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Mental Health Providers & Burnout

Research Paper Title

Predictors and Consequences of Veterans Affairs Mental Health Provider Burnout: Protocol for a Mixed Methods Study.

Background

In the Veterans Health Administration (VHA), mental health providers (MHPs) report the second highest level of burnout after primary care physicians. Burnout is defined as increased emotional exhaustion and depersonalisation and decreased sense of personal accomplishment at work.

Therefore the aim of this study is to characterise variation in MHP burnout by VHA facility over time, identifying workplace characteristics and practices of high-performing facilities.

Methods

Using both qualitative and quantitative methods, the researchers will evaluate factors that influence MHP burnout and their effects on patient outcomes. They will:

  • Compile annual survey data on workplace conditions and annual staffing as well as productivity data to assess same and subsequent year provider and patient outcomes reflecting provider and patient experiences.
  • Conduct interviews with mental health leadership at the facility level and with frontline MHPs sampled based on our quantitative findings.
  • Present their findings to an expert panel of operational partners, Veterans Affairs clinicians, administrators, policy leaders, and experts in burnout.
  • Reengage with facilities that participated in the earlier qualitative interviews and will hold focus groups that share results based on our quantitative and qualitative work combined with input from our expert panel.
  • Broadly disseminate these findings to support the development of actionable policies and approaches to addressing MHP burnout.

Results

This study will assist in developing and testing interventions to improve MHP burnout and employee engagement. Their work will contribute to improvements within VHA and will generate insights for health care delivery, informing efforts to address burnout.

Conclusions

This is the first comprehensive, longitudinal, national, mixed methods study that incorporates different types of MHPs. It will engage MHP leadership and frontline providers in understanding facilitators and barriers to effectively address burnout.

Reference

Zivin, K., Kononowech, J., Boden, M., Abraham, K., Harrod, M., Sripada, R.K., Kales, H.C., Garcia, H.A. & Pfeiffer, P. (2020) Predictors and Consequences of Veterans Affairs Mental Health Provider Burnout: Protocol for a Mixed Methods Study. JMIR Research Protocols. 9(12), pp.e18345. doi: 10.2196/18345.

On This Day … 30 December

People (Deaths)

  • 2002 – Eleanor J. Gibson, American psychologist and academic (b. 1910).

Eleanor J. Gibson

Eleanor Jack Gibson (07 December 1910 to 30 December 2002) was an American psychologist who focused on reading development and perceptual learning in infants.

Gibson began her career at Smith College as an instructor in 1932, publishing her first works on research conducted as an undergraduate student. Gibson was able to circumvent the many obstacles she faced due to the Great Depression and gender discrimination, by finding research opportunities that she could meld with her own interests.

Gibson, with her husband James J. Gibson, created the Gibsonian ecological theory of development, which emphasized how important perception was because it allows humans to adapt to their environments. Perhaps her most well-known contribution to psychology was the “visual cliff,” which studied depth perception in both human and animal species, leading to a new understanding of perceptual development in infants.

Gibson was elected to the National Academy of Sciences in 1971, the National Academy of Education in 1972, and to the American Academy of Arts and Sciences in 1977. In 1992, she was awarded the National Medal of Science.

On This Day … 29 December

People (Births)

  • 1955 – Donald D. Hoffman, American quantitative psychologist and popular science writer.

Donald D. Hoffman

Donald David Hoffman (born 29 December 1955) is an American cognitive psychologist and popular science author. He is a professor in the Department of Cognitive Sciences at the University of California, Irvine, with joint appointments in the Department of Philosophy, the Department of Logic and Philosophy of Science, and the School of Computer Science.

Hoffman studies consciousness, visual perception and evolutionary psychology using mathematical models and psychophysical experiments. His research subjects include facial attractiveness, the recognition of shape, the perception of motion and colour, the evolution of perception, and the mind-body problem. He has co-authored two technical books: Observer Mechanics: A Formal Theory of Perception (1989) offers a theory of consciousness and its relationship to physics; Automotive Lighting and Human Vision (2005) applies vision science to vehicle lighting. His book Visual Intelligence: How We Create What We See (1998) presents the modern science of visual perception to a broad audience. His 2015 TED Talk, “Do we see reality as it is?” explains how our perceptions have evolved to hide reality from us.

Does Lockdown Change Health Priorities in the Local Population?

Research Paper Title

Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from the AUSL Romagna, Italy.

Background

An observation of the admissions to the emergency room (ER) requiring psychiatric evaluation during the lockdown and investigation of the demographic and clinical variables.

Methods

Retrospective longitudinal observational study of ER accesses for psychiatric evaluation was performed, comparing two periods (09 March to 03 May 2020 vs. 09 March to 03 May 2019). Data (number of admissions, key baseline demographic and clinical variables) were extracted from the ER databases of referral centres in a well-defined geographic area of North-Eastern Italy (Cesena, Ravenna, Forlì, and Rimini).

Results

A 15% reduction of psychiatric referrals was observed, together with a 17% reduction in the total number of patients referring to the ER. This reduction was most evident in the first month of the lockdown period (almost 25% reduction of both referrals and patients). Female gender (OR: 1.52: 95%, CI: 1.12-2.06) and being a local resident (OR: 1.54: 95%CI: 1.02-2.34) were factors associated with the decrease.

Conclusions

Lockdown changed dramatically health priorities in the local population, including people with mental health. The researchers speculate that our observations do not only refer to the confinement due to the lockdown regime but also to fear of contagion and adoption of different coping strategies, especially in women. Key-points During lockdown 15% reduction of psychiatric visits and >17% reduction in the number of psychiatric patients referring to the ER was observed. in the first four weeks of the lockdown almost 25% reduction of both visits and patients was observed Female gender and being a local resident were factors associated with the decrease.

Reference

Beghi, M., Brandolini, R., Casolaro, I., Beghi, E., Cornaggia, C.M., Fraticelli, C., De Paoli, G., Ravani, C., Castelpietra, G. & Ferrari, S. (2020) Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from the AUSL Romagna, Italy. International Journal of Psychiatry in Clinical Practice. doi: 10.1080/13651501.2020.1859120.

On This Day … 25 December

People (Births)

  • 1875 – Francis Aveling, Canadian psychologist and priest (d. 1941).

People (Deaths)

  • 1925 – Karl Abraham, German psychoanalyst and author (b. 1877).

Francis Aveling

Francis Arthur Powell Aveling DD DSc PhD DLit MC ComC (25 December 1875 to 6 March 1941) was a Canadian psychologist and Catholic priest. He married Ethel Dancy of Steyning, Sussex in 1925.

Life

Francis Aveling was born at St. Catharines, Ontario 25 December 1875. He went to Bishop Ridley College in Ontario and McGill University before studying at Keble College at the Oxford University, England. Aveling was received into the Roman Catholic Church by Father Luke Rivington in 1896 and entered the Pontificio Collegio Canadese in Rome. There he earned his doctor of divinity degree. He was ordained to the priesthood in 1899, and served as a curate in Tottenham, before becoming first rector of Westminster Cathedral Choir School. He was also a chaplain at the Cathedral, and to St. Wilfrid’s Convent, Chelsea.

In 1910, Aveling obtained a doctor of philosophy degree at the age of 35 from the University of Louvain (his advisor was Albert Michotte), and in 1912 he was recipient of a doctor of science degree from the University of London, and received the Carpenter Medal following his work On the Consciousness of the Universal and the Individual: A Contribution to the Phenomenology of the Thought Process. Subsequently, Aveling received his doctor of letters degree from the University of London.

Career

Aveling taught at University College, London from 1912 as a Lecturer (Assistant Professor), under the leadership of Charles Spearman, until the First World War. During that war he served in France as a chaplain in the British Army, after which he returned to the University of London. In 1922, he transferred to King’s College, London where he was promoted to reader (associate professor), and later to professor of psychology. He was an extern examiner in philosophy at the National University of Ireland; and a lecturer in pedagogical methods for the London County Council.

Aveling authored several books. He was the doctoral advisor of Raymond Cattell From 1926 until 1929, Aveling was also a president of the British Psychological Society. Aveling was a member of the Council of the International Congresses, of the Aristotelian Society, of the council and advisory board of the National Institute of Industrial Psychology, of the council of the British Institute of Philosophical Studies and of the Child Guidance Council.

He was a contributor to the Dublin Review, The American Catholic Quarterly Review, Catholic World, The nineteenth Century, The Journal of Psychology, and the Catholic Encyclopaedia.

Karl Abraham

Karl Abraham 03 May 1877 to 25 December 1925) was an influential German psychoanalyst, and a collaborator of Sigmund Freud, who called him his ‘best pupil’.

Life

Abraham was born in Bremen, Germany. His parents were Nathan Abraham, a Jewish religion teacher (1842-1915) and his wife (and cousin) Ida (1847-1929). His studies in medicine enabled him to take a position at the Burghölzli Swiss Mental Hospital, where Eugen Bleuler practiced. The setting of this hospital initially introduced him to the psychoanalysis of Carl Gustav Jung.

Collaborations

In 1907, he had his first contact with Sigmund Freud, with whom he developed a lifetime relationship. Returning to Germany, he founded the Berliner Society of Psychoanalysis in 1910. He was the president of the International Psychoanalytical Association from 1914 to 1918 and again in 1925.

Karl Abraham collaborated with Freud on the understanding of manic-depressive illness, leading to Freud’s paper on ‘Mourning and Melancholia’ in 1917. He was the analyst of Melanie Klein during 1924–1925, and of a number of other British psychoanalysts, including Edward Glover, James Glover, and Alix Strachey. He was a mentor for an influential group of German analysts, including Karen Horney, Helene Deutsch, and Franz Alexander.

Karl Abraham studied the role of infant sexuality in character development and mental illness and, like Freud, suggested that if psychosexual development is fixated at some point, mental disorders will likely emerge. He described the personality traits and psychopathology that result from the oral and anal stages of development (1921). Abraham observed his only daughter Hilda Abraham reporting on her reaction to enemas and infantile masturbation by her brother. He asked that secrets be shared with him but he was careful to respect her privacy and some reports were not published until after Hilda.s death. Hilda was later to become a psychoanalyst.

In the oral stage of development, the first relationships children have with objects (caretakers) determine their subsequent relationship to reality. Oral satisfaction can result in self-assurance and optimism, whereas oral fixation can lead to pessimism and depression. Moreover, a person with an oral fixation will present a disinclination to take care of him/herself and will require others to look after him/her. This may be expressed through extreme passivity (corresponding to the oral benign suckling substage) or through a highly active oral-sadistic behaviour (corresponding to the later sadistic biting substage).

In the anal stage, when the training in cleanliness starts too early, conflicts may result between a conscious attitude of obedience and an unconscious desire for resistance. This can lead to traits such as frugality, orderliness and obstinacy, as well as to obsessional neurosis as a result of anal fixation (Abraham, 1921). In addition, Abraham based his understanding of manic-depressive illness on the study of the painter Segantini: an actual event of loss is not itself sufficient to bring the psychological disturbance involved in melancholic depression. This disturbance is linked with disappointing incidents of early childhood; in the case of men always with the mother (Abraham, 1911). This concept of the prooedipal “bad” mother was a new development in contrast to Freud’s oedipal mother and paved the way for the theories of Melanie Klein (May-Tolzmann, 1997).

Another important contribution is his work “A short study of the Development of the Libido”, where he elaborated on Freud’s “Mourning and Melancholia” (1917) and demonstrated the vicissitudes of normal and pathological object relations and reactions to object loss.

Moreover, Abraham investigated child sexual trauma and, like Freud, proposed that sexual abuse was common among psychotic and neurotic patients. Furthermore, he argued (1907) that dementia praecox is associated with child sexual trauma, based on the relationship between hysteria and child sexual trauma demonstrated by Freud.

Abraham (1920) also showed interest in cultural issues. He analysed various myths suggesting their relation to dreams (1909) and wrote an interpretation of the spiritual activities of the Egyptian monotheistic Pharaoh Amenhotep IV (1912).

Death

Abraham died prematurely on 25 December 1925 from complications of a lung infection and may have suffered from lung cancer.

Transference: A Love Story (2020)

Introduction

A secret threatens the love affair between two nurses in London.

Also known as Transference: A Bipolar Love Story.

Outline

Katarina, a Norwegian nurse in London, embarks on a passionate affair with a fellow immigrant nurse that suffers the consequences of unresolved mental health issues from the lovers’ secret pasts.

Cast

  • Raffaello Degruttola … Nik Coluzzi.
  • Emilie Sofie Johannesen … Katerina Nielsen.
  • Lotte Verbeek … Marieke.
  • Pernille Broch … Camilla.
  • Simone Lahbib … Sophie.
  • Ania Sowinski … Natasha Kocinska.
  • Christina Chong … Natasha Wong.
  • Iggy Blanco … Miguel Cortez.
  • Bea Watson … Senior PU Nurse Lisa.
  • Tyrone Keogh … Douglas Cornell.
  • Dylan McKiernan … Ryan.
  • Liza Mircheva … Laura.
  • Poya Shohani … Kaivan.
  • Reice Weathers … Jay.

Production & Filming Details

  • Director(s): Raffaello Degruttola.
  • Producer(s):
    • Bill Bossert … executive producer.
    • Sérgio Clinkett … consulting producer.
    • Raffaello Degruttola … producer.
    • Emilie Sofie Johannesen … co-producer.
    • Sadie Kaye … co-producer.
    • Simone Lahbib … consulting producer.
    • Poya Shohani … co-producer.
  • Writer(s):
  • Music:
  • Cinematography: Simon Hayes and Phil Summers.
  • Editor(s): Charles Lort-Phillips.
  • Production: Contro Vento Films, Mental Ideas, and AMG Media.
  • Distributor(s):
  • Release Date: 26 June 2020 (Internet, Socially Relevant Film Festival New York).
  • Running Time: 90 minutes.
  • Rating: Unknown.
  • Country: US.
  • Language: English.

Video Link

Erasing Family (2020)

Introduction

In North America, over 25 million parents are being erased from their children’s lives after divorce and separation.

The Erasing Family documentary follows young adults fighting to reunite with their broken families.

Outline

This documentary exposes the failure of family courts to keep children from being used as a weapon after separation. Courts decision ends up completely erasing one parent causing severe emotional trauma to children.

Psychologist refer to extreme cases as parental alienation which is a form of Child Psychological
Abuse.

Essentially brainwashing and manipulating children by one parent to hate or despise the other parent.

This results in severe psychological damage based on scientific findings, including depression, low self esteem, drug abuse, and being alienated from own children and suicide.

Family court reform is badly needed as this is preventable pandemic affecting over 20 million children in the United States.

Happy endings are possible! The film ends with children and parents being reunited on screen and will inspire other kids to reach out to #erased parents, siblings and grandparents.

The film will show how programmes that encourage mediation and shared parenting which will prevent future childhood trauma, making divorce and separation less costly both financially and emotionally.

Help

For those in the US, text HELP to (865)-4FAMILY between 8am-10pm ET to get emotional support if you are an erased kid or parent (not legal advice).

Find further information on the documentary @ https://erasingfamily.org/.

Production & Filming Details

  • Director(s): Ginger Gentile.
  • Producer(s):
    • Gabriel Balanovsky … producer.
    • Joe Barrow … associate producer.
    • Bernadette Bernstein … associate producer.
    • Elizabeth Bingham … associate producer.
    • Christina Campbell … associate producer.
    • Lisa Carle … associate producer.
    • Chad Cassiday … associate producer.
    • Chad Cassidy … associate producer.
    • Leslie Chambers … associate producer.
    • James Chance … associate producer.
    • Johanna Chua … associate producer.
    • Brian Conrad … associate producer.
    • Linda Conrad … associate producer.
    • Judy Cook … associate producer.
    • Frank DiMarco … associate producer.
    • Nancy Fein … associate producer.
    • Felicia Fox … associate producer.
    • Michael Fox … associate producer.
    • Jeffrey Gardere … co-producer.
    • Ginger Gentile … producer.
    • Christine Giancarlo … associate producer.
    • Jonathan Goodman … associate producer.
    • Joe Gorham … associate producer.
    • Michael Griffin … associate producer.
    • Kelly Gunn … associate producer.
    • Evie Hagist … associate producer.
    • Camilla Hall … producer.
    • Gail Hamilton … associate producer.
    • Lorne Hamilton … associate producer.
    • Emily Hastings … associate producer.
    • Helen Hazel … associate producer.
    • Uli Hesse … field producer.
    • Doug Hooks … associate producer.
    • Sandra Hooks … associate producer.
    • Henri Isenberg … associate producer.
    • Julie Janata … executive producer.
    • Michelle Jordan … associate producer.
    • Eddie Judge … associate producer.
    • Edward N. Judge … associate producer.
    • Tamra Judge … associate producer.
    • Brandy Koenig … associate producer.
    • Javier Lopez … associate producer.
    • Brian Ludmer … associate producer.
    • William B. Macomber … producer.
    • Denis McAteer … associate producer.
    • Kim McCord … associate producer.
    • Jeff Morgan … associate producer.
    • Erin O’Donnell … associate producer.
    • Margaret Olnek … associate producer.
    • Jennifer Peck … associate producer.
    • Jennifer Peters … associate producer.
    • Joseph Pietrafesa … associate producer.
    • Dorcy Pruter … associate producer.
    • Rebecca Reyes … line producer.
    • Don Saxton … associate producer.
    • Elvin N. Serrano … associate producer.
    • Robert Showers … associate producer.
    • Dave Slotter … associate producer.
    • Michelle Slotter … associate producer.
    • Krissy Smith … associate producer.
    • Joseph Sorge … associate producer.
    • Marah Strauch … executive producer.
    • Tamara Sweeney … associate producer.
    • David Tayani … associate producer.
    • Phillip Taylor … associate producer.
    • Tyler Thorne … associate producer.
    • Richard Tobin … associate producer.
    • Paul Trizonis … associate producer.
    • Kim Ully-McCord … associate producer.
    • Jodi Vest … associate producer.
    • Charles Anthony Ward … associate producer.
    • Carrie Weiss … associate producer.
    • Lila Yomtoob … line producer.
  • Writer(s): Blake Bruns (Voice Over Writer).
  • Music: Rafael Leloup.
  • Cinematography: Melanie Aronson, John Barnhardt, Jason Blalock, Ignacio Genzon, and Aimee Galicia Torres.
  • Editor(s): Sean Jarret.
  • Production:
  • Distributor(s): Glass House Distribution.
  • Release Date: 25 April 2020 (Internet).
  • Running Time: minutes.
  • Rating: Unknown.
  • Country: US.
  • Language: English.

Video Link

Complementary Medicine & Integrative Health Approaches to Trauma Therapy & Recovery

Research Paper Title

Introduction to the special issue: Complementary medicine and integrative health approaches to trauma therapy and recovery.

Abstract

The popularity of complementary and integrative health (also complementary integrated health; CIH) approaches has significantly increased in recent years.

According to the National Centre for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health, about 1 in 3 adults and 1 in 9 children used CIH approaches to healing.

Some reports estimate that the use of CIH approaches will continue to increase (Clarke et al., 2015) as these therapies are cost effective and also due to the difficulties in finding trained mental health professionals (Simon et al., 2020).

For the purpose of this special issue, the researchers use the NCCIH’s definition of CIH as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine” (Barnes et al., 2004, p. v). However, the integration of these therapies into the health system has not followed the same pattern despite the fact that patients report the need to discuss CIH therapies with their doctors or are actually using them (de Jonge et al., 2018; Jou & Johnson, 2016; Stapleton et al., 2015). This inability to keep up with the demand or patients’ preference is possibly due to providers’ lack of understanding and/or knowledge of these therapies, as well as scientific skepticism (Ali & Katz, 2015; Fletcher et al., 2017).

Using data from the 2012 National Health Interview Survey, Jou & Johnson (2016) identified patterns of CIH use in the United States and reasons for patients’ nondisclosure of the use of these therapies. Patients’ fear of disclosure due to perceived scepticism or disapproval from their provider was frequently attributed as a cause of patients’ nondisclosures to providers about the use of these therapies (Eisenberg et al., 2001; Jou & Johnson, 2016; Thomson et al., 2012).

The arrival of patient-centred care models is beginning to shift the ways we understand the patient’s role in treatment engagement. Patient-centred approaches often emphasize the use of preventative and holistic wellness models that go beyond the use of evidence-based treatments. This approach also seeks to be culturally responsive, which is a key factor in addressing health disparities in the United States (American Psychological Association [APA], 2019).

The Institute of Medicine, in its report on CIH therapies, highlighted the importance of engaging patients in their own care, including having a decision about therapeutic options (Bondurant et al., 2005). Likewise, the Race and Ethnicity Guidelines in Psychology (APA, 2019) recommend psychologists engage the patient’s cultural beliefs, or what Kleinman called the “explanatory belief model” (Kleinman, 1978)- for example, by “aim[ing] to understand and encourage indigenous/ ethnocultural sources of healing within professional practice” (APA, 2019, p. 24).

Reference

Mattar, S. & Frewenm P.A. (2020) Introduction to the special issue: Complementary medicine and integrative health approaches to trauma therapy and recovery. Psychological Trauma. 12(8):821-824. doi: 10.1037/tra0000994.

On This Day … 22 December

People (Deaths)

  • 1902 – Richard von Krafft-Ebing, German-Austrian psychiatrist and author (b. 1840).

Richard von Krafft-Ebing

Richard Freiherr von Krafft-Ebing (1840-1902; full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing) was an Austro–German psychiatrist and author of the foundational work Psychopathia Sexualis (1886).

Life

Krafft-Ebing was born in 1840 in Mannheim, Germany, studied medicine at the University of Heidelberg, where he specialised in psychiatry. He later practiced in psychiatric asylums. After leaving his work in asylums, he pursued a career in psychiatry, forensics, and hypnosis.

He died in Graz in 1902. He was recognised as an authority on deviant sexual behaviour and its medicolegal aspects.

Principal Work

Krafft-Ebing’s principal work is Psychopathia Sexualis: eine Klinisch-Forensische Studie (Sexual Psychopathy: A Clinical-Forensic Study), which was first published in 1886 and expanded in subsequent editions. The last edition from the hand of the author (the twelfth) contained a total of 238 case histories of human sexual behaviour.

Translations of various editions of this book introduced to English such terms as “sadist” (derived from the brutal sexual practices depicted in the novels of the Marquis de Sade), “masochist”, (derived from the name of Leopold von Sacher-Masoch), “homosexuality”, “bisexuality”, “necrophilia”, and “anilingus”.

Psychopathia Sexualis is a forensic reference book for psychiatrists, physicians, and judges. Written in an academic style, its introduction noted that, to discourage lay readers, the author had deliberately chosen a scientific term for the title of the book and that he had written parts of it in Latin for the same purpose.

Psychopathia Sexualis was one of the first books about sexual practices that studied homosexuality/bisexuality. It proposed consideration of the mental state of sex criminals in legal judgements of their crimes. During its time, it became the leading medico–legal textual authority on sexual pathology.

The twelfth and final edition of Psychopathia Sexualis presented four categories of what Krafft-Ebing called “cerebral neuroses”:

  • Paradoxia, sexual excitement occurring independently of the period of the physiological processes in the generative organs.
  • Anaesthesia, absence of sexual instinct.
  • Hyperaesthesia, increased desire, satyriasis.
  • Paraesthesia, perversion of the sexual instinct, i.e., excitability of the sexual functions to inadequate stimuli.

The term “hetero-sexual” is used, but not in chapter or section headings. The term “bi-sexuality” appears twice in the 7th edition, and more frequently in the 12th.

There is no mention of sexual activity with children in Chapter III, General Pathology, where the “cerebral neuroses” (including sexuality the paraesthesia’s) are covered. Various sexual acts with children are mentioned in Chapter IV, Special Pathology, but always in the context of specific mental disorders, such as dementia, epilepsy, and paranoia, never as resulting from its own disorder. However, Chapter V on sexual crimes has a section on sexual crimes with children. This section is brief in the 7th edition, but is expanded in the 12th to cover Non-Psychopathological Cases and Psychopathological Cases, in which latter subsection the term paedophilia erotica is used.

Krafft-Ebing considered procreation the purpose of sexual desire and that any form of recreational sex was a perversion of the sex drive. “With opportunity for the natural satisfaction of the sexual instinct, every expression of it that does not correspond with the purpose of nature – i.e., propagation, – must be regarded as perverse.” Hence, he concluded that homosexuals suffered a degree of sexual perversion because homosexual practices could not result in procreation. In some cases, homosexual libido was classified as a moral vice induced by the early practice of masturbation. Krafft-Ebing proposed a theory of homosexuality as biologically anomalous and originating in the embryonic and foetal stages of gestation, which evolved into a “sexual inversion” of the brain. In 1901, in an article in the Jahrbuch für sexuelle Zwischenstufen (Yearbook for Intermediate Sexual Types), he changed the biological term from anomaly to differentiation.

Although the primary focus is on sexual behaviour in men, there are sections on Sadism in Woman, Masochism in Woman, and Lesbian Love. Several of the cases of sexual activity with children were committed by women.

Krafft-Ebing’s conclusions about homosexuality are now largely forgotten, partly because Sigmund Freud’s theories were more interesting to physicians (who considered homosexuality to be a psychological problem) and partly because he incurred the enmity of the Austrian Catholic Church when he psychologically associated martyrdom (a desire for sanctity) with hysteria and masochism.

Mental Health in Nursing: One Student’s Perspective

Research Paper Title

Mental health in nursing: A student’s perspective.

Background

A stigma around mental health issues within healthcare and nursing itself has created a culture of perfectionism in the workplace, and nurses struggle to live up to the expectations while pushing aside their feelings, thoughts, and needs.

Inspired by one author’s personal experiences, this article explores mental health issues many nurses confront today.

Reference

Halsted, C. & Hart, V.T. (2020) Mental health in nursing: A student’s perspective. Nursing. 51(1), pp52-55. doi: 10.1097/01.NURSE.0000694764.76416.f9.