Parental Alienation Syndrome (PAS) is a term addressed to describe negative, psychopathological feelings, thinking and behaviours, including hostility and fear, exhibited by children who have been alienated from one parent by the other parent. Despite its relevance in the clinical psychology field, theoretical and empirical contributions to understanding and deepening the many facets of this concept are still few. In particular, literature aimed at disentangling the alienating parent\'s psychological characteristics is scarce and fragmented. Our contribution encompasses a narrative review of scientific literature since the term PAS was coined in 1987 by Gardner, to delineate narcissistic proneness in alienating parents. Namely, considering the narcissistic drift the western society is going toward, we hypothesised that narcissism has a pivotal role in parents\' alienating behaviours against the alienated ones. Firstly, the elements that emerged from our literature search confirmed our theoretical hypothesis, in terms of the likely role of narcissism/narcissistic marked traits in alienating parents. In the second section, we contextualised the phenomenon in a psychodynamic/psychoanalytic theoretical framework. Finally, based on previous findings/considerations, the developmental trajectories of children with PAS have been traced. An improved theoretical knowledge of this phenomenon, also in terms of the psychopathology associated with its genesis, means to refine the diagnostic and treatment tools to prevent it.

Although uncommon, the risk of aggression and violence is greater in people with schizophrenia than in the general population. Clozapine is the \"gold standard\" pharmacologic treatment for the management of persistent agitation and aggression in people with schizophrenia and is consistently recommended by guidelines and reviews for this purpose. Although clozapine is indicated for treatment-resistant schizophrenia based on its superior efficacy, studies have proposed that clozapine may have specific properties that ameliorate aggression and hostility that are distinct from its antipsychotic effects. A literature review was conducted on June 3, 2023, using the US National Library of Medicine\'s PubMed resource to identify articles focusing on clozapine for the treatment of aggression, violence, and/or hostility in patients with schizophrenia or schizoaffective disorder. The majority of evidence, including from randomized control trials, supports the utilization of clozapine as maintenance treatment for persistent aggressive behavior in patients with schizophrenia, and supports that its anti-aggressive effects may be independent from its antipsychotic properties (e.g. - treatment of hallucinations and delusions). Future randomized control studies evaluating clozapine and clozapine serum levels with aggression as the primary outcome would be of benefit.

Parent-Child Attachment (PCA) and Hostile Attribution Bias (HAB) are closely related to aggression, but findings regarding their relationships are inconsistent. There is a lack of understanding of the underlying mechanism between PCA and aggression. This review employed meta-analysis approaches to investigate the associations between PCA and aggression, as well as between HAB and aggression, and the mechanism for the PCA-aggression association. An article search was conducted in CNKI, PubMed, PsycINFO, Web of Science, ProQuest, and Google Scholar. Totally, 118 studies involving general populations and those at high risk for aggression were included. Results revealed negative associations between Parent-Child Attachment Security (PCAS) and aggression (ρ = -.267, p < .001) and positive associations between Parent-Child Attachment Insecurity (PCAI) and aggression (ρ = .240, p < .05). HAB and aggression were found to be positively associated (ρ = .303, p < .001). As for the PCAS-aggression association, a larger effect size was found in females than in males. The HAB-reactive aggression association was stronger than the HAB-proactive aggression association. In Eastern culture, the association between HAB and aggression was stronger than in Western culture. HAB mediated the association between PCAS and aggression. Our findings contribute to the understanding of the occurrence and development of aggression by establishing an association between attachment theory and the social information processing model. The practical implications include interventions targeting cultivating PCAS and alleviating HAB, which might serve as effective ways to reduce aggression, yet aggression type, gender, and cultural background should be taken into consideration.

Frontline workers for sexual and reproductive health and rights (SRHR) provide life-changing and life-saving services to millions of people every year. From accompanying the pregnant, delivering babies and caring for the newborn to supporting those subjected to sexual violence; from treating debilitating infections to expanding contraceptive choices; from enabling access to safe abortion services to countering homophobia: all over the world frontline SRHR carers and advocates make it possible for so many more to experience dignity in sex, sexuality and reproduction. Yet they are also subjected to hostility for what they do, for whom they provide care, for where they work and for the issues they address. From ostracistion and harassment in the workplace to verbal threats and physical violence, hostilities can extend even into their private lives. In other words, as SRHR workers seek to fulfil the human rights of others, their own human rights are put at risk. Yet, as grave as that is, it is a reality largely undocumented and thus also underestimated. This scoping review sets out to marshal what is known about how hostilities against frontline SRHR workers manifest, against whom, at whose hands and in which contexts. It is based on review of six sources: peer-reviewed and grey literature, news reports, sector surveys, and consultations with sector experts and, for contrast, literature issued by opposition groups. Each source contributes a partial picture only, yet taken together, they show that hostilities against frontline SRHR workers are committed the world over-in a range of countries, contexts and settings. Nevertheless, the narratives given in those sources more often treat hostilities as \'one-off\', exceptional events and/or as an \'inevitable\' part of daily work to be tolerated. That works in turn both to divorce such incidents from their wider historical, political and social contexts and to normalise the phenomena as if it is an expected part of a role and not a problem to be urgently addressed. Our findings confirm that the SRHR sector at large needs to step-up its response to such reprisals in ways more commensurate with their scale and gravity.

Academic medicine faces difficulty recruiting and retaining a diverse workforce. The proportion of medical students who are underrepresented in medicine (URiM) is smaller than the proportion of URiMs in the general population, and these numbers worsen with each step up the academic medicine ladder. Previously known as the \"leaky pipeline,\" this phenomenon may be better understood as disparate \"pathways with potholes,\" which acknowledges the different structural barriers that URiM trainees and faculty face in academic medicine. This critical scoping review analyzed current literature to determine what variables contribute to the inequitable \"pathways and potholes\" URiM physicians experience in academic medicine.
The authors combined scoping review methodology with a critical lens. The comprehensive search strategy used terms about academic medicine, underrepresented groups, and leaving academic medical careers. One reviewer conducted screening, full-text review, and data extraction while in consultation with members of the research team. Data extraction focused on themes related to pathways and potholes, such as attrition, recruitment, and retention in academic medicine. Themes were iteratively merged, and quality of contribution to the field and literature gaps were noted.
Included papers clustered into attrition, recruitment, and retention. Those pertaining to attrition noted that URiM faculty are less likely to get promoted even when controlling for scholarly output, and a hostile work environment may exacerbate attrition. Recruitment and retention strategies were most effective when multipronged approaches changed every step of the recruitment and promotion processes.
These studies provide examples of various \"potholes\" that can affect representation in academic medicine of URiM trainees and faculty. However, only a few studies examined the link between isolating and hostile work environments, the so-called \"chilly climate,\" and attrition from academic medicine. Understanding these concepts is key to producing the most effective interventions to improve diversity in medicine.

UNASSIGNED: Anger is commonly experienced by family caregivers of people living with dementia yet its effect on caregivers\' physical health remains unknown.
UNASSIGNED: The primary aim of this study was to systematically review current evidence on the effects of anger and hostility on caregivers\' physical health.
UNASSIGNED: We searched Medline, EMBASE, PubMed, and PsycINFO up to January 2022. Two review authors independently extracted data on study characteristics, study quality, and effect sizes of associations of anger and hostility with caregiver health outcomes.
UNASSIGNED: We found eight studies examining the effects of anger and hostility on caregivers\' physical health reporting on a total of 937 participants, of which four were cross-sectional and four were longitudinal. Overall findings indicated that higher levels of anger and hostility exerted a negative effect on caregivers\' physical health. Higher anger control was longitudinally associated with increased weight gain (β= 1.13, p < 0.001), whereas higher anger out predicted higher glucose dysregulation at long-term follow-up (r = 0.27, p < 0.05). Higher levels of caregiver hostility were associated with increased risk of chronic low-grade inflammation long-term (r = 0.18, p < 0.05), and increased risk of cognitive decline over time (r = -0.16, p < 0.05).
UNASSIGNED: Our review provides the first systematic synthesis of the evidence demonstrating the harmful effects of anger and hostility on dementia caregivers\' health and highlights the need for preventative interventions to support family caregivers experiencing high levels of anger.

Short sleep duration has been linked to higher levels of aggression. To synthetize all available research on this association, a systematic review and meta-analysis was performed. We included observational and experimental studies, using various measures of sleep duration and aggression. Eighty eligible papers were identified, describing 82 studies comprising a total number of 76.761 participants. Meta-analysis of results was possible for 60 studies. Pooled observational results on the association between sleep duration and aggression showed a correlation estimate of -0.16 (95%CI -0.19, -0.12; I2 = 83.9%) and an odds ratio estimate of 1.83 (95%CI 1.47, 2.28; I2 = 0.0%). For experimental studies, the pooled Standardized Mean Difference after manipulation of sleep duration was -0.37 (95%CI -0.80, 0.05; I2 = 89.05%) for controlled designs and -0.34 (95%CI -0.54, -0.14; I2 = 89.05%) for pre-post designs. Effect estimates were stronger for individuals with psychological vulnerabilities and younger persons. Exclusion of studies with low methodological quality strengthened the effect estimate in experimental but not in observational studies. To conclude, short sleep duration is associated with higher levels of aggression, with observational research strongly supporting the association and experimental studies providing mixed results. More well-designed prospective and experimental studies are needed to establish causality and optimize treatment, especially for individuals with psychological vulnerabilities.

The relationship between amphetamine use and aggressive or violent behaviour is unclear. This review examined laboratory data collected in humans, who were administered an acute dose of amphetamine or methamphetamine, in order to investigate the link between amphetamines and aggression. It is registered with PROSPERO (CRD42019127711). Included in the analysis are data from twenty-eight studies. Behavioural and/or subjective measures of aggression were assessed in one thousand and sixty-nine research participants, with limited amphetamine-use histories, following a single amphetamine dose (0-35 mg). The available published evidence indicates that neither amphetamine nor methamphetamine acutely increased aggression as assessed by traditional laboratory measures. Future research should assess supratherapeutic amphetamine doses as well as include a broader range of multiple aggression measures, facilitating simultaneous assessment of the various components that comprise this complex, multifaceted construct.

Chronic relational trauma can lead to the formation of pervasively unintegrated attachment representations in adulthood, referred to as Hostile-Helpless (HH) states of mind. Individuals with this type of attachment disorganization evidence conflicting evaluations of caregivers and have difficulty reflecting on their traumatic childhood experiences. This scoping review is the first to systematically integrate the results of all empirical studies on HH states of mind in an effort to highlight the scientific and clinical contributions of the concept and guide future research. Following Arksey and O\'Malley\'s (2005) Methodological Framework, cross-reference keywords were searched in three databases (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). In total, 19 studies met inclusion criteria and were included in the synthesis. Results suggest that prevalence rates of HH states of mind increase as a function of adults\' psychosocial risk status. Findings also reveal that the long-term consequences of early trauma are greater in the presence of a HH state of mind, whereas the absence of a HH state of mind acts as a protective factor against the intergenerational transmission of maladaptation. Finally, results support the discriminant validity of the HH classification against other forms of attachment disorganization in adulthood. Research gaps and future research directions are discussed.
El trauma crónico de la relación puede llevar a la formación de representaciones de afectividad profundamente desintegradas en la edad adulta, conocidas como estados mentales Hostiles-Sin Ayuda. Los individuos con este tipo de afectividad desorganizada demuestran evaluaciones conflictivas de quienes les cuidan y tienen dificultades para reflexionar acerca de sus experiencias traumáticas de niñez. Este estudio de alcance comprensivo es el primero en integrar sistemáticamente los resultados de todos los estudios empíricos acerca de los estados mentales Hostiles-Sin Ayuda como un esfuerzo para subrayar las contribuciones científicas y clínicas del concepto y guiar la investigación futura. Siguiendo el Marco de Trabajo Metodológico de Arksey y O\'Malley\'s (2005), se investigaron palabras claves con enlaces de referencia en tres bases de datos (PsycArticles, Colección de Psicología y Ciencias del Comportamiento, ProQuest). En total, 19 estudios reunieron los criterios de inclusión y se les incluyó en la síntesis. Los resultados indican que los puntajes prevalentes de los estados mentales Hostiles-Sin Ayuda aumentan como una función del riesgo sicosocial de los adultos. Los resultados también revelan que las consecuencias a largo plazo del trauma temprano son mayores en presencia de un estado mental Hostil-Sin Ayuda, mientras que la ausencia de un estado mental Hostil-Sin Ayuda actúa como un factor de protección contra la transmisión intergeneracional de mal adaptación. Finalmente, los resultados apoyan la validez discriminante de la clasificación Hostil-Sin Ayuda contra otras formas de desorganización de la afectividad en la edad adulta. Se discuten los vacíos y el futuro de la investigación.
Le trauma relationnel chronique peut mener à la formation de représentations de l\'attachement non intégré omniprésent à l’âge adulte, auquel on fait référence en tant qu’états d\'esprit Hostile-Impuissant. Les individus avec de type de désorganisation d\'attachement font état d’évaluations contradictoires des personnes prenant soin d\'eux et ont des difficultés à réfléchir à leurs expériences traumatiques durant l\'enfance. Ce passage en revue est le premier à systématiquement intégrer les résultats de toutes les études empiriques sur les états d\'esprit Hostile-Impuissant pour essayer de mettre en évidence les contributions scientifiques et cliniques du concept et guider les recherches futures. En suivant la structure méthodologique de Arksey et O\'Malley (2005) les mots clés de référence croisée ont fait l\'objet d\'une recherche dans trois bases de données (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). Au total 19 études ont rempli les critères d\'inclusion et ont été inclues dans la synthèse. Les résultats suggèrent que les taux de prévalence d’états d\'esprit Hostile-Impuissant augmentent en tant que fonction du statut de risque psychologique des adultes. Les résultats révèlent aussi que les conséquences à long terme du trauma précoce sont plus grandes en présence d\'un état d\'esprit Hostile-Impuissant, alors que l\'absence d’état d\'esprit hostile-Impuissance agit en tant que facteur protecteur contre la transmission intergénérationnel de mal-adaptation. Enfin, les résultats soutiennent la validité discriminante de la classification Hostile-Impuissant par rapport à d\'autres formes de désorganisation de l\'attachement à l’âge adulte. Les écarts dans les recherches et des directions futures de recherches sont discutés.
Feindselig-hilflose Gemütszustände: Ein Überblick über Risikofaktoren, Korrelate und Folgen Chronische Beziehungstraumata können im Erwachsenenalter zur Bildung von durchgängig unintegrierten Bindungsrepräsentationen führen, die als feindselig-hilflose Gemütszustände (Hostile-Helpless states of mind) bezeichnet werden. Personen mit dieser Art von Bindungsstörung weisen widersprüchliche Bewertungen von Bezugspersonen auf und haben Schwierigkeiten, über ihre traumatischen Kindheitserfahrungen zu reflektieren. Diese Übersichtsarbeit ist die erste, die die Ergebnisse aller empirischen Studien über feindselig-hilflose Gemütszustände systematisch zusammenfasst, um die wissenschaftlichen und klinischen Beiträge des Konzepts hervorzuheben und richtungsweisend für künftige Forschung zu sein. In Anlehnung an den methodischen Rahmen von Arksey und O\'Malley (2005) wurden Querverweis-Schlüsselwörter in drei Datenbanken (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest) durchsucht. Insgesamt erfüllten 19 Studien die Einschlusskriterien und wurden in die Synthese aufgenommen. Die Ergebnisse deuten darauf hin, dass die Prävalenzraten feindselig-hilfloser Gemütszustände in Abhängigkeit vom psychosozialen Risikostatus im Erwachsenenalter zunehmen. Die Ergebnisse zeigen auch, dass die langfristigen Folgen früher Traumata bei Vorliegen eines feindselig-hilflosen Gemütszustands schwerer sind, während das Fehlen eines feindselig-hilflosen Gemütszustands als Schutzfaktor gegen die intergenerationale Weitergabe von Fehlanpassungen wirkt. Schließlich unterstützen die Ergebnisse die diskriminante Validität der Feindselig-Hilflos-Klassifikation gegenüber anderen Formen der Bindungsdesorganisation im Erwachsenenalter. Forschungslücken und zukünftige Forschungsrichtungen werden diskutiert.
無力/敵対的な心性 (Hostile-Helpless States of Mind) :リスク因子、相関、結果に関するスコーピングレビュー 要旨 慢性的な関係性トラウマは、大人になってから、無力/敵対的な心性Hostile-Helpless States of Mindと呼ばれる、広範に統合されていない愛着形成につながる可能性がある。このような無秩序な愛着型をもつ成人は、養育者に対する評価が相反し、トラウマとなった幼少期の経験を振り返ることが困難であると証明されている。このスコーピングレビューは、無力/敵対的な心性に関するすべての経験的研究の結果を系統的に統合し、この概念の科学的および臨床的な貢献を明らかにし、今後の研究の指針とすることを目的とした初めてのものである。Arksey and O\'Malley (2005) の方法論的枠組みに従い、3つのデータベース (PsycArticles、Psychology and Behavioral Sciences Collection、ProQuest) で相互参照キーワードを検索した。その結果、19の研究が対象基準を満たし、統合に含まれることになった。結果は、無力/敵対的な心性の有病率は、成人の心理社会的リスク状態の関数として増加することを示唆している。また、早期トラウマの長期的影響は、無力/敵対的な心性がある場合に大きく、一方、無力/敵対的な心性がない場合は、リスクの世代間伝達に対する防御因子として作用することが明らかになった。最後に、成人の他の愛着障害と無力/敵対的な心性分類の識別妥当性を支持する結果が得られた。研究ギャップと今後の研究の方向性について議論する。.
慢性关系创伤可导致成年期普遍的不协调依恋表现的形成, 称为“敌对无助”心理状态。具有这种类型的依恋紊乱的个体, 对看护者的评价是相互矛盾的, 并且很难反思他们的创伤性童年经历。本范围综述第一次系统地整合了所有关于“敌对无助”心理状态的实证研究结果, 以突出这一概念的科学和临床贡献, 并指导未来的研究。按照Arksey和O\'Malley (2005) 的“方法论框架”, 在三个数据库 (PsycArticles、Psychology and Behavioral Sciences Collection、ProQuest) 中搜索了交叉引用关键词。总共有19项研究符合纳入标准并被纳入综合研究。结果表明, “敌对无助”心理状态的患病率随着成年人的社会心理风险状况而增加。研究结果还表明, 当存在“敌对无助”心理状态时, 早期创伤的长期后果更大, 而没有“敌对无助”心理状态则可作为一种保护因素, 防止适应不良的代际传递。最后, 研究结果支持“敌对无助”分类对成年期其他形式依恋紊乱的区分效度。本文还讨论了研究的空白和未来的研究方向。.
الحالات العقلية المعادية-العاجزة : استقصاء منهجي لعوامل المخاطرة والارتباطات والعواقب يمكن أن تؤدي الصدمة العلائقية المزمنة إلى تكوين تمثيلات تعلق غير متكاملة في مرحلة البلوغ ، ويشار إليها على أنها حالات عقلية معادية - عاجزة. الأفراد الذين يعانون من هذا النوع من عدم تنظيم التعلق يُقدمون تقييمات متضاربة لمقدمي الرعاية ويواجهون صعوبة في التعليق على تجارب طفولتهم المؤلمة. هذه المراجعة المنهجية هي الأولى التي تدمج بشكل منهجي نتائج جميع الدراسات التجريبية على الحالات الذهنية المعادية العاجزة في محاولة لتسليط الضوء على المساهمات العلمية والاكلينيكية للمفهوم وتوجيه البحث المستقبلي. ووفقاً لإطار Arksey and O\'Malley (2005) المنهجي ، تم البحث عن الكلمات الرئيسية المرجعية في ثلاث قواعد بيانات (PsycArticles ، مجموعة علم النفس والعلوم السلوكية ، ProQuest). في المجموع ، حققت 19 دراسة معايير الاشتمال وتم تضمينها في التحليل. تشير النتائج إلى أن معدلات انتشار الحالات الذهنية المعادية العاجزة تزداد بالارتباط مع حالة الخطر النفسي والاجتماعي للبالغين. تكشف النتائج أيضًا أن العواقب طويلة المدى للصدمة المبكرة تكون أكبر في وجود حالة ذهنية معادية عاجزة ، في حين أن غياب الحالة الذهنية المعادية العاجزة يعمل كعامل وقائي ضد انتقال سوء التكيف بين الأجيال. أخيرًا ، تدعم النتائج الصلاحية التمييزية لتصنيف \"معاد-عاجز\" بالمقارنة مع الأشكال الأخرى من عدم تنظيم التعلق في مرحلة البلوغ. تناقش الدراسة الفجوات البحثية واتجاهات البحث المستقبلية.

Research suggests associations between trait anger, hostility, and type 2 diabetes and diabetes-related complications, though evidence from longitudinal studies has not yet been synthesized.
The present systematic review examined findings from longitudinal research on trait anger or hostility and the risk of incident type 2 diabetes or diabetes-related complications. The review protocol was pre-registered in PROSPERO (CRD42020216356).
Electronic databases (MEDLINE, PsychINFO, Web of Science, and CINAHL) were searched for articles and abstracts published up to December 15, 2020. Peer-reviewed longitudinal studies with adult samples, with effect estimates reported for trait anger/hostility and incident diabetes or diabetes-related complications, were included. Title and abstract screening, full-text screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale were conducted by two independent reviewers. A narrative synthesis of the extracted data was conducted according to the Synthesis Without Meta-Analysis guidelines.
Five studies (N = 155,146 participants) met the inclusion criteria. While results were mixed, our synthesis suggested an overall positive association between high trait-anger/hostility and an increased risk of incident diabetes. Only one study met the criteria for the diabetes-related complications outcome, which demonstrated a positive association between hostility and incident coronary heart disease but no significant association between hostility and incident stroke.
Based on the available longitudinal evidence, trait anger and hostility are associated with an increased risk of diabetes. Longitudinal studies are needed to investigate the association between trait-anger or hostility and the risk of diabetes-related complications.