At a moment of dramatic retreat from refugee resettlement, accompanied by anti-immigrant political discourse that criminalizes migrants, this study examines how Iraqi resettled refugees who came to the United States with Special Immigrant Visa status following the 2003 war in Iraq navigate stigmatizing welfare dependency tropes and narrate their identities. Using the lens of narrative criminology and based on interviews with Iraqi resettled refugees and social service staff, this study asks how resettled Iraqi refugees construct narratives of self and identity in relation to the organizational narratives they encounter at social services offices, and what these narratives reveal about welfare administration as a site of social harm. Findings show that while resettled refugees construct counter-narratives, these are limited in their emancipatory potential and reproduce harmful narratives of welfare. The study contributes to narrative criminology's engagement with welfare settings as sites of social harm. How Iraqi refugees in Michigan navigate welfare, and how the stories of caseworkers and social services staff shape their experiencesIraqi refugee families in the United States require government assistance while undergoing resettlement and search for employment. The families interact with staff at welfare offices and nonprofit organizations who help them with assistance and resettlement. Their experiences of assistance are usually explained as part of their resettlement journey. However, there is more to understand about how these families see themselves specifically as welfare recipients and how stories about welfare told by their caseworkers and case managers affect them. To understand the connections between the way refugees are described in stories about welfare and how refugees see themselves, I interviewed Iraqi refugees, and staff members who worked at an organization helping refugee families in Michigan. I asked Iraqi families about their experiences of resettlement and receiving assistance. I asked the staff about their role in helping refugees with resettlement and assistance. Then, I looked for patterns in what people said about welfare, unemployment, and refugee resettlement. The staff at the organization often described unemployed refugees as lacking motivation or having the wrong attitude about employment. By contrast, refugees described themselves as professional, motivated to find work, and compliant with all welfare requirements. They described the experience of receiving welfare as humiliating and emphasized to me that they were different from other people who abuse welfare. These are important findings that tell us that people experience harm in these places through humiliating interactions that attack their sense of self-worth. Refugees push back against these negative experiences. Yet, they do so in ways that reinforce negative views about other people receiving welfare. Understanding how stories operate in social services offices can help us understand how welfare stereotypes amplify social harm against welfare recipients.
Healthcare workers are exposed to intense organizational pressures and demanding interpersonal dynamics that may undermine psychological wellbeing. Tyrannical leadership-characterized by hostile, controlling, and humiliating supervisory behaviors-represents a particularly harmful organizational stressor in healthcare settings. Under such conditions, psychotropic medication may be used as a coping response to sustained psychological strain. This study examined whether exposure to tyrannical leadership predicts subsequent psychotropic drug use among healthcare workers. A longitudinal panel study was conducted among healthcare workers employed in high-complexity public hospitals in Chile. Two waves of data were collected 10 months apart. The analytic sample included 683 participants who completed both measurements. Tyrannical leadership exposure was assessed using a validated scale. Psychotropic medication use was measured through self-reported intake of hypnotics, anxiolytics, or antidepressants. Logistic regression models were used to estimate crude and adjusted associations between baseline tyrannical leadership and psychotropic drug use at follow-up, controlling for baseline medication use, sex, and key psychosocial work stressors, including effort-reward imbalance and emotional demands. At follow-up, 39.8% of participants reported psychotropic medication use. In crude models, exposure to tyrannical leadership at baseline was associated with approximately twice the odds of psychotropic use at follow-up. In the fully adjusted model, baseline psychotropic use was the strongest predictor of subsequent consumption, with nearly tenfold higher odds of continued or increased use. After adjustment, tyrannical leadership remained significantly associated with psychotropic drug use, doubling the odds of consumption. Effort-reward imbalance also showed a significant association, whereas sex and emotional demands were not significant predictors. These findings identify tyrannical leadership as a significant and potentially preventable organizational risk factor linked to increased psychotropic medication use among healthcare workers. By highlighting leadership as a modifiable determinant of mental health outcomes, the study underscores the importance of organizational interventions aimed at improving supervisory practices in high-stress healthcare environments.
In multilingual nursing education, English-medium practices often dominate teaching, assessment and documentation, positioning students' home languages as informal or inappropriate for legitimate academic participation. This qualitative, descriptive, exploratory and contextual study investigates how nurse educators conceptualise the role of students' home languages in teaching and assessment, and what these conceptualisations disclose about language ideologies, recognition and the politics of voice in professional formation. Across five focus groups with 44 nurse educators, participants framed home language as a pathway to epistemic access, enabling comprehension, conceptual clarity and participation when English constrained expression. They also described multilingual responsiveness as a practice of dignity and cultural recognition, in which respectful communication and non-humiliating feedback enact humanising pedagogy. At the same time, educators highlighted structural tensions in which English operates as a gatekeeping regime in assessment and professional communication, producing moments where students 'know' content yet struggle to demonstrate competence in sanctioned discourse. Communication was further expanded beyond linguistic proficiency to include cultural nuance, nonverbal meaning and relational conduct, linking language to clinical readiness and patient care. The article argues for structured multilingual pedagogies and language-aware assessment that maintain standards while widening voice, belonging and equitable participation.
Every day patients make informal complaints directly to care professionals. Although common in care encounters, the practice remains understudied. In this study, we focus on informal complaints through an analysis of interviews with 19 patients in Sweden, many living with chronic illness. We conceptualise these complaints as 'informal complaint biographies': not merely verbal expressions, but interwoven with people's lives, identities and care trajectories. As a lens through which to examine informal complaining, this study investigates 'dirty work': work that is considered a nuisance or even humiliating. We identify three different kinds of dirty work. 'Disgusting' refers to work with physical dirt entangled with the complaint. 'Drudging' describes patients' persistence, their effort to make healthcare function. Finally, 'disrupting' characterises work that challenges expertise from a vulnerable position. Our analysis shows how informal complaining can involve various types of undignifying work that cannot be separated from the complaint itself. By including work done by others than the traditional 'worker', namely patients, this study expands scholarship on dirty work. The study calls attention to how dirty work is shaped by systemic inefficiencies in healthcare and contributes new perspectives to complaints, research and policy, which is often wiped clean from any kind of dirt.
Media often portray women in misogynous, discriminatory, and negative ways. By considering different types of misogynous media content and hostile responses to women, this meta-analysis of experimental and nonexperimental studies examined the relation between exposure to misogynous media content and hostility to women. The meta-analytic review included 257 eligible studies published across 47 years and encompassed 132,933 participants, thereby yielding 1,421 effect sizes. Analyses used robust variance estimation to examine the relationship between misogynous media exposure and hostility. On average, such exposure was associated with greater hostility to women (g = 0.26, 95% confidence interval, CI [.21, .30]), in both experimental (g = 0.28, 95% CI [.22, .35]) and nonexperimental (g = 0.24, 95% CI [.18, .29]) studies. Notably, exposure to misogynous media content affected both women and men, although the effect tended to be stronger among men (g = 0.27) than women (g = 0.20). The 95% prediction interval for the overall effect ranged from -0.52 to 1.04, indicating large heterogeneity. In fact, violent content easily recognized as antiwomen resulted in greater hostility among men (g = 0.38) but not women (g = 0.03), whereas humiliating (g = 0.29) and pornographic (g = 0.21) content yielded similarly hostile responses in women and men. In addition, adolescent participants were more influenced (g = 0.32) than participants in their midlate adulthood (g = 0.17), but they did not differ from those in their early adulthood (g = 0.27). Overall, this research showed that misogynous media content elicits demeaning attitudes and hostile behaviors directed toward women, thereby perpetuating the gender hierarchy defined by women's lower status in society. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Background/Objectives: Physical restraints and seclusion remain ethically contested interventions in psychiatric care, raising significant concerns regarding patient safety, dignity, and therapeutic impact. Despite growing international momentum towards restraint-reduction strategies, their use persists across the Eastern Mediterranean Region (EMR), an area that has been the subject of limited systematic attention. This review synthesises evidence on the knowledge, attitudes, and experiences of nurses and individuals with mental illness regarding these practices in EMR psychiatric settings. Methods: Following PRISMA 2020 guidelines (PROSPERO: CRD42023383751), we systematically searched nine electronic databases for studies published up to June 2023, supplemented by backward and forward citation searching. Multiple reviewers independently screened records against predefined eligibility criteria, with disagreements resolved through consensus. Methodological quality was assessed using Joanna Briggs Institute (JBI) Critical Appraisal tools, and reporting quality was evaluated using an adapted CROSS checklist; these two appraisal dimensions were conducted and reported independently. Findings were integrated through narrative synthesis. Results: From 4634 identified records, 19 studies conducted across 11 EMR countries met the inclusion criteria. Nursing knowledge deficits were identified across multiple settings, and attitudes towards restraint practices were predominantly negative. Individuals with mental illness consistently described restraint as humiliating, punitive, and physically distressing. Recurrent challenges identified across studies included inadequate staff training, chronic understaffing, and limited access to restraint-reduction alternatives. Conclusions: Substantial gaps in nursing knowledge and training persist across the EMR. The findings of this review, while derived predominantly from cross-sectional studies with convenience samples, suggest that evidence-based education programmes, standardised restraint-reduction policies, and patient-centred care frameworks warrant prioritisation to safeguard the rights, safety, and dignity of individuals with mental illness in this region. Longitudinal and experimental research is needed to confirm these directions and establish their effectiveness within EMR contexts.
The unsolicited receipt of genital images is a widespread form of cyber-sexual violence against women. While many women describe these experiences as humiliating or disgusting, others perceive them as harmless or even flattering. Building on a qualitative pilot study (92 women participants), we investigated how women evaluate and emotionally react to unsolicited genital images, and how these responses are influenced by prior sexual context and myths about cyber-sexual violence. A total of 218 Spanish women participants reported their acceptance of myths about cyber-sexual violence and evaluated a hypothetical incident of receiving an unsolicited genital image with the sexual context manipulated in a between-participants design. Results showed that women evaluated the incidents less positively and exhibited more anxiety, anger-hostility, and sadness, and less happiness and fewer feelings of power after exposure to both incidents of unsolicited genital images. Importantly, women with a higher acceptance of myths about cyber-sexual violence evaluated the incidents more positively, which in turn was associated with more positive and fewer negative feelings when the woman previously showed sexual interest toward the perpetrator (vs. no sexual interest or the control condition). These findings highlight the need for interventions that challenge these myths, empowering women to resist pressures to normalize such behaviors.
This study aimed to carry out the inferential analysis of the Violencemeter, identifying the most significant variables for the occurrence of domestic violence against women. This is an applied research, population-based, cross-sectional and quantitative in nature, developed in 52 Basic Health Units. The sample consisted of 563 women. The following eligibility criteria were used: women over 18 years of age who sought care at Basic Health Units during the data collection period and agreed to participate in the study. For the analysis of quantitative data, descriptive and inferential statistics were used, as well as a logistic regression model and the WoE binary classification model. The model used demonstrated that the Violencemeter variables with the greatest weight in identifying the occurrence of domestic violence were: ridiculing/offending, intimidating/threatening, disqualifying, humiliating in public, blackmailing, offensive jokes, jealousy, hurting, pushing, slapping, destroying personal property, slapping/tapping and threatening with objects. Thus, the Violencemeter presented itself as a powerful tool in combating domestic violence against women. Objetivou-se realizar a análise inferencial do Violentômetro identificando as variáveis mais expressivas para a ocorrência de violência doméstica contra a mulher. Trata-se de uma pesquisa do tipo aplicada, de base populacional, de corte transversal e natureza quantitativa, desenvolvida em 52 Unidades Básicas de Saúde. A amostra foi constituída por 563 mulheres. Foram utilizados os seguintes critérios de elegibilidade: mulheres a partir de 18 anos de idade que buscaram atendimento nas Unidades Básicas de Saúde durante o período da coleta de dados e concordaram em participar do estudo. Para a análise dos dados quantitativos, foi utilizada a estatística descritiva e inferencial, bem como um modelo de regressão logística e o de classificação binária WoE. O modelo utilizado demonstrou que as variáveis do Violentômetro com maior peso para identificar a ocorrência da violência doméstica foram: ridicularizar/ofender, intimidar/ameaçar, desqualificar, humilhar em público, chantagear, piadas ofensivas, ciúmes, machucar, empurrar, dar tapas, destruir bens pessoais, dar tapinhas/pancadinhas e ameaçar com objetos. Assim, o Violentômetro apresentou-se como uma potente ferramenta no enfrentamento à violência doméstica contra a mulher. El objetivo fue realizar un análisis inferencial del Violentómetro identificando las variables más expresivas para la ocurrencia de violencia doméstica contra la mujer. Se trata de una investigación del tipo aplicada, de base poblacional, de corte transversal y naturaleza cuantitativa, desarrollada en 52 Unidades Básicas de Salud. La muestra fue compuesta por 563 mujeres. Se utilizaron los siguientes criterios de elegibilidad: mujeres mayores de 18 años que buscaron atención en las Unidades Básicas de Salud durante el período de la recogida de datos y aceptaron participar del estudio. Para el análisis de los datos cuantitativos, se utilizó la estadística descriptiva e inferencial, así como un modelo de regresión logística y el de clasificación binaria WoE. El modelo utilizado demostró que las variables del Violentómetro con mayor peso para identificar la ocurrencia de violencia doméstica fueron: ridiculizar/ofender, intimidar/amenazar, descalificar, humillar en público, chantajear, bromas ofensivas, celos, lastimar, empujar, dar tapas, destruir bienes personales, dar palmadas/golpes y amenazar con objetos. Así, el Violentómetro se presentó como una poderosa herramienta en el enfrentamiento a la violencia doméstica contra la mujer.
Retraction of scientific papers may occur when the peer-review or publication process is compromised, even in cases where authors have no responsibility for the identified shortcomings. Using a recent case in which a peer-reviewed open-access mega-journal retracted a series of articles due to compromised peer review, also one from our group, this work examines the implications of limited editorial transparency in the retraction process. While failures in peer review can undermine the integrity of the scientific literature, inadequate communication by journal editors may have substantial negative effect on affected authors, particularly early-career researchers, including disorientation, humiliation, and a sense of perceived injustice. This analysis highlights the factors contributing to these outcomes such as the sense of loss associated with the substantial time and effort devoted to the research, as well as the practical impossibility of submitting the retracted article to alternative journals. Transparency represents a frontline defence against research misconduct but the call for increased transparency cannot be one-sided. Transparency needs to be a useful tool for the entire system, for those who report data and for those who publish data.
Torture in custody is a widespread and underreported phenomenon. Victims often present patterned injuries and behaviors, making medico-legal evaluation crucial for documenting abuse and assessing consistency with the reported events. We report 4 cases of individuals who were victims of torture in custody. Injuries predominantly included blunt-force trauma, with additional methods such as suspension, suffocation, sexual humiliation, and deprivation of food and water, confirming a recurring typical pattern regarding the types of injuries, instruments used, and body areas involved. These cases reflect typical patterns of injuries and behaviors associated with custodial torture, highlighting the importance of identifying and documenting findings consistent with the victim's account and physical examination.
ObjectivesMedical students are known to face significant psychological distress, making them vulnerable to substance use. There are few data on alcohol and drug consumption among medical students. The aim was to assess the prevalence of substance use, especially alcohol, in French medical students.MethodsThis cross-sectional nationwide study was conducted online from 10 June to 28 July 2024. A survey link was sent to French medical students and residents via official administrative emails. We assessed substance use (alcohol, tobacco, cannabis, cocaine, amphetamine, LSD, psilocybin, heroine, poppers, nitrous oxide and other). For alcohol consumption, we used the Alcohol Use Disorders Identification Test (AUDIT). Data analysis was performed, including recoding missing responses as zeros. Univariate and multivariate binary logistic regressions were performed with AUDIT as the dependent variable, categorized as binary (cutoff ≥8).ResultsWe included 8,312 students: 11% met criteria for hazardous drinking, and 5.5% for probable dependence according to the AUDIT; 23.3% respondents reported tobacco use, while cannabis use was reported by 13.4% with 1% using it more than 2 or 3 times a week. Among other substances, poppers (23.5%) and nitrous oxide (11.2%) were the most commonly reported. Multivariate analysis identified several factors associated with problematic alcohol use, such as male sex, younger age, financial difficulties, exposure to humiliation, harassment or sexual assault.ConclusionsAlcohol and psychoactive substance use remain prevalent among French medical students, at levels broadly comparable to those reported internationally. These findings underscore the need for targeted preventive and supportive actions within medical schools. On sait que les étudiants en médecine sont exposés à une détresse psychologique importante, ce qui les rend vulnérables à la consommation de substances. Il existe peu de données sur la consommation d’alcool et de substances chez les étudiants en médecine. L’objectif était d’évaluer la prévalence de la consommation de substances, en particulier d’alcool, chez les étudiants en médecine de France. Cette étude transversale nationale a été menée en ligne du 10 juin au 28 juillet 2024. Un lien vers un sondage a été envoyé aux étudiants en médecine et aux résidents de France par l’intermédiaire de courriels administratifs officiels. Nous avons évalué la consommation de substances (alcool, tabac, cannabis, cocaïne, amphétamines, LSD, psilocybine, héroïne, poppers, oxyde de diazote, etc.). Pour la consommation d’alcool, nous avons utilisé le questionnaire AUDIT (Alcohol Use Disorders Identification Test). On a procédé au recodage des réponses manquantes à zéro avant d’analyser les données. Des régressions logistiques binaires univariées et multivariées ont été réalisées avec le questionnaire AUDIT comme variable dépendante, dichotomisée selon un seuil ≥ 8. Nous avons inclus 8 312 étudiants : de ce nombre, 11% répondaient aux critères de consommation d’alcool à risque et 5,5% à ceux d’une dépendance probable selon le questionnaire AUDIT; parmi les répondants, 23,3% déclaraient consommer du tabac, tandis que 13,4% rapportaient une consommation de cannabis, dont 1% en consommaient plus de deux ou trois fois par semaine. Parmi les autres substances, les poppers (23,5%) et l’oxyde de diazote (11,2%) étaient les plus fréquemment signalés. L’analyse multivariée a permis de relever plusieurs facteurs associés à une consommation problématique d’alcool, notamment le sexe masculin, un âge plus jeune, des difficultés financières et l’exposition à l’humiliation, au harcèlement ou à une agression sexuelle. La prévalence de la consommation d’alcool et de substances psychoactives chez les étudiants en médecine de France s’établit à des niveaux globalement comparables à ceux rapportés à l’échelle internationale. Ces résultats font ressortir la nécessité de mettre en place des actions préventives et de soutien ciblées au sein des facultés de médecine.
This article investigates female homoeroticism encoded in cinematic form. I read two Polish films, In Custody/Nadzór (dir. Wiesław Saniewski, 1983) and By Touch/Przez Dotyk (dir. Magdalena Łazarkiewicz, 1985) to explore the new forms of femininity I call 'proto-queer'. 'Proto-queer' is used here to conceptualize the figure of woman bearing a gendered and sexual instability that carries the hallmarks of what subsequently has become known as queerness. At the historical moment of state socialism, these fledgling forms of queer femininity were neither fully developed nor clearly legible. Yet, their distinctly Polish and socialist inflections allow us to view them as precursors to transgressions that would only later be more recognizable within a queer interpretive framework. The analysis of sexual or erotic otherness in the context of isolation and social exclusion around which both films develop foregrounds the affective power of shame and its transformative abilities. I demonstrate how shame and humiliation are both de-constituting and foundational in relation to sexual identity. I analyze how cinematic articulations of proto-queer intimacies generate a reimagined understanding of female homoeroticism in socialist Poland and how this study contributes to the literature on queerness and its representation more generally.
Child emotional maltreatment (emotional abuse and neglect) is a prevalent yet under-recognized adversity associated with long-term socioemotional difficulties. Its role in shaping adults' endorsement of emotionally punitive disciplinary attitudes in the context of child-rearing and parenting, reflecting normative beliefs about the acceptability of emotionally punitive behaviors (e.g., shouting, humiliation, or withdrawal of affection), remains insufficiently understood. To examine whether childhood emotional maltreatment is associated with adults' endorsement of emotionally punitive disciplinary attitudes in a parenting context, and whether statistically significant indirect effects are observed via generalized interpersonal trust and emotion regulation strategies (cognitive reappraisal, expressive suppression). Data were drawn from a population-representative German survey conducted in 2024/2025 (analytic sample N = 2458; ages 16-92). Emotional maltreatment was assessed using the Childhood Trauma Questionnaire. Generalized trust (3 items) and emotion regulation (Emotion Regulation Questionnaire: reappraisal, suppression) served as statistical mediators (i.e., variables used to estimate indirect effects); endorsement of emotionally punitive disciplinary practices in a parenting context, reflecting normative beliefs rather than actual parenting behavior (3 items), was the outcome. Mediation analyses were conducted using PROCESS v4.2 (Model 4), controlling for age, gender, and education. Indirect effects were estimated with 5000 bias-corrected bootstrap resamples and HC3 standard errors. Greater severity of emotional maltreatment was associated with stronger endorsement of emotionally punitive discipline. In simple mediation models, lower generalized trust showed a statistically significant indirect effect in this association (accounting for ∼26% of the total effect). When emotional abuse and emotional neglect were examined separately, abuse showed an indirect-only pattern via reduced trust, whereas neglect demonstrated both direct and indirect associations via trust. In a parallel multiple-mediator model, lower trust, lower cognitive reappraisal, and higher expressive suppression each showed significant indirect effects, with trust emerging as the strongest pathway. Direct effects remained significant, indicating partial indirect effects overall. Childhood emotional maltreatment is linked to adults' acceptance of emotionally punitive disciplinary norms through enduring socio-cognitive and affective mechanisms. Interventions that promote interpersonal trust and adaptive emotion regulation may help disrupt intergenerational cycles of emotionally harsh discipline.
This cross-sectional study aimed to determine the effects of exposure to violence and psychological well-being on sexual distress in married women of reproductive age. The study sample consisted of 423 women from a sample recruited among hospital patients aged 18-45. Data were collected using the Female Sexual Distress Scale-Revised (FSDS-R) and the Psychological Wellbeing Scale (PWBS). Women who were exposed to insults, humiliations, or degrading behaviors, as well as kicking, slapping, beating, or being hit by their husbands, who were prevented from working or put in financial difficulties, who were forced into sexual intercourse, and who were afraid of their husbands had higher levels of sexual distress (p < 0.01). The results imply that 9.7% of the women had sexual distress; the mean FSDS-R score was 3.26 ± 5.48, and the mean PWBS score was 44.44 ± 11.72. For 17.3% of women's sexual distress scores, the variables of forced sexual intercourse, insults, humiliation, or degrading behavior, age, marital satisfaction, and willingness to marry were found to be significant predictors (p < 0.001). The results reveal a correlation between women's exposure to sexual and emotional violence and sexual distress.
This paper offers an active inference narrative that considers discriminatory behaviour in relation to the cognitive concept of zones of bounded surprisal (ZBS). It is argued that narrow ZBS band-widths characterise the discriminatory minds of people who see themselves as an in-group. They tend not to be indignant or outspoken, but acquiescent when they witness poor behaviour of those whom otherwise they regard as members of their in-group. When such behaviour harms other people, its perpetrators have a very narrow ZBS band-width: one that likely is a characteristic of dehumanising minds. Because such perpetrators see themselves as members of an in-group with entitlement to control aspects of society, they humiliate or abuse out-groups to which they assign others, and have no compunction about violating their dignity or human rights. We briefly consider policies that could lessen the unwelcome social repercussions of the behaviour of people with discriminatory and dehumanising minds.
Background: Psychological violence, defined as interpersonal acts intended to humiliate or diminish others without physical force, has been linked to significant psychological suffering. Despite its prevalence and association with mental health disorders, it is not classified as a potentially traumatic event under the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD) diagnosis.Objective: This study examines whether psychological violence, when identified as the index trauma, is associated with PTSD symptoms at levels comparable to those elicited by DSM-5-recognized traumas.Method: In this cross-sectional study, 530 Brazilian undergraduate students completed the Trauma History Questionnaire (THQ) and the PTSD Checklist for DSM-5 (PCL-5). Negative binomial regression and logistic regression models were used to examine associations between trauma type and PTSD symptom severity and probable diagnosis.Results: Compared to crime- and disaster-related trauma, psychological violence was associated with greater PTSD symptom severity and higher odds of probable PTSD diagnosis. Its impact was comparable to that of physical and sexual violence.Conclusions: These findings emphasize the importance of raising awareness about the emotional consequences of psychological violence and highlight the need for greater recognition of psychological violence as part of the spectrum of experiences associated with PTSD. Recognizing psychological trauma as a threat to the fundamental human need for social connection has critical implications for diagnostic refinement and treatment protocols. Psychological violence is associated with PTSD symptoms and probable diagnoses at higher levels than traumas related to crime or disasters.Psychological violence was reported as the worst event experienced in life even among some participants who had also experienced DSM-5–defined traumas.Recognizing psychological violence as a form of trauma can improve treatment, inform diagnostic criteria, and guide prevention and social justice initiatives by addressing the event itself rather than only its consequences. Antecedentes: La violencia psicológica, definida como actos interpersonales destinados a humillar o menospreciar a otros sin el uso de fuerza física, se ha asociado con un sufrimiento psicológico significativo. A pesar de su prevalencia y de su relación con trastornos de salud mental, no está clasificada como un evento potencialmente traumático según los criterios del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) para el diagnóstico de Trastorno de Estrés Postraumático (TEPT). Objetivo: Este estudio examina si la violencia psicológica, cuando se identifica como el trauma índice, se asocia con síntomas de TEPT en niveles comparables a los generados por traumas reconocidos por el DSM-5. Método: En este estudio transversal, 530 estudiantes universitarios brasileños completaron el Cuestionario de Historia de Trauma (THQ por sus siglas en ingles) y la Lista de Chequeo de TEPT para el DSM-5 (PCL-5). Se utilizaron modelos de regresión binomial negativa y regresión logística para examinar las asociaciones entre el tipo de trauma y la gravedad de los síntomas de TEPT, así como el diagnóstico probable. Resultados: En comparación con los traumas relacionados con delitos y desastres, la violencia psicológica se asoció con mayor gravedad de síntomas de TEPT y con mayores probabilidades de un diagnóstico probable de TEPT. Su impacto fue comparable al de la violencia física y sexual. Conclusiones: Estos hallazgos enfatizan la importancia de aumentar la conciencia sobre las consecuencias emocionales de la violencia psicológica y destacan la necesidad de un mayor reconocimiento de la violencia psicológica como parte del espectro de experiencias asociadas con el TEPT. Reconocer el trauma psicológico como una amenaza a la necesidad humana fundamental de conexión social tiene implicaciones críticas para el perfeccionamiento de los criterios diagnósticos y de los protocolos de tratamiento.
The aim of this study is to explore the conditions of pregnancy and gynaecological care for women in prison in Spain. An exploratory qualitative research study was carried out, involving 125 semi-structured interviews with 79 prison professionals and 46 women prisoners in 16 prisons in Spain. The participants were selected through theoretical sampling. The study was based on a thematic analytical procedure inspired by grounded theory, which produced certain unexpected results that are the focus of this study. The results of the interviews reveal that obstetric violence (OV) can take place through actors other than healthcare professionals, such as the police force when they guard and transfer pregnant inmates to obstetrics appointments or other inmates who require gynaecological services. During gynaecological examinations and tests, female inmates are kept in handcuffs or restraints and with police officers present in the room, violating their privacy and rights. The responses of gynaecologists to this situation are diverse. Gynaecologists should be the ones with authority in the medical consultations of female prisoners, and they should not allow the humiliation and violation of the rights of these women, as stated in the United Nations Bangkok Rules. Most female inmates are not dangerous, with non-aggressive and non-violent offences, so they would not put the lives of healthcare personnel at risk, and the continuation of this practice is more a question of compliance with protocols than of real risk.
Psychological safety is the belief that individuals may ask questions, express doubts, and admit mistakes without fear of humiliation. It has emerged as a fundamental determinant of learning in high-stakes clinical environments. Surgical education remains historically hierarchical, often privileging endurance over vulnerability and silence over inquiry. While operative exposure and technical skill acquisition remain central to training, emerging evidence demonstrates that hierarchical and punitive workplace cultures impair error disclosure, suppress speaking-up behaviours, reduce feedback uptake, and increase cognitive load during performance, thereby limiting skill consolidation and patient safety improvement. This paper adopts a narrative review and conceptual synthesis approach, drawing on contemporary surgical, organisational, and educational literature to examine the mechanisms, barriers, and practical applications of psychological safety within surgical training. This paper argues that psychological safety is not merely a cultural aspiration but also a critical determinant of effective surgical training. The author reviews historical and contemporary models of surgical teaching, examines barriers, including hierarchy and punitive error responses, and proposes practical strategies for cultivating safe learning environments. The surgeon of the future must be developed not only through procedural volume but through mentorship that supports curiosity, reflection, and compassion. A psychologically safe surgical culture produces faster learners, safer decision-makers, and more ethically grounded clinicians.
The prevalence of psychiatric disorders in young adults increased with the COVID-19 pandemic. The prevalence of mental disorders among physiotherapy students increased. Our study aimed to present the results on the mental health status of physiotherapy students in France since the COVID-19 pandemic. An online cross-sectional survey was performed between October 1st 2023 and November 5th 2023. Anonymous questionnaires were sent to physiotherapy students via academic emails by all physiotherapy schools in France. We assessed the prevalence of depressive symptoms, generalised anxiety symptoms, burnout, eating disorder symptoms, 12-month major depressive disorder and 12-month suicidal ideation, humiliation, sexual harassment, and sexual assaults. Multivariate logistic regression was performed to identify factors associated with major depressive disorder and suicidal ideation. Among the 12,568 physiotherapy students, 1280 responded (response rate: 10.2%) and were included. The prevalences of depressive symptoms, anxiety symptoms, eating disorder symptoms, 12-month major depressive disorder, and 12-month suicidal ideation were 25%, 23%, 21%, 11% and 11%, respectively. Humiliation, sexual harassment and sexual aggression were reported by 19%, 1.8% and 0.7%, respectively. In multivariable analyses, curriculum year and sexual violence were associated with higher rates of major depressive episodes and suicidal ideation. This survey is the first to be carried out on French physiotherapy students at a distance from the peak of the COVID-19 pandemic. It revealed a high prevalence of various mental issues. The results of this survey highlighted the urgent need for action to improve the mental health of physiotherapy students in France.
Urinary incontinence (UI) has a profound effect on aging patients, society, and the health care system. Older women's lived experiences with UI are not well described and may not be fully captured by current quality-of-life measures. Our primary objective was to understand the impact of UI in women aged 70 years and older. This was a qualitative study nested within a randomized controlled trial of OnabotulinumtoxinA 50 versus 100 units. Women were intentionally sampled before treatment based on age, race/ethnicity, and primary language (Spanish or English) for pretreatment interviews, which explored patients' experiences living with UI. Transcripts were coded using a mixed inductive and deductive approach using thematic analysis. Twenty-two women, aged 70-87 years, participated. In all, 73% identified as non-Hispanic White, 9% as Black and 18% as Hispanic.The analysis revealed 3 main themes: (1) burden: UI is profoundly impactful and distressing; for many older women, in our study, UI is the biggest controlling factor in their lives; (2) Coping strategies: most women reported restricting their activities due to UI, while self-identifying as independent and positive. Strategies also included significant hygiene rituals and protection of clothing, furniture, car seats, etc; (3) Loss: UI causes worry, fear, humiliation, and shame, and for many led to "choosing" isolation and reducing activities. UI causes a constant and profound burden and loss that affects emotional, physical, and relational domains of life. However, older women resiliently seek ways to overcome the havoc UI creates across all areas of life.