Self-cutting and prospective repetition of self-harm: studies of emergency department presentations in Ireland

Background Self-harm places an individual at increased risk of future self-harm and suicide, and indicates distress and maladaptive coping. Those who present to hospital with self-cutting form a significant minority of self-harm patients who are at increased risk of prospective repetition of self-harm and suicide compared with those presenting with intentional overdose. In addition to increased risk, there is emerging evidence of demographic, psychological, clinical, and social differences between those presenting with self-cutting and those presenting with overdose. Aim and Key Objectives The aim of the current doctoral work was to examine in detail the association between presenting with self-cutting and risk of prospective repetition. The objectives were: to identify evidence-based risk factors for repetition of self-harm among those presenting to emergency departments with self-harm; to compare demographic and presentation characteristics and prospective repetition across presentations of self-cutting only, self-cutting plus intentional overdose, and intentional overdose only; to compare prospective repetition and other characteristics within self-cutting presentations based on the type of treatment received; to compare self-cutting and intentional overdose patients on psychological risk and protective factors for repetition; and to examine the lived experience of engaging in repeated overdose and self-cutting. Methods The current doctoral work used a mixed-methods approach and is comprised of one systematic review and four empirical studies. The empirical studies were two registry-based prospective studies of Irish hospital presentations of self-harm, one prospective structured interview study, and one qualitative study using Interpretative Phenomenological Analysis. Results The systematic review identified several consistent and emerging risk factors for repetition of self-harm, compared to which self-cutting had a medium-sized effect. The registry studies demonstrated that the involvement of self-cutting, particularly less medically severe selfcutting, confers an increased risk of 1-month and 12-month repetition among Irish index selfharm presentations. The structured psychological study detected higher hopelessness and lower non-reactivity to inner experience among those presenting with self-cutting, and higher depression among those who repeated self-harm. Repeaters had lower baseline levels of protective psychological factors than non-repeaters and continued to have higher depression and hopelessness at follow-up. Finally, the qualitative study indicated that self-harm is a purposeful action taken in response to an overwhelming situation and is evaluated afterwards in terms of personal and social effects. Chosen method of self-harm seemed to be influenced by the desired outcome of the self-harm act, capability, accessibility and previous experience. Conclusion Despite limitations in terms of recruitment rates, the work presented in this thesis is innovative in examining the issue of the association between self-cutting and repetition from multiple perspectives. No one factor can reliably predict all repetition but self-cutting represents one consistent and easily detected risk factor for repetition. Those who present with self-cutting exhibit significant differences on demographic, clinical, and psychological variables compared with those presenting with intentional overdose, and seem to exhibit a more vulnerable profile. However, those who present with self-cutting do not form a discrete or homogenous group, and self-harm methods and levels of suicidal intent are liable to fluctuate over time.

Synergy between Piezo1 and Piezo2 channels confers high-strain mechanosensitivity to articular cartilage.

Diarthrodial joints are essential for load bearing and locomotion. Physiologically, articular cartilage sustains millions of cycles of mechanical loading. Chondrocytes, the cells in cartilage, regulate their metabolic activities in response to mechanical loading. Pathological mechanical stress can lead to maladaptive cellular responses and subsequent cartilage degeneration. We sought to deconstruct chondrocyte mechanotransduction by identifying mechanosensitive ion channels functioning at injurious levels of strain. We detected robust expression of the recently identified mechanosensitive channels, PIEZO1 and PIEZO2. Combined directed expression of Piezo1 and -2 sustained potentiated mechanically induced Ca(2+) signals and electrical currents compared with single-Piezo expression. In primary articular chondrocytes, mechanically evoked Ca(2+) transients produced by atomic force microscopy were inhibited by GsMTx4, a PIEZO-blocking peptide, and by Piezo1- or Piezo2-specific siRNA. We complemented the cellular approach with an explant-cartilage injury model. GsMTx4 reduced chondrocyte death after mechanical injury, suggesting a possible therapy for reducing cartilage injury and posttraumatic osteoarthritis by attenuating Piezo-mediated cartilage mechanotransduction of injurious strains.

La contribution des attentes et de l'expérience passée sur l'analgésie par placebo

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Team Building Interventions in Sport: A Meta-Analysis

A meta-analysis of team building interventions in sport was completed. Seventeen studies containing 180 effect sizes were retrieved. The overall effect (Hedges g) was .427. Analyses of possible moderator variables showed the largest effect sizes were in interventions where: (a) non-experimental designs were used (g=.474); (b) the data were unpublished (g=.539); (c) goal setting only was used (g=.714); (d) the coach/manager directed the delivery (g=.446); and (e) the teams were at the university level (g=.482). Finally, team building had the greatest influence on cognitions (g=.799

THE DARK PERSONALITY AND JOB SUCCESS IN THE UNITED STATES ARMY: USE OF INTERPERSONAL MANIPULATION IN THE WORKPLACE

This dissertation relates job desires and outcomes to the Dark Personality (Psychopathy, Machiavellianism, Narcissism, Low Agreeableness, Low Honesty-Humility) in the United States Army. It purports that individuals high on the Dark Personality desire more power, money, and status, and that they obtain jobs that afford them these luxuries by using manipulation at work. Two pilot studies used samples of United States Army members to create and test index variables: Dark Personality, Total Manipulation in the workplace, Desire for Job Success, and Total Job Success in the Army. Individual personality traits, manipulation tactics, and job desires were examined in secondary analyses. Using a sample of 468 United States Army Members, central analyses indicated that Army members high on the Dark Personality desired Job Success. Likewise, army members higher on the Dark Personality used more Manipulation tactics at work, including the egregious tactics. Yet, using more Manipulation tactics at work predicted lower levels of Job Success in the Army. Most manipulation tactics had a negative impact on Job Success, with the exception of soft tactics like Reason and Responsibility Invocation. Together, these results indicate that selective use of soft manipulation predicted Job Success, but use of more manipulation tactics predicted less Job Success in the Army. Curvilinear results indicated that being either very low or very high on the Dark Personality predicted more Job Success in the Army, whereas having intermediate levels of the Dark Personality predicted less Job Success. Finally, possessing the Dark Personality and using more Manipulation tactics at work, together, predicted less Job Success in the Army. Collectively, the results indicate that army members with intermediate levels of the Dark Personality want more powerful and high paying jobs, yet their strategy of manipulating their coworkers to move up the job ladder does not result in higher ranking, higher paying Army positions. However, Army members highest on the Dark Personality achieved job success, defying the maladaptive influence that antisocial personality traits and manipulative behaviour had on job success for most Army members. Therefore, this dissertation indicates that successful corporate scoundrels exist in the Army, but there are few of them.

A Group-Enhanced Sprint Interval Training Program for Amateur Athletes

Sprint interval training (SIT) can elicit improvements in aerobic and anaerobic capacity. While variations in SIT protocols have been investigated, the influence of social processes cannot be overlooked. As research supports the use of groups to influence individual cognitions and behaviours, the current project assessed the effectiveness of a group-based intervention with participants conducting SIT. Specifically, 53 amateur athletes (age, 21.9 ± 2.9 years; 53% females) took part in a 4-week training program (3 sessions per week, 30-s “all-out” efforts with 4 min active recovery, repeated 4–6 times per session), and were assigned to “true group”, aggregate, or individual conditions. Results indicated no significant differences between groups for the physiological measures. With regards to training improvements from baseline for all participants— regardless of condition — significant main effects for time were identified for maximal oxygen uptake (2.5–2.8 mL·kg−1·min−1, p < 0.001, η2 = 0.03), time-trial performance (14–32 s, p < 0.001, η2 = 0.37), and anaerobic power (1.1–1.7 k·h−1, p < 0.001, η2 = 0.66). With regards to the psychological measures, significant main effects between groups were found for motivation (p = 0.033, η2 = 0.13), task self-efficacy (p = 0.018, η2 = 0.15), and scheduling self-efficacy (p = 0.003, η2 = 0.22). The true group experienced greater improvements in motivation than the individual condition, but the aggregate and individual conditions demonstrated greater increases in task and scheduling self-efficacy. Though the SIT paradigm employed induced training improvements similar to previous work, the group intervention was not able to further these improvements

Motion Sickness

Over 2000 years ago the Greek physician Hippocrates wrote, “sailing on the sea proves that motion disorders the body.” Indeed, the word “nausea” derives from the Greek root word naus, hence “nautical,” meaning a ship. The primary signs and symptoms of motion sickness are nausea and vomiting. Motion sickness can be provoked by a wide variety of transport environments, including land, sea, air, and space. The recent introduction of new visual technologies may expose more of the population to visually induced motion sickness. This chapter describes the signs and symptoms of motion sickness and different types of provocative stimuli. The “how” of motion sickness (i.e., the mechanism) is generally accepted to involve sensory conflict, for which the evidence is reviewed. New observations concern the identification of putative “sensory conflict” neurons and the underlying brain mechanisms. But what reason or purpose does motion sickness serve, if any? This is the “why” of motion sickness, which is analyzed from both evolutionary and nonfunctional maladaptive theoretic perspectives. Individual differences in susceptibility are great in the normal population and predictors are reviewed. Motion sickness susceptibility also varies dramatically between special groups of patients, including those with different types of vestibular disease and in migraineurs. Finally, the efficacy and relative advantages and disadvantages of various behavioral and pharmacologic countermeasures are evaluated.

Duelo, ansiedad y depresión en familiares de pacientes en una unidad de cuidados paliativos a los dos meses de la pérdida

Aim: This study is going to assess the prevalance of prolonged grief diagnoses and it will evaluate the severity of the symptoms of depression, anxiety and complicated grief two months after a loved one is lost. We also intend to study which variables associated with the risk of grief could be more decisive when diagnosing it, its symptoms and the consequent emotional distress.Method: A total of 66 families of patients in the Palliative Care Unit (PCU) at Hospital San Cecilio in Granada have been evaluated. Measurements were taken two months after the death. This investigation has explored the existing emotional distress using the following questionnaires: Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), Inventory of Complicated Grief (ICG) and Prolongued Grief Disorder (PG-12).Results: The results show that 33.3% and 21.21% of the sufferers had high levels of depression and clinical anxiety two months after the death. The prevalence of prolongued grief diagnoses, according to the PG-12, is 10.6% and 53.03% of the participants showed symptoms of complicated grief according to the ICG. Additionally, statistically significant differences are found in the sufferers with and without a prolongued grief diagnosis and scores in the ICG and BDI-II. The family’s financial situation is linked to the presence of symptoms of anxiety and depression and complicated grief, with the most determining variable being the risk of grief. Finally, the greater the age of the deceased and the longer the time spent in the PCU is linked to fewer symptoms of grief. However, important links have been found between the sufferers who have experienced stressful critical events prior to losing their loved one, with symptoms of depression, anxiety and complicated grief.Conclusions: The high numbers of cases of symptoms of complicated grief and levels of anxiety and clinical depression two months after a death suggests that early interventions should be carried out in those individuals with greater vulnerability.

Plasticity varies with boldness in a weakly-electric fish

The expression of animal personality is indicated by patterns of consistency in  individual behaviour. Often, the differences exhibited between individuals are consistent across situations. However, between some situations, this can be biased by variable levels of individual plasticity. The interaction between individual plasticity and animal personality can be illustrated by examining situation-sensitive personality traits such as boldness (i.e. risk-taking and exploration tendency). For the weakly electric fish Gnathonemus petersii, light condition is a major factor influencing behaviour. Adapted to navigate in low-light conditions, this species chooses to be more active in dark environments where risk from visual predators is lower. However, G. petersii also exhibit individual differences in their degree of behavioural change from light to dark. The present study, therefore, aims to  examine if an increase of motivation to explore in the safety of the dark, not only affects mean levels of boldness, but also the variation between individuals, as a result of differences  in individual plasticity.  Results: Boldness was consistent between a novel-object and a novel-environment situation in bright light. However, no consistency in boldness was noted between a bright (risky) and a  dark (safe) novel environment. Furthermore, there was a negative association between boldness and the degree of change across novel environments, with shier individuals  exhibiting greater behavioural plasticity.  Conclusions: This study highlights that individual plasticity can vary with personality. In  addition, the effect of light suggests that variation in boldness is situation specific. Finally,  there appears to be a trade-off between personality and individual plasticity with shy but  plastic individuals minimizing costs when perceiving risk and bold but stable individuals  consistently maximizing rewards, which can be maladaptive.

A dyadic perspective on genito-pelvic pain : trauma antecedents and treatment effectiveness

La vestibulodynie provoquée (VP) est la forme la plus répandue de douleur génito-pelvienne/trouble de la pénétration et la cause la plus fréquente de douleur vaginale chez les femmes pré-ménopausées. Les femmes qui en souffrent rapportent plus de détresse psychologique ainsi qu’un fonctionnement sexuel appauvri, une diminution de la fréquence des activités sexuelles et du plaisir, et plus d’attitudes négatives à l’égard de la sexualité. Les recherches portant sur les couples souffrant de VP ont montré le rôle prépondérant des variables relationnelles dans la modulation des conséquences sexuelles et psychologiques pour les femmes et leurs partenaires. Cependant, aucune analyse dyadique n’a été appliquée au facteur de risque étiologique le plus robuste, soit la maltraitance durant l’enfance. Par ailleurs, malgré des recommandations répétées pour inclure le partenaire dans le traitement psychologique pour la VP, aucune étude à ce jour n’a examiné l’efficacité d’une psychothérapie qui inclut systématiquement le partenaire et dont la cible est le couple. L’objectif général de cette thèse a été d’utiliser une perspective dyadique afin d’examiner les antécédents de maltraitance et l’efficacité d’une intervention conçue pour améliorer les issues des couples souffrant de VP. Le premier article vise à examiner les liens entre la maltraitance durant l’enfance des femmes souffrant de VP et leurs partenaires, et leur fonctionnement sexuel, leur ajustement psychologique, leur satisfaction conjugale et enfin avec la douleur rapportée par les femmes durant les relations sexuelles. Quarante-neuf couples souffrant de VP ont complété des questionnaires auto-rapportés. La maltraitance durant l’enfance chez les femmes était associée à un fonctionnement sexuel plus faible chez les femmes et les hommes, une augmentation de l’anxiété chez les femmes seulement, et une douleur affective accrue durant les relations sexuelles. La maltraitance durant l’enfance chez les hommes était associée à un fonctionnement sexuel plus faible, moins de satisfaction conjugale, plus d’anxiété chez les femmes et les hommes, et une douleur affective accrue durant les relations sexuelles rapportée par les femmes. En se basant sur les recommandations issues des études empiriques, une thérapie cognitive et comportementale pour les couples (TCCC) souffrant de VP a été développée. Le deuxième article présente les résultats d’une étude pilote testant son efficacité, fidélité et faisabilité potentielles. Neuf couples ont complété des questionnaires auto-rapportés pré- et post-traitement. La TCCC de 12 rencontres était manualisée. Les femmes ont rapporté une amélioration significative de la douleur, du fonctionnement et de la satisfaction sexuels, et les partenaires ont rapporté une amélioration significative de leur satisfaction sexuelle. Les couples ont rapporté des niveaux élevés de satisfaction quant à la psychothérapie, et les psychothérapeutes ont rapporté suivre le manuel de traitement de manière fidèle. Le troisième article, s’appuyant sur les résultats prometteurs de l’étude pilote, décrit le protocole de recherche pour un essai clinique randomisé mesurant l’efficacité de la TCCC comparée à une intervention médicale de première ligne, la lidocaïne topique, pour le traitement de la VP. Enfin, les implications cliniques et théoriques de la thèse sont discutées.

Vinculação, Estilos Educativos Parentais e Esquemas Precoces Mal Adaptativos em Reclusos

Introdução: Sobretudo estudos internacionais focam a importância da vinculação e dos estilos educativos parentais no desenvolvimento de comportamentos delinquentes e antissociais. Em Portugal, alguns estudos focados na população reclusa, analisam, separadamente, estilos educativos parentais, personalidade e esquemas precoces mal adaptativos mas, segundo sabemos, nenhum explora, simultaneamente, a vinculação, os estilos educativos parentais e os esquemas precoces mal adaptativos nesta população. São nossos objetivos caracterizar uma amostra de reclusos quanto à vinculação em diferentes relacionamentos, estilos educativos parentais e esquemas precoces mal adaptativos (EPM) e, sobretudo, explorar associações entre estas três variáveis (e destas com variáveis sociodemográficas, familiares, clínicas e relativas à pena). Metodologia: 44 reclusos do sexo masculino (M = 37,3 anos; DP = 10,98; variação = 23-67) preencheram voluntariamente um questionário sociodemográfico e os seguintes instrumentos: EMBU – Memórias de Infância, Experiências em Relações Próximas - Questionário de Estruturas Relacionais e Questionário de Esquemas de Young (QEY). Resultados: Verificou-se, quanto às associações entre vinculação e estilos educativos parentais que: menor suporte emocional paterno associou-se a maior evitamento pai, evitamento mãe e evitamento companheira; menor suporte emocional materno associou-se a maior evitamento mãe, evitamento pai, ansiedade mãe e ansiedade pai; maior rejeição paterna associou-se a maior evitamento mãe, evitamento pai, ansiedade mãe e ansiedade pai; maior rejeição materna associou-se a maior evitamento pai e evitamento mãe. No que toca às associações entre as dimensões de vinculação e EPM, é de enfatizar a associação positivas entre os EPM do domínio distanciamento e rejeição com o evitamento mãe, ansiedade mãe e ansiedade pai, particularmente, os EPM de abandono, desconfiança/abuso e isolamento social, por consistentemente se associaram às dimensões de vinculação. No domínio autonomia e desempenho deteriorados, o fracasso e a dependência/incompetência associaram-se positivamente ao evitamento mãe, a dependência/incompetência à ansiedade pai e o fracasso ao evitamento companheira. Quanto ao domínio limites deteriorados, a grandiosidade associou-se positivamente à ansiedade pai. No domínio vigilância e inibição o pessimismo/negativismo correlacionou-se positivamente com a ansiedade mãe e pai e a autopunição com a ansiedade mãe. Quanto às associações entre dimensões de estilos educativos parentais e os EPM, o domínio distanciamento e rejeição apresentou, de novo resultados relevantes: menores níveis de suporte emocional materno associaram-se a maiores níveis de privação emocional; maiores níveis de rejeição e sobreproteção materna e paterna a maiores os níveis de abandono; maiores níveis de rejeição materna e paterna a maiores níveis de desconfiança/abuso; maiores níveis de rejeição materna e sobreproteção materna e paterna a maiores níveis de isolamento social; maiores níveis de rejeição e sobreproteção paterna a maiores níveis de defeito. Enfatiza-se, também, a associação entre níveis maiores de rejeição paterna e os EPM de grandiosidade, padrões excessivos e pessimismo. Maiores níveis de rejeição materna associaram-se a maiores níveis de pessimismo e autopunição. Discussão: Embora numa amostra pequena, este estudo explorou, pela primeira vez, numa amostra de reclusos portugueses, em simultâneo, associações entre a vinculação, os estilos educativos parentais e os esquemas precoces mal adaptativos. O domínio esquemático distanciamento e rejeição parece ser o mais influenciado pela vinculação estabelecida em diferentes relacionamentos e pelos estilos educativos parentais. / Introduction: Mainly international studies focus on the importance of attachment and parental rearing styles in the development of delinquent and antisocial behaviors. In Portugal some studies focused in the inmate population analyze, separately, parental rearing styles, personality and early maladaptive schemas but, to our knowledge, none simultaneously explores attachment, parental rearing styles and early maladaptive schemas in this population. It is our objective to characterize a sample of inmates concerning attachment in different relationships, parental rearing styles and early maladaptive schemas (EMS) and, above all, explore associations between this three variables (and also with sociodemographic, family, clinic and sentence related variables). Methodology: 44 male inmates (M = 37,3 years; SD = 10,98; variation = 23-67) voluntarily filled in a sociodemographic questionnaire and the following instruments: EMBU – Childhood Memories, Experiments in Close Relationships – Structural Relationship Form and the Young Schema Questionnaires (YSQ) Results: we verified, regarding associations between attachment and parental rearing styles that: less paternal emotional support associated with higher father avoidance (in attachment), mother avoidance and partner avoidance; less maternal emotional support associated with higher mother avoidance, father avoidance, mother anxiety and father anxiety; higher paternal rejection associated with higher mother avoidance, father avoidance, mother anxiety and father anxiety; higher mother rejection associated with father avoidance and mother avoidance. Regarding associations between attachment dimensions and EMS, we emphasize positive associations between EMS in the disconnection and rejection domain with mother avoidance, mother anxiety and father anxiety, particularly, the abandonment, distrust/abuse and social isolation EMS, as they were consistently associated with the this attachment dimension. In the impaired autonomy and performance domain, the failure and dependency/incompetence EMS are positively associated with mother avoidance, the dependence/incompetence EMS to father anxiety and failure to partner avoidance. About the impaired limits domain, grandiosity EMS positively associated with father anxiety. In the overvigilance and inhibition domain, pessimist/negativism EMS positively correlated with mother and father anxiety and self-punishment EMS with mother anxiety. About the associations between parental rearing styles and the EMS, the disconnection and rejection domain presented again relevant results: lower levels of maternal emotional support associated with higher levels of emotional deprivation; higher levels of maternal and paternal rejection and overprotection associated with higher levels of abandonment; higher levels of maternal and paternal rejection associated with higher levels of distrust/abuse; higher levels of maternal rejection and maternal and paternal overprotection associated with higher levels of social isolation; higher levels of paternal rejection and overprotection associated with higher levels of defectiveness. We also emphasize the association between higher levels of paternal rejection and the grandiosity, excessive patterns and pessimism EMS. Higher levels of maternal rejection associated with higher levels of pessimism and self-punishment EMS. Discussion: Although in a small sample, this study explored, for the first time, in sample of Portuguese inmates, simultaneously, the associations between attachment, parental rearing styles and early maladaptive schemas. The schematic domain of disconnection and rejection seems to be the most influenced by the established attachment in different relationships and by parental rearing styles.

Wearing Eye Tracking Technology During Batting Practice: Assessing the Experiences of Professional Baseball Athletes

Utilizing wearable technology in sport allows for the collection of motor behavior data during task engagement. This data can be assessed in real-time or retrospectively. Although enriching the scope of performance data, the consequences of wearable technology on the athlete-user, specifically the cognitive effects, has not been fully investigated, hence the purpose of this study. This qualitative study examines the cognitions of 57 professional baseball players who wore eye tracking technology whilst engaged in batting practice. Their verbal self-reports were framed by temporal context: before-during-after task. Three themes emerged during the pre-task segment: social appearance anxiety, claimed self-handicapping, and curiosity. During the task of batting, verbal behavior contained motivational and instructional overt self-talk while claimed self-handicapping was sustained. The final, post-performance segment was marked by the re-emergence of curiosity from the pre-task period as well as self-evaluation/appraisal. Given the participants were professional athletes, their performance has greater career implications than amateur competitors. Nonetheless, the verbal behavior elicited while wearing eye tracking technology indicates an awareness of the equipment by the user. This study found cognitive effects from wearable technology; more research is required to under-stand the scope and nature of those effects on cognitive and motor behaviors.

Évaluation des effets d'un programme d'éveil sensoriel au goût sur la reconnaissance d'aliments, les attitudes et le comportement alimentaire d'enfants dans la région de Sherbrooke

Manger est un geste davantage relié aux sensations plutôt qu’aux cognitions. Les ateliers Les aventuriers du goût constituent l’objet de cette évaluation qui cible les enfants âgés de 5 à 7 ans en milieu scolaire dans la région de Sherbrooke. Les objectifs de l’étude sont de décrire 1) les effets des ateliers sur la reconnaissance des aliments, l’envie de goûter et le comportement alimentaire quant à la diversité du choix alimentaire, et de décrire 2) le comportement alimentaire des enfants tel que perçu par leurs parents. Un devis mixte d’évaluation comportant des observations faites avant et après les ateliers avec groupe témoin a été utilisé. Il en ressort que les ateliers ont favorisé la reconnaissance des aliments et l’attitude envers l’envie de goûter à de nouveaux aliments. L’éveil sensoriel au goût semble une avenue prometteuse pour favoriser la reconnaissance d’aliments, encourager la diversité ainsi que l’acquisition de saines habitudes alimentaires.

A Biocultural Examination of Student Learning Behaviors in Large Undergraduate Lectures

Thesis (Ph.D.)--University of Washington, 2016-08

A qualitative study of the emotional coping and support needs of children living with a parent with a brain injury

Primary objective: To examine emotional coping and support needs in children of persons with acquired brain injury, with a view to understanding what interventions would be helpful for these children. Design: The study was qualitative, using a thematic analysis approach. Methods and procedure: Six children between 9 and 18 years of age, six parents (three with ABI), and three support workers were interviewed either at home or at a support centre, using a semi-structured interview guide. Results: Children reported using a variety of adaptive and maladaptive emotional coping strategies, but were consistent in expressing a need for credible validation, i.e. sharing experiences with peers. The results are presented under four overarching themes: difficulties faced; emotions experienced; coping strategies; and reported support needs. Conclusions: The results reveal an interaction between the child’s experiences of complex loss that is difficult to acknowledge, emotional distancing between parent and child, and the children’s need for credible validation. All children expressed a desire for talking to peers in a similar situation to themselves, but had not had this opportunity. Interventions should set up such peer interaction to create credible validation for the specific distress suffered by this population.