Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination partially mediating this association. Finally, based on factor analysis, expressive suppression and cognitive reappraisal appear to be independent constructs. Overall, expressive suppression, much more so than cognitive reappraisal, may play an important role in the experience of stress-related symptoms. Further, given their independence, there are potentially relevant clinical implications, as interventions that shift one of these emotion regulation strategies may not lead to changes in the other.

Objective To assess the effectiveness of nurse led follow up in the management of patients with lung cancer.

Does trauma exposure impair retrieval of autobiographical memories? Many theorists have suggested that the reduced ability to access specific memories of life events, termed overgenerality, is a protective mechanism helping attenuate painful emotions associated with trauma. The authors addressed this question by reviewing 24 studies that assessed trauma exposure and overgenerality, examining samples with posttraumatic stress disorder, acute stress disorder, depression, traumatic event exposure, and other clinical disorders. Limitations are discussed, including variations in assessment of events, depression, and overgenerality and the need for additional comparison groups. Across studies, there was no consistent association between trauma exposure and overgenerality, suggesting that trauma exposure is unlikely to be the primary mechanism leading to overgenerality. Instead, psychopathology factors such as depression and posttraumatic stress appear to be more consistently associated with overgenerality. Alternative overgenerality theories may help identify key overgenerality mechanisms, improving current understanding of autobiographical memory processes underlying psychopathology.

ObjectiveTo evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention.DesignA multicentre cluster randomised controlled trial.SettingClusters were 33 hospital wards within five hospitals in the UK.ParticipantsAll patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition.InterventionThe ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings.MeasurementsPrimary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS).ResultsIntervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention.LimitationsAdherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure.ConclusionsPatients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components.Trial registration numberISRCTN07689702; pre-results.

Findings suggest that for some patients, phase I trials fulfil a need to try everything in their fight against cancer. The study also suggests that being on treatment allows some patients to construct their lives meaningfully by providing a supportive structure and enabling hope. Implications for nursing practice and further research are discussed.

Alcohol use disorders (AUDs) and Posttraumatic Stress Disorder (PTSD) commonly co-occur. Craving for alcohol is a common aspect of AUD, with and without PTSD, and is one of the key predictors of continued problematic alcohol use among treatment seekers. The present study sought to investigate the self-medication hypothesis using daily Interactive Voice Response (IVR) reports to examine the relationships between PTSD symptomatology and both same-day and next-day alcohol craving. Twenty-nine individuals with an AUD (26 of whom screened positive for PTSD) entering AUD treatment provided daily IVR data for up to 28 days regarding their alcohol use, craving, and 7 symptoms of PTSD. Given the nested nature of daily data, generalized estimating equations using a negative binomial distribution and a log link function were used to test hypotheses. Results suggest that days with greater overall PTSD severity are associated with greater alcohol craving, and greater reports of startle and anger/irritability were particularly associated with same-day craving. The next-day results suggest that the combination of the 7 PTSD symptoms did not predict next-day craving. However, greater distress from nightmares the previous night, emotional numbing, and hypervigilance predicted greater next-day craving, while greater anger/irritability predicted lower next-day craving. These findings highlight the importance of assessing the relationship between specific symptoms of PTSD and alcohol cravings in order to increase our understanding of the functional interplay among them for theory building. Additionally, clinicians may be better able to refine treatment decisions to more efficiently break the cycle between PTSD-related distress and AUD symptoms.

There is limited research exploring the lived experiences of those with mesothelioma and lung cancer, with the majority of them having methodological and/or reporting concerns compromising the conclusions made. However, reoccurring themes in the evidence were found suggesting a number of areas where the psychological experience of mesothelioma differs from that of advanced lung cancer. These findings warrant further research to explore further and if proven, the need for the provision of specialist mesothelioma care services is affirmed.

BackgroundPatient safety measurement remains a global challenge. Patients are an important but neglected source of learning; however, little is known about what patients can add to our understanding of safety. We sought to understand the incidence and nature of patient-reported safety concerns in hospital.MethodsFeedback about the experience of safety within hospital was gathered from 2471 inpatients as part of a multicentre, waitlist cluster randomised controlled trial of an intervention, undertaken within 33 wards across three English NHS Trusts, between May 2013 and September 2014. Patient volunteers, supported by researchers, developed a classification framework of patient-reported safety concerns from a random sample of 231 reports. All reports were then classified using the patient-developed categories. Following this, all patient-reported safety concerns underwent a two-stage clinical review process for identification of patient safety incidents.ResultsOf the 2471 inpatients recruited, 579 provided 1155 patient-reported incident reports. 14 categories were developed for classification of reports, with communication the most frequently occurring (22%), followed by staffing issues (13%) and problems with the care environment (12%). 406 of the total 1155 patient incident reports (35%) were classified by clinicians as a patient safety incident according to the standard definition. 1 in 10 patients (264 patients) identified a patient safety incident, with medication errors the most frequently reported incident.ConclusionsOur findings suggest that patients can provide insight about safety that complements existing patient safety measurement, with a frequency of reported patient safety incidents that is similar to those obtained via case note review. However, patients provide a unique perspective about hospital safety which differs from and adds to current definitions of patient safety incidents.Trial registration numberISRCTN07689702; pre-results.