A Phenomenological Approach to Understanding the Association Between Psychosis and Violence

Aims Although there is an established but complex relationship between violence and psychosis, the nature of this relationship remains unclear. To date, there has been a predominant focus within group-level quantitative studies on specific types of psychopathology such as threat/control-override and command hallucinations. However, the literature has not produced a consensus on the profile of psychopathological predictors of violence. Furthermore, there is an emerging literature suggesting the predictive paradigm has limited clinical utility in the management of harm-related behaviour. In the way that phenomenological analysis has produced a fuller understanding of psychosis (that can inform improved aetiological and interventional frameworks), the authors assert that such an approach (with its focus on subjectivity) has the potential to advance our understanding of the relationship between psychosis and violence in a way that has clinical applicability. To test this assertion, it is necessary to develop a model of assessment and analysis. The aim of this paper is to develop an evidence-based model to explore the phenomenological underpinnings of violence in psychosis. Methods A two-stage method was followed. Firstly, drawing on existing phenomenological accounts of psychosis and approaches to understanding the subjectivity of violence perpetration, the authors developed a pilot evaluation model. This was tested and revised by applying the model to phenomenological case reports of psychosis and violence. Results The findings so far demonstrate that as well as the role of circumscribed psychopathology on the likelihood of violence, other experiences within the psychotic spectrum such as operative hyperreflexivity and disturbances of ipseity play an important role. Additionally, feelings of disconnectedness and loss of recognising others as real combined with impaired theory of mind can lead to loss of normal inhibitory processes and violent behaviour. In keeping with a recent shift in focus from strict diagnostic criteria to individual psychotic phenomena, existential analysis can be applied to explore changes in self-identity and sense of belonging in the world to develop our understanding of the association between psychosis and violence. Conclusion The phenomenological model developed produces a fuller picture of the association between psychosis and violence. As such it may generate insight into the association between psychosis and violence that has greater clinical utility than existing psychopathology-based theories do. This needs to be evaluated by field testing of the approach.

Aims. Smartphone addiction is a new concern due to its progressive global usage. Since this phenomenon occurs in adolescents and young people, especially in students, causing many problems in interpersonal relationships, occupational and educational performances, evaluation of smartphone addiction in this population seems to be necessary. Accordingly, this study aimed to examine the prevalence of smartphone addiction in Tehran university students for determining the risk factors associated with this issue. Methods. This analytical cross-sectional survey was carried out on university students in Tehran between 2016-2018. A study sample of 382 students from various faculties of Tehran universities was chosen by random multi-stage cluster sampling. The participants simultaneously completed a researcher-made questionnaire on demographic characteristics and risk factors, the Smartphone Addiction Scale (SAS), and Young's Internet Addiction Test (IAT). After checking the smartphone addiction questionnaire, smartphone-addicted individuals were identified, and a comparison with the non-addicted group was performed in terms of risk factors.
In this study, the participants were given written consent forms. Questionnaires were anonymous and the information was kept confidential. This study was registered at the Ethics Committee of Shahid Beheshti University of Medical Sciences with a code of 1395,309. Results. Our findings indicated that the frequency of smartphone addiction was 28.8%. The frequency of smartphone addiction in women (32.5%) was higher than that in men (23%) (p = 0.04). The highest incidence of smartphone addiction occurred in the age range of less than 20 while the lowest was found above the age of 40. (P = 0.001). The prevalence of smartphone addiction in the single population was 34.1% Vs 16.1% in married. (P = 0.000) The most prominent educational field of smartphone addicts was technical and engineering. (P = 0.007). Smartphone addiction was significantly more in internet service and social networking users. (P = 0.025) There was a significant relationship between the history of psychiatric illness and smartphone addiction. (P = 0.035) The most common psychiatric diseases were found to be obsessive-compulsive disorder (41.7%), followed by anxiety disorders. (33.3%) Conclusion. Smartphone addiction has a significant frequency among university students in Tehran, associated with access to internet services and social networking. It was more common in women, single adults, and younger ages. There was a significant relationship between the history of psychiatric illness and smartphone addiction. The highest frequency of psychiatric illnesses in the addiction group was obsessive-compulsive disorder and anxiety disorders. No relationship was found between smartphone addiction and history of substance use, as well as smoking and alcohol.
A Phenomenological Approach to Understanding the Association Between Psychosis and Violence Aims. Although there is an established but complex relationship between violence and psychosis, the nature of this relationship remains unclear. To date, there has been a predominant focus within group-level quantitative studies on specific types of psychopathology such as threat/control-override and command hallucinations. However, the literature has not produced a consensus on the profile of psychopathological predictors of violence. Furthermore, there is an emerging literature suggesting the predictive paradigm has limited clinical utility in the management of harm-related behaviour. In the way that phenomenological analysis has produced a fuller understanding of psychosis (that can inform improved aetiological and interventional frameworks), the authors assert that such an approach (with its focus on subjectivity) has the potential to advance our understanding of the relationship between psychosis and violence in a way that has clinical applicability. To test this assertion, it is necessary to develop a model of assessment and analysis. The aim of this paper is to develop an evidence-based model to explore the phenomenological underpinnings of violence in psychosis. Methods. A two-stage method was followed. Firstly, drawing on existing phenomenological accounts of psychosis and approaches to understanding the subjectivity of violence perpetration, the authors developed a pilot evaluation model. This was tested and revised by applying the model to phenomenological case reports of psychosis and violence. Results. The findings so far demonstrate that as well as the role of circumscribed psychopathology on the likelihood of violence, other experiences within the psychotic spectrum such as operative hyperreflexivity and disturbances of ipseity play an important role. Additionally, feelings of disconnectedness and loss of recognising others as real combined with impaired theory of mind can lead to loss of normal inhibitory processes and violent behaviour. In keeping with a recent shift in focus from strict diagnostic criteria to individual psychotic phenomena, existential analysis can be applied to explore changes in self-identity and sense of belonging in the world to develop our understanding of the association between psychosis and violence.
Conclusion. The phenomenological model developed produces a fuller picture of the association between psychosis and violence. As such it may generate insight into the association between psychosis and violence that has greater clinical utility than existing psychopathology-based theories do. This needs to be evaluated by field testing of the approach. Aims. Our purpose-built dementia unit investigates temperature and Behavioural and Psychological Symptoms of Dementia (BPSD). We sought to control for diurnality. Sundown Syndrome (SS) is emergence or worsening of BPSD in the late afternoon or early evening. The literature affords debate. Our methods of controlling for time as a confounder for temperature generated contributions which we offer here. Methods. Data were collected from two Older People's Organic wards within the Cumbria, Northumberland Tyne and Wear NHS Foundation Trust. Collection used the Trust's "Talk First" data system. That is an established, verified record, including "aggression" (non-contact) or "violence" (contact). Data from 16 months, September 2019 to January 2021 were analysed.

Gross Bimodal Diurnality in Dementia Behavioural Symptoms in an Inpatient Setting: High Noon and Sundown
Patients had moderate or severe dementia. Wards care for a maximum of 14 patients and serve either men or women. Data for the communal corridor and day room of each ward were analysed. This gave four site We used two methods. The first was basic, the overall histogram of incidents through the day.
The second analysis counts "incident signals" from each time or temperature. Each actual occurring combination of temperature and time is assigned a "cell". The background rate of all incidents per all cells is known. Any incident in any rare cell has low binomial probability. Low probabilities mean high "signal". The square of sums of signals across each hour provides each hour's "incident signal". Results. Median ages were 79 (women) and 82 (men). There were 99 incidents.
The histogram has two peaks, around lunchtime and evening. Late afternoon is relatively safe. Thermal incident signals are summarised as moderately coherent. Diurnal incident signals controlling for temperature did not show any coherent trend. Conclusion. We proffer approaches for controlling for temperature and time of day. The project has limits. We have a small sample. We have not compared sunset times; but that is not relevant to the mid-day peak. We present secondary data from an evaluation aimed at temperature. More favourably this is an a priori sample, shows the same thing is two ways, and adds to debate on an important and critiqued construct. Though SS uses "sun" as a shorthand, any effect will be mediated bio-psychosocially via light, social interaction, heat, circadian rhythms, etc. Our data support social interaction more than time of day. This may add to or challenge SS as a construct. Aims. Among various factors that determine an individual's selfesteem, parenting styles play a very significant role in this regard. Certain parenting styles that are practiced around the globe include authoritarian, authoritative and permissive parenting. The study aimed to investigate the co-relation between parenting styles and self-esteem among medical students. Methods. A cross-sectional study was conducted among the MBBS students of Rawalpindi Medical University, Rawalpindi from December 2020 to March 2021. 255 students took part in this study. An online survey was prepared by using Parental Authority Questionnaire-Short Version and Rosenberg Self-Esteem Scale and students were asked to fill it. Simple Random sampling technique was applied. SPSS version 26.0 was used to enter and analyze data. Pearson Correlation, Logistic regression and Hierarchal regression analysis were applied. Results. Out of 230, 60% of the sample population experienced authoritative, 29% experienced authoritarian whereas 11% experienced permissive style of parenting. Authoritative (r = 0.283, p < 0.001) and authoritarian (r = -0.227, p < 0.001) parenting styles were significantly correlated with self-esteem. Authoritarian parenting style (AOR = 2.20, 95% CI: 1.17, 4.14) was significantly associated with self-esteem of the participants compared to authoritative parenting style. Conclusion. Results indicated that authoritative parenting was only parenting style that correlates positively with self-esteem which suggest authoritative parenting is the optimum parenting style in Pakistani culture. Aims. COVID-19 imposed lockdowns have impacted the mental health of medical students worldwide. However, the relationship of social anxiety disorder with psychological distress during the pandemic has not been studied. The objective of this study was to assess the association of social anxiety disorder and physical activity with psychological distress in medical students during COVID-19 imposed lockdown. Methods. 256 medical students (M/F: 144/112) took part in this online cross-sectional survey conducted in September 2020 during a government imposed lockdown. Kessler-10 (K10) questionnaire, social interaction anxiety scale (SIAS) and international physical activity questionnaire (IPAQ) -short form were used