Alexithymia is an important mental health construct, but there is continuing debate regarding its definition and measurement. We attempt to resolve this definitional uncertainty in two ways. Firstly, we trace the development of the alexithymia construct, focusing particularly on what we call the Toronto and Amsterdam models, and examine a body of empirical research that shows strong support for the hypothesis that alexithymia consists of three components (difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking). Based on these components, we formulate an alternate theoretical model of alexithymia, the attention-appraisal model of alexithymia, that aligns alexithymia theory with recent advances in the broader emotion regulation field. Secondly, we examine the construct\u27s latent structure by factor analysing data from multiple psychometric measures administered to a community sample (N = 368). Our results suggest statistical support for our model, rather than the Toronto or Amsterdam models. We end by discussing how our model accounts for several unresolved issues within the alexithymia field, including the construct\u27s relation to imaginal capacities and emotional reactivity, whether alexithymia is a deficit or a defence, how it might be addressed in psychiatric treatment, and the discordance that has existed between alexithymia theory and alexithymia measurement. Ethical statement Ethics approval for this project was granted by the Edith Cowan University Human Research Ethics Committee. The guidelines of this committee were followed. All participants provided informed consent for their data to be used

Rick Iedema professor (organisational communication) AbstractObjectives To investigate patients' and family members' perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure.Design Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members.Setting Nationwide multisite survey across Australia.Participants 39 patients and 80 family members who were involved in high severity healthcare incidents (leading to death, permanent disability, or long term harm) and incident disclosure. Recruitment was via national newspapers (43%), health services where the incidents occurred (28%), two internet marketing companies (27%), and consumer organisations (2%). Main outcome measures Participants' recurrent experiences and concerns expressed in interviews.Results Most patients and family members felt that the health service incident disclosure rarely met their needs and expectations. They expected better preparation for incident disclosure, more shared dialogue about what went wrong, more follow-up support, input into when the time was ripe for closure, and more information about subsequent improvement in process. This analysis provided the basis for the formulation of a set of principles of effective incident disclosure.Conclusions Despite growing prominence of open disclosure, discussion about healthcare incidents still falls short of patient and family member expectations. Healthcare organisations and providers should strengthen their efforts to meet patients' (and family members') needs and expectations. IntroductionHealth providers in Western countries are adopting "open disclosure" policies that promote the discussion of healthcare incidents with patients.1-5 Studies using hypothetical designs have suggested that a gap exists between clinicians' and patients' views of what is appropriate incident disclosure. Clinicians tend to consider unexpected clinical outcomes as less serious and therefore less in need of disclosure than do patients. 6 Clinicians also err on the side of caution, whereas patients expect openness and admission of responsibility.7 Such breakdowns in the disclosure process exacerbate the distress patients experience from the event itself. Several studies have highlighted clinicians' concerns about the personal, professional, and legal consequences of disclosure. 10Clinicians are also concerned about the considerable time and effort often required for incident disclosure, 11 including ; and the importance of provider responses that are caring, honest, quick, personal, accessible, and frequent. 15 Some studies suggest that patients may have an interest in extending disclosure discussions to encompass plans for and evidence of practice improvement, with some interviewees indicating interest in contributing to the monitoring of improvement processes over time. 9 14 16 However, few studies have measured the actual experiences of patients and families with the disclosure process. The dearth of i...

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Forgiving may lead to an improvement of mental health, and from a therapeutic jurisprudence perspective it is important to establish what aspects of judicial procedures can be changed to promote forgiving. The literature suggests that receiving an apology may encourage forgiving. However, there is a dearth of empirical research regarding the association between forgiving and apology in judicial settings. This paper reports the findings of a study that examined the association between forgiving and four restorative situations (i.e. excuse, admission of guilt, apology, and true sorriness) in a group of 134 victims of gross human rights violations who were actual or potential participants in the proceedings of the South African Truth and Reconciliation Commission. The best predictors of forgiveness in this sample were gender and whether victims perceived wrongdoers to be truly sorry.

Cyberbullying can be harmful to adolescents using online technology, and one way of combating it may be to use interventions that have been successfully utilised for traditional bullying, such as encouraging peer bystander intervention. The online environment, however, differs notably from the environment in which traditional bullying takes place raising questions about the suitability of transferring traditional bullying approaches to the cyber environment. This study explored the perceptions of, and key influences on, adolescent bystanders who witness cyberbullying. In all, 24 interviews were conducted with students aged 13–16 years. Relationships emerged as a key theme with participants believing that a bystander’s relationship with both the perpetrator and the target influenced whether they would intervene when witnessing cyberbullying. Relationships also influenced their ability to understand the context of the situation, the perceived severity of the effect of the incident on the target and therefore the need, or otherwise, to seek help from adults.