Search Results (135)

Rates of self-harm in Australian young people have increased significantly in recent years, especially in young women. Self-harm has been associated with several risk factors, including a history of abuse, bullying, mood and personality disorders, social isolation and suicidal ideation. However, little is known about why rates have increased in the past decade, and the voices of young Australian women have been conspicuously absent from the research. This study explored perceived subjective reasons for the increase in self-harm rates by interviewing 24 young Australian women with lived experience of self-harming behaviours. A reflexive thematic analysis identified three interwoven themes: ‘The world is hard, and it’s getting harder’, ‘New media exacerbates old challenges’, and ‘The online world brings unique challenges’. Participants also highlighted the complexity of social media as both a negative influence and a supportive factor. These themes extend previous research by highlighting the nuanced and multi-faceted psychosocial factors that influence self-harming behaviours and may help inform effective, evidence-based strategies that help minimise harm. Full article

Background/Objectives: Trauma-related distress poses significant mental health challenges, with psychotherapy serving as a primary intervention. The Walters Method is a promising new alternative that may help where traditional methods fall short (i.e., in complex or violent cases), but before it can be implemented widely, the existing evidence on the effectiveness of other psychotherapies for trauma-related distress must be mapped to see how and where it relates to other techniques. The aim of this scoping review was to provide an overview of existing evidence on the effectiveness of psychotherapy for trauma-related distress. Methods: A scoping review was conducted to better understand the effectiveness of psychotherapies for trauma-related distress (including PTSD, acute stress disorder, or other serious mental health issues). Results: Thirty-three articles were analysed. Included articles included adults with PTSD, incarcerated women, childbirth trauma survivors, female survivors of sexual abuse, hospitalised COVID-19 patients, adults with serious mental illness, veterans and active soldiers, firefighters, and refugees. Eye Movement Desensitisation and Reprocessing and Cognitive Behavioural Therapy were the most studied and effective treatments. Prolonged Exposure and Narrative Exposure Therapy were less common but noteworthy. Other therapies, including psychodynamic approaches, are seldom studied but have proven effective when explored, highlighting knowledge gaps and potential missed opportunities. Success with these alternative approaches—especially in complex trauma cases like intimate partner violence or child loss where EMDR and CBT may be less effective—suggests they have potential, but further research is needed for validation. Conclusions: This review offers novel contributions to the field by emphasising innovative therapeutic perspectives that extend beyond traditional, more studied, evidence-based approaches such as CBT and EMDR, thereby expanding treatment options for diverse clinical presentations. Alternative therapies show promise, particularly for complex trauma cases like intimate partner violence or child loss where established approaches may be less effective; however, further research is needed to validate their efficacy across diverse populations. Selection of psychotherapy should be based on clients’ goals and comfort, and the cultural and contextual compatibility between the person and intervention. Future research should prioritise underexplored therapies to address current knowledge gaps and improve treatment accessibility for varied clinical needs. Full article

This scoping review study examines seven governments and some non-governmental organisations’ youth development mechanisms in response to drug and alcohol abuse among their youth. This scoping review, including sources from 39 studies and 16 government or organisational reports, are reviewed to investigate youth development measures to mitigate drug and alcohol abuse. This study revealed that youth development mechanisms, such as outreach youth work, digital youth work, and detached youth work, lead to significant changes in risky behaviours. The study further revealed that non-governmental organisations play a critical role in solving drug- and alcohol-related challenges among youth by deterring local merchants from selling drugs and alcohol to underage customers and by strictly regulating their promotion and advertising. Effective mechanisms to develop self-efficacy, purpose, and meaning in life among youth are needed. This study also highlights the need for a joint effort between government departments, local municipalities, non-governmental youth-focused organisations, and schools to come up with effective youth work strategies. This study concludes by proposing the establishment of a Southern African Development Community (SADC) Youth Work Association and the professionalisation of youth work in the region. This will ensure that intervention programmes are implemented by professional youth workers who have the skills and knowledge to work with vulnerable young people. Full article

Childhood trauma has been associated with criminal behaviour and a variety of psychopathologies. Furthermore, it is known that emotional dysregulation (ED) predicts anxiety and depression and can be a product of traumatic experiences. In order to develop effective interventions for offenders’ rehabilitation and prevent recidivism, it is essential to fully understand their mental health and its relation with previous child trauma experiences and ED. This study involved a sample of 100 male inmates incarcerated in seven different prisons in the northern region of Portugal. The following measures were used: the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the International Trauma Questionnaire (ITQ), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Difficulties in Emotional Regulation Scale (DERS). Our findings suggest that individuals who experienced physical and sexual abuse are more likely to perpetrate violent crimes and that ED increases anxiety and depressive symptoms in individuals with traumatic symptoms. In conclusion, it is imperative to provide psychological support to this population, and interventions need to be adapted according to trauma exposure. Full article

Tuberculosis (TB) remains a critical public health issue in Johannesburg, South Africa, driven by a complex interplay of individual, social, and structural factors. This study assessed the syndemic relationship between these determinants to understand their collective impact on TB burden and treatment outcomes. A cross-sectional survey was conducted among TB patients attending selected clinics, examining behavioural risks (e.g., smoking, alcohol use, HIV co-infection), social conditions (poverty, overcrowding, stigma), and structural challenges (access to healthcare, migration status). The results revealed a significant co-occurrence of TB and HIV (56.1%), alongside high rates of smoking (33.1%) and alcohol use (45.2%). Unemployment (50.2%), inadequate housing, and limited healthcare access, particularly for undocumented migrants (26.2%), were also prominent. Factor analysis demonstrated a syndemic interaction between behavioural and social determinants, underscoring the compounded vulnerability of affected populations. The findings highlight the necessity of integrating medical interventions with social and structural reforms. Recommendations include TB-HIV co-management, substance abuse programmes, improved housing, and inclusive healthcare access. A multisectoral approach addressing both health and socioeconomic inequalities is critical for comprehensive TB control in urban South African contexts. Full article

Background: It is common for patients with eating disorders (ED) to report traumatic experiences early in their lifetime. The objective of this study was to explore the presence and types of traumatic events and the comorbidity with Post-Traumatic Stress Disorder (PTSD) in a sample of adolescents with severe ED. Method: A total of 118 adolescents treated at our Eating Disorders Day Care Hospital (EDDCH) were systematically evaluated for depressive symptoms, disordered eating, early traumatic experiences, and presence of PTSD. Likewise, various clinical variables were collected including comorbidities, age upon ED diagnosis, number of hospital admissions, presence of non-suicidal self-injury, and suicide attempts. Results: Seventy-seven (65.3%) of adolescents of the total sample reported exposure to four or more traumatic events (bullying, psychological abuse, and sexual abuse being the most common). Fifty-seven of them (48.3% of the total sample) scored significantly high in PTSD assessment. Patients with ED and comorbid PTSD (PTSD+) presented higher disordered eating (p < 0.001) and depressive symptoms (p < 0.001) and also a higher prevalence of both non-suicidal self-injury (p = 0.031) and suicide attempts (p = 0.004). The depressive symptoms, measured with the CDI, emerged as an independent predictor of belonging to the PTSD+ group, explaining 22.9% of the variance. Conclusions: It is imperative to systematically screen adolescents with severe ED for traumatic events and PTSD, especially in patients presenting with more depressive symptoms and suicidal or non-suicidal self-injury behaviours, since this subset of patients could be at a higher risk of PTSD. Offering specific psychotherapeutic care targeting PTSD and/or posttraumatic symptoms in addition to the ED standard of care could arguably improve the prognosis of the ED in comorbid patients. Full article

Education-to-work transition among war-affected youth in post-conflict settings is fraught with challenges, not least compounded by the little attention placed on individual agency and mental health. This review examines the debate on war-affected youth skilling programmes in post-conflict settings, which neglect the roles of individual agency and mental health in the education-to-work transition. Building on Albert Bandura’s Self-Efficacy Theory (SET) and the Cumulative Stress Hypothesis (CSH), the review presents an integrated approach to skills development for improving education-to-work transition among war-affected youth. According to SET, the development of self-efficacy is anchored on enactive mastery, vicarious experience, verbal persuasion, and physiological arousal. Moreover, individual agency factors such as motivation, aspiration, goal orientation, active efforts, and alignment of intentions with skills are protective factors for effective education-to-work transition, but they are also eroded by the adverse consequences of violent conflicts. Similarly, the CSH also suggests that the effects of exposure to protracted violent conflicts are cumulative and may lead, in turn, to a plethora of mental health problems in the aftermath of violent conflicts. Mental health problems like depression, anxiety, and PTSD are linked to, inter alia, behaviours such as aggression, substance abuse, and apathy, all related to poor employment outcomes. To increase the employability of young people affected by war, skills training institutions and work settings need to prioritise the mental health and individual agency of the youth, as well as skills acquisition for specific trades. Consequently, we propose an integrated model of reintegrating war-affected and vulnerable youth anchored on professional technical and vocational skills training; recognition of individual agency; provision of mental and psychosocial support; and life skills training, all nested within the local economic realities. Full article

Globally, 1–3% of the population has an intellectual disability, but some remain undiagnosed, resulting in limited access to essential health and social care services, poor health outcomes, and higher risks of homelessness, substance abuse, and imprisonment. A formal diagnosis enables early intervention and support. A scoping review was conducted to explore research on undiagnosed intellectual disability, screening processes, and identifying indicators. Method: The scoping review search was conducted using academic databases such as CINAHL, PsycINFO, Scopus, and PubMed, along with eight grey literature sources. In addition, the reference lists of the included studies were explored. Information specialists supported and guided the search process. The search included qualitative, quantitative, review, and mixed-method research studies published in English between 2000 and 2024. Two reviewers screened papers for eligibility by title, abstract, and full text. Result: A total of 11,475 papers were screened, with 57 papers from various countries included in the review. Indicators of intellectual disability were identified in three settings: (1) educational settings (preschool, primary, and secondary schools); (2) social care services, including homeless and community services; and (3) criminal services, such as courts, probation, and prisons, highlighting the wide applicability of findings. These indicators were linked to “experiences”, “behaviours”, “challenges”, and “observations”. Conclusion: This review emphasised the importance of early diagnosis by adopting appropriate assessment tools, which require national screening policies. It also highlighted the essential role of professionals working in intellectual disability services in identifying and supporting undiagnosed individuals, particularly within high-risk populations. Implication: The review’s findings will guide policy, practice, and research recommendations for enhancing the early identification of people with intellectual disabilities. Full article

Background: Adverse childhood experiences (ACEs) are linked to increased risk of deliberate self-harm (DSH), yet little is known about how women in forensic inpatient settings with histories of childhood abuse understand their self-harm. This study aimed to explore how such women make sense of their self-harm, including perceived contributing and protective factors. Methods: Semi-structured interviews were conducted with six female psychiatric inpatients (aged 22–38) detained in a low-secure forensic hospital in the north of England. All had a history of ACEs and DSH. Interpretative phenomenological analysis (IPA) was used to analyse the data. Results: Three overarching themes were identified: (1) Journey of self-harm, (2) reasons for self-harm, and (3) relationships and self-harm. Participants described self-harm as a method of emotional regulation, a way to regain control, or a means of feeling something. Protective factors included supportive relationships, self-awareness, and having meaningful goals. The findings reflect complex, evolving understandings of self-harm shaped by personal histories and relational dynamics. Conclusions: This study highlights the persistent and multifaceted nature of self-harm among women in forensic settings. The findings support the need for trauma-informed interventions that address emotion regulation, relational support, and personal empowerment. Implications for clinical practice and directions for future research are discussed. Full article

Substance Use Disorders (SUDs) are frequently associated with impairments in emotional regulation and behavioural control. Among the most prevalent substances of abuse, alcohol and cocaine are known to exert distinct effects on neuropsychological functioning. This study aimed to compare individuals with Alcohol Use Disorder (AUD) and Cocaine Use Disorder (CUD) in terms of impulsivity and alexithymia, and to examine the clinical implications of poly-substance use involving both alcohol and cocaine. Participants completed standardized psychometric assessments, including the Barratt Impulsiveness Scale (BIS-11), the Brief Psychiatric Rating Scale (BPRS), and the Toronto Alexithymia Scale (TAS-20). Group comparisons were conducted using non-parametric tests, and logistic regression models were applied to control for demographic covariates. The findings showed that impulsivity levels were comparable across groups, whereas alexithymia scores were significantly higher in individuals with AUD and in those with poly-substance use, relative to CUD-only participants. These findings underscore the relevance of targeting emotional regulation difficulties, particularly alexithymia, in the assessment and treatment of SUDs. Integrating emotion-focused interventions may enhance treatment outcomes, especially for individuals with co-occurring substance use patterns. Future research is needed to clarify the underlying neuropsychological mechanisms contributing to these differences and to inform more personalized approaches to addiction care. Full article

Facilitating a just response to staff involved in patient safety events is complex, with varying perceptions of safe behaviour and practice across settings. This viewpoint paper explores the challenges of developing a just culture, particularly in safeguarding situations involving peer-to-peer harm. It argues that established just culture principles, such as balancing staff and organisational accountability and using After Action Review (AAR) debriefs, need to be tailored to these contexts. In particular, organisational accountability is paramount in safeguarding situations, especially where individuals do not have the capacity to understand or intend their behaviours. Furthermore, AARs are inappropriate incident responses for serious aggression, violence, and abuse cases. To counter this, a consistent AAR practice can be valuable for preventative learning when applied to the service user care journey and comprehensive incident learning responses. The incorporation of social workers, service users, and families can help promote learning and the prevention of events. Finally, this paper emphasises the need for consistency in core safety principles across settings and the need to tailor just cultural principles to particular contexts. Future research on the role of AAR in diverse settings is recommended. Full article

The growth seen in the number of addictive behaviours related to substance and drug use among adolescents has become one of society’s major problems. Several research studies have tried to find answers to this problem, highlighting the potential of physical activity as a prevention method for substance abuse. The aims of this study were (1) to conduct a systematic review analysing the effects of physical activity, exercise or sports-based interventions on substance use among young people and adolescents and (2) to describe and analyse these interventions. To this end, the guidelines of the PRISMA Declaration were followed, and six databases were searched: PubMed, Web of Science (WOS), PsycINFO, ERIC, SPORTDiscus, and SCOPUS. After screening and meeting the proposed eligibility criteria, a total of 10 articles were included. The results provided scientific evidence of the benefits of physical activity in preventing and reducing substance use, most significantly in interventions based on yoga and structured physical activity. Full article

While the effect of ageing has been thoroughly analysed, to improve the cycle life of lithium-ion batteries, its impact on safety in case of a mechanical loading is still a new field of research. It has to be found out how mechanical properties, such as the tolerable failure force or deformation, change over the operational lifetime of a battery. To answer this question, mechanical abuse tests were carried out with pouch cells used in recent electric vehicles in a fresh state and after usage over 160.000 km. These tests were complemented with a detailed component level analysis, in order to identify mechanisms that lead to changed cell behaviour. For the analysed aged cells, a significantly different mechanical response was observed in comparison with the respective fresh samples. The tolerable force was severely reduced (up to −27%), accompanied by a notable reduction in the allowable deformation level (up to −15%) prior to failure, making the aged cells clearly more safety critical. Based on the subsequent component tests, the predominant mechanism for this different behaviour was concluded to be particle cracking in the cathode active material. The found results are partly in contrast with the (few) other already published works. It is, however, unclear if this difference is rooted in different cell chemistries or types, or another battery state resulting from varying ageing procedures. This underlies the importance of further investigations in this research field to close the apparent gap of knowledge. Full article

High-risk and high-harm domestic abuse perpetrators pose the greatest risk of serious harm to (ex-)partners and family members. Robust evidence of perpetrator intervention is lacking for this group. The Drive perpetrator intervention in the United Kingdom focuses specifically on high-harm perpetrators to reduce abuse and increase safety of victims, using individual case management via support and disruption, co-ordinated multi-agency response and targeted support to victims. This paper reports on evaluation of the Drive pilot. A high quality quasi-experimental approach with individually randomised intervention and controls was applied in three areas in England and Wales. High-risk perpetrators (N = 2627) were allocated randomly to either Drive or usual care (support to victim). Change in safety and risk for Drive-associated victims was compared with the usual care victim group. Longer-term outcomes were assessed before, during and 12 months following the intervention for Drive and control group perpetrators at one site. The Drive intervention reduced abusive perpetrator behaviours and increased safety for victims compared to the control. The reduction in perpetration by both serial and repeat perpetrators sustained for a year after the end of the intervention and was statistically significant (p < 0.001) for Drive perpetrators compared to the control. Full article

Background: Family breakdown, separation, and divorce (FBSD) are often traumatic events, particularly for fathers who face unique challenges. These include emotional, psychological, and financial struggles, often exacerbated by abusive behaviours from ex-partners. This study explores fathers’ experiences of FBSD, focusing on both the breakdown event itself and any abuse, including coercive control and parental alienation, before and after the separation. Methods: A mixed-methods approach was employed, including a survey of 141 men and follow-up interviews with 30 participants. Data were analysed using reflexive thematic analysis to identify key themes related to FBSD and associated abuse. Results: Fathers reported significant emotional, psychological, and financial distress, with many experiencing ongoing abuse and coercive control after separation. Abuse often continued through legal processes and manipulation of child access. Parental alienation emerged as a prominent form of post-separation abuse, with fathers describing attempts by ex-partners to undermine their relationships with their children. Conclusions: The findings highlight the need for gender-inclusive services that address the specific challenges fathers face during and after FBSD, particularly in relation to post-separation abuse. Targeted interventions are necessary to support fathers’ well-being and ensure their continued involvement in their children’s lives. Full article