Workers' compensation for psychological injury: demographic and work-related correlates

This study aimed to determine the demographic and work-related factors that contributed to the filing of a workers' compensation claim for psychological injury. Four groups of employees were compared: those who filed a workers' compensation claim, those who sought psychological treatment for occupational stress but did not file a workers' compensation claim, those who experienced elevated stress levels but did not seek help or lodge a claim, and those who experienced stressful events at work but did not develop symptomatology. The results indicated few variables that could adequately explain why some stressed employees opted for a workers' compensation claim. The implications of these results are discussed.     

Stressful Life Events and Physical and Psychological Health: Mediating Effects of Differentiation of Self in a Spanish Sample

The pathways between differentiation of self and health remain only partly elucidated. This cross‐cultural study sought to test Bowen's hypothesis about the associations between differentiation, stressful life events, and physical and psychological health, in a sample of 466 Spanish adults. Results show that people with higher levels of differentiation were less prone to physical ailments (e.g., heart disease, cancer, or blood disorders) and psychological symptoms (e.g., depression or anxiety). Further, differentiation mediated the association between stress (i.e., perceived negativity of stress in the past year and number of stressful events across the lifetime) and physical and psychological health. The current research provides cross‐cultural empirical evidence for the links between differentiation and mind and body health in a Mediterranean culture.     

Traumatic symptomatology characteristics of adult children of alcoholics

Traumatic experience symptomatology, resiliency factors, and stress among young adults who had experienced alcoholism within their family of origin were assessed in comparison to adults who as children experienced traumatic life events other than alcoholism and those who indicated neither problem (parental alcoholism or traumatic life event) during their childhood. These three groups were compared on self-report measures of stress, resiliency, depressive symptomatology, and trauma symptoms. Results indicated adult children of alcoholics (ACOA) had more self-reported stress, more difficulty initiating the use of mediating factors in response to life events, and more symptoms of personal dysfunction than the control group. Results suggest ACOAs may develop less effective stress management strategies and present more clinically at-risk patterns of responses than their counterparts.     

Trauma Related Critical Incident Debriefing for Adolescents

Events like the tragedy at Columbine High School and the terrorists attacks on New York City in 2001 have highlighted the need for mental health practitioners to become familiar with interventions that are designed to assist young people who have survived extremely stressful events. Mental health professionals often see people who have experienced car accidents, severe abuse, rape, or other victimization, as well as survivors of natural and man-made disasters during the first critical stages of the recovery period. This article describes the process of critical incident de-briefing and provides a step-by-step primer for its application. The process is short-term (four sessions or less) and provides an intervention designed to reduce the frequency and severity of post-traumatic stress symptoms. Adolescents are particularly at risk because of issues surrounding identity formation, self- esteem, and developmental differences in coping mechanisms. Therefore, those who work with an adolescent cohort should be familiar with debriefing methods and how to apply them to the teenager.     

Fish harvesters with injuries' accounts of their experiences with the workers' compensation system

The workers' compensation system was established to provide fair access to compensation for workers who have experienced occupational injury and can no longer work. It was expected that such a system would reduce individual legal claims. Evidence indicates that many injured workers proceed with a variety of appeals indicating dissatisfaction with the current system. The fishing industry is extremely dangerous. The aim of this research was to explore the experience of injured fish harvesters who were making use of a compensation system. Interviews were held with a sample of injured in-shore and deep-sea fish harvesters. In general, they identified themselves strongly as hard-working people who did not deserve their injury. They also reported substantial frustration with the staff of the compensation system who they believed treated them with suspicion and disrespect. The deep-sea fish harvesters were more concerned with the amount of compensation. This dissatisfaction with the system contributed to the fish harvesters' use of the appeals procedure. The fish harvesters' complaints are discussed with reference to the concepts of distributive and procedural justice.     

An evaluation of traumatic and organizational experiences on the psychological health of New Zealand police recruits

Police officers face the occupational hazard of repeated exposure to traumatic stressors. Additionally, as for employees of any large organization, they are subjected to routine organizational stressors in the workplace. Although police work is generally believed to be inherently stressful, very little is known of the impact of the police organization upon officers' psychological well-being. This study evaluated the impact on psychological health of both traumatic and organizational police experiences. Baseline measures of prior traumatic experiences, and psychological health were established at point of entry for 512 police recruits. One year later, the impact of police related trauma and organizational events was assessed. Multiple regression analyses determined that while both traumatic events and organizational stressors affected psychological distress, organizational stressors had the strongest effect, including the exacerbation of Posttraumatic Stress Disorder symptoms. The main implication of these findings is that traumatic stress is a hazard for police officers, but the importance of daily organizational stressors must also be taken into account.     

The impact of childhood stressful life events on health and behavior in at-risk youth

Stressful life events experienced in childhood affect heath throughout the lifespan. Given the high prevalence of stressful life events, especially for children at-risk for child welfare involvement, the impacts of these events across different developmental stages need to be better understood. The current study examines the relation between previously experienced stressful life events and psychosocial health and risk behaviors in adolescence. Several links between maltreatment and psychosocial health were found. Namely, youth who had experienced sexual abuse were more likely to report anxious arousal symptoms, youth who had experienced physical maltreatment and emotional maltreatment were more likely to drop out of school, and youth who had experienced neglect were more likely to dropout, have unprotected sex and use cigarettes. Latent class analysis of life events revealed three groups of children with certain patterns of life events: Chronic, Moderate/Declining, and Low Life Events. After accounting for gender, race, and exposure to maltreatment, members of the Chronic Life Events group uniquely and significantly predicted higher likelihood of Anger/Irritability, Depression, Intrusive Experiences, and Dissociation on the Trauma Symptom Inventory at age 18. Additionally, members of the Chronic Life Events group were significantly more likely to drop out of school, have more sexual partners, be arrested more often and use marijuana or other illicit drugs more often. Membership in the Moderate/Declining Life Events group was significantly associated with likelihood of dropping out of school. The amount of stressful life events appears to be strong predictors of psychosocial outcomes and risk behaviors in adolescence. Efforts to intervene and prevent childhood exposure to stressful life events—particularly in children at-risk and/or maltreated—should begin early in life and continue throughout childhood and adolescence.     

After Farming: Emotional Health Trajectories of Farm,Nonfarm, and Displaced Farm Couples*

Abstract This study links macro social change to emotional health through continuity and change in farming. Families were divided into four groups, depending on whether they were full‐time farmers, part‐time farmers, displaced farm families who had left farming during the 1980s, or nonfarm families. Using four waves of panel data, we estimated initial levels and subsequent changes in per capita family income, stressful life events, and depressive symptoms of wives and husbands. Between 1989 and 1992, full‐time farm families' incomes decreased dramatically, while displaced farm families started 1989 with the lowest average per capita family income but saw the largest average increases in subsequent years. Farm status and changes in income predicted changes in stressful life events; changes in stressful life events, in turn, predicted changes in wives' and husbands' reports of depressive symptoms.     

The short-term and decade-long effects of divorce on women's midlife health

We hypothesize that divorce immediately increases psychological distress and has long-term negative consequences for the physical health of divorced people. In addition, we hypothesize that divorce indirectly causes long-term increases in distress through stressful midlife events. The hypotheses are tested using data from 416 rural Iowa women who were interviewed repeatedly in the early 1990s when they were mothers of adolescent children; the women were interviewed again in 2001. The data support the hypotheses. In the years immediately after their divorce (1991-1994), divorced women reported significantly higher levels ofpsychological distress than married women but no differences in physical illness. A decade later (in 2001), the divorced women reported significantly higher levels of illness, even after controlling for age, remarriage, education, income, and prior health. Compared to their married counterparts, divorced women reported higher levels of stressful life events between 1994 and 2000, which led to higher levels of depressive symptoms in 2001.     

Stress in Parents and Late Elementary Age Children in Divorced and Intact Families and Child Adjustment

The cumulative effect of stressful life events on 40 children in the 4th to 6th grades who were in matched pairs from intact and divorced families were investigated. Children's adjustment was assessed by parent report, teacher report and fantasy material from an abbreviated Thematic Apperception Test. In comparison to children from intact families, children of divorce were rates as less well adjusted by parents and teachers (as expected), and they had a greater number of rejection themes in fantasy. There was no interaction between stress levels and marital status in predicting child adjustment. Higher parental stress was related to parent ratings of internalizing and externalizing symptoms in the child, and to teacher rated externalizing symptoms in the child. Higher numbers of stressful life events that were primarily child oriented were related to higher teacher ratins of anxiety, social withdrawal and internalizing symptoms. Thus, the source of stress leads to different types of maladjustment.     

Acute stress reactions to everyday stressful life events among sexual abuse survivors with PTSD

This study examined symptoms of Acute Stress Disorder (ASD), which is often thought of as a precursor to PTSD, among 54 women who already had PTSD for childhood sexual abuse for which they were seeking treatment. We examined the prevalence of ASD symptoms as well as their relationships to trauma symptoms measured by the Trauma Symptom Checklist-40. The ASD diagnosis requires the occurrence of a traumatic life event as well as meeting specific symptoms criteria. We found that fourty-four percent of participants met all symptom criteria for ASD, but only three of these 24 participants described a traumatic life event. Moreover, ASD symptoms were significantly related to trauma symptom scores. These findings suggest that a significant proportion of women with PTSD for childhood sexual abuse may be highly symptomatic for everyday stressful events that would not be experienced as traumatizing to others. Thus, these individuals need assistance in coping with everyday life stressors that do not involve a serious threat or injury in addition to needing help to alleviate their trauma symptoms.     

Life Stress and Depression in University Students: Clinical Illustrations of Recent Research

Abstract

Through the use of case vignettes, this paper demonstrates the clinical relevance of findings from previously reported research conducted at the University of Toronto. These published studies link life stress to depression in university students. Three psychosocial factors—a family history of psychiatric illness, stressful life events, and lack of social support—are found to be significantly related to depressive symptoms. A fourth psychosocial factor, childhood or adolescent loss of a nurturing person, was not significantly related to the occurrence of depression. However, that factor remains an important therapeutic focus for a number of depressed students. In addition, the absence of at least a single confidant and certain life events (recent loss of a significant person, changes in living arrangements or academic situation, and financial problems) were identified as specific risk factors for depression. Although depression experienced by students is often serious enough to warrant professional intervention, only a minority seek professional help. The majority of those who do seek help are women; male students are less likely to associate somatic symptoms with emotional problems and are less willing to seek psychiatric help. The four case studies presented illustrate the clinical relevance of these research findings.     

The Experience of Gambling and its Role in Problem Gambling

This paper reports on the results of a psychological study conducted in Ontario, Canada, that attempted to answer the question of why some people develop gambling problems while others do not. A group of social gamblers (n = 38), sub-clinical problem gamblers (n = 33) and pathological gamblers (n = 34) completed a battery of questionnaires. Compared to non-problem gamblers, pathological gamblers were more likely to report experiencing big wins early in their gambling career, stressful life events, impulsivity, depression, using escape to cope with stress and a poorer understanding of random events. We grouped these variables into three risk factors: cognitive/experiential, emotional and impulsive and tested the extent to which each risk factor could differentiate non-problem and pathological gamblers. Each risk factor correctly identified about three-quarters of the pathological gamblers. More than half (53%) of the pathological gamblers had elevated scores on all three risk factors. Interestingly, 60% of the sub-clinical cases had elevated scores on only one risk factor. The results are interpreted in terms of a bio-psycho-social model of gambling addiction.     

Psychosocial Profile of Children Having Participated in an Intervention Program for Their Sexual Behavior Problems: The Predictor Role of Maltreatment

This study sought to verify if a history of maltreatment may predict the psychosocial profile of children who participated in an intervention program aiming at reducing sexual behavior problems. Data were collected at both the beginning and the end of the intervention program using a clinical protocol and standardized tests selected on the basis of the intervention targets. In general, the results indicate that children who had experienced maltreatment display a psychosocial profile that is similar to that of children who had not experienced maltreatment. However, children who had experienced psychological abuse or neglect may display greater externalized or sexualized behaviors, whereas children who have a parent who had been a victim of sexual abuse may display fewer sexualized behaviors.     

Improving work programs' delivery of information and service to workers' compensation carriers

This paper presents the results of a telephone survey of workers' compensation carriers, addressing how occupational therapy work programs can best meet these carriers' needs. Fifty percent of the market share of workers' compensation carriers in Michigan participated in the survey. Survey results indicated that workers' compensation carriers found Functional Capacity Evaluations, job analyses, and work hardening to be important work rehabilitation services. A significant portion of the respondents (88%) stated that they recognized the need for clinically successful work rehabilitation programs and indicated that if they had return to work rates for different providers, they would utilize providers that had the most successful outcome data in a specific geographical area. Occupational therapists can use these survey results to improve their services and communication with insurance to ensure that injured workers will continue to have access to the efficacious interventions occupational therapists provide in work rehabilitation.     

The Safety Costs of Contingent Work: Evidence from Minnesota*

We find that workers' compensation costs for leased/staff agency workers are about three times higher than for regular full-time workers. This differential grows even wider when controlling for worker characteristics. Authors give a number of reasons for this result, including claims-reporting moral hazard on the part of contingent workers. We also present results on claim denials by work status, which seems to support the cost model.     

Looked after children and offending: An exploration of risk,resilience and the role of social cognition

There have been serious concerns in the UK about the number of young people who are looked after in state care but are also young offenders. The relationship between the care system and offending is complex, since there are shared risk factors, in particular histories of poor parenting, abuse and neglect. This article reports on a mixed methods study. It focuses on findings regarding a sample of 100 young people (age 14–19), using data from file searches, psychological measures and narrative interviews. The sample was made up of three sub-samples — looked after young people who had offended, looked after young people who had not offended and young people who had offended but were not looked after. This paper presents the study's findings in relation to the characteristics and pathways of these groups. It illustrates the range and interaction of individual, family and education and activity risk and resilience factors. In particular, it highlights the role of social cognition deficits in increasing the risk of offending for young people in state care. It also identifies the significance of relationships and constructive activity in promoting resilience.     

Posttraumatic stress disorder (PTSD) symptoms among firefighters: Roles of resilience and locus of control

Firefighting is a an extremely stressful occupation that risks exposure to traumatic events as part of the job. Despite this, the literature on stress and trauma pays little attention to this occupation and its generalization to other, high risk occupations. This study examined resilience and work locus of control as predictors of posttraumatic stress disorder (PTSD) symptoms among Nigerian firefighters. Participants were 116 paid, professional firefighters (98 males and 18 females) who completed the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Resilience Scale (RS-14), and Work Locus of Control Scale (WLCS) and provided vital demographic information. Multiple regression analysis was used to analyze the data. Results showed that resilience negatively predicted PTSD symptoms such that higher resilience was associated with fewer symptoms of PTSD. Work locus of control was a positive predictor of PTSD symptoms, indicating that externality of control beliefs in the workplace was associated with more PTSD symptoms. Relevant demographic factors especially higher years of service, being a senior firefighter, and higher educational status were associated with lower PTSD symptoms. Findings underscore the potential value of resilience training and implementing behavioral health programs to modify firefighters’ external locus of control beliefs. Interventions should consider resilience and locus of control focused interventions as protective factors for PTSD.     

Understanding the Factors Related to Stepmother Anxiety: A Qualitative Approach

Stepparenting is widely recognized as a stressful experience, with higher levels of stress and anxiety experienced by stepmothers than stepfathers. This study sought to examine the experiences of stepmothers to help understand the perceived factors related to their increased anxiety within the stepfamily. A qualitative study using focus groups was conducted in the United Kingdom. Results suggested that stepmother anxiety is predominantly related to three areas: their relationship with the biological mother, their relationship with their stepchildren, and lack of clarity regarding the stepmother role. It is posited that interventions designed to clarify the stepmother role and improve and strengthen relationships between stepfamily members would help alleviate anxiety and thus improve stepmother well-being.     

New Scoring Method of the Family Drawing for Sexually Abused Preschoolers

This study assesses whether the global psychological adjustment score on the family drawing, derived with a new scoring method, can predict the presence of internalized and externalized behavior problems among sexually abused children. A family drawing was completed by 78 sexually abused children, and three questionnaires were administered to the nonoffending parent. The results indicate that a poorer global psychological adjustment score on the family drawing is associated with a higher probability of clinical thresholds for internalized and externalized behavior problems in children who have been sexually abused, even when controlling for parents’ psychological distress, child's age, number of stressful events experienced by the child, and type of sexual abuse.