Anger and it's management for survivors of acquired brain injury

Uncontrollable anger is a common problem for people with acquired brain injury (ABI). Little is known about how to properly manage this kind of anger, since it can result from both neuropsychological and psychological factors associated with the brain damage. Moreover, the outcome research on anger treatments is lacking. This paper is an examination of the causes of anger problems in this population, as well as a review of the basic therapeutic techniques typically used to treat anger with suggested alterations for their implementation with people with ABI. This literature will be integrated into a model that can be useful for helping people with ABI to handle their anger in an appropriate fashion. Finally, this paper will discuss the advantages of conducting anger management in a group format for people with ABI.     

Health Content Analysis of Organ Donation and Transplantation News on Turkish Television Channels and in Turkish Print Media

The media affects individuals' behaviors, especially by means of news and advertisements. In this study, we evaluated health content of organ donation and transplantation news in the printed media and on television programs for a 1-year period in Turkey. We examined 2449 news items in 230 newspapers and magazines; 1179 news programs on 45 television channels, all concerning organ donation and transplantation. The news obtained from the Media Pursuit Center were transferred to an electronic file to evaluate the format and content of the news. Nine variables were examined about the scope and the formal characteristics of the news: the publication name, its type, the province, the date, the headline, the title length, the presence of a photograph, or its kind, the news size, and the page number. In the content analysis of the news, we also examined 9 variables: the topic, the message of the headline, the property of the words in the title, the identification of photographs in the news, the age, gender of actors in the news, as well as donor or recipient. In a summary, print media and television channels, failed to show sufficient information about organ donation and transplantation. The percentage of news about organ donation and transplantation was small and mostly negative items in the media. On television channels, sufficient place was not given to organ donation and transplantation. The news in printed media and on television channels was not about motivated or altruistic behavior. The pattern of organ donation and transplantation news is important in terms of perception and comment by the public. Furthermore it directly affects the perception of the news by the reader.     

Fake news: Why do we believe it?

Fake news dissemination has increased greatly in recent years, with peaks during the US presidential elections and the COVID-19 pandemic. Research has addressed fake news creation, consumption, sharing, and detection as well as approaches to counteract it and prevent people from believing it. This update addresses only a part of the fake news-related issues and focuses on determinants leading individuals to believe fake news, noting that rheumatology is scarcely represented. Some determinants relate to the ecosystem of media and social networks, such as the availability and rapid spread of fake news, the unselected information on platforms and the fact that consumers can become creators of fake news. Cognitive factors are important, such as confirmation bias, political partisanship, prior exposure and intuitive thinking. Low science knowledge and low educational level are also involved. Psychological factors include attraction to novelty, high emotional state, and the emotionally evocative content of fake news. High digital literacy protects against believing fake news. Sociological factors such as online communities, or echo chambers, and the role of pressure groups have been identified. The implication for practice can be deduced, including education in media literacy and warning tips, reliable journalism and fact-checking, social media regulation, partnership of media platforms’ with fact-checkers, warning messages on networks, and digital detection solutions. Health professionals need to better understand the factors that cause individuals to believe fake news. Identifying these determinants may help them in their counseling role when talking to patients about misinformation.     

Anger Dimensions and Mental Health Following a Disaster: Distribution and Implications After a Major Bushfire

Anger is an important dimension of affect and a prominent feature of posttraumatic mental health, but it is commonly overlooked in postdisaster settings. We aimed to examine the distribution and implications of significant anger problems in the aftermath of a natural disaster, via analyses of Beyond Bushfires survey data from 736 residents of rural communities 5 years after the 2009 Black Saturday bushfires in Victoria, Australia. Assessments included the five‐item Dimensions of Anger Reaction (DAR‐5) scale along with measures of PTSD, depression, and significant mental illness, and indicators of life satisfaction, suicidality, hostile aggressive behavior, and violence exposure. The results indicated that approximately 10% of respondents from areas highly affected by the bushfires scored above the provisional cutoff criteria for significant anger problems on the DAR‐5, which was a more than 3‐fold increase, OR = 3.26, relative to respondents from areas of low‐to‐moderate bushfire impact. The rates were higher among women, younger participants, and those who were unemployed, and co‐occurred commonly, although not exclusively, with other postdisaster mental health problems. Anger problems were also associated with lower life satisfaction, β = ?.31, an 8‐fold increase in suicidal ideation, OR = 8.68, and a nearly 13‐fold increase in hostile aggressive behavior, OR = 12.98. There were associations with anger problems and violence exposure, which were reduced when controlling for covariates, including probable PTSD. The findings provide evidence indicating that anger is a significant issue for postdisaster mental health and should be considered routinely alongside other posttraumatic mental health issues.     

Anger,Dissociation, and Posttraumatic Stress Disorder Among Female Assault Victims

The goal of the present study was to explore the relationship between anger and dissociation and their relationship to symptoms of posttrauma pathology. One hundred four female assault victims were assessed prospectively 2, 4, and 12 weeks postassault. Measures of posttraumatic stress disorder (PTSD) severity, social functioning, anger, and dissociation were obtained at all assessments. Results revealed that differentiation between symptoms that predict later PTSD and impaired social functioning first becomes evident at 4 weeks postassault. At 4 weeks postassault, anger expression was predictive of later PTSD severity, whereas dissociation was predictive of poorer later functioning.     

Concordance between physiological arousal and subjective distress among vietnam combat veterans undergoing challenge testing for PTSD

This study examined concordance between physiological arousal and subjective distress during a laboratory challenge task. Data were collected during the multisite VA Cooperative Study 334 in the early 1990s examining psychophysiological arousal among combat-exposed Vietnam veterans with (n = 775) and without (n = 369) posttraumatic stress disorder (PTSD). Study participants were presented with 6 standardized neutral scenes and 6 standardized combat scenes. Participants provided a subjective rating of distress after each slide. During the presentation, levels of heart rate (HR) and skin conductance (SC) were recorded. Using linear mixed effects modeling, both HR level and SC level exhibited significant positive associations with subjective distress ratings (pr = .33, p < .001 and pr = .19, p < .001, respectively). Individuals with PTSD demonstrated greater concordance between their distress ratings and SC level during exposure to combat slides than participants without PTSD (pr = .28, p < .001 vs. pr = .18, p < .001). Although a significant association was found between subjective distress and HR reactivity and SC reactivity, these findings were not moderated by PTSD status. The results of these analyses suggest that patients' reports of distress during exposure-based treatments might serve as approximate measures of actual physiological arousal.     

Can antistress music tapes reduce mental stress?

The effects of so-called antistress music tapes on reduction of mental stress were examined using Cox and Mackay's SACL, Japanese edition (J-SACL). Fifty-two subjects were exposed to experimentally induced stressful situations and the J-SACL was administered before and after this stress exposure. The results indicated that: (1) music tapes in general could reduce both the stress and arousal factors of the J-SACL; (2) however, differential effects in stress reduction of antistress music tapes were not demonstrated; (3) stress-reducing effects were more prominent in stress than in arousal factors.     

Using international emotional picture sets in countries suffering from violence

It is hypothesized that ratings of emotional stimuli are affected by a constant threat of traumatic events. Ratings of valence and arousal on the International Affective Picture System from young adults in the United States were compared to those of young Israeli adults. Israelis rated the pictures as less negative and less positive than did participants from the United States. Israeli women gave higher arousal ratings compared to the American women. These differences may be due to compulsory military service in Israel, during which exposure to traumatic events is more likely to occur, and to the timing of the study which followed a year of frequent suicide bomb attacks. The authors suggest that these findings may reflect mild symptoms of stress disorders.     

The regulation of affect,anxiety, and stressful arousal from adopting mastery‐avoidance goal orientations

Achievement goal theory has proved to be very influential in our understanding of student's regulation of academic and non‐academic behaviours. Recently, Elliot and McGregor proposed mastery‐avoidance goals in the trichotomous model of achievement motivation. The purpose of the present studies was to examine the regulation of mastery‐avoidance goals with regard to persistence, affect and arousal. In Study 1, 96 college students' regulation of their own behaviour was assessed during a stressful exam. Results showed that mastery‐avoidance goals were associated with significantly elevated cognitive anxiety, negative affect and fear of failure. Study 2 attempted to replicate and extend the findings of Study 1 by examining the regulation of affect and arousal using self‐report and physiological assessments, during stressful in‐class presentations (n = 70). Results indicated that negative affect was significantly predicted by adoption of mastery‐avoidance goals. Modelling the effects using Multilevel Random Coefficient Modelling showed that students espousing mastery‐avoidance goals were significantly more aroused, compared to students who adopted any other type of goal orientation, at both the intercept level and the slope (linear or quadratic). It is concluded that mastery‐avoidance goals have deleterious effects on student's regulation of their emotional experience in stressful achievement situations and should be avoided by all means. Copyright © 2007 John Wiley & Sons, Ltd.     

Patterns of Trauma Exposure in Childhood and Adolescence and Their Associations With Behavioral Well‐Being

The majority of youth living in the United States experience a potentially traumatic event (PTE) by 18 years of age, with many experiencing multiple PTEs. Variation in the nature and range of PTE exposure differentially impacts youth functioning, although this association is poorly understood. We used latent class analysis (LCA) to identify patterns of PTE exposure from caregiver and youth report in a treatment‐seeking sample of children and adolescents (N = 701) and examined how these patterns predict youths’ behavioral health outcomes. We identified four classes based on both caregiver and youth reports of PTE exposure, with the best‐fitting model representing a constrained measurement model across reporters; these included high polyvictimization, moderate polyvictimization (general), moderate polyvictimization (interpersonal), and low polyvictimization classes. Prevalence of classes varied across reporters, and agreement in classification based on caregiver and youth report was mixed. Despite these differences, we observed similar patterns of association between caregiver‐ and youth‐reported classes and their respective ratings of posttraumatic stress disorder and depressive symptoms, as well as both caregiver and therapist ratings of problem behavior, with Cohen's d effect size estimates of significant differences ranging from d = 0.25 to d = 0.51. The PTE exposure classes did not differ with respect to ratings of child functioning. Findings highlight the importance of gathering information from multiple informants.     

#BCSM and #breastcancer: Contemporary cancer‐specific online social media communities

Online health care communities are commonplace on social media. This report investigates the engagement and use of breast cancer‐specific hashtags: #BCSM and #breastcancer. With over 5 million Twitter impressions weekly and increased engagement around academic meetings and news releases, these communities connect a global population. Most participants are based in the USA and work in health care; however, there is also significant engagement from the general population. Improved understanding of online hashtag communities and their output will allow us to innovate and improve the utility of this popular medium for communication in breast cancer and other disease‐specific populations.     

Spirituality, Resilience, and Anger in Survivors of Violent Trauma: A Community Survey

This study evaluates the relationship between spirituality, resilience, anger and health status, and posttraumatic symptom severity in trauma survivors. A community sample (N = 1,200) completed an online survey that included measures of resilience, spirituality (general beliefs and reincarnation), anger, forgiveness, and hatred. In survivors of violent trauma (n = 648), these measures were evaluated with respect to their relationship to physical and mental health, trauma-related distress, and posttraumatic symptom severity. Using multivariate regression models, general spiritual beliefs and anger emerged in association with each outcome, whereas resilience was associated with health status and posttraumatic symptom severity only. Forgiveness, hatred, and beliefs in reincarnation were not associated with outcome. The importance of these findings to treating trauma survivors is discussed.     

Mass media involvement in education and information about HIV/AIDS

AIDS is the first international mass media disease. Throughout the world, most people have learned more about AIDS from radio, television and the press than from personal contacts with health professionals. Mass media AIDS materials influence behavior most when they are designed and developed for different segments of the audience, with the specific needs and concerns of those segments in mind. In the past mass media evoked fear, anxiety and other negative emotional responses to AIDS and didn't proposed practical and realistic ways of action. The journalists made frequently distinctions between innocent victims of HIV, that are infants and recipients of infected blood or blood products through health care, and other "guilty" infected people such as gays, sex workers or african people. Mass media can change behavior and if journalists accept their responsibility in presenting the news, the publicity about AIDS may have a great and positive impact in HIV/AIDS.     

Opioid analgesic effects on subjective well-being in the operating theatre*

Exposure to opioid analgesics due to surgery increases the risk of new persistent opioid use. A mechanistic hypothesis for opioids' abuse liability rests on the belief that, in addition to pain relief, acute opioid treatment improves well-being (e.g. via euphoria) and relieves anxiety. However, opioids do not consistently improve mood in laboratory studies of healthy non-opioid users. This observational study determined how two commonly used opioid analgesics affected patients' subjective well-being in standard clinical practice. Day surgery patients rated how good and how anxious they felt before and after an open-label infusion of remifentanil (n = 159) or oxycodone (n = 110) in the operating theatre before general anaesthesia. One minute after drug injection, patients reported feeling intoxicated (> 6/10 points). Anxiety was reduced after opioids, but this anxiolytic effect was modest (remifentanil Cohen's d = 0.21; oxycodone d = 0.31). There was moderate to strong evidence against a concurrent improvement in well-being (Bayes factors > 6). After remifentanil, ratings of ‘feeling good’ were significantly reduced from pre-drug ratings (d = 0.28). After oxycodone, one in three participants felt better than pre-drug. Exploratory ordered logistic regressions revealed a link between previous opioid exposure and opioid effects on well-being, as only 14 of the 80 opioid-naïve patients reported feeling better after opioid injection. The odds of improved well-being ratings after opioids were higher in patients with previous opioid exposure and highest in patients with > 2 weeks previous opioid use (adjusted OR = 4.4). These data suggest that opioid-induced improvement of well-being is infrequent in opioid-naïve patients. We speculate that peri-operative exposure could increase risk of persistent use by rendering subsequent positive opioid effects on well-being more likely.     

Influence of Empathy,Beliefs, Attitudes,and Demographic Variables on Willingness to Donate Organs

Background

As organ transplantation has become a more routine medical procedure, there has been a growing interest in studying people's attitudes and knowledge concerning organ donation. Trait empathy and self-interest influence different pro-social behaviors to a great extent; still, their role in the promotion of organ donation registration and willingness to donate organs remains unclear. However, people with higher levels of empathy report more altruistic beliefs. We assessed the influence of empathy, beliefs, and demographic variables on willingness to donate organs.

Methods

We included 191 subjects (135 female, 56 male) aged 16–61 years (mean, 26.86 ± 12.88), who participated in educational meetings concerning organ donation. The group was composed of students, teachers, and nurses. Survey tools included the Individual Questionnaire: Study of Attitudes Towards Transplantation, consisting of 26 closed-ended questions (with the consent of the Krakow Statistical Office) and the Empathy Scale by Mehrabian and Epstein.

Results

Of the respondents, 97.4% accept transplantation from living donors, 95.8% accept deceased donations, and 78.5% agree with posthumous life-saving organ donation. The majority of respondents (73%) achieved an average level of empathy, and 20.4% of respondents exhibited considerably higher empathy levels. There was a significant difference between the respondents' sex and their agreement to make a life-saving organ donation. Differences were found among the groups, the attitudes and willingness to donate organs, and between the level of empathy and agreement/consent for organ donation.

Conclusions

Our findings show that the group in general has favorable beliefs about transplantation and declares a willingness to make a posthumous organ donation. These beliefs vary based on demographic variables. Education about organ and tissue donation a has a positive impact on donation and transplantation rates.     

The influence of news events on health after disaster: A longitudinal study in general practice

This study investigates the influence of local and international news events on utilization of health services resources and health complaints as presented by victims of a fireworks depot disaster. It was hypothesized that victims (N = 2,854) will show more utilization and health complaints to their general practitioner (GP) in the week after 11 local news reports of events relating to the specific index trauma and 6 unrelated disasters reported in international print news, than the week before. Health data of victims and matched controls were extracted from electronic medical records, covering 4‐years postdisaster. Especially local news events concerning the cause of the disaster were associated in both victims and controls with an increase of GP utilization and health complaints, including medically unexplained physical symptoms, chronic diseases, and psychological problems. No difference between victims and controls were found.     

Anger Regulation Deficits in Combat-Related Posttraumatic Stress Disorder

We describe a typology of regulatory deficits associated with anger in combat-related posttraumatic stress disorder (PTSD). Cognitive, arousal, and behavioral domain deficits in anger regulation were observed clinically in PTSD patients with high levels of anger who were participating in a multi-year trial of a structured anger treatment. We also describe a category of patients whose anger type we have termed ball of rage. These patients exhibit regulatory deficits in all three domains of anger regulation. We offer a conceptual framework to advance the understanding of anger associated with PTSD and to guide its effective treatment.     

Parental perception on the effects of early exposure to anaesthesia on neurodevelopment

Several studies have investigated the effects of general anaesthesia on neurodevelopment in children, with conflicting results. The potential for early general anaesthesia exposure to impact neurodevelopment in children may cause significant concern for parents. Administering a questionnaire in 200 parents, we aimed to explore their knowledge, concerns and perceptions, and determine factors which influence parents’ willingness for their children to participate in relevant research studies. A significant proportion of parents (40%) were concerned that general anaesthesia may affect their child's neurodevelopment. Generally these concerns arose from the parents’ own beliefs or preconceived ideas and only 25.5% had encountered prior information in this domain. Parents with children aged 2 years or younger, those whose children had previous general anaesthesia exposure, and those who had encountered information about potential neurodevelopmental effects were most likely to be concerned. The majority of parents (68%) would agree to participate in research studies, especially if they were able to receive the test results. Anaesthetists should pre-emptively initiate discussions to address any potential misconceptions regarding the effects of general anaesthesia on neurodevelopment in children.     

Numbing of Positive,Negative, and General Emotions: Associations With Trauma Exposure,Posttraumatic Stress,and Depressive Symptoms Among Justice‐Involved Youth

Increasing attention has been drawn to the symptom of emotional numbing in the phenomenology of posttraumatic stress disorder (PTSD), particularly regarding its implications for maladaptive outcomes in adolescence such as delinquent behavior. One change in the definition of emotional numbing according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM‐5; American Psychiatric Association, 2013) was the limitation to the numbing of positive emotions. Previous research with youth, however, has implicated general numbing or numbing of negative emotions in PTSD, whereas numbing of positive emotions may overlap with other disorders, particularly depression. Consequently, the goal of this study was to investigate whether numbing of positive emotions was associated with PTSD symptoms above and beyond numbing of negative emotions, general emotional numbing, or depressive symptoms among at‐risk adolescents. In a sample of 221 detained youth (mean age = 15.98 years, SD = 1.25; 50.7% ethnic minority), results of hierarchical multiple regressions indicated that only general emotional numbing and numbing of anger accounted for significant variance in PTSD symptoms (total R² = .37). In contrast, numbing of sadness and positive emotions were statistical correlates of depressive symptoms (total R² = .24). Further tests using Hayes’ Process macro showed that general numbing, 95% CI [.02, .45], and numbing of anger, 95% CI [.01, .42], demonstrated indirect effects on the association between trauma exposure and PTSD symptoms.     

Role for opinion leaders in promoting evidence-based surgery

HYPOTHESIS: "Opinion leaders" can be identified by surgeons from among their peers, and opinion leaders have a role in promoting best surgical practice. DESIGN: Postal survey. SETTING AND PARTICIPANTS: Four hundred eighteen (77% response fraction) randomly selected fellows of the Royal Australasian College of Surgeons. MAIN OUTCOME MEASURES: Number of opinion leaders identified locally, statewide, and nationally; ratings of 22 possible attributes in conferring status as an opinion leader; and views about and ratings of the role of opinion leaders. RESULTS: Most respondents were unable to identify a local colleague whom they considered to be an opinion leader in their own specialty (mode, 0; and median, 1) or in surgery in general (mode, 0; and median, 0). Estimated numbers of opinion leaders were significantly higher at the state and national levels for the respondents' own specialty and for surgery in general (P<.001 for all). Surgical expertise and teaching skills were rated most highly as conferring status as an opinion leader. Academic and professional contributions received the lowest ratings. Most surgeons (88%; 95% confidence interval, 84%-91%) agreed that opinion leaders could influence them to change their practice. Opinion leaders were rated as "very influential" by significantly more surgeons than clinical audit (38% vs 27%, chi21 = 13.6, P<.001) and clinical practice guidelines (38% vs 24%, chi21 = 21.4, P<.001) (McNemar test for both). CONCLUSIONS: Australian surgeons support the concept of opinion leaders. Although few local colleagues whom they consider as fulfilling such a role can be identified, opinion leaders are evident at a national level. Once opinion leaders are identified using attributes ranked in our survey, interventional studies will further delineate their influence in improving evidence-based surgical practice.