Parents of children with mental health disorders are often faced with the dilemma of disclosing or concealing their child's disorder. These decisions have important implications for both child and parent. Our aim is to describe mothers' experiences with the disclosure dilemma; specifically, we describe what is disclosed (or concealed), how, and why, as well as the consequences of these decisions. Data from interviews with 11 mothers of children (aged 5-13 years) with mental health disorders, and a participatory action research group (four mothers) were thematically analyzed. Mothers selectively disclosed (and concealed) to protect and advocate for their child. Their decisions were often influenced by, or were a reactance to, others' opinions, with mothers not only avoiding, but also defending against stigma, and exercising their right to privacy. Despite anticipating negative feedback, mothers more often experienced empathy and support following disclosure. Recommendations are made for developing mothers' confidence in disclosing.
Cognitive models of insomnia consistently suggest that negative expectations regarding the consequences of poor sleep contribute to the maintenance of insomnia. To date, however, no research has sought to determine whether insomnia is indeed characterised by such a negative sleep-related expectancy bias, using objective cognitive assessment tasks which are more immune to response biases than questionnaire assessments. Therefore, the current study employed a reaction-time task assessing biased expectations among a group with clinically significant insomnia symptoms (n = 30) and a low insomnia symptoms group (n = 40). The task involved the presentation of scenarios describing the consequences of poor sleep, and non-sleep related activities, which could be resolved in a benign or a negative manner. The results demonstrated that the high insomnia symptoms group were disproportionately fast to resolve sleep-related scenarios in line with negative outcomes, as compared to benign outcomes, relative to the low insomnia symptoms group. The two groups did not differ in their pattern of resolving non-sleep related scenarios. This pattern of findings is entirely consistent with a sleep-specific expectancy bias operating in individuals with clinically significant insomnia symptoms, and highlights the potential of cognitive-experimental assessment tasks to objectively index patterns of biased cognition in insomnia.
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