Raising awareness of psychosocial factors in the occurrence of low back symptoms in developing countries

Although there is strong evidence that single physical, psychosocial and organisational risk factors are each independent predictors of low back symptoms (LBS), little is known about their combination/interaction, particularly in those working in developing countries. A total of 1294 Indonesian coal mining industry workers reported information about physical, psychosocial, and organisational factors using self-reported questionnaires and were placed into one of four combination exposure groups: 1) high physical (working with bent trunk; whole body vibration exposure; lifting) and high psychosocial (high effort; low reward; work stress), 2) high physical and low psychosocial, 3) low physical and high psychosocial, and 4) low physical and low psychosocial (as the reference group). The odds of LBS in the high physical and high psychosocial group was 5.15 times (95% confidence interval 2.69-9.86) that of the reference group. Psychosocial factors played a more important role than physical factors in increasing the likelihood of reporting LBS. Permanent and night shift workers were more likely to report LBS. These findings imply that efforts to reduce LBS in this workplace should address both psychosocial and physical factors but psychosocial factors should be the priority, with a special focus on permanent and night shift workers.     

HIV/AIDS and Homelessness

This article describes the results of research on the demographic, housing, psychosocial characteristics, and service needs of a sample of homeless people with HIV disease_ Results show that respondents are similar in demographic and housing characteristics to the general homeless population. On average, respondents report high levels of stress and depression, moderate satisfaction with perceived social support availability, moderate beliefs in their ability to influence health related outcomes, moderate levels of self-efficacy, and low levels ofphysical and psychosocial disability. A range of services was identified as both helpful and useful in supporting a stable living arrangement. Implications for social policy, service provision, and research are discussed.     

HIV/AIDS and homelessness

This article describes the results of research on the demographic, housing, psychosocial characteristics, and service needs of a sample of homeless people with HIV disease. Results show that respondents are similar in demographic and housing characteristics to the general homeless population. On average, respondents report high levels of stress and depression, moderate satisfaction with perceived social support availability, moderate beliefs in their ability to influence health related outcomes, moderate levels of self-efficacy, and low levels of physical and psychosocial disability. A range of services was identified as both helpful and useful in supporting a stable living arrangement. Implications for social policy, service provision, and research are discussed.     

The transitional object reconsidered: Some sociocultural variations and their implications

Winnicott's trasitional object concept has generated vigorous theoretical inquiry and has been applied broadly in practice. His hypothesis that transitional object attachments are healthy and universal has fostered assumptions about psychosocial health and disturbance that may not apply across the range of clients seen in practice. The purpose of this article is to heighten clinicians' awareness of the wide normative sociocultural variation in transitional object attachments. A review of the theory is followed by presentation of findings from cross-cultural studies. The article concludes with a discussion of implications for theory-building and practice.     

Occupational stress and biomechanical risk in a high fashion clothing company

Psychosocial discomfort may amplify job-related risk factors. The aim of this study is to evaluate job stress in a high fashion clothing company with upper limb biomechanical overload due to repetitive and forceful manual activities. Biomechanical risk was analyzed and in part reduced using the OCRA Check list. A total of 518 workers (433 females and 85 males) were investigated to determine anxiety (by STAI 1 and 2), occupational stress (using the Italian version of the Karasek Job Content Questionnaire) and perception of symptoms. Final biomechanical assessment did not reveal high risk jobs, except for cutting. Although the perception of anxiety and job insecurity was within the normal range, all the workers showed a high level of job strain (correlated with the perception of symptoms) due, probably, to very low decision latitude. It was suggested that job strain may increase the perception of symptoms. Moreover, the result of this study indicates that musculoskeletal overload has to be further analyzed since its low level is not in agreement with the level of discomfort due to the repetitive tasks.     

Gender Role Identity and Stress in African American Women

Abstract

Womanism is a feminist perspective that has recently been appropriated for social work practice with African American women (Littlefleld, in press). It emphasizes the centrality of gender role in African American women's psychosocial adaptation, and asserts that the archetypal gender role for this group incorporates both nurturing and economic providing functions. This gender role fluidity has been characterized both as a source of strength (Billingsley, 1992; Hill, 1999) and strain (Lewis, 1989; McAdoo, 1985). The present study empirically investigated the relationship between gender role identity and stress in African American women to clarify its adaptive value. The Bem Sex Role Inventory was used to classify subjects into groups based on the degree to which they identified themselves with stereotypically masculine and feminine traits. Women who endorsed high levels of both masculine and feminine traits experienced lower levels of stress than did other women. The findings indicate that gender role identity is a factor in African American women's psychosocial well-being, and that mainstream gender role norms may not be adequate for analyzing the experiences of this group.     

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.     

Student assistance program: a new approach for student success in addressing behavioral health and life events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

Student Assistance Program: A New Approach for Student Success in Addressing Behavioral Health and Life Events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

Early Psychosocial Stress Affects Men's Relationship Length

Life history theory predicts that the optimal reproductive strategy for individuals in risky and uncertain environments (subjectively experienced as early psychosocial stress) is to maximize current reproduction to minimize the chances of lineage extinction. Having many short-term relationships and many lifetime sex partners are ways to maximize current reproduction, but they come at a cost (e.g., decreased resources for future reproduction, decreased desirability as a future mate, etc.). This study, therefore, examined whether sexually active individuals with high levels of early psychosocial stress report more terminated short-term relationships, a shorter relationship length with their current partner, and more lifetime sex partners than those with less early psychosocial stress. Early psychosocial stress in men was associated with more terminated short-term relationships and a greater number of lifetime sex partners, but not with current relationship length; in women, high early psychosocial stress was associated with shorter current relationship length but not with the number of terminated short-term relationships or number of lifetime sex partners. Results are discussed from the perspective of life history theory and gender differences in preferences for short- and long-term relationships.     

An overview of current clinical issues in separation and placement

This article reviews a wide range of literature and the knowledge base that is necessary for effective treatment of children in foster and adoptive homes. The pitfalls in clinical work with placed children are identified. In addition to the psychological effects of placement on children, there is review of knowledge affecting both foster and adoptive parents. Treatment approaches and tools that are presented in the literature are summarized.     

Back to Stir It Up: Erectile Dysfunction in an Evolutionary,Developmental, and Clinical Perspective

In this review, we analyze erectile dysfunction (ED) in the context of sexual selection. We highlight that ED is a specific human male characteristic linked to the loss of the baculum or penile bone and results from a range of physical and psychological factors. We discuss evolutionary interpretations that consider dysfunctional penile erection as an honest signal of a low-quality male. We further emphasize the importance of considering psychosocial context and early attachment dynamics for understanding the etiology of some types of ED. Finally, we suggest that the integration of developmental factors for understanding the emergence of this sexual disorder is instrumental for the calibration of more effective therapies.     

Broadening the etiological discourse on Alzheimer's disease to include trauma and posttraumatic stress disorder as psychosocial risk factors

Biomedical perspectives have long dominated research on the etiology and progression of Alzheimer's disease (AD); yet these approaches do not solely explain observed variations in individual AD trajectories. More robust biopsychosocial models regard the course of AD as a dialectical interplay of neuropathological and psychosocial influences. Drawing on this broader conceptualization, we conducted an extensive review of empirical and theoretical literature on the associations of trauma, posttraumatic stress disorder (PTSD) and AD to develop a working model that conceptualizes the role of psychosocial stressors and physiological mechanisms in the onset and course of AD. The proposed model suggests two pathways. In the first, previous life trauma acts as a risk factor for later-life onset of AD, either directly or mediated by PTSD or PTSD correlates. In the second, de novo AD experiential trauma is associated with accelerated cognitive decline, either directly or mediated through PTSD or PTSD correlates. Evidence synthesized in this paper indicates that previous life trauma and PTSD are strong candidates as psychosocial risk factors for AD and warrant further empirical scrutiny. Psychosocial and neurological-based intervention implications are discussed. A biopsychosocial approach has the capacity to enhance understanding of individual AD trajectories, moving the field toward ‘person-centered’ models of care.     

Understanding social factors and inequalities in health: 20th century progress and 21st century prospects

The development of social epidemiology and medical sociology over the last half of the 20th century, in which Leo Reeder played a central role, transformed scientific and popular understanding of the nature and causes of physical health and illness. Viewed in the early 1950s as shaped almost entirely by biological processes and medical care, physical health and illness are now understood to be as much or more a function of social, psychological, and behavioral factors. Utilizing a stress and adaptation conceptual framework, social epidemiology has identified a broad range of psychosocial risk factors for health, most notably: (1) social relationships and support; (2) acute or event-based stress; (3) chronic stress in work and life; and (4) psychological dispositions such as anger/hostility, lack of self-efficacy/control, and negative affect/hopelessness/pessimism, with new risk factors continuing to be identified. However, proliferation of risk factors must be balanced by conceptual integration and causal understanding of the relationships among them, their causes, and consequences. One source of such integration and understanding has been the rediscovery of large and persistent socioeconomic and racial-ethnic disparities in health. Socioeconomic position and race/ethnicity shape individuals' exposure to and experience of virtually all known psychosocial, and well as many environmental and biomedical, risk factors, and these risk factors help to explain the size and persistence of social disparities in health. Improving the socioeconomic position of a broad range of disadvantaged socioeconomic and racial-ethnic strata constitutes a major avenue for reducing exposure to and experience of deleterious risk factors for health, and hence for improving the health of these groups and the overall population. This in turn requires better understanding of the macrosocial forces that influence the socioeconomic position of individuals.     

A toolkit for MSDs prevention--WHO and IEA context

Many simple MSD risk management tools have been developed by ergonomists for use by workers and employers with little or no training to undertake injury prevention programs in their workplace. However, currently there is no "toolkit" which places such tools within an holistic, participative ergonomics framework and provides guidance on how best to use individual tools. It is proposed that such an holistic approach should entail initial analysis and evaluation of underlying systems of work and related health and performance indicators, prior to focusing in assessment of MSD risks stemming from particular hazards. Depending on the context, more narrowly focused tools might then be selected to assess risk associated with jobs or tasks identified as problematic. This approach ensures that biomechanical risk factors are considered within a broad context of organizational and psychosocial risk factors. This is consistent with current research evidence on work- related causes of MSDs.     

Not in employment,education or training: Mental health,substance use,and disengagement in a multi-sectoral sample of service-seeking Canadian youth

BackgroundYouth who are not engaged in employment, education or training (NEET) face multiple health, economic and psychosocial challenges. Despite the popularity of the NEET metric internationally, there is a paucity of research describing Canadian NEET youth.MethodThe proportion of NEET youth aged 12 to 24 presenting for services across multiple service sectors in Canada was examined. Their sociodemographic characteristics and mental health concerns were compared with those of their non-NEET peers.ResultsOver a quarter of youth were NEET, and they presented for services across all sectors. NEET youth showed multiple psychosocial risk factors. They were also more likely to endorse substance use and crime/violence concerns than their non-NEET service-seeking counterparts. Gender-based differences were observed.DiscussionSince many youth presenting for services across sectors are NEET, youth-serving agencies should be prepared to offer a wide range of services to address their diverse needs. Implications for systematic screening and integrated service provision are discussed.     

Homeless Children and Stress: An Empirical Study

Families with children constitute the fastest-growing segment of the homeless population. Past literature has indicated that children who are homeless experience more stress than children who are not homeless. This study measured the level of psychosocial stress experienced by homeless children by utilizing two direct and two indirect measurement tools. The sample included 52 children from family-shelter facilities in Central Florida. T-test results indicated a statistically significant difference between the sample's scores and that of the normative group. Prompt intervention at both the individual and environmental level is recommended.     

Personal and Family Correlates of Resilience Among Adolescents Living in Single-Parent Households in Taiwan

ABSTRACT

Based on the responses of 291 Taiwanese adolescents living with single parents, this article examines the personal (gender and academic performance) and family (gender of parent living together and family type) correlates of resilience of the participants with reference to different psychosocial domains. Whereas girls displayed higher resilience in some dimensions of personal and school resilience domains than did boys, boys experienced higher family resilience than did girls. Better academic performance was positively related to effective coping, personal independence, global personal resilience, and parental expectation on academic performance. Adolescents living with single mothers displayed higher personal independence and family resilience than did adolescents living with single fathers. Compared with adolescents not living with any parent or those who lived with both parents after divorce, adolescents living in nuclear and stem families displayed higher positive orientation to older people and experienced higher family resilience.     

Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children's experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial risk factors and emotional and behavioral symptoms of stress in homeless children. Twenty-two homeless mothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.     

Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children’s experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial riskfactors and emotional and behavioral symptoms of stress in homeless children, Twenty-two homeless nlothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.