The structure and dynamics of worry: theory, measurement, and cross-national replications

This article presents a comprehensive conceptualization of the structure of worry and the relation of worry to mental health and well-being. It is assumed that worries have two facets, namely, the object of a worry (e.g., self, close others, society, the world) and the domain of a worry (the field of life with which it is concerned). The object of a worry is presumed to be more important than its domain in determining the impact of worries on mental health. Only worries concerned with self and close others (micro worries) are expected to be related to poor mental health, whereas worries about society or the entire world (macro worries) are expected to be positively related to mental health. An instrument is introduced to study worries in accordance with the proposed structure. Its validity is tested by two confirmatory techniques (similarity structure analysis and confirmatory factor analysis) in samples from Israel, West Germany, and (the former) East Germany. Worry scores are also related to five mental health indicators. Results show that across samples micro and macro worries can validly be distinguished. Micro worries are strongly related to poor mental health, whereas macro worries are unrelated to mental health or relate marginally to positive well-being.     

Improving Employees’ Work-Life Balance in the Construction Industry: Project Alliance Case Study

Work-life conflict has a damaging effect on job satisfaction, organizational commitment, productivity turnover, and absenteeism. On an individual level, work-life conflict is associated with employee burnout, mental health issues, substance abuse, and diminished family functioning. Thus, work-life balance is an important issue to the construction industry, in terms of both organizational effectiveness and occupational health. Long and inflexible work hours are the most consistent predictor of work-life conflict among construction employees, particularly those working on-site or in a project office. There is considerable resistance to the adoption of new ways of scheduling work within the industry. This paper describes the post hoc evaluation of a compressed work week (reducing the length of the working week, but increasing the length of the working day) in a case study project alliance in Queensland, Australia. Quantitative and qualitative data are presented to demonstrate the beneficial impact of the initiative on employees’ work-life balance. The evaluation provides prima facie evidence that alternative work schedules can improve construction employees’ work-life balance, creating benefits for construction employees and organizations. The paper concludes that project alliances provide an ideal environment in which work-life balance initiatives can help to create high-performance work systems in the construction sector.     

Promoting adolescent mental health in primary care: a review of the literature

High levels of psychological disturbance amongst adolescents have been linked to behaviours which can damage physical health, and with mental health problems in adulthood. The aim of this review was to see if published literature supports the hypothesis that primary care is a suitable setting in which mental health problems in adolescents can be prevented by early detection and treatment. Medline, BIDS, SIGLE and Psychlit databases (January 1990-February 1997) were systematically searched for English language studies on adolescent health promotion and mental health in primary care; reference sections were checked for earlier work. When offered, adolescent health checks and clinics have been well received with attendance rates of 73% and 83% reported, respectively. Primary care offers a setting for the prevention and detection of mental health problems in adolescents. Further research is needed to determine cost effective ways of using these opportunities.     

Work-Family Conflict in Construction: Case for a Finer-Grained Analysis

A multidimensional work-family conflict (WFC) scale was tested using a sample of 169 workers in the Australian construction industry. The construction sample showed higher mean scores for time-based, strain-based, and behavior-based work-interference with family (WIF) than scores reported in international studies that have used the multidimensional scale. Waged construction workers, who work on-site in direct construction activity, reported higher levels of time-based and strain-based WIF than salaried workers, who work predominantly in office-based roles. Mean levels of family-interference with work (FIW) in the construction sample were generally comparable to levels reported in previous research. A principal components analysis revealed four clear dimensions of WFC. These dimensions were significantly correlated with other variables of theoretical relevance indicating acceptable criterion validity. The experience of WIF varied by workers’ employment situation, sex, and work location, while the experience of FIW varied by workers’ age. The results suggest that the use of global measures of WFC might mask important differences in construction workers’ experiences at the work-family interface.     

Job Strain, Job Insecurity, and Health: Rethinking the Relationship.

Job strain (high demands and low control) is a widely used measure of work stress. The authors introduce a new way of looking at work stress by combining job strain with job insecurity, a combination increasingly prevalent in contemporary economies, using data from a cross-sectional survey (N = 1,188) of mid-aged Australian managers and professionals. Those reporting both strain and insecurity showed markedly higher odds for mental and physical health problems (depression: odds ratio [OR] 13.88, 95% confidence interval [CI] 5.67-34.01; anxiety: OR 12.88, CI 5.12-32.39; physical health problems: OR 3.97, CI 1.72-9.16; and poor self-rated health: OR 7.12, CI 2.81-18.01). Job strain and insecurity showed synergistic associations with health, and employees experiencing both could be at heightened health risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and law enforcement professionals: Trauma history, psychological symptoms, and impact of providing services to child sexual abuse survivors.

A survey of 558 mental health and law enforcement professionals assessed current and past trauma experiences, exposure to traumatic client material, and the sequelae of both of those types of personal and professional trauma experiences. Results indicated that 29.8% of therapists and 19.6% of officers reported experiencing some form of childhood trauma. The 2 groups differed in their reports of psychological symptoms, trauma-specific symptoms, and work-related posttraumatic stress disorder (PTSD) symptoms. There was some evidence that professionals with a history of child abuse reported significantly higher levels of symptoms that have been associated with trauma survivors in past research. However, more proximal variables seem to have greater relevance to current functioning. The implications for training and prevention of secondary traumatization are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health professionals versus non-mental-health professionals: Childhood trauma and adult functioning.

Research on childhood family environments of mental health professionals suggests that therapists are often raised in dysfunctional families and experience significant psychological distress in adult life. This study examined the prevalence of childhood trauma, family dysfunction, and current psychological distress among female mental health professionals (N?=?340) and compared it with the prevalence among women working in other professions (N?=?2,623). Psychotherapists reported higher rates of physical abuse, sexual molestation, parental alcoholism, psychiatric hospitalization of a parent, death of a family member, and greater family dysfunction in their families of origin than did other professionals. As adults, psychotherapists experienced less anxiety, depression, dissociation, sleep disturbance, and impairment in interpersonal relationships than did women in professions other than mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Afferent mechanism of cortical myoclonus studied by proprioception-related SEPs

This questionnaire study examined perceived sources of stress and satisfaction at work among 121 mental health staff members. Five factors were derived from principal component analysis of sources of work stress items (stress from: role, poor support, clients, future, and overload), and accounted for 70% of the total variance. Four factors were derived from the items related to sources of job satisfaction (satisfaction from: career, working with people, management, and money), accounting for 68% of the variance. The associations of these factors with sociodemographic and job characteristics were examined, and they were entered as explanatory variables into regression models predicting mental health, burnout, and job satisfaction. Stress from "overload" was associated with being based outside an in-patient ward, and with emotional exhaustion and worse mental health. Stress related to the "future" was associated with not being white. Stress from "clients" was associated with the "depersonalization" component of burnout. Higher job satisfaction was associated with "management" and "working with people" as sources of satisfaction, whereas emotional exhaustion and poorer mental health were associated with less "career" satisfaction.     

Specific developmental disorders. The language-learning continuum

The goal of this article is to inform and educate those who work with children who present with language-learning disorders about phonologic processing deficits, because this area has been shown to have a significant impact on children and adults who exhibit reading disabilities. Mental health professionals who work with children with reading problems need to be aware of what is known about this source of reading disorders and the implications of this knowledge for prevention and treatment. Advocating for appropriate instruction for children with reading problems is an important role mental health professionals can play in working with this population.     

Aging, mental health, and demographic change: Challenges for psychotherapists.

People are living longer, and in better health, than in any prior point in history, with far-reaching but as yet underrecognized implications for mental health professionals. This phenomenon affects both the developed and the developing world. With greater numbers of older people, mental health professionals will need to develop greater awareness, understanding, and appreciation of gerontology to deliver optimally effective psychotherapy with this population. The nature of psychological issues encountered in clinical practice will also change—for example, intergenerational issues among blended families, increased retirement and leisure time, and expectations of greater health and productivity in later life from baby boomer cohorts. These issues are important for mental health professionals to recognize, as the increased sophistication of the baby boomer generation in terms of health care will lead to higher expectations of mental health care. The authors have chosen to discuss the implications of an ageing population with reference to a cognitive–behavioral perspective, but the issues raised here and practical suggestions contained within this article are not restricted to practitioners of Cognitive–Behavior Therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Customer driven mental healthcare and the role of the mental healthcare consultant.

Health care, including mental health care (MHC), is in the midst of revolutionary change. The simultaneous demands for increasing quality and constraining costs have necessitated the search for a new service delivery paradigm. The Total Quality Management model has been introduced into health care under the term Continuous Quality Improvement. In order to meet the demands being placed on it, MHC is beginning to introduce the "patient-customer" into its quality improvement programs. The transition to a customer driven framework will be a difficult one for many MHC practitioners. MHC consultants (i.e., consultants with knowledge of organizational processes and MHC issues) can facilitate this transition by helping MHC administrators and practitioners align around the goal of improved quality of care, defined in terms of both patient outcome and patient satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consultation and training with school-based crisis teams.

Schools often bring outside mental health consultants to provide postcrisis counseling after a suicide or another tragedy. This article describes a different role for consultants who specialize in this type of work: training school personnel to provide this valuable service themselves. It is argued that training school-based personnel to provide postcrisis counseling results in greater value to a school system than does direct service provision by an outside consultant. The author's experience as mental health consultant to a large urban/suburban school district's crisis team is used to illustrate various training techniques that can be used and benefits that can be derived from this type of consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental Health Professionals' Disability Competence: Measuring Self-Awareness, Perceived Knowledge, and Perceived Skills.

Objective: To describe mental health professionals' self-reported competence when working with clients with disabilities. Study Design: Survey administered with a measure of social desirability. Participants and Setting: One hundred eight professionals in counseling offices, disability services offices, and doctoral counseling programs. Main Outcome Measure: Competence as self-reported on the Counseling Clients With Disabilities Survey (CCDS). Results: CCDS scores paralleled participants' disability experience. Participants reported most competence in awareness, less competence in knowledge, and least competence in skills. Neither socially desirable responding nor years of experience accounted for these results. Conclusions: Findings indicate the need for mental health professionals to develop (a) awareness/beliefs/attitudes toward disability, (b) knowledge of disability and disability-related issues, and (c) skills/behaviors working with clients with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference issues in crisis work with natural disaster victims.

Effects of trauma work on mental health workers and intervention methods were studied in a group of American mental health professionals who volunteered to provide crisis intervention and a group of Armenian counselors-in-training who were themselves victims of the catastrophic 1988 earthquake in Soviet Armenia. American clinicians' reactions were addressed through psychodynamic peer support group meetings, while a didactic experiential group instruction program resulted in changes in the posttraumatic stress disorder (PTSD) and depression symptoms of indigenous counselors. Issues related to intergenerational trauma, seeing self as victim, repetition compulsion, and assigned roles in the therapeutic relationship are addressed. Benefits of group process in trauma work, training issues, and implications for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping, negative affectivity, and the work environment: Additive and interactive predictors of mental health.

The present study tested the hypothesis that direct coping would moderate relations between work stress and mental health outcome, whereas suppression (a form of emotion-focused coping) would show an overall effect on outcome. Data on coping, perceived work demand and support, and affective symptoms were obtained from trainee teachers (N?=?157). The results supported the hypothesis. Gender differences also were observed; men reported more use of suppression than did women. In addition, negative affectivity (NA) was examined as a confounding variable and as an index of reactivity in stress–outcome relations. NA acted to inflate associations between work perceptions and affective symptoms, but it was also a significant moderator variable; high NA subjects showed greater reactivity to work demand than did low NA subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Students' stress, coping strategies, and school completion: A longitudinal perspective.

This study investigated the relationship between two intrapersonal variables-- stressful life change events and reported coping strategies-- and high school completion status among early adolescents. The sample was comprised of 92 students (44 females and 48 males) who had completed questionnaires regarding the number and types of life change events they had experienced and the coping strategies they reported using during ninth grade. A 3-year follow-up study of these students was completed to determine whether they finished high school or reported dropping out. Discriminant analysis was used to build a prediction model and indicated that the coping factors of Social Activities and Seeking Professional Support significantly predicted high school dropout status, whereas Family Involvement was negatively related to this outcome. These findings are discussed in light of current research, and suggestions for future research are provided. Interventions that focus on the contextual variables related to family and peers are indicated, as is the need for school psychologists and other school mental health professionals to offer coping skills training. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Mental health, not social support, mediates the forgiveness-alcohol outcome relationship.

Religiousness and spirituality are important to most Americans, and evidence suggests that they may contribute to both addiction and recovery. Forgiveness is a specific dimension of religiousness and spirituality that may enhance recovery, but the mechanism(s) through which it operates is unknown. We hypothesized that higher levels of forgiveness would be associated with higher levels of mental health and social support, which, in turn, would be associated with improved alcohol-related outcomes. Baseline and 6-month longitudinal data from a sample of 149 individuals with alcohol use disorders seeking outpatient substance abuse treatment were analyzed through multiple-mediation statistical techniques. While previous research has shown direct associations among forgiveness, alcohol-related outcomes, mental health, and social support, this study found that the direct associations between forgiveness and alcohol-related outcomes were no longer significant when mental health and social support were analyzed as mediator variables. At baseline, for each alcohol-related outcome measured (alcohol-related problems, percent heavy drinking days, percent days abstinent, and drinks per drinking day), mental health individually played a role in the relationship with both forgiveness of self and forgiveness of others, fully mediating or operating through an indirect-only pathway. For alcohol-related problems only, mental health fully mediated the relationship with forgiveness of self at follow-up and operated through an indirect-only pathway with forgiveness of others longitudinally. Social support and feeling forgiven by God were nonsignificant variables at baseline, follow-up, and longitudinally. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Safety at work: A meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes.

In this article, we develop and meta-analytically test the relationship between job demands and resources and burnout, engagement, and safety outcomes in the workplace. In a meta-analysis of 203 independent samples (N = 186,440), we found support for a health impairment process and for a motivational process as mechanisms through which job demands and resources relate to safety outcomes. In particular, we found that job demands such as risks and hazards and complexity impair employees' health and positively relate to burnout. Likewise, we found support for job resources such as knowledge, autonomy, and a supportive environment motivating employees and positively relating to engagement. Job demands were found to hinder an employee with a negative relationship to engagement, whereas job resources were found to negatively relate to burnout. Finally, we found that burnout was negatively related to working safely but that engagement motivated employees and was positively related to working safely. Across industries, risks and hazards was the most consistent job demand and a supportive environment was the most consistent job resource in terms of explaining variance in burnout, engagement, and safety outcomes. The type of job demand that explained the most variance differed by industry, whereas a supportive environment remained consistent in explaining the most variance in all industries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial Factors, Gender, and Sleep.

Low social support may contribute to poor sleep, more so than adverse aspects of demand and control and more so for women than men. This study on 1,179 working individuals, 623 women and 556 men, from the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study investigated the association between sleep and psychosocial factors. Chi-square analyses investigated the associations among sleep and demand, control, social networks, and emotional support. A logit log-linear model analyzed interactions. More women reported poorer sleep when perceiving adverse psychosocial factors. Interactive effects were found between adverse scores on demand, control, and emotional support. A multivariate partial least square analysis showed that poorer health, pain, and adverse aspects of emotional support and social networks contributed significantly to the pattern of poor sleep. (PsycINFO Database Record (c) 2010 APA, all rights reserved)