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Communication in clinical research: Uncertainty, stress, and emotional labor
- Jade Williams, H. Robert Kolb
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- Journal:
- Journal of Clinical and Translational Science / Volume 6 / Issue 1 / 2022
- Published online by Cambridge University Press:
- 08 November 2021, e11
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This exploratory study investigated perceptions of competent vs. contentious communication in the workplace as experienced by Clinical Research Professionals (CRPs) managing or coordinating clinical research. Qualitative data collected from a 90-min focus group interview were thematically analyzed using open and axial coding and constant comparison. Findings suggest CRPs associate contentious communication with uncertainty, stress, and emotional labor. Further, although many participants regularly utilize effective conflict and emotion management strategies, they lack confidence in both knowledge and efficacy of competent communication, stress management, and emotion management skills. Conclusions support revising “Wheel of Competencies” figure representing the Joint Task Force for Clinical Trial Competency framework. Study limitations and suggestions for future research and educational training are discussed.
Understanding aggression and microaggressions by and against people of colour
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- Monnica T. Williams, Terence H. W. Ching, Jade Gallo
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- Journal:
- The Cognitive Behaviour Therapist / Volume 14 / 2021
- Published online by Cambridge University Press:
- 08 September 2021, e25
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Efforts to understand racial microaggressions have focused on the impact on targets, but few studies have examined the motivations and characteristics of offenders, and none has examined microaggressions committed by members of racialized groups. The purpose of this study is to determine if racial microaggressions should be conceptualized as a form of aggression when committed by racialized individuals by examining the relationship between propensity to commit microaggressions and aggressive tendencies to help inform interventions. This nationwide survey recruited 356 Asian, Black and Hispanic American adults. Participants completed measures of likelihood of committing anti-Black microaggressions, aggression, negative affect, and ethnic identity. There was a significant negative correlation between ratings by diversity experts of microaggressive interactions being racist and participants’ likelihood of engaging in those same interactions. For each ethnoracial group, likelihood of committing anti-Black microaggressions was significantly positively correlated with all measures of aggression examined. The correlation between microaggressions and aggression was strongest for non-White Hispanic participants and weakest among Asian participants. A linear regression showed that aggression uniquely predicted microaggression likelihood, after controlling for respective co-variates within groups. Among non-White Hispanic participants, there was a significant positive correlation between negative affect and propensity to commit microaggressions, but this association disappeared in the regression analysis after accounting for aggression. A positive ethnic identity was not correlated with microaggression likelihood among Black participants. Findings indicate that microaggressions represent aggression on the part of offenders and constitute a form of behaviour that is generally socially unacceptable. Implications and cognitive behavioural treatment approaches are discussed.
Key learning aims(1) People of colour generally recognize that racial microaggressions are unacceptable.
(2) People of colour may commit microaggressions against other people of colour.
(3) Anti-Black microaggressions are correlated to aggression in perpetrators.
(4) Microaggressions are not solely attributable to negative affect or low ethnic identity.
(5) Therapists should address microaggressions, even when committed by people of colour.
A retrospective examination of care pathways in individuals with treatment-resistant depression
- Elana Day, Rupal Shah, Rachael W. Taylor, Lindsey Marwood, Kimberley Nortey, Jade Harvey, R. Hamish McAllister-Williams, John R. Geddes, Alvaro Barrera, Allan H. Young, Anthony J. Cleare, Rebecca Strawbridge
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- Journal:
- BJPsych Open / Volume 7 / Issue 3 / May 2021
- Published online by Cambridge University Press:
- 14 May 2021, e101
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Background
Individuals with treatment-resistant depression (TRD) experience a high burden of illness. Current guidelines recommend a stepped care approach for treating depression, but the extent to which best-practice care pathways are adhered to is unclear.
AimsTo explore the extent and nature of ‘treatment gaps’ (non-adherence to stepped care pathways) experienced by a sample of patients with established TRD (non-response to two or more adequate treatments in the current depressive episode) across three cities in the UK.
MethodFive treatment gaps were considered and compared with guidelines, in a cross-sectional retrospective analysis: delay to receiving treatment, lack of access to psychological therapies, delays to medication changes, delays to adjunctive (pharmacological augmentation) treatment and lack of access to secondary care. We additionally explored participant characteristics associated with the extent of treatment gaps experienced.
ResultsOf 178 patients with TRD, 47% had been in the current depressive episode for >1 year before initiating antidepressants; 53% had received adequate psychological therapy. A total of 47 and 51% had remained on an unsuccessful first and second antidepressant trial respectively for >16 weeks, and 24 and 27% for >1 year before medication switch, respectively. Further, 54% had tried three or more antidepressant medications within their episode, and only 11% had received adjunctive treatment.
ConclusionsThere appears to be a considerable difference between treatment guidelines for depression and the reality of care received by people with TRD. Future research examining representative samples of patients could determine recommendations for optimising care pathways, and ultimately outcomes, for individuals with this illness.
Contributors
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- By Lenard A. Adler, Pinky Agarwal, Rehan Ahmed, Jagga Rao Alluri, Fawaz Al-Mufti, Samuel Alperin, Michael Amoashiy, Michael Andary, David J. Anschel, Padmaja Aradhya, Vandana Aspen, Esther Baldinger, Jee Bang, George D. Baquis, John J. Barry, Jason J. S. Barton, Julius Bazan, Amanda R. Bedford, Marlene Behrmann, Lourdes Bello-Espinosa, Ajay Berdia, Alan R. Berger, Mark Beyer, Don C. Bienfang, Kevin M. Biglan, Thomas M. Boes, Paul W. Brazis, Jonathan L. Brisman, Jeffrey A. Brown, Scott E. Brown, Ryan R. Byrne, Rina Caprarella, Casey A. Chamberlain, Wan-Tsu W. Chang, Grace M. Charles, Jasvinder Chawla, David Clark, Todd J. Cohen, Joe Colombo, Howard Crystal, Vladimir Dadashev, Sarita B. Dave, Jean Robert Desrouleaux, Richard L. Doty, Robert Duarte, Jeffrey S. Durmer, Christyn M. Edmundson, Eric R. Eggenberger, Steven Ender, Noam Epstein, Alberto J. Espay, Alan B. Ettinger, Niloofar (Nelly) Faghani, Amtul Farheen, Edward Firouztale, Rod Foroozan, Anne L. Foundas, David Elliot Friedman, Deborah I. Friedman, Steven J. Frucht, Oded Gerber, Tal Gilboa, Martin Gizzi, Teneille G. Gofton, Louis J. Goodrich, Malcolm H. Gottesman, Varda Gross-Tsur, Deepak Grover, David A. Gudis, John J. Halperin, Maxim D. Hammer, Andrew R. Harrison, L. Anne Hayman, Galen V. Henderson, Steven Herskovitz, Caitlin Hoffman, Laryssa A. Huryn, Andres M. Kanner, Gary P. Kaplan, Bashar Katirji, Kenneth R. Kaufman, Annie Killoran, Nina Kirz, Gad E. Klein, Danielle G. Koby, Christopher P. Kogut, W. Curt LaFrance, Patrick J.M. Lavin, Susan W. Law, James L. Levenson, Richard B. Lipton, Glenn Lopate, Daniel J. Luciano, Reema Maindiratta, Robert M. Mallery, Georgios Manousakis, Alan Mazurek, Luis J. Mejico, Dragana Micic, Ali Mokhtarzadeh, Walter J. Molofsky, Heather E. Moss, Mark L. Moster, Manpreet Multani, Siddhartha Nadkarni, George C. Newman, Rolla Nuoman, Paul A. Nyquist, Gaia Donata Oggioni, Odi Oguh, Denis Ostrovskiy, Kristina Y. Pao, Juwen Park, Anastas F. Pass, Victoria S. Pelak, Jeffrey Peterson, John Pile-Spellman, Misha L. Pless, Gregory M. Pontone, Aparna M. Prabhu, Michael T. Pulley, Philip Ragone, Prajwal Rajappa, Venkat Ramani, Sindhu Ramchandren, Ritesh A. Ramdhani, Ramses Ribot, Heidi D. Riney, Diana Rojas-Soto, Michael Ronthal, Daniel M. Rosenbaum, David B. Rosenfield, Durga Roy, Michael J. Ruckenstein, Max C. Rudansky, Eva Sahay, Friedhelm Sandbrink, Jade S. Schiffman, Angela Scicutella, Maroun T. Semaan, Robert C. Sergott, Aashit K. Shah, David M. Shaw, Amit M. Shelat, Claire A. Sheldon, Anant M. Shenoy, Yelizaveta Sher, Jessica A. Shields, Tanya Simuni, Rajpaul Singh, Eric E. Smouha, David Solomon, Mehri Songhorian, Steven A. Sparr, Egilius L. H. Spierings, Eve G. Spratt, Beth Stein, S.H. Subramony, Rosa Ana Tang, Cara Tannenbaum, Hakan Tekeli, Amanda J. Thompson, Michael J. Thorpy, Matthew J. Thurtell, Pedro J. Torrico, Ira M. Turner, Scott Uretsky, Ruth H. Walker, Deborah M. Weisbrot, Michael A. Williams, Jacques Winter, Randall J. Wright, Jay Elliot Yasen, Shicong Ye, G. Bryan Young, Huiying Yu, Ryan J. Zehnder
- Edited by Alan B. Ettinger, Albert Einstein College of Medicine, New York, Deborah M. Weisbrot, State University of New York, Stony Brook
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- Book:
- Neurologic Differential Diagnosis
- Published online:
- 05 June 2014
- Print publication:
- 17 April 2014, pp xi-xx
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Contributors
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- By Nozomi Akanuma, Gonzalo Alarcón, R. Arunachalam, Sarah H. Bernard, Frank M. C. Besag, Istvan Bodi, Stephen Brown, Franz Brunnhuber, Antonella Cerquiglini, J. Helen Cross, R. Shane Delamont, Archana Desurkar, Lee Drummond, Rona Eade, Robert D. C. Elwes, Bidi Evans, Peter Fenwick, Colin D. Ferrie, Paul L. Furlong, Laura H. Goldstein, Sally Gomersall, Sushma Goyal, Jane Hanna, Yvonne Hart, Dominic C. Heaney, Graham E. Holder, Mrinalini Honavar, Elaine Hughes, Jozef M. Jarosz, John G. R. Jefferys, Jane Juler, Mathias Koepp, Michalis Koutroumanidis, Maureen Lahiff, Louis Lemieux, David McCormick, Brian Meldrum, John D. C. Mellers, Nicholas Moran, John Moriarty, Robin G. Morris, Nandini Mullatti, Lina Nashef, Jennifer Nightingale, T. J. von Oertzen, Corina O'Neill, Philip N. Patsalos, Stella Pearson, Charles E. Polkey, Ronit Pressler, Edward H. Reynolds, Mark P. Richardson, Leone Ridsdale, Robert Robinson, Greg Rogers, Euan M. Ross, Richard P. Selway, Stefano Seri, Simeran Sharma, Graeme J. Sills, Andrew Simmons, Shiri Spector, Mark Stevenson, Jade N. Thai, Brian Toone, Antonio Valentín, Nuria T. Villagra, Matthew Walker, William Whitehouse
- Edited by Gonzalo Alarcón, King's College London, Antonio Valentín, King's College London
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- Book:
- Introduction to Epilepsy
- Published online:
- 05 July 2012
- Print publication:
- 26 April 2012, pp xii-xv
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