The roles of shame and poor self-concept in explaining low social connection among adult survivors of childhood emotional maltreatment.

Emotional maltreatment (EM) is the most common retrospectively self-reported form of child abuse/neglect. One potential negative outcome for EM survivors is a lack of social connection (SC; i.e., feeling interpersonally distant from others, socially uncomfortable, etc.). Explanations of the link between EM and low SC, however, are insufficiently tested. Theory and empirical work point to shame as a ubiquitous consequence of EM that negatively affects self-concept and is also associated with low SC in adulthood. OBJECTIVE: We test the hypothesis that experiences of EM lead to shame that impairs the development of social self-concept and, ultimately, one's sense of SC. PARTICIPANTS AND SETTING: We collected self-report data from 244 American college students. METHOD: Using structural equation modeling, we tested shame and social self-concept as sequential mediators of the path from EM to SC. RESULTS: Shame and social self-concept mediated the relationship between EM and SC, bringing this direct path below significance. Social self-concept partially mediated shame and SC. Overall, our model accounted for 77% of the variability in SC. CONCLUSIONS: Children subjected to EM by caregivers are likely to experience themselves as deeply flawed (i.e., shame) and have difficulty developing a secure sense of themselves, especially as relational beings. Our results suggest that when shame interferes with the development of a positive social self-concept, survivors of EM are at-risk for low SC. Treatment implications include a focus on healing shame and building social self-concept. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Community asthma management of emergency department patients: A pilot study of adherence with national consensus guidelines.

We aimed to determine whether the outpatient management of ED patients with asthma adheres to Australia's Asthma Consensus Guidelines. Adult patients, under treatment for asthma, were administered a validated questionnaire. Data on their outpatient management were collected and analysed descriptively. Of 51 patients, 14 smoked and 35 did not undergo regular GP review. Twenty-one patients had a good understanding of a written asthma action plan although only 15 owned one. Fourteen patients used no preventer medication. Patients were only able to identify a mean of 3.4 asthma triggers. Most patients' management does not adhere to Australian guidelines.

The Period Prevalence of Mind and Body Practice Use by Adult Emergency Department Patients.

OBJECTIVES: Mind and Body Practice (MBP) use (e.g., chiropractic, acupuncture, meditation) among Emergency Department (ED) patients is largely unknown. We aimed to determine the period prevalence, nature of MBP use, and perceptions of MBP among adult ED patients. DESIGN AND SETTING: We undertook a cross-sectional survey of a convenience sample of patients presenting to three EDs between February and June 2016. SUBJECTS: Patients were eligible for inclusion if they were aged 18 years or more and had presented for medical treatment. INTERVENTION: An anonymous, self-administered questionnaire, based upon a validated pediatric questionnaire, was completed by the patient, with assistance if required. OUTCOME MEASURES: The primary outcome was the nature and 12 month period prevalence of MBP use. Secondary outcomes were variables associated with use and patient perceptions of MBP. RESULTS: 674 patients were enrolled. In the previous 12 months, 500 (74.2%) patients had used at least one MBP. MBP users and nonusers did not differ in gender, ancestry, or chronic illness status (p > 0.05). However, users were significantly younger and more likely to have private health insurance (p < 0.001). A total of 2094 courses of 68 different MBP had been used including massage (75.0% of users), meditation (35.2%), chiropractic (32.6%), acupuncture (32.0%), and yoga (30.6%). Users were significantly more likely (p < 0.01) to believe that MBP prevented illness, treated illness, were more effective than prescription medicines, assisted prescription medications, and were safe and provided a more holistic approach. Forty-one (6.1%) patients used MBP for their ED presenting complaint. However, only 14 (34.1%) advised their ED physician of this. CONCLUSION: The period prevalence of MBP use among ED patients is high. Knowledge of the MBP used for a patient's presenting complaint may better inform the ED physician when making management decisions.