Anxious children in adulthood: a prospective study of adjustment

OBJECTIVE: To prospectively examine psychosocial functioning in young adulthood for children and adolescents with anxiety disorders. METHOD: This 8-year prospective study compared psychosocial functioning in young adults (mean age 22 years) who had histories of early-onset anxiety disorders, comorbid anxiety and depressive disorders, or no history of psychiatric illness (NPI). Follow-up interviews assessed subjects' residential, educational, occupational, and marital status; utilization of mental health services; and psychological status RESULTS: Anxious subjects without histories of depression were less likely than NPI controls to be living independently. Anxious-depressed subjects were less likely than controls to be working or in school; more likely than purely anxious subjects to utilize mental health services; and more likely than both anxious and control subjects to report psychological problems, most frequently depression. CONCLUSIONS: Overall, results suggest that children with anxiety disorders are relatively well adjusted in young adulthood. However, a history of comorbid depression is prognostic of a more negative outcome.     

Work organization research at the National Institute for Occupational Safety and Health.

For 25 years, the National Institute for Occupational Safety and Health (NIOSH) has conducted and sponsored laboratory, field, and epidemiological studies that have helped define the role of work organization factors in occupational safety and health. Research has focused on the health effects of specific job conditions, occupational stressors in specific occupations, occupational differences in the incidence of stressors and stress-related disorders, and intervention strategies. NIOSH and the American Psychological Association have formalized the concept of occupational health psychology and developed a postdoctoral training program. The National Occupational Research Agenda recognizes organization of work as one of 21 national occupational safety and health research priority areas. Future research should focus on industries, occupations, and populations at special risk; the impact of work organization on overall health; the identification of healthy organization characteristics; and the development of intervention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of commonly used lifting assessment methods to identify industrial jobs associated with elevated risk of low-back disorders

Low-back disorders (LBD) continue to be the most costly and common musculoskeletal problem facing society today. Investigators have developed tools or measures that are intended to identify jobs that will probably be associated with an elevated risk of low-back disorders. However, an important and not widely discussed issue associated with these tools and procedures has been that of the validity or effectiveness of the tools. Therefore the objective of this study was to evaluate the validity and effectiveness of two commonly used types of LBD assessment methods in terms of their ability to correctly associate jobs with LBD risk. The 1981 NIOSH Work Practices Guide for Manual Lifting and the 1991 NIOSH revised lifting equation, along with psychophysical measures were assessed for their ability to correctly identify high-, medium-, and low-risk (of LBD) jobs. Risk was defined according to a database of 353 industrial jobs representing over 21 million person-hours of exposure. The results indicated that both NIOSH measures were predictive and resulted in odds ratios between 3.1 and 4.6. Higher odds ratios were found when the maximum horizontal distance was used to assess a job compared to the average horizontal distance. Further analyses indicated that the two NIOSH assessment methods classified risk in very different ways. The 1981 NIOSH Guide demonstrated good specificity (91%) in that it identified low-risk jobs well but it also displayed low sensitivity by only correctly identifying 10% of the high-risk jobs. The 1993 NIOSH revised lifting equation, on the other hand, had better sensitivity. It correctly identified 73% of the high-risk jobs but did not identify low- and medium-risk jobs well. Using psychophysical criteria it was observed that 60% of the high-risk jobs would be judged to be acceptable, whereas, 64% and 91% of the medium- and low-risk jobs, respectively, would be judged to be acceptable. This study indicates that the different measures have various strengths and weaknesses. When controlling for occupational LBD it should be recognized that a variety of measures exist and that the measure that most appropriately assesses risk depends upon the characteristics of the job.     

Nursing and Psychological Treatments.

Presents a comment on "Psychological Treatments" (see record 2004-21168-001) by D. H. Barlow. In his article, Barlow pointed to the need "to solidify the identification of psychology as a health care profession" by changing the terminology of practice in the health care context from psychotherapy to psychological treatments and suggested that the only persons qualified to carry out such interventions are doctoral-level psychologists. Unfortunately, there was no discussion of the health care professionals who already provide psychological treatments in health care settings and their contribution to the evidence base supporting such treatment. The authors find several aspects of the article to be problematic. Overall, the authors feel that suggesting that psychology should claim treatment of psychological disorders and psychological components of physical disorders in health care settings as exclusively its own domain ignores the research and clinical contributions of others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community mental health practice and the elderly.

Discusses some of the working knowledge necessary for a professional psychologist to provide effective mental health services for elderly community residents. The relevance of branches of psychology such as life-span developmental and health and community psychology, which can augment traditional clinical skills, are presented as critical to a psychologist's understanding and management of psychological disorders in older community residents. Also emphasized are the mobility of the psychologist and the provision of services in familiar settings. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing medical patients' reluctance to participate in psychological therapies: The initial session.

Clinical psychologists are increasingly being asked to work with patients presenting with physical health complaints rather than exclusively with patients presenting mental health symptoms. The reluctance of a significant portion of these newer patients to participate in an intervention strategy perceived as psychological rather than medical is a commonplace problem. The present author presents several initial-session strategies for confronting this reluctance and establishing a cooperative nondefensive patient–therapist relationship. From a psychoeducational perspective, all of these strategies can be viewed as special efforts to educate and enlist the patient's interest in treatment alternatives. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women with bulimic eating disorders: When do they receive treatment for an eating problem?

Variables associated with the use of health services were examined in a prospective, community-based study of women with bulimic-type eating disorders who did (n = 33) or did not (n = 58) receive treatment for an eating problem during a 12-month follow-up period. Participants who received treatment for an eating problem differed from those who did not in several respects, including higher body weight, higher levels of eating disorder psychopathology, general psychological distress, and impairment in role functioning, deficits in specific aspects of coping style, greater awareness of an eating problem, and greater likelihood of prior treatment for a problem with weight. However, the variables most strongly associated with treatment seeking were greater perceived impairment in role functioning specifically associated with an eating problem and greater perceived inability to suppress emotional difficulties. These were the only variables that were significantly associated with treatment seeking in multivariable analysis. The findings suggest that individuals’ recognition of the adverse effects of eating-disordered behavior on quality of life may need to be addressed in prevention and early intervention programs for eating disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychologist as a consultant in a nursing home: Effect on staff morale and turnover.

Many elderly patients have been transferred from long-term psychiatric hospitals to nursing homes, where knowledge of psychological aspects of patient care is generally poor and where emotional and behavioral disorders are poorly tolerated by staff. One solution to this problem is for psychologists to provide in-service training to nursing-home staff in the psychological aspects of patient care, but this approach ignores such problems as poor staff morale and high staff turnover. A 188-bed skilled nursing home was selected for a 12-wk consultation program based on a mental health and organizational development approach. Turnover rates fell from 73.4%, during the quarter prior to consultation, to 27.8%, during the period of consultation, and averaged 33.6% for the next 3 quarters. Staff morale also improved. Results indicate that before training nursing-home staff in the psychological aspects of geriatric care, problems such as high staff turnover and poor morale should be resolved. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internal–external expectancies and health-related behaviors.

Reviews research on internal–external (I–E) locus of control expectancies and health attitudes and behaviors. The theoretical background of the I–E construct is described. Topics include I–E relation to health knowledge, precautionary health practices, reactions to physical disorders, psychological responding, psychological disturbances, and responses to psychological treatment. (5? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of work in psychological health and well-being: A conceptual, historical, and public policy perspective.

The primary theme of this article, which serves as the introductory contribution of a special section of the American Psychologist, is that work plays a central role in the development, expression, and maintenance of psychological health. The argument underlying this assumption is articulated at the outset of the article in conjunction with a historical review of vocational psychology and industrial/organizational psychology. The article follows with an overview of contemporary vocational psychology and a presentation of the psychology-of-working perspective, which has emerged from critiques of vocational psychology and from multicultural, feminist, and expanded epistemological analyses of psychological explorations of working. Three illustrative lines of inquiry in which research has affected the potential for informing public policy are presented. These three lines of scholarship (role of work in recovery from mental illness; occupational health psychology; and working, racism, and psychological health) are reviewed briefly to furnish exemplars of how the psychological study of working can inform public policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working conditions, living conditions and physical health problems declared among penitentiary administration personnel in France

A cross-sectional epidemiological survey was conducted among prison staff in France to investigate the relationships between working conditions and health. The sample included men and women 20 to 64 years old belonging to all categories of prison personnel: prison guards, administrative staff, socioeducational workers, technicians, health care workers, and managers (n = 4587, response rate 45.7%). A mailed self-administered questionnaire was used to assess sociodemographic characteristics, working conditions, and physical and mental disorders. Multiple logistic regression analyses were conducted to determine the effects of working conditions and social relationships on health of prison staff. However, the results reported here only concern 17 health disorders: body mass index, sick leave, medication use, accidents, digestive disorders, lower extremities and back disorders, hypertension, hemorrhoids, arthritis, skin disorders, urinary infections, chronic bronchitis, cholesterol, gastric ulcer, respiratory infections, ocular disorders. The living non professional conditions mostly associated with health disorders were financial difficulties (OR: 1.9 for digestive disorders, 1.8 for gastric ulcer, 1.7 for medication use) and irregularity of meals (OR = 1.5 for digestive disorders, and hypertension). In the occupational environment, the factors most associated with health disorders are seniority (OR = 4.2 for arthritis, 2.3 for cholesterol) and constraints (OR = 1.7 for lower extremities disorders). In spite of some limits associated to this kind of study, relationships between occupational and non occupational factors and physical health conditions were observed; the results also pointed out the protective role of the social relationships for health conditions.     

NIOSH research initiatives to prevent back injuries to nursing assistants, aides, and orderlies in nursing homes

Over the past 100 years, advances in nutrition, modern medicine, public health, and a multitude of public health improvements have increased the life expectancy of U.S. residents. The fact that Americans are living longer has resulted in extensive growth in our elderly population and a rapid employment growth that delivered about 2 million new jobs between 1980 and 1989 in the health care workforce. The Bureau of Labor Statistics Injury and Illness Data for nursing homes rose from 10.7 to 18.6 injuries or illnesses per 100 full-time workers between 1980 and 1992. The injury and illness rates among nursing home workers are partly due to the physical stress of providing round-the-clock assistance with the basic activities of daily living, such as getting in and out of a bed or chair, as well as bathing and toileting. The National Institute for Occupational Safety and Health (NIOSH) is conducting a series of research studies to identify strategies to reduce the risk of musculoskeletal injuries to workers in nursing homes. NIOSH has funded two laboratory evaluations of resident transferring methods and one field study in an actual nursing home. The purpose of this paper is to describe the key findings from past NIOSH research initiatives and to present an overview of future research.     

How psychology can improve effectiveness and reduce costs of health services.

Contends that psychology can be used to prevent heart disease, cancer, accidents and violence, and respiratory disease through programs such as those designed to eliminate smoking, control obesity, reduce stress, and intervene when multiple risk factors are present. Psychological techniques—as useful and cost-saving companions to traditional medical treatments—can increase checkup visits and participation in health screening, improve adherence to medication schedules, aid recovery from surgery, and facilitate outpatient medical service delivery. Since 40–60% of physician visits are for nonmedical reasons that are psychological and behavioral in nature, psychologists can reduce medical care overutilization and unnecessary medical expenditures by offering less costly and more appropriate alternatives. Psychological interventions for health disorders include treatment for pain, asthma attacks not responsive to medical treatment, heart rate variability, gastrointestinal problems, skin disorders, and self-destructive behaviors. It is concluded that psychological procedures offer a means of reducing health care expenditures reliably. (4 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leading Psychology Forward: Staying the Course in Uncertain Times.

Like everyone in the country, those in organized psychology have functioned recently in a climate marked by threats of terrorism, uncertainty, and a declining economy. In such challenging times, it might seem logical for the profession to wonder how it needs to change to respond to current circumstances. Yet at such times, staying the course already charted is likely a far more effective strategy. For psychology, this means continuing to press for mental health parity, educating decision makers about the important role of psychological services in preventive care, helping to integrate psychological and physical health services, continuing to hold managed care companies accountable, and increasing the profession's political giving. Psychologists must also be prepared to ensure that psychological services are treated as an integral part of any health reform plan that emerges. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting and psychological adjustment of adolescent immigrants in Israel.

Parental and familial factors and their association with adolescents’ mental health were examined among former Soviet Union (FSU) immigrants and nonimmigrants in Israel. Questionnaires regarding parental control, inconsistency, and rejection, in addition to adolescent–family connectedness and psychological disorders, were administered to 83 FSU immigrants and 106 nonimmigrant adolescents. According to the results, FSU adolescents are less connected to their families, experience their parents as less warm and more inconsistent in their childrearing behavior, report that their mothers subject them to a higher level of control, and the psychological disorders among them are more widespread than among nonimmigrant adolescents. Maternal control, maternal temporal inconsistency, and maternal and paternal rejection were associated with psychological disorders only among nonimmigrant adolescents. No such association was found among FSU adolescents, suggesting that FSU mental health problems are associated with immigration and cultural and social factors, rather than parental and familial factors. A comprehensive intervention program is required to provide support and assistance to help immigrants overcome their psychological distresses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary investigation of family coping styles and psychological well-being among adolescent survivors of Hurricane Katrina.

The relation between family coping styles and psychological well-being was compared for adolescents (12-17 years) displaced by Hurricane Katrina and currently living in a relocation camp (n = 50) and nonaffected adolescents (n = 31) matched on age, race, and socioeconomic status. Adolescents in the Katrina sample reported a family mobilizing strategy that reflected an increased reliance and seeking of extra-familial, community-based support but lower self-esteem and more symptoms of distress and depression. Follow-up analyses suggested that the relations between group differences in participants' hurricane-related trauma experiences and greater psychological distress may be mediated in part by the family coping strategy; exposure to increased levels of community-provided support may have unintended consequences on adolescents' psychological health. These results highlight the importance of future research on both potential benefits and costs of family coping styles in adolescents affected by a large-scale disaster. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expanding the specialty of occupational and environmental medicine: the role of the chief health officer. The Sappington Lecture

Passage of the Occupational Safety and Health Act in 1971 represented a major milestone for occupational and environmental medicine. Creation of the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) flowed directly from the legislation, and the specialty of occupational medicine entered a new era. As the 25th anniversaries of OSHA and NIOSH are celebrated, consideration of the future of the specialty of occupational and environmental medicine seems timely. In this lecture, an expanded role for the specialty is proposed, based on an analysis of the forces shaping the practice of public health and the opportunities that these forces present. This analysis suggests considering the concept of a "Chief Health Officer" serving the broad health needs of the workplace.     

Pediatric oncology consultations: A generalizable model for medical settings.

The traditional medical or disease model of emotional disorders is often counterproductive to the establishment of an effective psychological consultation service in a medical setting. The reasons for this problem are discussed in relation to the differences between psychological and medical consultants. The development of an effective psychological consultation service in a complex pediatric oncology setting is described in relation to staff and patient needs. The evolution of the consultation service suggests several generalizable principles that can be adapted for application in other medical settings. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary Care Psychology Training on Campus: Collaboration Within a Student Health Center.

Applied psychological services are being implemented into the primary care treatment milieu to improve patient treatment and reduce health care costs. Unfortunately, few psychologists have training specifically oriented to working in this setting. A predoctoral training program wherein psychology graduate students may obtain practicum experience working in a student health center on a university campus is described. The theoretical underpinnings of this training are based on the integrated primary care models of K. Strosahl (1997) and K. Strosahl, N. Baker, M. Braddick, M. Stuart, and M. Handley (1997), which emphasize integration of psychological and medical treatment, brief intervention, consultation, and expedited referral for longer term cases. Though many issues remain, integrated primary care offers promise for improved health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Males and eating disorders: Gender-based therapy for eating disorder recovery.

Mental health professionals may wonder how males with eating disorders differ from females with eating disorders and how best to treat males with eating disorders. The eating disorder literature largely focuses on females. Limited research has examined assessment and treatment of eating disorders in males. This article offers a unique view of eating disorder treatment for males by integrating it with the literature on the psychology of men. Mental health professionals are given practical suggestions to guide eating disorder recovery in males. A case example shows treatment considerations for working with males with disordered eating behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)