesquisa conduzida no Senegal entre 2014 e 2019, abordamos esse cenário no qual os sujeitos enfrentam vergonha, humilhação e abjeção quando retornam, ficando condenados a um espaço marginal de entre-dois migratório.

Abstract: Return migration has only recently become subject of research in the field of mental health. The experience of the returning migrant in his community of origin exposes him to the eyes of otherness that point to the fragility of both his ego ideals and those shared with the cultural group, particularly when the return is made "with empty hands". With two clinical vignettes taken from a survey conducted in Senegal between 2014 and 2019, we approach this scenario in which the subjects face shame, humiliation and abjection when they return, being condemned to a "migratory between-two" marginal space.

"Loss of Dignity" in Claims for Damages for "Humiliation, Loss of Dignity and Injury to Feelings" in the Human Rights Review Tribunal of New Zealand.

The Human Rights Review Tribunal of New Zealand recently determined that it has the power to award damages for loss of dignity in cases where the person whose rights have been breached does not have the mental capacity to understand that this is the case, or the impact of that breach on their dignity. In defining the meaning of dignity, determining how to assess its loss (by way of an objective rather than subjective test) and categorising the nature of damages for loss of dignity as vindicatory rather than compensatory, the Tribunal broke new ground. However, after analysing the Tribunal's decision, and considering relevant case law, this article concludes that the Tribunal's decision was flawed, and that the legislation only allows for the award of compensatory damages. Legislative change would be required to expand the scope of remedies available to include vindicatory damages.

Identification of Elder Abuse through Out-of-Hospital Emergency Care Providers.

BACKGROUND AND PURPOSE: Elder abuse, neglect, and exploitation are under-detected and under-reported. The purpose of this qualitative study was to describe out-ofhospital emergency care providers' experiences of identifying elder abuse. METHODS: Individual theme interviews were conducted with nine prehospital emergency care providers and three community paramedics in spring 2019. The transcribed data were analyzed using inductive content analysis. RESULTS: Although the short duration of care contacts made the identification of elder abuse challenging, the emergency care providers detected indicators of physical, psychological and social abuse, unethical action, material exploitation, and self-neglect/self-abuse. The professionals based their observations on patient and family interviews, on clues in the home environment, on caregiving quality combined with the patient's medical history, and on physical signs, which were the easiest to identify. IMPLICATIONS FOR PRACTICE: The identification of elder abuse may be improved by multiprofessional collaboration, by increased attention given to risk groups and common indicators of abuse, and by adoption or creation of screening tools to assist detection and reporting. Training on the detection of elder abuse should be included in nursing and social work curricula and in the continuing professional development of emergency care providers.

[Humiliation at work - theoretical concepts and importance for the health of workers and the functioning of the organisation]. / Upokorzenie w pracy ­ koncepcje teoretyczne oraz znaczenie dla zdrowia pracowników i funkcjonowania organizacji.

Humiliation at work is a dangerous and, at the same time, poorly understood phenomenon. It is associated with an asymmetry of power, which induces in the humiliated person a feeling of having a lesser value and being inferior. It manifests itself as an internal event (judgment and emotions), an external event (an act of violence) or systemic social conditions (poverty and discrimination). Experiencing humiliation has negative consequences both when an individual becomes a subject and a witness of a humiliating event. These consequences concern many areas of an individual's life and functioning within an organization. The article discusses the relationship between humiliation at the organizational level and work pathologies such as mobbing, intimidation, bullying, or harassment. Their purpose and effect is to humiliate an individual or a group of people, and since humiliation is associated with a sense of injustice and a desire for revenge, it often permanently disrupts the relationship between the parties and observers of such behaviors. Despite its individual and social significance, the phenomenon of humiliation is still a gap in the consideration of a healthy working environment and the relationship between people employed in the organization. Unlike in foreign literature, the phenomenon of humiliation is not a frequent subject of consideration in Polish studies, although interest has increased in recent years. The article proposes definitions of this phenomenon from 3 research perspectives, along with presenting selected concepts concerning the nature of this phenomenon and reports from research on the consequences of humiliating behavior at work, from the point of view of both an individual and an organization. Med Pr. 2021;72(1):61-8.

Grupo de apoio psicológico aos trabalhadores em situação de desemprego / Support group for unemployed workers / Grupo de apoyo psicológico a trabajadores desempleados

Resumo A legislação do trabalho em vigência no Brasil intensificou formas mais flexíveis de contratação de força de trabalho e métodos de produção mais ajustáveis ao mercado, o que contribui para o aumento do desemprego no país. As mudanças afetaram diretamente a saúde mental dos trabalhadores, que passaram a se submeter a pressões e formas mais rígidas de contratação. Diante do cenário atual, este artigo objetiva analisar uma experiência de um grupo de apoio psicológico com trabalhadores em situação de desemprego, desenvolvido em uma clínica-escola de Psicologia da região Norte do Brasil. Foram realizados sete encontros, com média de duração de 90 minutos cada, o aceite foi estabelecido por meio do Termo de Consentimento Livre e Esclarecido. Os participantes tinham idades entre 37 e 51 anos, sendo dois homens e três mulheres; o tempo mínimo de desemprego foi de oito meses e o máximo de dois anos. Verificou-se que estes valorizavam o trabalho formal em detrimento do informal, pois o primeiro representava maior reconhecimento social, segurança e estabilidade profissional. A situação de desemprego gerou sentimentos de perda, humilhação e exclusão social que repercutiram no estado de humor, no aumento da ansiedade e do estresse. Conclui-se que a Psicologia pode oferecer suporte baseado em uma escuta acolhedora e compreensiva dos fenômenos ligados ao mundo do trabalho e/ou nas repercussões ligadas à subjetividade dos trabalhadores em situação de desemprego.(AU)

Abstract The labor legislation in force in Brazil has improved flexible forms of employment recruitment and labor-intensive production techniques, which contributes to the increase in the country unemployment rates. With the pressure and more rigid forms of hiring, these changes directly affected the mental health of workers. Considering that, this article aims to analyze the experience of a support group for unemployed workers developed in a school psychology clinic in Northern Brazil. The intervention consisted of seven meetings with an average duration of 90 minutes each, and the group was formed by two men and three women aged from 37 to 51 years, with minimum unemployment time of eight months and maximum of two years; all individuals agreed to participate by signing the Informed Consent Term. The participants reported preferring formal work over the informal one, for it represents greater social recognition, security, and professional stability. Unemployment evoked feelings of loss, humiliation, and social exclusion, besides impacting humor and heightening anxiety and stress. The results indicate that psychology can offer support based on a welcoming and comprehensive listening of phenomena related to the world of work and/or consequences of unemployment on workers' subjectivity.(AU)

Resumen La nueva legislación laboral en Brasil intensificó formas más flexibles de contratación de fuerza laboral y métodos de producción más ajustables al mercado de trabajo, lo que contribuye al aumento del desempleo en el país. Los cambios afectaron directamente la salud mental de los trabajadores que pasaron a someterse a presiones y formas más rígidas de contratación. Ante el escenario actual, este artículo tiene como objetivo analizar la experiencia de un grupo de apoyo psicológico a trabajadores en situación de desempleo, desarrollado en una clínica-escuela de psicología de la región Norte de Brasil. Se realizaron siete reuniones, con media de duración de 90 minutos cada una, y se obtuvo el consentimiento por medio de la firma del documento de consentimiento informado. Los participantes tenían edades entre 37 y 51 años, siendo dos hombres y tres mujeres; el tiempo mínimo de desempleo fue de ocho meses y el máximo de dos años. Se observó que los participantes valoraban el trabajo formal en relación a lo informal, pues aquel les garantía un mayor reconocimiento social, seguridad y estabilidad profesional. La situación de desempleo les generó sentimientos de pérdida, humillación y exclusión social, que repercutieron en el estado de humor, en el aumento de la ansiedad y el estrés. Se concluye que la psicología puede brindar soporte por medio de una escucha acogedora y comprensiva de los fenómenos relacionados al mundo laboral y/o a las repercusiones asociadas a la subjetividad de los trabajadores en situación de desempleo.(AU)

An Indecent Society, Sick Souls, and the Weak Messianic Force of God: A Reflection on Religious Health in the Anthropocene Era.

This article posits that the dire realities associated with the Anthropocene Era will increase the presence of indecent societies that humiliate Others while securing the well-being of privileged groups. Within the society, humiliation, which is carried out by various political, social, and economic apparatuses, leads to civic carelessness and perfidy that accompanies both the foreclosure of the space of appearances, wherein people speak and act together, and the diminution of Others' self-esteem, self-confidence, and self-respect. It is argued that indecent societies depend on sick souls who seek to retain social, political, and economic privileges that depend on the illusions of their superiority and the inferiority of humiliated Others. At the same time, humiliated Others, who believe in and accept their inferiority, are understood as sick souls. Healthy souls vis-à-vis the looming realities of the Anthropocene and indecent societies are depicted in terms of inoperativity or the weak messianic force of God, wherein healthy individuals and groups are not captive to and do not operate out of the illusions of superiority and inferiority, but instead recognize the unfathomableness of Others (human and otherwise). This means that Others are recognized in their suchness, which attends mutual self-respect, self-esteem, and self-confidence that are necessary for speaking and acting together vis-à-vis the space of appearances. This slight adjustment renders the beliefs of indecent societies inoperative, making possible both human agency that cares for human beings in their suchness and ecological agency that cares for the habitat and all its creatures.

Resilience as a Mediator Between Interpersonal Risk Factors and Hopelessness in Depression.

Several studies investigated the role of resilience as a mediating factor for psychopathological phenotypes. The aim of the current study is to explore the putative role of resilience as a mediator between different vulnerability factors and depressive symptoms. One hundred and fifty patients with a major depressive disorder diagnosis have been evaluated on the basis of humiliation (Humiliation Inventory), adverse past family experiences (Risky Family Questionnaire), hopelessness (Beck Hopelessness Scale), and resilience (Resilience Scale for Adult) scores. A multiple regression analysis and a bootstrapping method were carried out to assess the hypothesis that resilience could mediate the relationships between these risk factors as predictors and hopelessness as a dependent variable. Our results show that resilience has a mediating role in the relationship between several risk factors that are specifically involved in interpersonal functioning and hopelessness. The main limitations of the study are the cross-sectional nature of the study, the use of self-report instruments, the lack of personality assessment, and the consideration of the resilience as a unique construct. The understanding of the mechanisms through which resilience mediates the effects of different interpersonal risk factors is crucial in the study of depression. In fact, future prevention-oriented studies can also be carried out considering the mediating role of resilience between interpersonal risk factors and depressive symptoms.

Perfectionism and Prospective Near-Term Suicidal Thoughts and Behaviors: The Mediation of Fear of Humiliation and Suicide Crisis Syndrome.

BACKGROUND: Perfectionism has been linked to suicide. According to the Narrative-Crisis Model of suicide, individuals with trait vulnerabilities are prone to develop a certain mindset, known as a Suicidal Narrative, which may precipitate the Suicide Crisis Syndrome (SCS), culminating in suicide. The purpose of this study was to investigate the association between perfectionism (trait vulnerability), fear of humiliation (component of the Suicidal Narrative), SCS, and prospective near-term suicidal thoughts and behaviors (STB). METHODS: Adult psychiatric outpatient participants (N = 336) were assessed at baseline with the Suicidal Narrative Inventory for perfectionism and fear of humiliation. The questions used to assess perfectionism were adapted from the Multidimensional Perfectionism Scale. The severity of the SCS was calculated using the Suicide Crisis Inventory. STB were assessed at baseline and after one month using the Columbia Suicide Severity Rating Scale. Serial mediation analyses were conducted using PROCESS version 3.3 in SPSS. RESULTS: While the direct effect of perfectionism on prospective STB was not significant (b = 0.01, p = 0.19), the indirect effect of perfectionism on STB, through serial mediation by fear of humiliation and the SCS, was significant (indirect effect p = 0.007, 95% CI [0.003,0.013]). The indirect effect was not significant for models that did not include both mediators. LIMITATIONS: Variables were assessed at one time only. CONCLUSION: Perfectionism did not directly modulate STB. Perfectionism may be related to suicidal behavior through fear of humiliation, leading to the SCS. These results support the Narrative-Crisis Model of suicide and clarify the role of perfectionism in the etiology of suicide.

Survival and Resilience of Female Street Children Experiencing Sexual Violence in Bangladesh: A Qualitative Study.

The goal of this exploratory study was to inspect and comprehend the phenomenon of female street children who left their homes and came to the streets for survival. The study explored any violent experience (i.e., sexual violence) they had, their feedback about the support they receive from the non-governmental organizations (NGOs). It also aimed to explore their hopes, aspiration, resilience and their thoughts about their lives, despite the challenges they faced. The study utilized qualitative methodology and information was collected through open-ended questions. The study was guided by resilience theory to understand the coping strategy and resilience among these children. Twelve female children between the ages 13-14 were selected from the local NGOs in Dhaka, Bangladesh. For analysis purposes, the study utilized grounded theory and identified three themes. These themes include Reasons for moving to the streets, experience of living on the streets and hopes and aspiration: Resilience. Majority of the respondents experienced sexual violence and despite all the challenges many of these children could still dream of a pleasant future.