Work stress precipitates depression and anxiety in young, working women and men

Psychometric Properties of the Korean Version of the Mental Health Professionals Stress Scale

Background: Job stress of mental health professionals can have a negative impact on them, particularly their psychological health and mortality, and may also affect organizations' and institutions' ability to provide quality mental health services to patients. Aim: This study aimed to: (1) investigate the validity and reliability of the Korean Mental Health Professionals Stress Scale (K-MHPSS), (2) develop K-MHPSS cut-off points to measure clinical depression and anxiety, and (3) examine whether specific stressors vary by area of expertise. Methodology: Data were collected via an online survey over 3 months, from August to October 2020. An online survey using a survey website was administered to volunteers who accessed the link and consented to participate. Data from 558 participants (200 clinical psychologists, 157 nurses, and 201 social workers) were included in the final analysis. Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the K-MHPSS; concurrent validity of the scale was determined by analyzing correlation; internal consistency was determined by Cronbach's alpha coefficient. In addition, ROC curve analysis and Youden's index were used to estimate optimal cut-off points for K-MHPSS; one-way ANOVA was performed to investigate the difference among the three groups. Results: The seven-factor model of the original scale did not be replicated by Korean mental health professionals. The K-MHPSS had the best fit with the six-factor model, which consists of 34 items. Concurrent validity was confirmed, and overall reliability was found to be good. The K-MHPSS cut-off points for depression and anxiety appeared to slightly different by professional groups. Furthermore, nurses and social workers showed significantly higher total scores compared to clinical psychologists, and there are significant differences in subscale scores among professionals. Conclusion: The Korean version of the MHPSS has appropriate psychometric properties and can be used to assess the occupational stress of mental health professionals. It can also serve as a reference point for screening clinical level of depression and anxiety in mental health professionals.

Effectiveness of a Smartphone App (BioBase) for Reducing Anxiety and Increasing Mental Well-Being: Pilot Feasibility and Acceptability Study

Background

The prevalence of workplace-related stress and anxiety is high, resulting in stress-related physical and mental illness. Digital self-guided interventions aimed at key areas of workplace design may be able to provide remote anxiolytic effects.

Objective

The aim of this feasibility study is to assess changes in anxiety and mental well-being after use of the BioBase programme, a mobile phone platform for psycho-educational modules, tools, and real-time feedback of physiological data.

Methods

A 4-week observational study was carried out in 55 healthy adults who were screened for stress with the Depression Anxiety Stress Scale (DASS) Stress subscale. Participants completed anxiety (6-item State-Trait Anxiety Inventory [STAI]) and mental well-being (Warwick-Edinburgh Mental Well-being Scale [WEMWBS]) questionnaires at baseline and at 4 weeks. Feedback questionnaires were administered after 4 weeks.

Results

After 4 weeks of using the programme and controlling for any effect of being paid to take part in the study, STAI significantly decreased (baseline mean 45.52 [SD 13.2]; 4-week mean 39.82 [SD 11.2]; t₅₄=–3.51; P<.001; CI –8.88 to –2.52; Cohen d=0.96) and WEMWBS significantly increased (baseline mean 48.12 [SD 6.4]; 4-week mean 50.4 [SD 6.9]; t₅₃=2.41; P=.019; CI 0.44-4.23; Cohen d=0.66). Further, higher baseline stress was significantly associated with a greater decrease in STAI (t₅₃=–3.41; P=.001; CI –8.10 to –2.10; R²=0.180) and a greater increase in WEMWBS (t₅₂=2.41; P=.019; CI 0.38-4.11, R²=0.101). On feedback, participants found the programme easy to use/navigate, with the content being acceptable and relevant to workplace-related stressors; 70% (21/30) of participants would recommend the programme to a friend.

Conclusions

The BioBase programme is a potentially effective intervention in decreasing anxiety and increasing mental well-being, with larger changes in those with higher baseline levels of stress.

A Pilot Evaluation of a Smartphone Application for Workplace Depression

Interventions delivered via mobile apps show particular promise in tackling the burden of common mental disorders. Appropriately targeting these interventions to at-risk populations is critical to their success. This pilot study aimed to assess the usability, feasibility, acceptability, and preliminary effects of an app-based intervention designed to target depressive symptoms in a stressed working population. Anchored, a smartphone app including a 30-day program of mindfulness and cognitive and behavioural therapeutic components, was tested in a pre-post pilot study with participants recruited via social media advertisements. Eligible participants (N = 81) were Australian adults who were employed and reported elevated stress levels on a single-item screening measure. Follow-up assessment occurred 5 weeks after baseline. The primary outcome measure was change in depressive symptoms, with secondary outcomes measuring change in anxiety, wellbeing, stress, resilience, exercise, alcohol use, absenteeism, and work performance. User feedback and in-app data were analysed to assess engagement and intervention adherence. At follow-up, there were significant reductions in depressive symptoms (t₆₁ = 6.35; p < 0.001) and anxiety symptoms (t₆₀ = 7.35; p < 0.001), along with significantly reduced cases of likely new onset depression compared to baseline (24% vs. 6%, p = 0.012). Significant improvements were also seen in wellbeing (t₆₀ = -5.64; p < 0.001), resilience (t₆₀ = -3.89; p < 0.001), stress (t₆₁ = 11.18; p < 0.001), and alcohol use (t₆₀ = 3.40; p = 0.001). Participants reported no significant changes in work performance, absenteeism or exercise. There were satisfactory levels of app usability, feasibility, and acceptability. Most participants found the app easy to use (93.2%), understood the app content well (83.0%), and rated the app highly or very highly overall (72.9%). User feedback suggestions were predominantly focused on improving app navigation and user interface. This pilot study provides encouraging evidence that Anchored has potentially beneficial effects, and is usable, feasible, and acceptable as an app-based intervention for the working population experiencing elevated stress. Further testing of Anchored in a randomised controlled trial is required to investigate its efficacy as an intervention for workplace mental ill-health.

A repeated-measures examination of organizational stressors, perceived psychological and physical health, and perceived performance in semi-elite athletes

Organizational stressors can undermine the psychological well-being and performance of athletes. Less is known, however, about how these relationships unfold over time and whether organizational stressors can impact upon perceived physical health. The current study, therefore, used a repeated-measures design to examine relationships between organizational stressors with components of perceived psychological (anxiety and depression) and physical (illness symptoms and missed training days via illness) ill-health, and perceived performance at the within-person level. Twenty-three semi-elite female rowers completed monthly measures of study variables for six-months. Multilevel models indicated that selection-related stressors positively predicted symptoms of perceived psychological and physical ill-health, and negatively predicted perceived performance. Conversely, coaching stressors negatively predicted symptoms of perceived psychological ill-health. Logistics and operations stressors positively predicted perceived performance, whereas goals and development stressors negatively predicted perceived performance. These findings demonstrate for the first time that, with a repeated-measures design, organizational stressors can predict components of perceived physical and psychological ill-health, and perceived performance at the within-person level in athletes. From a practical perspective, practitioners should incorporate these findings when diagnosing the need for, developing, and optimally implementing primary and secondary stress management interventions.

Delivery of a Mental Health First Aid training package and staff peer support service in secondary schools: a process evaluation of uptake and fidelity of the WISE intervention

BACKGROUND

Improving children and young people's provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprised a Mental Health First Aid (MHFA) training package delivered to at least 16% of staff, a short mental health awareness session to all teachers and development of a staff peer support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings regarding the extent of uptake and fidelity of the intervention.

METHODS

Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data.

RESULTS

In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the 2-day standard MHFA training course, and a further 146 (11.1%) staff completed the 1-day MHFA for schools and colleges training. In seven (58.3%) schools, the required 8% of staff completed the MHFA training packages. A 1-h mental health awareness-raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study at the outset. Teachers reported limited use of the peer support service during follow-up. At the 1-year follow-up, only three (25.0%) schools indicated they had re-advertised the service and there was evidence of a reduction in support from senior leadership.

CONCLUSION

The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools, insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach.

TRIAL REGISTRATION

ISRCTN 95909211 . Registered on 15 January 2016.

The effect of job demands on health and work outcomes: A longitudinal study among Malaysian employees

The purpose of the current study was to investigate the impact of job demands on health and work outcomes among Malaysian workers. We hypothesized that job demands (i.e., emotional demands and physical demands) would predict future work-related burnout and work engagement, in turn affecting sleep problems and job performance (in-role, extra-role). A longitudinal two-wave survey was conducted among Malaysian workers and valid data from 345 participants were analyzed using structural equation modeling. The results revealed that work-related burnout predicts sleep problems while work engagement increased employees' job performance over time. Overall, the current study highlights the importance of specific job demands (i.e., emotional demands and physical demands) that specifically affect health-related behavior and work-related behavior among workers.

A meta-analysis: Internet mindfulness-based interventions for stress management in the general population

BACKGROUND

Psychological stress was an important mental health problem among the general population and warrant research to inform strategies for effective prevention. iMBIs provide a possibility to offer easily accessible, efficacious, convenient, and low-cost interventions on a wide scale. However, the efficacy of iMBIs in the general population remains unclear. The aim of this meta-analysis is to evaluate the effects of iMBIs for stress reduction in the general population.

METHODS

A systematic search in PubMed, Embase, Web of Science, Medline, Cochrane Library, CNKI, and Wanfang Data databases was performed up to April 10, 2019. The overall effect sizes of the iMBIs on stress, depression, anxiety, and mindfulness were recorded by the metric of Hedges' g with 95% confidence interval (CI), Z-value, and P value.

RESULTS

Sixteen eligible studies were included in the meta-analysis. The overall results indicated that iMBIs had small to moderate effects on stress (Hedges' g = -0.393) and mindfulness (Hedges' g = -0.316) compared with the control group. Results from subgroup analyses revealed that the type of sample and delivery mode had a greater impact on heterogeneity across the studies. Meta-regression found that the overall effect might be moderated by guidance for iMBIs.

CONCLUSION

The present meta-analysis suggested that iMBIs had small to moderate effects in reducing stress and improving mindfulness of the general population in comparison with the control group. Future research is needed to explore how iMBIs are remolded to improve adherence and suit specific individuals.

Practicing the Ideal Depressed Self: Young Professional Women's Accounts of Managing Depression

This article is based on a qualitative investigation of contemporary female subjectivities at the intersection of two particular identities: being a "young professional woman" and "depressed." Thirteen women working in both private and public sector roles in two major cities in Aotearoa New Zealand participated in semi-structured, in-depth interviews. Employing a practice-based approach to analysis, my aim was to explore whether participants' accounts are inflected by what cultural scholars call the "top girl" or "can-do girl" ideal and the implications for "recovering" from depression. I identified five identity practices which constitute the subject position of the "ideal depressed self" who (a) delivers no matter what, (b) puts on a brave face (particularly at work), (c) treats her depression medically, (d) looks after herself, and (e) works toward becoming more positive. A discussion of the discursive underpinnings, in particular, neoliberal and postfeminist rhetoric, highlights the harmful effects of this individualizing perspective.

IMPROVEjob - Participatory intervention to improve job satisfaction of general practice teams: a model for structural and behavioural prevention in small and medium-sized enterprises - a study protocol of a cluster-randomised controlled trial

Background

Perceived high chronic stress is twice as prevalent among German general practitioners (GPs) and non-physician medical staff compared to the general population. The reasons are multi-factorial and include patient, practice, healthcare system and societal factors, such as multi-morbidity, the diversity of populations and innovations in medical care. Also, practice-related factors, like stressful patient-staff interactions, poor process management of waiting times and lack of leadership, play a role. This publicly funded study evaluates the effectiveness of the newly developed participatory, interdisciplinary, and multimodal IMPROVEjob intervention on improving job satisfaction among general practice personnel. The intervention aims at structural stress prevention with regard to working conditions and behavioural stress prevention for leaders and other practice personnel.

Methods

In this cluster-randomised controlled trial, a total of 56 general practices will be assigned to either (1) participation in the IMPROVEjob intervention or (2) the waiting-list control group. The IMPROVEjob intervention consists of the following elements: three workshops, a toolbox with supplemental material and an implementation period with regular contact to so-called IMPROVEjob facilitators. The first workshop, addressing leadership issues, is designed for physicians with leadership responsibilities only. The two subsequent workshops target all GP and non-physician personnel; they address issues of communication (with patients and within the team), self-care and team-care and practice organisation. During the 9-month implementation period, practices will be contacted by IMPROVEjob facilitators to enhance motivation. Additionally, the practices will have access to the toolbox materials online. All participants will complete questionnaires at baseline and follow up. The primary outcome is the change in job satisfaction as measured by the respective scale of the validated German version of the Copenhagen Psychosocial Questionnaire (COPSOQ, version 2018). Secondary outcomes obtained by questionnaires and - qualitatively - by facilitators comprise psychosocial working conditions including leadership aspects, expectations and experiences of the workshops, team and individual efforts and organisational changes.

Discussion

It is hypothesised that participation in the IMPROVEjob intervention will improve job satisfaction and thus constitute a structural and behavioural prevention strategy for the promotion of psychological wellbeing of personnel in general practices and prospectively in other small and medium sized enterprises.

Trial registration

German Clinical Trials Register: DRKS00012677. Registered on 16 October 2019. Retrospectively, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID = DRKS00012677.

Risk Factors for Depressive Symptoms in Long-Haul Truck Drivers

Work-related stress is a salient risk factor for depression. While long-haul truck drivers (LHTDs) face a myriad of occupational pressures and demands, little research has examined predictors of depressive symptoms in this occupational group. The purpose of this study was to identify predictors of depressive symptoms in LHTDs. A cross-sectional study was used to examine depressive symptoms, health and working conditions in a sample of 107 LHTDs (mean age of 50.7 ± 12.3; 95.6% were men) at truck stops from five Western Canadian cities. The findings show that 44% of LHTDs reported symptoms of depression in the past 12 months. Severe work-related stress, the use of psychiatric medications and broken sleep were significant predictors of depressive symptomology accounting for 41% of the variance. The findings suggest that LHTDs experience a host of occupational stressors that are embedded within the transportation industry that may increase the risk for depressive symptoms. Mental health promotion efforts that improve sleep quality, decrease work-related demands and pressures, and increase the use of psychiatric medication may reduce rates of depressive symptoms among LHTDs.

The association between job strain, depressive symptoms, and cardiovascular disease risk: results from a cross-sectional population-based study in Québec, Canada

PURPOSE

Job strain (high psychological demands and low decision control) has been associated with cardiovascular disease (CVD). It is unclear if job strain is associated with CVD risk score independently of depression, an established risk factor for CVD. This study investigated whether there is an association between job strain and CVD risk score, when depressive symptoms are controlled for. Sex differences were examined.

METHODS

Data came from the CARTaGENE study, a community health survey of adults in Québec, Canada (n = 7848). Participants were working adults aged 40-69 years. CVD risk was estimated using the Framingham risk score. Job strain was measured as the ratio of job demands to control using the Job Content Questionnaire. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression analyses were conducted to examine the association between job strain and CVD risk score controlling for depressive symptoms. There was no interaction effect between job strain and depressive symptoms in the association with CVD risk score.

RESULTS

High job strain was reported in approximately 21% of participants, high Framingham risk score was observed in approximately 9%. Job strain was associated with the Framingham risk score (B = 0.73, p < 0.001, adjusted for age, sex, and education) and controlling for depressive symptoms did not significantly change the association (B = 0.59, p < 0.001).

CONCLUSION

The results suggest that the job strain is associated with CVD risk score and that this association is not explained by depressive symptoms. Similar associations were observed for males and females.

Effectiveness of a Cognitive Behavioral Coaching Program Delivered via Video in Real World Settings

Background: Many employees experience high levels of stress in the workplace, which negatively impact their productivity and well-being. Effective stress management interventions exist, but are inaccessible due to insufficient numbers of mental health providers, long waiting times to initiate care, high out-of-pocket cost of care, and stigma related to receiving psychotherapy.

Introduction: The purpose of this study was to test the efficacy, in real-world circumstances, of a structured, cognitive behavioral coaching (CBC) program delivered through video or telephone.

Materials and Methods: Retrospective data on 289 subjects who had sought support for emotional health through a behavioral health benefit offered through employers were examined. Changes in perceived stress and well-being over the course of the program were measured using the Perceived Stress Scale (PSS) and Warwick–Edinburgh Mental Well-being Scale (WEMWBS), respectively. Rates of reliable change and satisfaction with the coaching program were also assessed.

Results: Scores on both the PSS and WEMWBS improved between baseline and follow-up. Approximately 61.9% (n = 289) of participants demonstrated reliable improvement on either measure.

Discussion: CBC is a promising intervention that has the potential to significantly expand access to effective and more affordable interventions for emotional health care.

Conclusions: Coaching, when delivered by accredited professionals trained in cognitive behavioral theory and interventions and working in real-world settings, can be efficacious in decreasing perceived stress and increasing well-being when delivered through video or telephone.

Mediating Factors for the Relationship between Stress and Work Ability over Time in Young Adults

Stress can affect work ability. The aim of this study was to identify how this pathway is mediated over time in young adults. Participants of the Work Ability in Young Adults cohort were selected. A theoretical framework was built, which lead to a statistical model. Selected dimensions of mediators were recovery, work demands affecting private life, feelings of control over private life, and physical activity in leisure time. A quadruple serial mediation model was built with four mediators. The total effect of stress on work ability was -0.3955, 95% CI [-0.4764, -0.3146]. The total indirect effect amounted to 81% with an effect of -0.3182, 95% CI [-0.3750, -0.2642]. The relationship between stress and Work Ability Score five years later in young adults was mediated by stress five years later, work demands affecting private life, feelings of control over private life and feeling well-rested upon waking. These results indicate that work demands affecting private life and feelings of control over private life are important mediators of the relationship between stress and work ability in young adults. A well-balanced relationship between work and private life can counteract the influence of stress on work ability in this age group.

Modifiable risk and protective factors for anxiety disorders among adults: A systematic review

Anxiety disorders are highly prevalent in the general population and associated with high rates of impairment and disability. This burden highlights the need to identify risk factors that individuals can modify without professional intervention. A systematic review was conducted to identify studies that examined modifiable risk and protective factors for anxiety disorders among adults in the general population. Searches were conducted in PubMed, PsycINFO and MEDLINE using medical subject headings and text words related to risk factors, protective factors, and each anxiety disorder. Screening, data extraction, and quality assessment were performed by three study authors. Modifiable risk and protective factors from 19 studies across seven countries were identified. Risk factors identified included cigarette smoking, alcohol use, cannabis use, negative appraisals of life events, avoidance, and occupational factors. Protective factors included social support, coping, and physical activity. Cigarette smoking was the most studied risk factor. Support was found for cigarette smoking as a risk factor for agoraphobia and panic disorder. Mixed results were found for generalized anxiety disorder and specific phobia. Across disorders, smoking frequency was associated with greater risk. Results indicate an important gap in the literature in that few studies have examined modifiable risk factors for anxiety disorders.

Depression symptoms and recurrent aphthous stomatitis-Evidence from a population-based study in Indonesia

OBJECTIVES

This study aims to report the prevalence and distribution of recurrent aphthous stomatitis (RAS) among Indonesian adults and to test the relationship between symptom of depression and RAS.

METHODS

Data from the 2007 Indonesia Family Life Survey (IFLS 2007) were analysed to assess the association between symptom of depression and RAS. The prevalence of RAS in the previous month was self-reported. Symptom of depression was measured using the 10-item Center for Epidemiologic Studies Depression (CES-D) scale. The distribution of RAS according to age, sex and level of stress was also presented in the bivariate analysis. Multivariable logistic regression models were fitted to test associations between symptom of depression and RAS, controlling for age, sex and the stress level.

RESULTS

The previous month prevalence of RAS in Indonesian population was 12%. The adjusted odds ratios (ORs) from the logistic regression models indicate that, for each unit increase in the CES-D depression score (range: 0-30), there was a 9% increase in the odds of having RAS (OR: 1.09, 95%CI: 1.08-1.10). Being older and being male was related with lower prevalence of RAS.

CONCLUSIONS

A higher score of depression was related to a higher prevalence of RAS. This association was persistent even after controlling for age, sex and the level of stress.

The role of psychological detachment in burnout and depression: A longitudinal study of Malaysian workers

The current study aimed to examine the role of psychological detachment in the relationship between working conditions and burnout and depression. First, the study proposed that job demands would increase burnout after four months but not depression. Second, it proposed that psychological detachment would moderate the impact of job demands and job resources on burnout and depression. Third, it was proposed that the interaction between job demands, job resources and psychological detachment would predict burnout and depression. The longitudinal study design involved 345 workers (at both Time 1 and Time 2). The hierarchical regression analysis showed that increasing psychological detachment reduced the negative relationship between physical demands and depression four months later. In contrast, high psychological detachment increased the negative association between emotional resources and burnout, but not between emotional resources and depression. Overall, this study, in its discovery of the impact of working conditions on psychological health, has made a new contribution to psychological detachment studies by using different sub-constructs of job demands and job resources (i.e., emotional and physical) with four-month gaps, as previous studies did not address the impact within this time frame.

Do burnout and depressive symptoms form a single syndrome? Confirmatory factor analysis and exploratory structural equation modeling bifactor analysis

OBJECTIVE

The issue of burnout-depression overlap remains contentious. In this study, the question of whether burnout symptoms form a syndrome that is distinct from depression was reexamined.

METHODS

The study involved 332 employed individuals (65% female; mean age: 34). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure (SMBM). The SMBM operationalizes burnout based on three interconnected components, namely, physical fatigue, cognitive weariness, and emotional exhaustion. Depressive symptoms were assessed with the PHQ-9, a scale that covers the main manifestations of major depression. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) bifactor analysis were conducted.

RESULTS

On average, the factors underlying burnout's components correlated more strongly with the Depressive Symptom factor than with each other. Remarkably, such results were obtained even when fatigue-related items were excluded from the depression scale. Second-order CFA revealed that the factors underlying burnout's components and the Depressive Symptom factor were reflective of the same higher-order factor. ESEM bifactor analysis indicated that the general factor accounted for about 2/3 of the common variance extracted.

CONCLUSION

Consistent with a growing corpus of research, this study suggests that the burnout-depression distinction is untenable. Because the burnout-depression distinction tends to convey the idea that burnout is not as serious a problem as depression, many people struggling with depression might underestimate the gravity of their condition and not seek help when self-identifying as "burned out." Maintaining a line of demarcation between burnout and depression may thus be problematic from both a scientific and a health management standpoint.

Does Depression Mediate the Effect of Work Organization Conditions on Job Performance?

OBJECTIVE

The present study proposes to shed light on the impact of workers' depression on their work performance.

METHODS

We implemented a path analyses adjusted for design effects resulting from cluster sampling using MPlus software on a sample of 1957 workers. These analyses allowed us to evaluate direct and indirect effects (mediation) while taking into account the nonindependence of observations due to cluster sampling (workers nested in their workplace).

RESULTS

Results indicate that three indirect associations were found to be significant. Psychological demands, work schedule, and job insecurity were indirectly associated with lower levels of professional efficacy/job performance because of their positive associations with depression.

CONCLUSIONS

The results obtained suggest that interventions targeting specific work organization conditions could be warranted.

A systematic review on the effect of work-related stressors on mental health of young workers

PURPOSE

There is no review on the effect of work-related stressors on mental health of young workers. We systematically reviewed epidemiological evidence on this relationship.

METHODS

The review searched eight databases: Embase, PubMed, Web of Science, Cinahl, Cochrane Library, Informit, PsycINFO, and Scopus from their respective start dates until May 2017. Studies that have examined a mental health outcome in relation to a work-related stressor as exposure in young workers were included. The review was reported based on the PRISMA statement.

RESULTS

Three cross-sectional studies and six longitudinal cohort studies were included. Cross-sectional evidence showed that adverse work conditions including working overtime, job boredom, low skill variety, low autonomy, high job insecurity, and lack of reward were associated with poor mental health of young workers. Longitudinal evidence showed that high job demands, low job control, effort-reward imbalance, and low work support (men only) were associated with poor mental health. There was evidence on the contemporaneous relationship between two or more adverse work conditions and poor mental health.

CONCLUSIONS

Although more research (particularly high-quality longitudinal studies) is warranted in this area, our review indicates that work-related stressors have a negative impact on the mental health of young workers. The current review suggests that workplace interventions and policy are required to improve the quality of work for young workers.

A five-sample confirmatory factor analytic study of burnout-depression overlap

OBJECTIVE

It has been asserted that burnout-a condition ascribed to unresolvable job stress-should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined.

METHODS

Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)-General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ-9.

RESULTS

In all five samples, the latent factors pertaining to burnout's components correlated on average more highly with the latent Depression factor than with each other, even with fatigue-related items removed from the PHQ-9. Second-order factor analyses indicated that the latent Depression factor and the latent factors pertaining to burnout's components were reflective of the same overarching factor.

CONCLUSIONS

This study suggests that the burnout-depression distinction is artificial.

Factors Associated with Electronic Cigarette Use among Young Adults: The French "Trajectoires EpidéMiologiques en POpulation" (TEMPO) Cohort Study

Background: Electronic cigarettes (e-cigarettes) are sold in France since 2010 and have rapidly become popular. However, factors associated with e-cigarette use among young adults are not well known. Methods: We used data from the 2015 French TEMPO community based cohort study, restricted to current and former smokers with data on e-cigarette use (n = 368 adults, 23-41 years). Participants completed a self-administered questionnaire including information on family status, educational attainment, occupation and type of work contract, health problems, alcohol and cannabis use, electronic cigarette use, as well as perceptions of e-cigarettes. Use of traditional tobacco was assessed in 2011 and 2015. Data were analyzed using logistic regression models. Results: Among current and former smokers, 26.9% reported lifetime e-cigarettes use and 15.2% current use. Factors associated with lifetime use were: low socioeconomic position (OR = 2.2; 95% CI = 1.2-4.2), traditional cigarette use (OR associated with smoking in 2011 and 2015 = 13.1; 95% CI = 5.2-32.6) and positive perceptions of e-cigarettes (OR = 4.4; 95% CI = 2.4-8.1) as well as asthma (OR = 2.1; 95% CI = 0.9-4.9) and overweight/obesity (OR = 2.5, 95% CI = 0.9-6.9). Factors associated with current use were traditional cigarette smoking (OR associated with smoking in 2011 and 2015 = 3.9; 95% CI= 1.3-12.2) and positive perceptions of e-cigarettes (OR =4.4; 95% CI = 2.3-8.4). Conclusions: Young adults who use e-cigarettes tend to persist in smoking traditional cigarettes. The conditions under which e-cigarette use can help individuals quit traditional tobacco products remain to be elucidated.

Is prenatal maternal distress context-dependent? Comparing United States and the Netherlands

BACKGROUND

Maternal anxiety and depression symptoms during pregnancy can compromise a woman's well-being and affect offspring development. The present study represents a comparison of maternal late-pregnancy internalizing symptoms (i.e., depression and anxiety) between the United States of America (US) and the Netherlands. We hypothesized that women in the US would report higher levels of anxiety and depression during pregnancy compared to their Dutch counterparts, both on individual symptom indicators and overall latent distress, due to more favorable policies/accessible services relevant to perinatal health in the Netherlands.

METHODS

Pregnant women were recruited at two comparable sites in the Netherlands (n = 327) and the US (n = 228). Measures included self-reports of internalizing distress and key covariates (i.e., parity, gestational, and maternal age).

RESULTS

Expectant mothers in the US reported higher depressive and anxiety symptoms compared to their Dutch counterparts. Results were consistent across individual internalizing symptom indicators and the overall latent prenatal distress means computed for US and Dutch samples, with an estimated large effect size for the latter after controlling for covariates.

LIMITATIONS

Despite their relatively large sizes, our samples were limited in their representativeness of the two cultures and mechanisms contributing to observed differences were not examined.

CONCLUSIONS

Pregnant women in the US reported higher levels of depression and anxiety symptoms than women in the Netherlands. Implications concern perinatal policy and clinical services (e.g., emotional health support provided to mothers).

Experiences of internet-delivered and work-focused cognitive behavioral therapy for stress: A qualitative study

INTRODUCTION

Stress is one of the major challenges of modern society, causing significant costs and personal problems. In the recent decade a growing body of research has provided support for the efficacy of internet interventions for stress. However, few studies have focused on how participants experience internet interventions for stress.

METHOD

The current study was a qualitative follow-up study of an internet-delivered and work-focused cognitive behavioral treatment for stress. The aim was to capture participants' experiences of the treatment and their views on effects on health and well-being. Participants were selected from a controlled study (n = 27), using a criterion-based sampling approach selecting those participants who had completed all treatment modules. Nine semi-structured interviews were held, and the material was analyzed using Thematic Analysis.

RESULTS

The results indicated that most of the participants experienced positive effects on their mental health and well-being in both life and at work. All participants emphasized the importance of having access to therapist support. In line with previous research, participants found the intervention to be extensive and demanding and expressed the need for extended treatment time and therapist support.

CONCLUSIONS

Considering the limitations of the present study, future research could examine the feasibility of reducing the length of each session, extending deadlines and increasing therapist support. This could improve treatment efficacy and further enhance utilization in the target population.

Burnout is associated with a depressive interpretation style

The aim of this 188-participant study (65% female; mean age = 40.31) was to examine whether burnout and depression are associated with similar interpretation biases in the processing of emotional information. Burnout symptoms were assessed with the Maslach Burnout Inventory-General Survey and depressive symptoms with the 9-item depression module of the Patient Health Questionnaire. Interpretation bias toward emotional information was examined using an amended version of the Word-Sentence Association Paradigm (WSAP). In the WSAP, participants are asked to decide whether emotionally-valenced words are related to ambiguous sentences. Burnout and depression were each associated with a higher endorsement of negative interpretations and a higher ratio of negative interpretations to positive interpretations. Negative word endorsement and positive word endorsement interacted in such a way that negative word endorsement was predictive of burnout and depression only when positive word endorsement levels were relatively low. Our findings suggest that burnout and depression are associated with similar alterations in the interpretation of ambiguous information. This study supports the view that burned out individuals perceive the world with "depressive glasses." Cognitive bias modification techniques employed in the treatment of depressive conditions may constitute relevant therapeutic options for "burned out" individuals.

Perceived Stress among Different Occupational Groups and the Interaction with Sedentary Behaviour

Sedentary lifestyle and low physical activity are associated with health issues, including both physical and mental health, non-communicable diseases, overweight, obesity and reduced quality of life. This study investigated differences in physical activity and other individual factors among different occupational groups, highlighting the impact of sedentary behaviour on perceived stress by occupation. Cross-sectional study included 571 full-time workers of Kaunas city, Lithuania. The outcome of this study was assessment of perceived stress. Time spent sedentary per day, occupation and other individual characteristics were self-reported using questionnaires. Two main occupational groups were analysed: white-collar and blue-collar workers. Multivariate logistic regression was used to assess the impact of sedentary behaviour on perceived stress among different occupational groups. The prevalence of high sedentary behaviour was 21.7 and 16.8 % among white-collar and blue-collar workers, respectively. Blue-collar workers had a higher risk of high perceived stress (OR 1.55, 95% CI 1.05-2.29) compared to white-collar workers; however, sedentary time did not have any impact on high perceived stress level. Meanwhile, white-collar male (OR 4.34, 95% CI 1.46-12.95) and white-collar female (OR 3.26, 95% CI 1.23-8.65) workers who spend more than three hours per day sedentary had a greater risk of high levels of perceived stress. These findings indicate sedentary behaviour effect on perceived stress among two occupational groups-white-collar and blue-collar workers-and other important factors associated with perceived stress.

Modelling management response and online reviews for improved financial performance of hospitals

Hospitals are increasingly changing their online review strategy from active listening to proactive engagement to ensure proper responses to patients. Reviews of and responses from hospitals vary in different regions of the world, thereby the process of ranking of hospitals is bounded to a specific region. On the other hand, working conditions in public hospitals have been of great concern worldwide for healthcare personnel. Due to the poor review of a hospital, financial performance is gradually deteriorating, which leads to the migration of healthcare personnel from one hospital to another. This study investigates the combined effect of management responses and online reviews on the financial performance of hospitals by concentrating on three areas of concern. First, how variation in management responses, both within a hospital and on peer review sites, affects the motivation of healthcare personnel towards service and number of patients seeking services. Second, a cyclic link depicting interrelationships among four major domains, namely rating, management response, financial performance, and recommendation, has been presented. Third, a generic model is proposed to improve the performance of hospitals in each of the above domains, and analysis has been done to make the model region-specific. A case study on Indian hospitals is performed to depict the sufficiency of models. It is found that management intervention on social media should be strategic, and a higher average rating tends to mitigate the effect of negative responses.

The association between quality of direct supervisor's behavior and depressive mood in Korean wage workers: the 4th Korean Working Conditions Survey

Background

Workers spend most of their social lives at work and have relationships of varying nature with people in the workplace. Direct supervisors, in particular, have a direct and lasting impact on workers, which may influence workers' mental health. Depression is very prevalent worldwide, and social concern about the disease is on the rise. The aim of this study is to investigate the effect of direct supervisors' behavior on the depressive mood of Korean wage workers.

Methods

We used data from the 4th Korean Working Conditions Survey held in 2014; 22,212 participants were included in the analysis. The quality of a direct supervisor's behavior was categorized from 0 (= lowest) to 5 (= highest) points. The degree of depressive mood was measured on a scale from “normal mood” to “likely depression” based on the 5-item World Health Organization Well-Being Index (WHO-5) questionnaire. Multiple logistic regression was used to analyze the association between the quality of the direct supervisor's behavior and the depressive mood of wage workers.

Results

After multivariable adjustment, significantly increased odds ratio (OR) for likely depression was found in the 4, 3, 2, 1, and 0 points of the quality of the direct supervisor's behavior compared to 5 points. After stratification for the level of satisfaction with working conditions, the OR of the unsatisfied groups was higher than that of the satisfied groups.

Conclusions

Likely depression was found to be significantly associated with a low quality of direct supervisor's behavior. This association was stronger in workers who were not satisfied with their working conditions. This study suggests that proper management of the direct supervisor's behavior is needed to reduce the risk of depression among Korean wage workers.

The impact of military service on the mental health of older UK veterans: A qualitative study

BACKGROUND

There may be ongoing psychological problems associated with military service later in life; yet as the elderly in the general population also suffer from mental health problems, whether such issues can be attributed to military service or are a feature of ageing remains unclear. This study aimed to explore veteran and nonveteran perceptions of the impact of their occupation on their psychological well-being later in life.

METHODS

Twenty-five veterans (≥65 y); 25 nonveterans (≥65 y); 10 veterans with diagnoses of mental health issues (≥65 y); and a close companion of all participants (≥18 y, spouse, child, and close friend) were recruited. Using a qualitative approach, participants completed semistructured qualitative interviews with measures of psychological adjustment used to describe the sample.

RESULTS

Veterans were found to experience higher levels of workplace stress and trauma exposure compared with nonveterans. When such challenges were positively appraised, veterans described increased confidence and resilience. Social support in response to occupational stress was central to veteran and nonveteran well-being, especially for those with mental health problems. Nonetheless, providing support was challenging for close companions, with many feeling overwhelmed and requiring additional guidance from the veteran's clinical care team.

CONCLUSIONS

The findings delineate the impact of occupation on the well-being of older veterans and nonveterans. The results illustrated the psychological support needs and formal guidance desired by veterans, nonveterans, and their families, which could ultimately improve coping of both the individual and family.

Increased Posterior Cingulate Functional Connectivity Following 6-Month High-Dose B-Vitamin Multivitamin Supplementation: A Randomized, Double-Blind, Placebo-Controlled Trial

B vitamins are essential for optimal brain and body function, and are particularly important for cortical metabolic processes that have downstream effects on mitigating oxidative stress. Oxidative stress has been linked to poor psychological outcomes including psychological distress, which has wide-reaching implications for the community and the workplace. Given work-related stress has been associated with poor mental health outcomes, high-dose B vitamin supplementation may be effective in improving brain function and psychological outcomes via attenuation of oxidative stress. This randomized, double-blind, placebo-controlled study investigated psychological outcomes following 6-month supplementation of a high-B-vitamin multivitamin in a large sample of healthy adults (n = 108, aged 30-70 years), as well as changes in default mode network functional connectivity in a subset of the original sample (n = 28). Improvements in occupational stress, general health, perceived stress, depressive symptoms, and mood profiles were identified for both active and placebo groups over time (p < 0.05 corrected). Seed-based functional connectivity analysis centered on the posterior cingulate cortex (PCC) showed that connectivity between the PCC and the caudate increased for the active treatment group, but decreased for the placebo group (p < 0.05 corrected). These findings reveal a substantial intervention effect for both active and placebo treatments, which could in part be associated with a placebo effect in subjective measures. There was, however, a significant treatment effect in the objective measure of functional connectivity, suggesting that reduced psychological stress and high-B-vitamin multivitamin supplementation may lead to an increase in DMN and caudate functional connectivity, which might reflect a strengthening of neurocircuitry within areas associated with reward and emotion at rest. Future studies should consider a placebo run-in methodology to reduce the placebo effect on the subjective measures of stress.

The influence of work engagement in social workers in England

Background

Social workers help to maintain and improve the lives of children, their families and adult service users in the UK. However, while engagement is shown to be an important determinant of both patient and employee outcomes in related health care professions, the influence of engagement has not been demonstrated in social workers.

Aims

To investigate the influence of employee engagement on perceived stress, turnover intentions, job satisfaction and presenteeism.

Methods

A cross-sectional survey of members of one English social work organization including measures of engagement (Utrecht Work Engagement Scale), the Perceived Stress Scale and single-item measures of job satisfaction, turnover intentions and presenteeism. T-tests and Mann-Whitney analyses were conducted to investigate differences in these measures in high and low engagement scores.

Results

A total of 1049 responses were analysed; social workers with greater engagement had significantly lower stress and turnover intentions, less presenteeism and greater job satisfaction. Additionally, overall respondents had poor levels of perceived stress, turnover intentions and presenteeism.

Conclusions

Employee engagement is significantly associated with a number of work-related outcomes in social workers in England. However, social workers seem to have high turnover intentions and presenteeism, and greater than average perceived stress.

Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya

Background

Truck drivers in sub-Saharan Africa are at high risk for both mental health disorders and sexually transmitted infections. We sought to determine the prevalence of depression among a sample of long-distance truck drivers seeking services at roadside wellness clinics in Kenya and explore the relationship between depression and sexual risk behavior.

Methods

We used data from an interviewer-administered questionnaire from 284 truck drivers in Kenya who participated in a randomized controlled trial evaluating whether offering oral HIV self-testing could increase HIV test uptake. Depression was categorized based on the Patient Health Questionnaire-9 score, with a score ≥10 indicative of probable major depressive disorder (MDD). Sexual risk behavior was operationalized as the number of condomless sex partners in the past 6 months.

Results

The mean participant age was 36.9 years, 83.0% were married, and 37.0% had a secondary school education or higher. Overall, 24% of participants had probable MDD, and 58.2% reported having one condomless sex partner in the past 6 months, whereas 27.3% reported having had two or more. In a multivariable Poisson regression model adjusted for demographic and other relevant variables, including number of sex partners, MDD was significantly associated with a greater number of condomless sex partners (adjusted prevalence ratio 1.63, 95% confidence interval [1.25–2.12], p < 0.001). General self-efficacy significantly mediated the association between MDD and number of condomless sex partners.

Conclusions

The high prevalence of depression highlights the need to test the feasibility and acceptability of mental healthcare interventions for this population, possibly integrated with HIV prevention services. Future research is needed to better understand the association between depression and sexual risk behavior, as well as the role of self-efficacy.

Depressive symptoms in Chinese assembly-line migrant workers: A case study in the shoe-making industry

INTRODUCTION

Assembly-line migrant workers (AMWs), as a major workforce in China, may be at particularly high risk of depression due to their relative low social economic status and particular job characteristics. However, little is known about the frequency and characteristics of depression among Chinese AMWs. This study investigated the prevalence and correlates of depressive symptoms in Chinese AMWs.

METHODS

In this cross-sectional survey, 915 Chinese AMWs from two shoe-making factories completed a standardized questionnaire to report their socio-demographics, physical health, migration, and work. They also reported their depressive symptoms by completing the Beck Depression Inventory-Short Form (BDI-SF). We conducted multiple logistic regression analysis to identify factors related to depression.

RESULTS

We found that 31.7% of AMWs were clinically depressed (BDI-SF ≥ 8). The multiple regression model included age, self-rated physical health, pain, family relationships, having no good friends at the same factory, and working under high pressure.

DISCUSSION

Our findings suggest that depression is common among Chinese AMWs. We argue that there is an urgent need for health care providers and factory managers to work on the early identification of AMWs, who are at high risk for depression. Psychological and psychiatric treatments are necessary in the Chinese labor-intensive industries.

The Role of Occupational Stress in the Association between Emotional Labor and Mental Health: A Moderated Mediation Model

This study investigated whether occupational stress factors moderate the effect of emotional labor on psychological distress in call center employees. A cross-sectional and descriptive study using anonymous paper-based survey methods was conducted in a sample of 283 call center employees in South Korea. Participants completed the Emotional Labor Scale, the Depression Anxiety Stress Scale, and the Korean Occupational Stress Scale. Moderated mediation analyses were conducted using the PROCESS macro in order to investigate the relationship among variables. The results showed that the association between surface acting while having emotional labor and psychological distress was mediated by emotional dissonance. The mediated effect of emotional dissonance was moderated by discomfort in occupational climate, suggesting that improving the occupational environment can lessen the level of psychological distress among emotional workers, and that more attention should be devoted to the development of an intervention at the organizational level in order to prevent mental health problems in this population.

Zero-hour contracts and stress in UK domiciliary care workers

The UK domiciliary care workers play a vital role in maintaining and improving the lives of service users who have a variety of needs. Around 60% of these employees work under zero-hours contracts but, while it is known that conditions such as temporary and shift working can influence employee health and performance, zero-hours have not been widely investigated. This project sought to first investigate the stress associated with working as a domiciliary care worker, as well as comparing the experiences of employees contracted to zero-hours with those contracted to at least 16 hr per week. Twenty-nine semistructured interviews (15 zero-hour, 14 contracted hours) were conducted in the West Midlands of the United Kingdom and analysed using thematic analysis. Across all participants, four predominant stressors were found. First, the level of pay for a job with high levels of responsibility was poor. Second, participants described struggling to maintain an adequate work-life balance due to the varied timings of visits, as well as rude and aggressive behaviour from both service users and their families. Lastly, a lack of peer support and poor care from peers was discussed. However, every respondent described the positive relationships that they develop with service users being a distinct stress reliever. Zero-hours respondents discussed two further stressors. Power refers to the relationship between employee and management, with respondents describing the balance of power being with the management. Uncertainty reflected respondents not having set hours of work or pay, and thus not being able to plan their personal lives and sometimes not being able to pay bills. Findings suggest that domiciliary care workers are exposed to a range of stressors, with zero-hours adding to these. Further research should look into methods to improve both the job role for workers, and redress the power relationships for those with zero-hours contracts.

Sex differences in stress reactivity in arousal and attention systems

Women are more likely than men to suffer from psychiatric disorders with hyperarousal symptoms, including posttraumatic stress disorder (PTSD) and major depression. In contrast, women are less likely than men to be diagnosed with schizophrenia and attention deficit hyperactivity disorder (ADHD), which share attentional impairments as a feature. Stressful events exacerbate symptoms of the aforementioned disorders. Thus, researchers are examining whether sex differences in stress responses bias women and men towards different psychopathology. Here we review the preclinical literature suggesting that, compared to males, females are more vulnerable to stress-induced hyperarousal, while they are more resilient to stress-induced attention deficits. Specifically described are sex differences in receptors for the stress neuropeptide, corticotropin-releasing factor (CRF), that render the locus coeruleus arousal system of females more vulnerable to stress and less adaptable to CRF hypersecretion, a condition found in patients with PTSD and depression. Studies on the protective effects of ovarian hormones against CRF-induced deficits in sustained attention are also detailed. Importantly, we highlight how comparing males and females in preclinical studies can lead to the development of novel therapeutics to improve treatments for psychiatric disorders in both women and men.

Is teachers' mental health and wellbeing associated with students' mental health and wellbeing?

BACKGROUND

Factors within the school environment may impact young people's mental health and wellbeing. The aim of this study was to understand the association between teacher and student mental health and wellbeing. Further, it seeked to identify possible explanations by examining whether the strength of any association is weakened once quality of teacher-student relationships, teacher presenteeism and absence are considered.

METHODS

Cross-sectional data were collected from 3216 year 8 (aged 12-13 years) students and from 1182 teachers in 25 secondary schools in England and Wales. The association between teacher wellbeing (measured by Warwick Edinburgh Mental Wellbeing Scale (WEMWBS)) with student wellbeing (WEMWBS) and with student psychological distress (Total Difficulties Score (TDS)) was assessed using Random Effects Mixed Models. Analyses were repeated using teacher depression (measured by Patient Health Questionnaire) as the explanatory variable.

RESULTS

Better teacher wellbeing was associated with i) better student wellbeing (standardised effect = 0·07, 95% CI = 0·02 to 0·12) and ii) lower student psychological distress (standardised effect = -0·10, 95% CI = -0·16 to -0·04). Teacher presenteeism and the quality of the teacher-student relationship appeared to be on the pathway of these relationships. Higher levels of teacher depressive symptoms were associated with poorer student wellbeing and psychological distress (standardised effect = -0·06, 95% CI = -0·11 to -0·01 & 0·09, 95% CI = 0·03 to 0·15). This association did not withstand adjustment for teacher presenteeism.

LIMITATIONS

Cross sectional in design so unable to establish temporal associations.

CONCLUSIONS

Associations were found between teacher wellbeing and student wellbeing and psychological distress. There were also an association between teacher depression and student wellbeing. Both may be partially explained by teacher presenteeism and quality of teacher-student relationships.

The relation of alexithymia, chronic perceived stress and declarative memory performance: Results from the general population

Previous evidence showed associations of alexithymia with altered declarative memory performance. However, these findings were not fully consistent and the underlying mechanism remains unclear. Alexithymic subjects may be at specific risk for chronic psychosocial stress, which in turn represents a predictor for poorer memory performance. We investigated independent and interaction effects of alexithymia and chronic perceived stress on declarative memory performance. Data were used from two independent general-population samples from the Study of Health in Pomerania (SHIP). In sample 1 (N = 1981), the Auditory Verbal Learning Test, the Toronto Alexithymia Scale (TAS-20) and the Screening Scale for Chronic Stress (SSCS) were applied. In sample 2 (N = 3799), the word list of the Nuremburg Age Inventory and TAS-20 were administered to replicate findings. Alexithymia was significantly associated with poorer immediate and delayed word recall. Chronic stress negatively predicted immediate, but not delayed recall. Alexithymia and particularly "Difficulties Identifying Feelings" showed significant associations with chronic perceived stress. Our findings provide clear evidence for an association of alexithymia with impaired declarative memory performance for words. The strong association of alexithymia with perceived chronic stress could contribute to explain the association of alexithymia with stress-related disorders.

Development of a taxonomy of practice-related stressors experienced by veterinarians in the United States

OBJECTIVE To develop a comprehensive taxonomy of practice-related stressors experienced by US veterinarians. DESIGN Cross-sectional survey. SAMPLE A subset of 1,422 US veterinarians who provided written (vs selected) responses to a question in a previous survey regarding practice-related stressors. PROCEDURES Using grounded theory analysis, 3 researchers inductively analyzed written survey responses concerning respondents' main practice-related stressors. In 5 iterations, responses were individually coded and categorized, and a final list of practice-related stressor categories and subcategories was iteratively and collaboratively developed until theoretical and analytic saturation of the data was achieved. RESULTS A taxonomy of 15 categories of broad practice-related stressors and 40 subcategories of more specific practice-related stressors was developed. The most common practice-related stressor categories included financial insecurity (n = 289 [20.3%]), client issues (254 [17.9%]), coworker or interpersonal issues (181 [12.7%]), and work-life balance (166 [11.7%]). The most common subcategories were clients unwilling to pay (118 [8.3%]), low income (98 [6.9%]), cost of maintaining practice (56 [3.9%]), and government or state board policies (48 [3.4%]). CONCLUSIONS AND CLINICAL RELEVANCE This study provided a comprehensive list of the types of practice-related stressors experienced by US veterinarians, building a foundation for future research into relationships between job stress and mental health in this population. Frequency data on the various stressors provided an initial understanding of factors that might be contributing to high stress rates among US veterinarians.

Eating Disorders in the Workplace: A Qualitative Investigation of Women’s Experiences

Though employment is typically associated with positive mental health outcomes for individuals with disabilities, the ubiquity of stress and stigma at work may complicate the relation between work and well-being for women with eating disorders (EDs). To date, however, the experiences of women with EDs in the workplace have not been examined. By utilizing a qualitative methodology to form an initial framework for the examination of EDs in the workplace, we address this gap in the literature. Seventy adult women with anorexia, bulimia, and binge eating disorder discussed the relation between work and their condition. The data analysis led to the delineation of a theoretical model, which we propose explains the interconnections between key study constructs, including individual characteristics; workplace stressors; identity, stigma, and stress management techniques; and related personal and organizational outcomes. Our research suggests that, depending on how stress is managed, the workplace can serve as a bridge or a barrier to ED recovery. This study lays the groundwork for understanding the ways in which workplace life interacts and interferes with ED management, opening up a new line of investigation for researchers working to enhance the lives of individuals with EDs across life domains.

Pressure management as an occupational stress risk factor in irritable bowel syndrome: A cross-sectional study

Irritable Bowel Syndrome (IBS) is the most prevalent functional gastrointestinal disorder. Psychosocial stress is one of the pathogenic factors involved in the pathogenesis of IBS. The Pressure Management Indicator (PMI) is a validated questionnaire to analyze all aspects of occupational stress-a model involving sources of pressure, the mechanisms of coping, the personality, and the resulting effects of the interaction between these 3 elements. The purpose of this study was to analyze the association between socio-professional stress effects in IBS, and the relationship of IL-6 levels and salivary cortisol with occupational stress.We conducted a prospective cross-sectional study on 76 patients (39 patients with IBS, diagnosed according to the Rome III criteria and 37 healthy controls) who were investigated using a validated self-administered questionnaire: PMI. The biologic markers of chronic stress were analyzed using salivary cortisol and the immune response with serum interleukin 6 (IL-6).The IBS patients corresponded to the following subtypes: diarrhea-predominant: 22, constipation-predominant: 14 and mixed: 3. All the socio-professional pressure effects variables and scales were statistically significant, in an inversely proportional relation with IBS. Lower scores (poor effects) were found in IBS subjects. The adjusted odds ratios of having IBS versus healthy subjects for the socio-professional pressure effects scales were: 0.81 (95% confidence interval (CI) 0.72-0.88), for satisfaction, 0.85 (95% CI 0.78-0.91) for organization, 0.85 (95% CI 0.79-0.91) for mental wellbeing and 0.8 (95% CI 0.71-0.87) for physical wellbeing (P <.001). Also, the serum IL-6 levels were significantly higher in IBS than in controls (p < 0.001). There was no statistical difference between the salivary levels of cortisol between IBS patients and controls (P = .898).The level of occupational stress was higher in IBS patients compared to healthy subjects (socio-professional stress effects were lower in IBS patients) and correlated with IL-6 levels. Salivary cortisol was not associated with occupational pressure management.

The role of optimism in the relationship between job stress and depressive symptoms. Longitudinal findings from the German Ageing Survey

BACKGROUND

The aim of the present study was to investigate the effect of job stress on depressive symptoms and whether optimism moderates this relationship longitudinally. Data were used from 2002 until 2014 (wave 2 to 5) of the German Ageing Survey. The sample consists of community-dwelling individuals living in Germany aged from 40 to 95 years (7086 observations in fixed effects regression analysis).

METHODS

A self-report questionnaire was used to measure depressive symptoms (Center for Epidemiologic Studies Depression Scale), job stress (scale 1 to 5) and optimism (Optimism Scale of Brandtstaedter & Wentura).

RESULTS

Adjusting for potential confounders, fixed effects regression analysis revealed that an increase in job stress was associated with an increase in depressive symptoms, whereas an increase in optimism was associated with a decrease in depressive symptoms. Optimism significantly moderated the relation between job stress and depressive symptoms.

LIMITATIONS

The possibility of a small sample selection bias cannot be dismissed.

CONCLUSIONS

The present study highlights the moderating role of optimism in the relation between job stress and depressive symptoms longitudinally. Thus, efforts to increase optimism in individuals might be beneficial in reducing depressive symptoms among individuals with high job stress.