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Behav. Sci., Volume 11, Issue 6 (June 2021) – 13 articles

Cover Story (view full-size image): Men seek significantly less help for mental health issues compared to women, even when experiencing similar symptom burden. In an anonymous online study of 716 German-speaking men and women, we examined mental health symptoms, masculinity ideologies, and possible interactions to analyze their predictive value for psychotherapy use among men and women who report suffering from psychological distress. Our findings support previous research suggesting that adherence to traditional masculinity ideologies may prevent men from seeking professional help for mental health issues. Significant interaction effects between mental health symptoms and traditional masculinity ideologies further indicate that men with high adherence to traditional masculinity ideologies seek professional help only when experiencing elevated symptoms. View this paper.
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10 pages, 2229 KiB  
Article
Hacking Trust: The Presence of Faces on Automated Teller Machines (ATMs) Affects Trustworthiness
by Giulio Gabrieli, Sarah Ng and Gianluca Esposito
Behav. Sci. 2021, 11(6), 91; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060091 - 21 Jun 2021
Cited by 5 | Viewed by 2964
Abstract
Trustworthiness is a core concept that drives individuals’ interaction with others, as well with objects and digital interfaces. The perceived trustworthiness of strangers from the evaluation of their faces has been widely studies in social psychology; however, little is known about the possibility [...] Read more.
Trustworthiness is a core concept that drives individuals’ interaction with others, as well with objects and digital interfaces. The perceived trustworthiness of strangers from the evaluation of their faces has been widely studies in social psychology; however, little is known about the possibility of transferring trustworthiness from human faces to other individuals, objects or interfaces. In this study, we explore how the perceived trustworthiness of automated teller machines (ATMs) is influenced by the presence of faces on the machines, and how the trustworthiness of the faces themselves is transferred to the machine. In our study, participants (N = 57) rated the trustworthiness of ATMs on which faces of different age, gender, and ethnicity are placed. Subsequently, the trustworthiness of the ATMs is compared to the trustworthiness ratings of faces presented on their own. Results of our works support the idea that faces’ trustworthiness can be transferred to objects on which faces are presented. Moreover, the trustworthiness of ATMs seems to be influenced by the age of presented faces, with ATMs on which children faces are presented are trusted more than the same machines when adults’ or elders’ faces are presented, but not by the ethnicity (Asian or Caucasian) or gender (male or female) of presented faces. Full article
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11 pages, 305 KiB  
Article
Vowel Length Expands Perceptual and Emotional Evaluations in Written Japanese Sound-Symbolic Words
by Zihan Lin, Nan Wang, Yan Yan and Toshimune Kambara
Behav. Sci. 2021, 11(6), 90; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060090 - 21 Jun 2021
Cited by 5 | Viewed by 2338
Abstract
In this study, we examined whether vowel length affected the perceptual and emotional evaluations of Japanese sound-symbolic words. The perceptual and emotional features of Japanese sound-symbolic words, which included short and long vowels, were evaluated by 209 native Japanese speakers. The results showed [...] Read more.
In this study, we examined whether vowel length affected the perceptual and emotional evaluations of Japanese sound-symbolic words. The perceptual and emotional features of Japanese sound-symbolic words, which included short and long vowels, were evaluated by 209 native Japanese speakers. The results showed that subjective evaluations of familiarity, visual imageability, auditory imageability, tactile imageability, emotional valence, arousal, and length were significantly higher for sound-symbolic words with long vowels compared to those with short vowels. Additionally, a subjective evaluation of speed was significantly higher for written Japanese sound-symbolic words with short vowels than for those with long vowels. The current findings suggest that vowel length in written Japanese sound-symbolic words increases the perceptually and emotionally subjective evaluations of Japanese sound-symbolic words. Full article
6 pages, 1744 KiB  
Communication
Obsessive-Compulsive Disorders and Functional Urinary Disorders: A Fortuitous Association?
by Qin Xiang Ng, Yu Liang Lim, Wayren Loke, Wee Song Yeo and Kuan Tsee Chee
Behav. Sci. 2021, 11(6), 89; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060089 - 17 Jun 2021
Cited by 4 | Viewed by 5007
Abstract
Although psychological factors are known to affect bladder and bowel control, the occurrence of functional urinary disorders in patients with psychiatric disorders has not been well-studied or described. A higher prevalence of functional lower urinary tract disorders have also been reported amongst patients [...] Read more.
Although psychological factors are known to affect bladder and bowel control, the occurrence of functional urinary disorders in patients with psychiatric disorders has not been well-studied or described. A higher prevalence of functional lower urinary tract disorders have also been reported amongst patients with obsessive-compulsive (OC) disorders. A systematic literature search of PubMed, EMBASE, OVID Medline, PsycINFO, Clinical Trials Register of the Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDANTR), Clinicaltrials.gov and Google Scholar databases found five observational studies on the topic. Unfortunately, as only one study had a (healthy) control group, a meta-analytic approach was not possible. Overall, patients with OC symptoms appeared to have increased occurrence of functional urinary symptoms, e.g., overactive bladder, increase in urgency, frequency, incontinence and enuresis. This was even more common amongst patients with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) as opposed to patients with OCD alone. Several biological and behavioural mechanisms and treatment approaches were discussed. However, as the current evidence base was significantly limited and had moderate to serious risk of bias, no strong inferences could be drawn. Further well-designed cohort studies are necessary to better elucidate the observed associations and their management. Full article
(This article belongs to the Special Issue Clinical Psychology Research and Public Health)
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15 pages, 623 KiB  
Review
An Integrative Review Considering the Impact of Storytelling and Sharing Interventions in Stroke
by Rana Alawafi, Sheeba Rosewilliam and Andrew Soundy
Behav. Sci. 2021, 11(6), 88; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060088 - 16 Jun 2021
Cited by 6 | Viewed by 2954
Abstract
Background: Review-based research is needed which can establish the psychosocial outcomes and mechanisms of “storytelling and sharing” interventions for people with stroke. This information will act to inform the value and development of such interventions. Methods: An integrative review was conducted in three [...] Read more.
Background: Review-based research is needed which can establish the psychosocial outcomes and mechanisms of “storytelling and sharing” interventions for people with stroke. This information will act to inform the value and development of such interventions. Methods: An integrative review was conducted in three stages: (a) a systematic search strategy was undertaken to focus on articles between 2009 until January 2020 to locate articles the considered storytelling and sharing interventions for people diagnosed with stroke; (b) critical appraisal was undertaken to assess study quality; and (c) synthesis within three stages including data reduction, data display and conclusion. Results: Fourteen articles (including 727 participants) were identified that met the eligibility criteria. Five themes were identified that represented the outcome and mechanisms that appeared to be associated with a stroke intervention. These included introducing the concept of hope and learning to be positive, the enhanced ability to cope, the impact of loneliness and social interaction, impact on emotions, depression and related emotions such as fear. Conclusions: Storytelling interventions appear to impact loneliness, introduce positivity and hope and enable coping through knowledge exchange. The main mechanisms which appeared to influence these outcomes were social comparisons and social control. Full article
(This article belongs to the Special Issue Physical Activity, Physical and Psychological Health)
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20 pages, 1159 KiB  
Article
From Fear to Hopelessness: The Buffering Effect of Patient-Centered Communication in a Sample of Oncological Patients during COVID-19
by Alessandro Alberto Rossi, Maria Marconi, Federica Taccini, Claudio Verusio and Stefania Mannarini
Behav. Sci. 2021, 11(6), 87; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060087 - 14 Jun 2021
Cited by 30 | Viewed by 3720
Abstract
Background: COVID-19 represents a threat both for the physical and psychological health of oncological patients experiencing heightened distress levels to which the fear of the virus is also added. Moreover, fear of COVID-19 could lead oncological patients to experience feelings of hopelessness related [...] Read more.
Background: COVID-19 represents a threat both for the physical and psychological health of oncological patients experiencing heightened distress levels to which the fear of the virus is also added. Moreover, fear of COVID-19 could lead oncological patients to experience feelings of hopelessness related to their medical care. Patient-centered communication may act as a buffer against the aforementioned variables. This study aimed to test the role of doctor–patient communication in the relationship between fear of COVID-19 and hopelessness. Methods: During the COVID-19 pandemic, a sample of 90 oncological outpatients was recruited (40 males (44.4%) and 50 females (55.6%), mean age = 66.08 (SD = 12.12)). A structured interview was developed and used during the pandemic to measure the patients’ perceived (A) fear of COVID-19, and (B) feelings of hopelessness, and (C) physicians’ use of empathetic and (D) clear language during the consultation. A multiple mediation model was tested, and the effects between males and females were also compared. Results: Empathetic and clear doctor–patient communication buffered the adverse effect of the fear of COVID-19 on hopelessness through a full-mediation model. The effects did not differ between males and females in the overall model but its indirect effects. Discussions: Patient-centered communication using empathy and clear language can buffer the adverse effect of the fear of COVID-19 and protect oncological patients from hopelessness during the pandemic. These findings might help to improve clinical oncological practice. Full article
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15 pages, 1139 KiB  
Review
Repetitive Transcranial Magnetic Stimulation: A Potential Treatment for Obesity in Patients with Schizophrenia
by Ramey G. Monem and Olaoluwa O. Okusaga
Behav. Sci. 2021, 11(6), 86; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060086 - 11 Jun 2021
Cited by 4 | Viewed by 3621
Abstract
Obesity is highly prevalent in patients with schizophrenia and, in association with metabolic syndrome, contributes to premature deaths of patients due to cardiovascular disease complications. Moreover, pharmacologic, and behavioral interventions have not stemmed the tide of obesity in schizophrenia. Therefore, novel effective interventions [...] Read more.
Obesity is highly prevalent in patients with schizophrenia and, in association with metabolic syndrome, contributes to premature deaths of patients due to cardiovascular disease complications. Moreover, pharmacologic, and behavioral interventions have not stemmed the tide of obesity in schizophrenia. Therefore, novel effective interventions are urgently needed. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for inducing weight loss in obese non-psychiatric samples but this promising intervention has not been evaluated as a weight loss intervention in patients with schizophrenia. In this narrative review, we describe three brain mechanisms (hypothalamic inflammation, dysregulated mesocorticolimbic reward system, and impaired prefrontal cortex function) implicated in the pathogenesis and pathophysiology of obesity and emphasize how the three mechanisms have also been implicated in the neurobiology of schizophrenia. We then argue that, based on the three overlapping brain mechanisms in obesity and schizophrenia, rTMS would be effective as a weight loss intervention in patients with schizophrenia and comorbid obesity. We end this review by describing how deep TMS, relative to conventional TMS, could potentially result in larger effect size for weight loss. While this review is mainly conceptual and based on an extrapolation of findings from non-schizophrenia samples, our aim is to stimulate research in the use of rTMS for weight loss in patients with schizophrenia. Full article
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17 pages, 805 KiB  
Article
Sitting in Judgment: How Body Posture Influences Deception Detection and Gazing Behavior
by Mircea Zloteanu, Eva G. Krumhuber and Daniel C. Richardson
Behav. Sci. 2021, 11(6), 85; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060085 - 10 Jun 2021
Cited by 3 | Viewed by 6679
Abstract
Body postures can affect how we process and attend to information. Here, a novel effect of adopting an open or closed posture on the ability to detect deception was investigated. It was hypothesized that the posture adopted by judges would affect their social [...] Read more.
Body postures can affect how we process and attend to information. Here, a novel effect of adopting an open or closed posture on the ability to detect deception was investigated. It was hypothesized that the posture adopted by judges would affect their social acuity, resulting in differences in the detection of nonverbal behavior (i.e., microexpression recognition) and the discrimination of deceptive and truthful statements. In Study 1, adopting an open posture produced higher accuracy for detecting naturalistic lies, but no difference was observed in the recognition of brief facial expressions as compared to adopting a closed posture; trait empathy was found to have an additive effect on posture, with more empathic judges having higher deception detection scores. In Study 2, with the use of an eye-tracker, posture effects on gazing behavior when judging both low-stakes and high-stakes lies were measured. Sitting in an open posture reduced judges’ average dwell times looking at senders, and in particular, the amount and length of time they focused on their hands. The findings suggest that simply shifting posture can impact judges’ attention to visual information and veracity judgments (Mg = 0.40, 95% CI (0.03, 0.78)). Full article
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18 pages, 1968 KiB  
Article
Effects of a Mindfulness and Acceptance-Based Program on Intimate Relationships in a Youth Sample: A Randomized Controlled Trial
by María de Lourdes Rosales-Villacrés, Cristián Oyanadel, Diana Changotasig-Loja and Wenceslao Peñate-Castro
Behav. Sci. 2021, 11(6), 84; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060084 - 09 Jun 2021
Viewed by 3010
Abstract
Intimate relationship conflicts in young people are crucial experiences for change. They can lead to more or less satisfactory relationships, depending on individuals’ skills to cope with these conflicts. This may or may not lead to violence in couples. Acceptance and self-regulation processes [...] Read more.
Intimate relationship conflicts in young people are crucial experiences for change. They can lead to more or less satisfactory relationships, depending on individuals’ skills to cope with these conflicts. This may or may not lead to violence in couples. Acceptance and self-regulation processes are an effective strategy to address individual factors such as avoidance and anxiety in intimate relationships of people in these age groups, thus preventing violence. The aim of this study was to assess the effects of an eight-session mindfulness and acceptance-based program (MAP). Participants (n = 40), who were aged from 18 to 25 years old, were randomly assigned to a group receiving the MAP or an active control group. Outcome measures were anxiety about abandonment, intimacy avoidance (Experiences in Close Relationships scale), well-being (Psychological Well-being Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and flexibility (Acceptance and Action Questionnaire-II). Measures were taken at pre-intervention, post-intervention and follow-up. Results showed that the MAP decreased anxiety (p = 0.025) and avoidance (p = 0.01) and increased mindfulness (p < 0.001) and flexibility (p = 0.001). In general, these improvements persisted at follow-up. Results are discussed in relation to the usefulness of mindfulness-acceptance strategies to cope with non-pathological intimate relationship conflicts. Full article
(This article belongs to the Section Health Psychology)
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21 pages, 2578 KiB  
Article
Men’s Psychotherapy Use, Male Role Norms, and Male-Typical Depression Symptoms: Examining 716 Men and Women Experiencing Psychological Distress
by Lukas Eggenberger, Callia Fordschmid, Claudio Ludwig, Seraina Weber, Jessica Grub, Nikola Komlenac and Andreas Walther
Behav. Sci. 2021, 11(6), 83; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060083 - 02 Jun 2021
Cited by 18 | Viewed by 4470
Abstract
Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from [...] Read more.
Men as compared to women are half as often affected by depressive and anxiety disorders and seek significantly less help for mental health issues than women. Adherence to traditional male role norms (AtTMRN) may hinder men from describing prototypical depression symptoms and from seeking psychotherapy. The current study compared whether AtTMRN, gender role identity, or the experience of prototypical or male-typical externalizing mental health symptoms were associated with psychotherapy use in men and women. In an anonymous online survey, 716 participants (37% men) reporting to currently experience psychological distress were examined. Information was obtained on psychotherapy use, depression and anxiety symptoms, gender role identity, and traditional male role norms. Although experiencing similar levels of depression, men compared to women showed a reduction in psychotherapy use by 29%. Masculine role identity was directly associated with reduced psychotherapy use in men (β = −0.41, p = 0.029), whereas AtTMRN was not (men: β = −0.04, p = 0.818; women: β = −0.25, p = 0.064). Higher externalizing depression symptomatology (β = −0.68, p = 0.005), but not prototypical depression symptomatology (β = −0.02, p = 0.499), was associated with reduced psychotherapy use in men but not women (p > 0.05). Interactions revealed that men, but not women, with high AtTMRN use psychotherapy only when exhibiting elevated symptom levels. The results corroborate previous reports showing reduced psychotherapy use in men as compared to women and identify elevated masculine role identity and male-typical externalizing depression symptomatology as direct factors associated with reduced psychotherapy use in psychologically distressed men. AtTMRN interacts with mental health symptoms to predict psychotherapy use, indicating that men with high AtTMRN only use psychotherapy when exhibiting high symptomatology. Full article
(This article belongs to the Special Issue Male Depression and Therapy)
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17 pages, 1284 KiB  
Article
Parents’ Perceptions of Educational Apps Use for Kindergarten Children: Development and Validation of a New Instrument (PEAU-p) and Exploration of Parents’ Profiles
by Julie Vaiopoulou, Stamatios Papadakis, Eirini Sifaki, Dimitrios Stamovlasis and Michail Kalogiannakis
Behav. Sci. 2021, 11(6), 82; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060082 - 27 May 2021
Cited by 34 | Viewed by 6015
Abstract
Contemporary mobile technologies offer tablets and smartphones that elicit young children’s active participation in various educational apps, dramatically transforming playing, learning, and communication. Even the most knowledgeable users face difficulties in deciding about the value and appropriateness of the so-called educational apps because [...] Read more.
Contemporary mobile technologies offer tablets and smartphones that elicit young children’s active participation in various educational apps, dramatically transforming playing, learning, and communication. Even the most knowledgeable users face difficulties in deciding about the value and appropriateness of the so-called educational apps because of many factors that should be considered. Their importance for children’s attitudes is affected by the perceived positive and negative aspects, which vary across a multiplicity of criteria. Filling the gap in the relevant literature, a new instrument, named PEAU-p (Perceptions about Educational Apps Use–parents), was developed and validated in the present study designed to measure parents’ perception of educational apps for kindergarten pupils. Data (N = 435) were collected via online procedures, and the psychometric properties of PEAU-p were studied via exploratory and confirmatory methods. Principal Components Analysis extracted six factors, namely Usability, Enjoyment, Involvement, Learning, Worries, and Values, which explained 72.42% of the total variance. Subsequently, by implementing Latent Class Analysis based on the above factors, four Clusters (i.e., parents’ Profiles) were extracted corresponding to their perceptions and attitudes towards the educational apps used for kindergarten pupils. Those were named as ‘mild attitude’, ‘negative attitude’, ‘positive attitude’, and ‘indifferent attitude’. This categorization, besides the statistical support, is fully interpretable, and the profiles were associated with certain covariates, such as age, the number of children, knowledge on new technologies, or distal outcomes, e.g., the frequency of using apps, the general position towards apps or their intention to recommend apps use. The findings are discussed within the current research field, investigating the influential role parents play in young children’s media selection and use. Full article
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17 pages, 456 KiB  
Article
The Superior Visual Perception Hypothesis: Neuroaesthetics of Cave Art
by Per Olav Folgerø, Christer Johansson and Linn Heidi Stokkedal
Behav. Sci. 2021, 11(6), 81; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060081 - 26 May 2021
Cited by 6 | Viewed by 5600
Abstract
Cave Art in the Upper Paleolithic presents a boost of creativity and visual thinking. What can explain these savant-like paintings? The normal brain function in modern man rarely supports the creation of highly detailed paintings, particularly the convincing representation of animal movement, without [...] Read more.
Cave Art in the Upper Paleolithic presents a boost of creativity and visual thinking. What can explain these savant-like paintings? The normal brain function in modern man rarely supports the creation of highly detailed paintings, particularly the convincing representation of animal movement, without extensive training and access to modern technology. Differences in neuro-signaling and brain anatomy between modern and archaic Homo sapiens could also cause differences in perception. The brain of archaic Homo sapiens could perceive raw detailed information without using pre-established top-down concepts, as opposed to the common understanding of the normal modern non-savant brain driven by top-down control. Some ancient genes preserved in modern humans may be expressed in rare disorders. Researchers have compared Cave Art with art made by people with autism spectrum disorder. We propose that archaic primary consciousness, as opposed to modern secondary consciousness, included a savant-like perception with a superior richness of details compared to modern man. Modern people with high frequencies of Neanderthal genes, have notable anatomical features such as increased skull width in the occipital and parietal visual areas. We hypothesize that the anatomical differences are functional and may allow a different path to visual perception. Full article
(This article belongs to the Section Cognition)
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18 pages, 575 KiB  
Systematic Review
Current Intervention Treatments for Food Addiction: A Systematic Review
by Mark Leary, Kirrilly M. Pursey, Antonio Verdejo-Garcia and Tracy L. Burrows
Behav. Sci. 2021, 11(6), 80; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060080 - 23 May 2021
Cited by 17 | Viewed by 11902
Abstract
Research on the concept of food addiction (FA) has steadily grown and, based on a widely used self-report, FA is estimated to affect between 16–20% of the adult population. However, there are few interventions available for people with self-reported FA, and their efficacy [...] Read more.
Research on the concept of food addiction (FA) has steadily grown and, based on a widely used self-report, FA is estimated to affect between 16–20% of the adult population. However, there are few interventions available for people with self-reported FA, and their efficacy is unclear. The primary aim of the review was to examine the efficacy of different interventions, including behavioural/lifestyle, medication and surgical approaches, for reducing symptoms and/or changing diagnosis of FA among adolescents and adults. A secondary aim was to examine the influence of sex as a moderator of intervention effects. A systematic search was performed from 2008–2020 to identify studies that used the YFAS to assess the effectiveness of interventions on FA. Nine studies were identified (n = 7 adults, n = 2 adolescents) including a total of 812 participants (range 22–256) with an average of 69% females per study. The types of interventions included medications (n = 3), lifestyle modification (n = 3), surgical (n = 2) and behavioural (n = 1), with FA being assessed as a secondary outcome in all studies. Five studies in adults reported a significant reduction in FA symptoms or diagnosis from pre to post-intervention, two when compared to a control group and three in the intervention group only. Efficacious interventions included: medication (combination of naltrexone and bupropion, as well as pexacerfont), bariatric surgery and lifestyle modification. No significant changes in FA were reported in adolescent studies. Given few studies were identified by the review, there is insufficient evidence to provide clear recommendations for practice; however, some interventions show potential for reducing self-reported FA outcomes in adults. Future research should explore the longer-term efficacy of interventions and the effectiveness of treatments with sufficient sample sizes. Full article
(This article belongs to the Section Psychiatric, Emotional and Behavioral Disorders)
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16 pages, 698 KiB  
Article
Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies
by Silvia Cimino, Eleonora Marzilli, Michela Erriu, Paola Carbone, Elisa Casini and Luca Cerniglia
Behav. Sci. 2021, 11(6), 79; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11060079 - 21 May 2021
Cited by 5 | Viewed by 2795
Abstract
International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate [...] Read more.
International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications. Full article
(This article belongs to the Special Issue Road Crash Injury and Driver Behavior)
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