Determinants of mental health treatment seeking among soldiers who recognize their problem: implications for high-risk occupations

Although research has documented an increased risk of mental health problems among employees in high-stress occupations, little attention has been devoted to the process by which employees seek treatment for these problems. Using components of the Stages of Change Model (Prochaska & DiClemente, 1982), this study examined the correlates of considering and receiving treatment for such problems among active-duty military personnel in the U.S. Army. A multidimensional assessment of determinants of treatment seeking was administered to 1725 military personnel, along with measures of mental health symptoms and treatment seeking. These determinants were examined as predictors of considering and receiving treatment among a sub-sample of 466 personnel who recognized having a current mental health problem. Multinomial logistic regressions indicated that attitudes towards treatment and a preference for self-reliance distinguished those considering treatment from those who had not sought treatment. A larger number of factors distinguished soldiers considering treatment from those who had actually received treatment, with operational barriers and self-reliance being the strongest and unique correlates. The discussion focuses on the importance of what organizations can do to facilitate treatment seeking among employees in high-risk environments.     

Return to work among employees with mental health problems: Development and validation of a self-efficacy questionnaire

Abstract

Because of the costs to both the organization and the individual, it is important that employees who are sick-listed with mental health problems are facilitated in their return to work (RTW). In order to provide adequate interventions, it is necessary to obtain a better understanding of the RTW process of people with mental health problems. Work-related self-efficacy (SE) might play a key role within this process. This paper describes the development and validation of the return-to-work self-efficacy’ scale (RTW-SE) for employees with mental health problems. Three Dutch samples of sick-listed employees were used to validate the 11-item instrument (N=2214). Based on the factor structure and reliability results, RTW-SE was conceptualized as a unitary construct. The associations with general SE, locus of control, coping, physical workload and mental health problems support the construct validity of this scale. Most importantly, RTW-SE proved to be a robust predictor of actual return to work within three months. The encouraging preliminary psychometric properties of the scale make it a potentially valuable tool in research and in clinical practice and occupational health care settings, both before and after employees have returned to work.     

The importance of self-efficacy in the moderating effects of social support on stressor–strain relationships

Abstract

Occupational stress research offers inconsistent findings on the moderating effects of social support on the stressor–strain relationship. This study contributes to the research literature by examining how social support's moderating effect is dependent on one's self-efficacy. Ninety-six US military police soldiers completed two surveys 3 months apart. The results showed that three out of four regression equations had significant three-way interactions. Organizational constraints×supervisor support×self-efficacy had statistically significant interactions in the prediction of job satisfaction and psychological well-being. Organizational constraints×co-worker support×self-efficacy had a significant interaction in the predicted of psychological well-being. These interactions explained between 5% and 10% of the variance in the dependent variables. Social support buffered the stressor–strain relationship when self-efficacy was high and reverse buffered the relationship when self-efficacy was low. These results indicate that interventions aimed at reducing strains by increasing social support should consider an individual's self-efficacy. Future research should consider incorporating content of communication to determine if high and low self-efficacy individuals receive or react differently to different types of communication content.     

The importance of self-efficacy in the moderating effects of social support on stressor-strain relationships

Occupational stress research offers inconsistent findings on the moderating effects of social support on the stressor-strain relationship. This study contributes to the research literature by examining how social support's moderating effect is dependent on one's self-efficacy. Ninety-six US military police soldiers completed two surveys 3 months apart. The results showed that three out of four regression equations had significant three-way interactions. Organizational constraints×supervisor support×self-efficacy had statistically significant interactions in the prediction of job satisfaction and psychological well-being. Organizational constraints×co-worker support×self-efficacy had a significant interaction in the predicted of psychological well-being. These interactions explained between 5% and 10% of the variance in the dependent variables. Social support buffered the stressor-strain relationship when self-efficacy was high and reverse buffered the relationship when self-efficacy was low. These results indicate that interventions aimed at reducing strains by increasing social support should consider an individual's self-efficacy. Future research should consider incorporating content of communication to determine if high and low self-efficacy individuals receive or react differently to different types of communication content.     

The nature,extent and determinants of violence against psychiatric personnel

Violence against psychiatric staff seems to be on the increase. Such abuse can lead to mental health consequences for the staff and a reluctance to be closely involved with patients. Few Swedish investigations have examined violence against mental nurses and psychiatrists, or undertaken comparative studies between them. In this study we examined the extent, nature and determinants (i.e. risk factors) of violence against psychiatric nurses (n = 731) and psychiatrists (n = 320) working in the eight health care districts of Stockholm. These caregivers were assessed cross-sectionally by means of a questionnaire covering various areas (e.g. violence and work environment). The majority of the participants (85%) reported having been exposed to violence during their careers, with 57% being victimized in the past 12 months. Physical violence was common, and factors such as negative attitudes to work and diminished sense of autonomy were associated with an increased vulnerability to violence. Nurses and psychiatrists did not differ in violence variables. In spite of the weaknesses of the design (cross-sectional self-selecting sample), this study corroborates previous findings and identifies personal factors associated with violence that have received little attention in the literature (e.g. lack of respect for the organization of care).     

College student bereavement experience in a Christian university

As part of the National College Grief Study, college student bereavement experience was examined specifically in a Christian university climate. Sex, year in school, and closeness to the deceased were measured in terms of academic and mental health outcomes and resources utilized. Females reported more mental health problems when close to the deceased, and seniors were less likely than first year students to utilize personal support resources of family and religion. During close losses, students experienced more mental health problems and negative social outcomes, but they did not access more resources. Recommendations for university personnel and suggestions for further research are given.     

The role of stress and social support in Sick Building Syndrome

Sick Building Syndrome (SBS) involves seemingly healthy individuals experiencing long-lasting symptoms of physical distress in their work settings and is estimated to exist in 20 to 30% of all work settings in the USA. We examined differences in stress, social support and both physical and psychological symptoms reported by hospital personnel working in known SBS sites in Halifax, Nova Scotia (n = 297) with control employees working in relatively SBS-free settings (n = 228). We found that employees reporting that their health had been affected by the building in which they worked and those complaining of poor air quality were more likely to be found in SBS locations. In addition, those people with higher levels of organizational support and marginally higher levels of union support were also more likely to be found in SBS locations. Further analyses revealed that employees with higher role overload and greater family support, but lower levels of organizational support were more likely to report that their own health had been adversely affected by their place of work. Perceptions of poor air quality were predicted by higher levels of role conflict, role overload, and organizational stress and lower levels of organizational support. These results suggest that SBS may not be solely dependent on environmental factors.     

Job insecurity and trust: Uncovering a mechanism linking job insecurity to well-being

Job insecurity has well-documented negative effects for individuals as well as organisations. However, the mechanisms by which job insecurity relates to its outcomes have received less research attention. The purpose of this study is to investigate trust in the organisation as a potential mechanism that may explain why job insecurity relates to two well-documented outcomes: decreased job satisfaction and lowered mental health. These hypotheses were tested in a Swedish longitudinal sample that consists of employees (longitudinal n?=?906) from three organisations, using structural equation modelling. Overall, the results showed support for our hypotheses. Our findings reveal an indirect effect of trust on job satisfaction, regardless of whether the previous levels of job satisfaction were controlled for. With regard to mental health, the indirect effect was only evident when previous levels of mental health were not controlled for. The results of this study contribute to our understanding about the intervening factors in the relationship between job insecurity and outcomes. Moreover, the results might be important for human resources departments and managers when there are indications that employees are worrying about the future of their jobs.     

A matter of time? Challenging and hindering effects of time pressure on work engagement

The aim of our research was to test time-exposure effects of time pressure as a stressor typically considered to be a challenge, rather than a hindrance stressor. We examined the within- and between-person effects of time pressure on work engagement in two diary/panel studies with employees using intervals of five days and three weeks, respectively (Study 1, n?=?350, and n?=?357, respectively) and six to eight weeks (Study 2, n?=?238). We assumed that it is a matter of time whether time pressure acts as a challenge (under short-term exposure) or as a hindrance stressor (under long-term exposure). We found significant positive within-person effects of time pressure on work engagement when controlling for strain in the daily and weekly diary assessment (Study 1), but a significant negative within-person effect in the six to eight weeks’ assessment (Study 2). The between-person effects were significant and negative in all studies. Although a short-term increase can be beneficial for a certain time, stable and long-time exposure of time pressure does rather reduce work engagement. Thus, employers should not keep time pressure permanently high to motivate their employees. However, short-term increases of time pressure (e.g. before a deadline) may serve as a motivating factor.     

SOCIAL LEARNING THEORY AND THE IMPLEMENTATION OF PRODUCTION INNOVATION*

In a study of the implementation of production innovation using a social learning theory focus, four organizations were monitored with a real-time study design. The following propositions were strongly supported: (1) During the initial implementation period (3–4 months), the stress felt by personnel in new user organizations was significantly higher (p < .01) than for organizations previously experienced with technology; (2) Firms experienced with the new technology obtain early success when compared with inexperienced firms (p < .01). Moderate support was found for the proposition that new users rely heavily on original equipment manufacturers for demonstration to acquire new skills, but gradually models within the user organization emerge as the dominant influence. The proposition that new users have significantly higher imitation scores than users experienced with the technology was only weakly supported. No substantive or significant changes in the attitudes of users toward the innovation were found during the first three to four months of the implementation period. These and other results suggest that longitudinal studies of this type ought to be carried out over periods in excess of 2 1/2 years. Implications for the management of change are presented.     

Kitchen Hygiene in the Spotlight: How Cooking Shows Influence Viewers’ Hygiene Practices

Poor hygiene when handling food is a major cause of foodborne illness. To investigate whether hygiene practices visible in television cooking shows influence viewers’ kitchen hygiene, a study on the adoption of demonstrated hygiene behavior was conducted under controlled, experimental conditions. In a study ostensibly on cooking by following recipes participants (n = 65) were randomly assigned to one of three conditions, in which they watched a cooking video that differed only with regard to the hygiene behavior of the chef. In condition 1, the chef engaged in poor hygiene practices while preparing the dish, in condition 2 the chef's hygiene behavior was exemplary and in condition 3, the chef's hygiene behavior was not visible (control condition). After watching the video, participants were instructed to cook the recipe individually in the fully equipped laboratory kitchen. Cooking sessions were videotaped and experimenters blind to condition coded hygiene lapses committed by participants. The level of kitchen hygiene displayed in the cooking video significantly affected hygiene practices of participants cooking the recipe. Participants who had watched the cooking video with correct hygiene practices committed significantly fewer hygiene lapses than those who had watched the video with poor hygiene practices. From a risk communication perspective, TV cooking shows are well placed to convey knowledge of essential hygiene practices during food preparation to a broad audience. To facilitate behavioral change toward safer food‐handling practices among viewers, visibly performing correct hygiene practices in cooking shows is a promising strategy.     

Reducing Overconfidence in the Interval Judgments of Experts

Elicitation of expert opinion is important for risk analysis when only limited data are available. Expert opinion is often elicited in the form of subjective confidence intervals; however, these are prone to substantial overconfidence. We investigated the influence of elicitation question format, in particular the number of steps in the elicitation procedure. In a 3‐point elicitation procedure, an expert is asked for a lower limit, upper limit, and best guess, the two limits creating an interval of some assigned confidence level (e.g., 80%). In our 4‐step interval elicitation procedure, experts were also asked for a realistic lower limit, upper limit, and best guess, but no confidence level was assigned; the fourth step was to rate their anticipated confidence in the interval produced. In our three studies, experts made interval predictions of rates of infectious diseases (Study 1, n = 21 and Study 2, n = 24: epidemiologists and public health experts), or marine invertebrate populations (Study 3, n = 34: ecologists and biologists). We combined the results from our studies using meta‐analysis, which found average overconfidence of 11.9%, 95% CI [3.5, 20.3] (a hit rate of 68.1% for 80% intervals)—a substantial decrease in overconfidence compared with previous studies. Studies 2 and 3 suggest that the 4‐step procedure is more likely to reduce overconfidence than the 3‐point procedure (Cohen's d = 0.61, [0.04, 1.18]).     

The Effects of Verbal and Written Supervisory Feedback on Staff Compliance with Assigned Prompted Voiding in a Nursing Home

We examined the effects of staff performance feedback delivered by a supervisor verbally, and combined with written feedback on geriatric nursing assistants' (GNAs) completion of assigned prompted voiding. The goal of the staff management procedures was to increase the frequency of prompted voiding which would consequently maintain improvements in continence brought about on a specialized continence unit. The basic staff management system included GNA self-monitoring of their performance of prompted voiding, periodic supervisory monitoring, and verbal and graphic feedback provided to all GNAs on their performance. At a later time, the staff management program was modified to include letters of praise or disapproval sent bi-weekly to all GNAs based on their performance of the prompted voiding procedure. Also, a letter was sent to all GNAs every three months summarizing their performance during this period. These summary letters were placed in the GNAs' personnel file and used as part of their annual performance evaluation. Results suggest that, although individual verbal feedback alone resulted in acceptable maintenance of prompted voiding, the addition of written feedback produced significant improvements in the number of assigned prompted voiding completed. This study displays the utility and practicality of employing formalized staff management procedures in nursing homes.     

Psychosocial safety climate,psychosocial and physical factors in the aetiology of musculoskeletal disorder symptoms and workplace injury compensation claims

Causal agents for workers' compensation claims and physical injury have largely been identified as physical demands. We proposed an integrated theory of physical injury (i.e. musculoskeletal disorder symptoms [MSDs]) and workers' compensation claims, which combined psychosocial and physical mechanisms. A random, population-based sample of 1095 Australian workers completed a telephone interview on two occasions 12 months apart. As expected, the physical mechanism was confirmed; physical demands were related to MSDs, which in turn predicted workers' compensation claims. Further, a novel psychosocial mechanism was confirmed. Psychosocial safety climate (PSC; perceptions about the organisation's climate for psychological health) was a precursor to psychosocial risks (e.g. harassment, violence, bullying and work pressure). In turn, these psychosocial risks were related to emotional exhaustion, MSDs and then workers' compensation claims. Evidence was therefore provided for psychosocial-physical processes in explaining MSDs and workers' compensation for claims for physical injury. Occupational health and safety legislators and policy makers should be aware that, beyond physical demands, factors usually associated with risk for mental stress claims (e.g. harassment, bullying, and violence) may additionally manifest in physical health problems and workers' compensation injury claims. Focusing on modifying the PSC in an organisation, “the cause of the causes”, may be an effective injury prevention and intervention strategy.     

SCAT AND SPAT: LARGE-SCALE COMPUTER-BASED OPTIMIZATION SYSTEMS FOR THE PERSONNEL ASSIGNMENT PROBLEM

The personnel assignment problem involves the assignment of people to tasks, projects, etc., in a manner that maximizes a measure of aggregate utility for the assignees subject to several assignment constraints. In addition to computationally efficient solution algorithms, the effective implementation of mathematical models to solve the personnel assignment problem must include data processing systems with comprehensive error checking/resolution procedures, end user reports, documentation, and training. This paper summarizes two successful computer-based systems for solving large-scale personnel assignment problems that frequently occur in university settings. SCAT, the Student-Company Assignment Technique, assigns students to job interview slots. SPAT, the Student-Project Assignment Technique, assigns students to project teams in an MBA field project course. The SCAT and SPAT approaches can be generalized to a wide variety of personnel assignment problems in university, industry, government, and military settings.     

State extraversion and emergent leadership: Do introverts emerge as leaders when they act like extraverts?

Extraverts are more likely than introverts to emerge as leaders, however little is known about the explicit behaviours that cause such an advantage and what introverts can do to overcome their relative disadvantage. Utilising an experiment (n = 601) in a group context, we assessed the effects of manipulating state extraversion on peer-rated emergent leadership, self-rated emergent leadership, and post-activity affect. Participants completed a big five personality measure and were randomly assigned to one of three conditions: a control condition, an ‘act extraverted’ treatment, or an ‘act introverted’ treatment. Results confirmed extraverts' emergent leadership advantage but demonstrated that state extraversion was the proximal cause of emergent leadership, with both extraverts and introverts emerging as leaders when instructed to act extraverted. Acting introverted i) had a particularly deleterious effect on self-rated emergent leadership regardless of trait extraversion, ii) caused a reduction in positive affect for ambiverts and extraverts but not for introverts, and iii) caused an increase in negative affect for ambiverts and extraverts but not for introverts.     

COMMON DUE-WINDOW SCHEDULING

In this paper, we solve common due-window scheduling problems within the just-in-time window concept, i.e., scheduling problems including both earliness and tardiness penalties. We assume that jobs share the same due window and incur no penalty as long as they are completed within the due window. We further assume that the earliness and tardiness penalty factors are constant and that the size of the window is a given parameter. For cases where the location of the due window is a decision variable, we provide a polynomial algorithm with complexity O(n * log (n)) to solve the problem. For cases where the location of the due window is a given parameter, we use dynamic programming with pseudopolynomial complexity to solve the problem.     

Risk Communication,Values Clarification,and Vaccination Decisions

Many health‐related decisions require choosing between two options, each with risks and benefits. When presented with such tradeoffs, people often make choices that fail to align with scientific evidence or with their own values. This study tested whether risk communication and values clarification methods could help parents and guardians make evidence‐based, values‐congruent decisions about children's influenza vaccinations. In 2013–2014 we conducted an online 2×2 factorial experiment in which a diverse sample of U.S. parents and guardians (n = 407) were randomly assigned to view either standard information about influenza vaccines or risk communication using absolute and incremental risk formats. Participants were then either presented or not presented with an interactive values clarification interface with constrained sliders and dynamic visual feedback. Participants randomized to the risk communication condition combined with the values clarification interface were more likely to indicate intentions to vaccinate (β = 2.10, t(399) = 2.63, p < 0.01). The effect was particularly notable among participants who had previously demonstrated less interest in having their children vaccinated against influenza (β = –2.14, t(399) = –2.06, p < 0.05). When assessing vaccination status reported by participants who agreed to participate in a follow‐up study six months later (n = 116), vaccination intentions significantly predicted vaccination status (OR = 1.66, 95%CI (1.13, 2.44), p < 0.05) and rates of informed choice (OR = 1.51, 95%CI (1.07, 2.13), p < 0.012), although there were no direct effects of experimental factors on vaccination rates. Qualitative analysis suggested that logistical barriers impeded immunization rates. Risk communication and values clarification methods may contribute to increased vaccination intentions, which may, in turn, predict vaccination status if logistical barriers are also addressed.     

A temporal investigation of the direct,interactive, and reverse relations between demand and control and affective strain

Abstract

Few studies have tested how stressors affect outcomes over time. We sought to extend the literature by means of a longitudinal study testing for direct, interactive, and causal relations between demands and control and affective strain. We extended prior work testing causal relationships for Karasek's (1979 Karasek, R.A. Jr. 1979. Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrative Science Quarterly, 24: 285–307. [Crossref], [Web of Science ®] , [Google Scholar]) Job Demand-Control (JDC) model by examining both the effects of demands and control on strain and in turn the effects of strain on demand and control. We tested our hypotheses using hierarchical linear modelling with a military sample of 1539 soldiers who completed six waves of survey data at 3-month time lags. The results replicate earlier cross-sectional studies reporting effects of work characteristics on strain; however, in our study these effects did not persist past three months. The results also provide evidence for reverse causal effects such that higher strain was associated with higher subsequent work overload and lower control over a six month time period. Similar to past research, we did not find support for the interactive effects of work overload and control on strain. We discuss the implications of our findings for theory and practice (such as the optimum time for applying interventions during the management of change), especially in terms of understanding the specific time lags for different stress–strain associations and the need for additional theories to explain reverse relationships.     

Median problems with positive and negative weights on cycles and cacti

This paper deals with facility location problems on graphs with positive and negative vertex weights. We consider two different objective functions: In the first one (MWD) vertices with positive weight are assigned to the closest facility, whereas vertices with negative weight are assigned to the farthest facility. In the second one (WMD) all the vertices are assigned to the nearest facility. For the MWD model it is shown that there exists a finite set of points in the graph which contains the locations of facilities in an optimal solution. Furthermore, algorithms for both models for the 2-median problem on a cycle are developed. The algorithm for the MWD model runs in linear time, whereas the algorithm for the WMD model has a time complexity of  O(n²)\mathcal{O}(n^{2}) .