Anxiety disorders and workplace-related anxieties

Digital Challenges: Investigating Computer Vision Syndrome in Thai Esports Through a Case-Control Approach

Purpose

To determine the factors associated with eyestrain in esports athletes in Bangkok compared with controls.

Patients and Methods

A cross-sectional descriptive study was conducted between April and June 2023, involving 160 male participants (aged 20-35 years) who used digital devices, consisting of esports athletes and a control group. Data were collected using a general information questionnaire, Computer Vision Syndrome Questionnaire (CVS-Q), and Depression anxiety stress scale-21 (DASS-21). Ophthalmic instruments were used for the eye examinations by an optometrist.

Results

Seventy-six esports athletes showed significantly lower visual performance than controls in logMAR visual acuity (p < 0.020), phoria (p < 0.001), negative fusional vergence (blur, break, and recovery) (p < 0.012, p < 0.004 and p < 0.039), positive fusional vergence (blur, break, and recovery) (p < 0.005, p < 0.001 and p < 0.005), monocular estimation method (p < 0.001), monocular and binocular accommodative facility (p < 0.001), and vergence facility (p < 0.001). A study on risk factors for CVS found that esports athletes were significantly more likely to have CVS (p < 0.001). Work environments with high-intensity lighting significantly increase the risk of CVS compared to low-intensity lighting (p < 0.001). The use of a digital device for >4 h/day, having a history of alcohol consumption, and stress significantly increased the risk of CVS (p < 0.001, p < 0.023, p < 0.048).

Conclusion

This study found that esports athletes experienced vision health problems, indicating the need to prevent eyestrain caused by the use of digital devices.

High-performance HR practices, job demands and employee well-being: The moderating role of managerial support

Drawing on the labour process theory and the job-demands resources model, this study challenges the assumption of beneficial effects of high-performance HR practices (HPHRP). The study argues that such practices lead to heightened work demands, which in turn compromise employees' well-being. The study also argues that the negative consequences associated with HPHRP can be ameliorated when employees receive support from their managers. To test the study's moderated mediation model, multisource matched employer-employee data from the Workplace Employment Relations Survey 2011 is used. Results of generalised multilevel structural equation modelling in STATA revealed that the relationship between HPHRP and well-being (anxiety and depression) is mediated by Job demands (JD). Furthermore, the relationship between JD and both anxiety and depression is moderated by Managerial support (MS), such that when the level of MS is high, the positive relationship between HPHRP and both anxiety and depression via JD is weaker. Taken together, the findings of the study advance our understanding of why and when HPHRP may impair employees' well-being.

Development and Psychometric Properties of Work Information Anxiety Questionnaire

Purpose

The purpose of this study is to develop and validate the Work Information Anxiety Questionnaire (WIAQ), and to report on the psychometric properties of the WIAQ.

Methods

Based on the Approach-Avoidance Conflict theory, and combining previous literature reviews and open-ended interviews, initial scale items for the Work Information Anxiety Questionnaire were developed. Using 324 full-time corporate employees as subjects (Sample 1), an exploratory structural examination of work information anxiety was conducted, including item analysis, exploratory factor analysis, and network analysis. An additional 210 corporate employees were selected for formal testing (Sample 2), and the obtained data underwent structural validation, including confirmatory factor analysis, validity testing, and reliability testing.

Results

The WIAQ (9 items) exhibited a two-factor structure of reception anxiety and missing out anxiety, with a cumulative variance contribution rate of 67.56%. The confirmatory factor model showed good model fit, with cross-group and cross-measurement stability. The Cronbach's α of the WIAQ was 0.899, and the McDonald's ω of the two factors were 0.906 and 0.831 respectively. The WIAQ demonstrated good criterion-related validity with the SAS and DASS.

Conclusion

The factor structure of the WIAQ is clear, and its reliability and validity indicators meet psychometric requirements. It can serve as an effective tool for measuring work information anxiety.

Psychometric properties of the generalized anxiety disorder-7 (GAD-7) in a sample of workers

Objective

To evaluate the psychometric properties of the GAD-7 by obtaining evidence of internal structure (dimensionality, precision and differential functioning of items) and association with external variables.

Methods

A total of 2,219 protocols from three different studies conducted with Puerto Rican employees that administered the GAD-7 were selected for the current study. Item response theory modeling was used to assess internal structure, and linear association with external variables.

Results

The items were adapted to a graduated response model, with high similarity in the discrimination and location parameters, as well as in the precision at the level of the items and in the total score. No violation of local independence and differential item functioning was detected. The association with convergent (work-related rumination) and divergent (work engagement, sex, and age) variables were theoretically consistent.

Conclusion

The GAD-7 is a psychometrically robust tool for detecting individual variability in symptoms of anxiety in workers.

Can Rational Emotive Behaviour Therapy (REBT) and Mindfulness be Integrated Effectively within High Performance Settings?

Our critical commentary explores the overlaps and divergences between Rational Emotive Behaviour Therapy (REBT) and contemporary mindfulness practice and considers whether the approaches could be integrated and applied effectively within two high performance settings in particular: sport and business. It highlights how REBT and mindfulness share similar philosophical positions on the causes of emotional disturbance, on the importance of acceptance, and on cultivating self-awareness to respond healthily and adaptively to adverse events. It also acknowledges diverenges relating to REBT and mindfulness' respective positions on judgement of thoughts, an emphasis on the present moment, and meditative practice. We observe that by cultivating metacognitive awareness-a capacity to impartially observe thinking-mindfulness may help individuals in high performance settings to see more clearly how their beliefs influence their emotional, cognitive, and behavioural outcomes. Mindfulness could thus potentially aid an individual's transition from intellectual insight to emotional rational insight within an REBT framework. Moreover, appropriately integrated mindfulness practice alongside REBT-based work may help individuals within high performance settings, and beyond, to cultivate a mindset that is grounded in the present, less distracted and more task focused, potentially enhancing performance outcomes.

Prevalence and Correlates of Work-Phobic Anxiety in a National Representative Sample

Abstract. Work anxiety is a common mental health problem that is often overlooked and often causes long periods of sick leave. This is the first representative survey on the distribution of work-phobic anxiety in Germany. Of the 2,030 working-age participants (18 – 67 years), 7 % had increased work-phobic anxiety of a moderate (5 % with scores >1.5 – 2.5 on a scale from 0 – 4) or high (2 % with scores >2.5 – 4) degree. People with high levels of work-phobic anxiety reported the longest sick leave durations during the past 12 months (8 weeks) and the most periods of unemployment in their professional lives. The three groups were similar in age, sex, and partnership status. People with high work-phobic anxiety perceived themselves least competent in almost all dimensions of psychological capacity. Occupational health must consider work-phobic anxiety as a specific mental health problem closely linked to work-ability problems.

Effectiveness of a Water Intake Program at the Workplace in Physical and Mental Health Outcomes

Introduction

Adequate water intake is a low-cost and effectively non-invasive strategy for individual health outcomes. We aimed to demonstrate the efficacy of water intake intervention in intensive-labor and static-type workplaces.

Method

Smart drinking cups were provided to the participants, and a built-in application (App) associated with the cup was downloaded on their phones. The App collected and recorded the amount of drinking water consumed by the participants set reminders for drinking water and drinking water health education information. We assessed the data, including the amount of and time interval between water intake, sedentary time, the degree of physical and psychological importance of oneself, self-satisfaction, and physical fitness.

Results

After the intervention, water intake in the two companies significantly increased during the reminder period compared with the non-reminder period. A significant increase was noted in week 3 in the amount of water intake by the participants after using the App, and the total sedentary time considerably decreased. Furthermore, the interval between water consumption decreased compared with the preintervention interval. The systolic and diastolic blood pressure decreased in the participants working at the static-type and intensive-labor workplaces after the intervention, respectively. The participants ' lower limb muscle performance also improved significantly, and the emphasis on self-care was significantly improved.

Conclusions

The health-promoting effects of the water intake wellness intervention were akin to the butterfly effect. Besides significantly increasing water intake, the intervention improved other health behaviors, thereby benefiting physical and mental health. Hence, promoting water consumption in workplaces till it becomes a habit may benefit the employees.

The Impact of Telework and Closure of Educational and Childcare Facilities on Working People During COVID-19

Abstract. This study examines the impact of telework and closure of educational and childcare facilities on working people during COVID-19. We compare telework versus nontelework conditions and people with and without stay-at-home children. Data from 465 working people in Germany were collected via an online survey. People who do not work from home experience more stress, more negative and less positive affect, less life satisfaction and trust in government, and less loss of control over career success than those working from home. Concerning the conservation of resources theory, working from home can thus be seen as a resource gain, representing, in accordance with the self-regulation theory, a way to deal with pandemic threats. However, home office only seems to be beneficial if working conditions at home are supportive; otherwise, it is experienced as a resource threat or loss, especially with stay-at-home children.

Occupational groups and its physical and mental health correlates: results from the Singapore Mental Health Study 2016

Purpose

The physical and mental wellbeing of an individual is impacted by the type occupation one does. This study aims to establish the prevalence of mental and physical disorders, the association of occupational groups and health-related quality of life, and the extent of work-loss and work-cut back in past 30 days among the employed in the Singapore resident population.

Methods

Data from a population-based, epidemiological survey of a representative sample of Singapore citizens and permanent residents aged 18 years and above were used. Lifetime diagnosis of select mental disorders was established using the World Health Organization’s Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0). Data on nicotine dependence, work productivity, quality of life and socio-demographics were obtained via self-report. Ten major occupational groups based on the Singapore Standard Occupational Classification were included in the analysis.

Results

The sample comprised 4021 employed individuals who were predominantly males (54.7%) and aged 35–49 years (35.4%). ‘Service and sales workers’ (22.6%), ‘Professionals’ (17.3%) and ‘Legislators, senior officials and managers’ (16.4%) were the three largest occupational groups. Socio-demographic characteristics differed significantly (p < 0.001) across all occupational groups. Lifetime prevalence of mood disorders among the employed was 8.4% and the most prevalent physical disorder was chronic pain (18.9%). No significant differences were observed in work productivity loss across the occupational groups.

Conclusions

The disparities in the socio-demographic characteristics and prevalence of mental and physical disorders across occupational categories provide policymakers with vital information to pilot effective interventions that can improve the psychosocial and physical conditions at work.

Stress, anxiety, work-related burnout among primary health care worker: A community based cross sectional study in Kolar

Background:

Because of Primary Health care workers most of the national programmes run efficiently at grass root level. Workplace stress is alteration in one's physical or mental state in response to workplaces. Anxiety related to work among them is increasing and also Burnout.

Objectives of the Study:

To assess stress, anxiety and burnout related to work among ASHA workers and to assess the socio-demographic factors influencing the stress, anxiety and burnout related to work among ASHA workers.

Methodology:

This was a community based cross sectional study carried out for a period of 6 months from January 2019 to July 2019 at Kolar, India. Multistage cluster sampling was applied. From the selected 8 PHC all ASHA workers were part of the study. Sample size was calculated based on previous study with effect size of 1.5 from which final sample size was 150. Ethical clearance was obtained from the Institutional Ethical Committee (IEC) before the start of study. Written Informed consent was taken from the study. All data were entered in excel sheet and analyzed using SPSS version 22.

Results:

150 ASHA workers were interviewed. 75.5% belonged to Nuclear family, 50.7% belonged to age group of 31-40 years, 86.7% perceived that received payment for the work was low, 60.7% had to spend more than 2 hours for walking for the official work, 72% had work experience less than 10 years and 35.3% had working hours more than 8 hours. 45.3% had mild to moderate anxiety, 9.3% had Moderate Anxiety according to Zung Anxiety scale, 54% had moderate stress according to Cohen's perceived stress scale and 23.3% had personal burnout, 33 (22%) had work-related burnout and 4 (2.7%) had Client related Burnout of Moderate levels according to Copenhagen Burnout Inventory scale.

Conclusion:

Socioeconomic status, Training received before joining work, Type of work, perceptions regarding Work was found to be important factors affecting the mental health. Screening regularly for stress, anxiety and work-related burnout at work place is the need of the hour.

Person-Message Fit: Racial Identification Moderates the Benefits of Multicultural and Colorblind Diversity Approaches

Although diversity approaches attempt to foster inclusion, one size may not fit all. In five studies, African Americans (N = 1,316), who varied in strength of racial identification, contemplated interviewing at a company with a multicultural or colorblind approach. Participants in the multicultural condition anticipated pressure to be prototypical group members relative to colorblind and control conditions. Only weakly identified participants reacted to this pressure, experiencing more anxiety and inauthenticity in the multicultural relative to colorblind (not control) company. Strongly identified participants experienced less anxiety and inauthenticity in the multicultural relative to colorblind and control companies. Inauthenticity among weakly identified participants was apparent in self-descriptions and linked with worse hiring outcomes in multicultural relative to colorblind and control contexts. Despite predictions, there were no self-stereotyping effects. Diversity approaches that make some group members more comfortable may prove simultaneously constraining for others, highlighting the complexity in how diversity approaches affect individuals.

The Moderated-Mediation Effect of Workplace Anxiety and Regulatory Focus in the Relationship between Work-Related Identity Discrepancy and Employee Innovation

Extant research on work-related identity discrepancy mostly has probed its effects on employees' attitudes and emotions but has paid little attention to its impact on employee behaviors. Drawing on self-discrepancy theory, we examined the influencing mechanism and conditions of work-related identity discrepancy on employee innovation behavior. With data collected from 563 employees who personally experienced leadership transition in the workplace, we found that work-related identity discrepancy predicts employee innovation behavior through workplace anxiety. We also discovered that employees' personality traits-promotion regulatory focus and prevention regulatory focus in particular-can intensify or buffer the negative relationship between work-related identity discrepancy and employee innovation behavior. We further discuss the conceptual and practical implications of these findings.

Group therapists: combine alliance building with paying specific attention to the patient’s perception

In slow-open groups as well as therapies of less than ten sessions, each group session holds importance. Patients, therapists and co-therapists have different perspectives and may gain different experiences from a group session. This study investigates the perspectives of patients, therapists and co-therapists on alliance, new insights and therapist techniques in the same group session. Do the three actors perceive these group aspects similarly or differently? Which group aspects are related with the outcome coping? One hundred and forty-nine sessions of a cognitive behaviour therapy group have been investigated. Patients, therapists and co-therapists gave ratings on their perceived alliance, group topics and insights as well as therapists’ technique competency. Concerning new insights, there was concordance between patients and co-therapists (r = .211, p < .05). Concerning alliance, there was a concordance between patients and therapists (r = .327, p < .01). Therapists focusing on alliance building was associated with lower patient outcomes in terms of work coping (β = –.391). The quality of therapeutic techniques was the same in groups with higher and lower outcomes. Patients’ perception of whether they felt good in the group session was explanative for session outcome, while therapists’ perceptions and context conditions (supervision, number of participants) was not. Patients, therapists and co-therapists have different perspectives on the same group therapy session. Patients’ perceptions are associated with session outcomes. A lower session outcome must not be associated with a poor technique performance of the therapist. Therapists should not only be aware of alliance building and correct technical performance, but they must also be aware of patients’ perceptions of the group process and outcome.

Key learning aims

The present research is the first evaluation of group session aspects and session outcomes in rehabilitation patients with work anxieties in slow-open groups. We will learn: (1)

Die gruppentherapeutische Intervention „Gesund bleiben im Beruf“ zur Wiedererlangung der Arbeitsfähigkeit

Zusammenfassung. Theoretischer Hintergrund: In der psychotherapeutischen Forschung und Versorgung wurde die Wiedererlangung der Arbeitsfähigkeit bislang nur unzureichend berücksichtigt. Einige Studien weisen jedoch auf die Wirksamkeit arbeitsbezogener kognitiv-verhaltenstherapeutischer Therapieansätze hin. Fragestellung: Die vorliegende Pilotstudie soll ein neues Gruppentherapiekonzept mit dem Ziel der Verbesserung der Arbeitsfähigkeit evaluieren. Methoden: Es wurden Daten von N = 17 Teilnehmenden mit depressiven Störungen erhoben. Dafür wurden die Arbeitsfähigkeit, Arbeitsmotivation, generelle Symptombelastung und Depressivität zu drei Messzeitpunkten erfasst. Ergebnisse: Die Arbeitsfähigkeit verbesserte sich tendenziell. Teilnehmende wiesen kurz- und mittelfristig eine geringere Symptombelastung und geringere Depressivität auf. Die Aktivität und Partizipation erhöhten sich kurz- und mittelfristig. Schlussfolgerungen: Die Intervention scheint die psychische Gesundheit zu verbessern, allerdings müssen diese ersten Ergebnisse in einer randomisierten-kontrollierten Studie verifiziert werden.

Psychological strains, depressive symptoms, and suicidal ideation among medical and non-medical staff in urban china

BACKGROUND

The Strain Theory of Suicide has been tested and well supported regarding rural people who show risk of suicide. Studies on the impact of psychological strains on psychopathologies and suicidality in urban environments in China have been lacking.

AIMS

This study was designed to further examine the associations between psychological strains, depressive symptoms, and suicidal ideation in two separate urban samples of adults in China.

METHODS

One sample consisted of randomly selected medical employees of a large hospital (n = 1012), and a second sample included heterogeneous office employees (n = 1052). A self-administered questionnaire was used to collect demographics, psychological strains, social support, depressive symptoms, and suicidal ideation.

RESULTS

Depressive symptoms were associated with longer work hours, less social support, value strain, aspiration strain and coping strain among medical staff, and were linked to longer work hours, less social support, aspiration strain and coping strain among non-medical staff. Suicide ideation was associated with longer work hours, coping strain, and depression among medical staff, and was linked to longer work hours, gender, religion, value strain and depression among non-medical staff.

CONCLUSIONS

Both depressive symptoms and suicidal ideation were associated with psychological strains among Chinese urban professionals. Reduction of psychological strain is necessary to help maintain proper mental health and to ensure optimal performance at work.

Work Ability Impairment and Facets of Workplace Perception Are Predictive of Sick Leave Duration in Persons With Work Anxiety

Abstract. Individuals with work anxiety are at risk for long-term sick leave and create high costs for society, companies, and their own work biography. Understanding psychological return-to-work predictors is important for early reintegration of these persons into the work context. This longitudinal study for the first time investigates the predictive value of workplace perception and objective work ability impairment for future sick leave duration in persons with work anxiety. The investigation was carried out with 103 individuals with work anxieties. They were of working age and confronted with a return-to-work situation after somatic illness. Work ability impairment was assessed in a structured interview by a state-licensed sociomedical specialist using the established Mini-ICF-APP Scale. Participants completed a questionnaire on their workplace perception (KFZA). The degree of work ability impairment (Mini-ICF-APP) was predictive of longer sick leave as well as workplace perception (KFZA dimensions scope of action, social support, need for cooperation). Training and return-to-work support in persons with work anxiety should focus on both work ability impairment and on workplace perception.

Treatment Changes in General Practice Patients With Chronic Mental Disorders Following a Psychiatric-Psychosomatic Consultation

Objective:

To determine whether a psychiatric–psychosomatic consultation can identify unmet treatment needs and improve treatment of patients with mental disorders in general practice.

Methods:

In 40 primary care practices, 307 consecutive primary patients who met criteria for chronic mental disorders were assessed by a psychiatric–psychosomatic consultant. After random assignment, general practitioners (GPs) were informed for half of the patients about the results of the assessment and received recommendations on how to improve treatment. Changes in treatment and patient status were reevaluated after 6 months.

Results:

Patients were mostly having depression, adjustment, or anxiety disorders, with 28.8% on sick leave. Contact with their respective GPs was longer than a year in 77.2% of cases. Patients had already received pharmacotherapy (60.9%), psychotherapeutic counseling by GPs themselves (27.7%), psychotherapy by specialists (73.9%), psychiatric outpatient care (57%), inpatient psychiatric treatment (12.1%), inpatient psychosomatic rehabilitation (ie, specialized behavioral medicine facilities for patients with work problems; 41.4%), and a broad spectrum of other diagnostic and therapeutic measures. Newly recommended interventions included leisure activities (42%), a new specialist psychotherapy (37.5%), or inpatient psychosomatic treatment (15.3%). Most recommendations were agreed upon by the GP. Nevertheless, there was only a limited increase in therapeutic actions 6 months later, and no statistically significant improvement in the status of patients.

Conclusion:

General practitioners undertake a broad spectrum of therapeutic interventions in patients with chronic mental disorders. According to our results, additional psychiatric–psychosomatic consultations can intensify treatment but does not significantly change the general course of chronic mental disorders.

Workplace Phobic Anxiety as a Mental Health Phenomenon in the Job Demands-Resources Model

Purpose

Anxiety-related problems at work are a serious problem in the occupational context, as they come along with sick leave and problems in work participation. The aim of this study is to analyse workplace phobic anxiety in nonclinical context using the Job Demands-Resources model.

Methods

The study involved a sample of 739 workers from a retail company, mostly with permanent contracts. Structural equation modelling analyses were performed using AMOS software.

Results

Both the health impairment and motivational variables in the JD-R model were significantly related to workplace phobic anxiety and subsequently to absenteeism, specifically, exhaustion mediated between perceived job demands and workplace phobic anxiety and work engagement mediated between perceived job resources and workplace phobic anxiety. Moreover, workplace phobic anxiety was significantly positively related to absenteeism.

Conclusions

Results suggest that workplace phobic anxiety is a specific concept and an important issue in organizations for both workers' health and the organizational costs linked to absenteeism. Supervisors and occupational physicians should be aware of workplace phobic anxiety, especially when workers are on sick leave often or for long periods.

Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients: A Cross-Sectional Observation Study

OBJECTIVE

To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness.

DESIGN

Cross-sectional observation study.

SETTING

Neurology, orthopedic, and cardiology rehabilitation clinics.

PARTICIPANTS

Patients (N=1610; age, 18-65y) with work anxieties.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non-work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data.

RESULTS

Approximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications.

CONCLUSIONS

About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave.

Is it a Case of "Work-Anxiety" When Patients Report Bad Workplace Characteristics and Low Work Ability?

Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients' work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians' judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments.

Negative work perception not changed in a short work-anxiety-coping group therapy intervention

BACKGROUND

Work anxiety is often associated with long-term sick leave and requires early intervention. Work anxieties are associated with negative work perception. Therefore, one aim in early intervention is a cognitive reframing of dysfunctional perceptions of workplace characteristics.

METHODS

A psychotherapeutic specialist conducted two group programs of four sessions each. One hundred twenty-three rehabilitation in-patients with work anxieties were randomly assigned either to a work anxiety-coping group or to a recreational group. The Short Questionnaire for Work Analysis (KFZA) was administered before and after the group treatment to measure perceptions of working conditions.

RESULTS

Participants from the work anxiety-coping group did not see their work in a significantly more positive light at the end of the intervention compared to participants from the recreational group.

CONCLUSIONS

A short work anxiety-coping group did not initiate a consistent positive re-appraisal of work. Employers and occupational physicians should not expect positive changes of work perception when an employee returns from short medical rehabilitation including work-directed treatment. Additional support from the workplace must be considered, e.g. employer-physician-employee conversation preceding return to work, or (temporary) work adjustment.

Arbeitsbezogene Ängste in Forschung und Praxis

Arbeitsplätze besitzen ihrer Natur nach zahlreiche potentiell angstauslösende oder angstverstärkende Charakteristika. Manifestieren sich arbeitsbezogene Ängste, können Absentismus und Langzeitarbeitsunfähigkeit bis hin zur Erwerbsunfähigkeit die Folgen sein. Bei Rehabilitanden findet man in 30 – 60 % der Fälle arbeitsbezogene Ängste, die die berufliche Wiedereingliederung erschweren. Aber auch bei psychisch gesunden Erwerbstätigen wurde bei 5 % der Beschäftigten eine arbeitsangstbedingte Neigung zur Krankschreibung gefunden. In der zukünftigen Forschung sollte arbeitsbezogenen Ängsten nicht erst in der Rehabilitation, sondern bereits präventiv am Arbeitsplatz selbst Aufmerksamkeit geschenkt werden. Das Konzept bietet Ansatzpunkte für psychische Gefährdungsanalysen, sowie Arbeitsplatzgestaltung und -passung.

The significance of job-anxiety in a working population

BACKGROUND

Job-anxiety, as distinguished from trait-anxiety, is associated with long-term sickness absence. The prevalence of job-anxiety within a working population is not known. Identifying individuals who would benefit from intervention might be useful.

AIMS

To investigate job-anxiety in employees not undergoing treatment for mental health illness, firstly by assessing the level of job-anxiety and work-related avoidance tendencies in a working sample, and secondly by testing whether job-anxiety is distinguishable from trait-anxiety.

METHODS

Cross-sectional survey of a convenience sample obtained through personal contact distribution. Employees from different professional settings completed an anonymous questionnaire and provided information on their employment status. The State-Trait-Anxiety Inventory (STAI-T) was used to measure trait-anxiety and the Job-Anxiety-Scale (JAS) was used to assess job (state) anxiety.

RESULTS

There was a 69% response rate (240 responses); 188 responses were available for analysis of whom 62% were women. There were no employees with high trait-anxiety. Ten employees (5%) reported increased job-anxiety and of these nine employees reported high 'tendencies of avoidance and workplace absence'. Avoidance was most often accompanied by the comorbid job-anxieties 'job-related social anxiety', 'fear of changes at work' and 'fears of existence', 'anticipatory' and 'conditioned' job-anxiety and 'panic symptoms'.

CONCLUSIONS

In this sample, self-reported job-anxiety appeared as a specific type of anxiety as opposed to trait-anxiety. In the workplace job-anxiety can present as job-avoidance and sickness absence and should be distinguished from trait-anxiety. In practice, employers and occupational health practitioners should be aware of those employees prone to sickness absence.

[Socio-medical aspects of mental disorders : Definition, epidemiology, context and assessment of capacity]

Social medicine is an interdisciplinary field of medicine which analyses and describes the interactions between illness, individual, society, and organisational structures of the health care system, including prevention, treatment and rehabilitation. Part of social medicine is epidemiology, including analytic epidemiology. The goal is to monitor the prevalence and spectrum of illnesses in the general population or subpopulations and to study possible risks of illness. The question is which environmental or contextual factors influence the prevalence and course of illnesses. Another area of social medicine is to evaluate patients and decide who needs social support. Important topics are inability to work, need for early retirement and pension, or disability. In this context it is important to make a distinction between functions, capacities, context and participation. There is a second paper on social medicine which covers modes of care and treatment in social medicine.

Specific job anxiety in comparison to general psychosomatic symptoms at admission, discharge and six months after psychosomatic inpatient treatment

OBJECTIVE

Job anxiety is a severe problem in many patients with chronic mental disorders, as it usually results in specific participation problems in the workplace and long-term sick leave. The aim of this study was to explore the development of sick leave in dependence on general psychosomatic complaints and job anxiety from admission to a psychosomatic inpatient treatment until 6 months after discharge.

METHOD

A convenience sample of 91 patients, suffering from multiple mental disorders, filled in self-rating questionnaires on job anxiety (Job Anxiety Scale) and on general psychosomatic symptom load (Symptom Checklist-90-Revised) at the beginning, the end, and 6 months after discharge from an inpatient psychosomatic treatment. Additionally, sick leave status and employment status were assessed before and 6 months after the treatment.

RESULTS

15.4% of 91 patients were on sick leave before inpatient treatment and at follow-up (SS group), 20.9% were fit for work at intake and follow-up (FF group), 6.6% were fit for work initially and on sick leave later (FS group), and 57.1% on sick leave first and working at follow-up (SF group). In regard to general psychosomatic complaints, there were initially high scores on the SCL, a marked reduction during inpatient treatment, and a bouncing back to initial levels at follow-up for all 4 patient groups. SS and FS patients showed the highest scores at intake and follow-up. Concerning job anxiety, SS patients had the highest scores at all three assessments, while FF patients had significantly lower scores, with only low variation between assessments. SF patients started with comparatively high scores of job anxiety, which even increased before reentering work, but decreased in the follow-up period when they were confronted with work again. FS patients started low (like the FF patients) at intake, reduced their job anxiety further till discharge, but increased to higher scores at follow-up.

CONCLUSIONS

General psychosomatic symptom load and job anxiety show a different course during treatment and are differently related to sick leave. General psychosomatic symptom load can be understood as a measure of the degree of the chronic illness status, whereas job anxiety reflects specific additional context-related problems, i.e. problems with work. A core finding is that job anxiety is related to work avoidance, but work exposure may reduce job anxiety. This has direct consequences for putting patients on sick leave or not.

Do measures used in studies of anxiety disorders reflect activities and participation as defined in the WHO International Classification of Functioning, Disability and Health?

Background: Besides the measurement of symptoms, information on functioning and disability in daily routines expands the description of impairments in patients with anxiety disorders. Therefore, the measurement of activities and participation, as theoretically included in the International Classification of Functioning, Disability and Health (ICF) is of increasing importance. The objective of this study is to give an overview over the implementation of the concept ‘activities and participation’ in outcome measurements of patients with anxiety disorders.

Methods: Based on a literature review in PubMed and PsycInfo databases and including 200 papers, this study analyses 65 outcome instruments used in randomized controlled trials in anxiety disorders according to their content related to the ICF domain of ‘Activities and participation’.

Results: Instruments used in trials evaluating outcome in patients with anxiety disorder only partially address activities and participation. Over all 65 instruments, the chapters on ‘Interpersonal interactions and relationships’ and ‘Mobility’ were most frequently included in measurements.

Conclusions: The identification of relevant ICF categories (core sets) according to activities and participation and especially interpersonal interactions and relationships as well as mobility, can be a basis for describing functioning and evaluating treatment in anxiety disorders, helping to improve outcome assessment in clinical practice.

Disability, sickness, and unemployment benefits among long-term sickness absentees five years before, during, and after a multidisciplinary medical assessment

AIM

The aim was to describe how a multidisciplinary medical assessment changed the distribution of long-term sickness absentees between three different forms of social security support during a period of eleven years.

METHODS

The study group (n = 1002) consisted of persons on long-term sickness absence who were referred to a multidisciplinary medical assessment by the Social Insurance Office in Stockholm, Sweden between 1998 and 2007. Register data from the years 1993-2008 were linked to the study group. A calculation was provided for the number of days per person and year on unemployment benefits, sickness benefits, and disability pension, five years before, during, and five years after the assessment. Also, differences in the average number of days per person and year were calculated with one-way analysis of variance.

RESULTS

The number of days on sickness benefits increased up to the time of multidisciplinary medical assessment, from 69 to 218 days on average. After the assessment there was a decrease in the average number of days on sickness benefits, from 218 to 16 days. Before the assessment the number of days on disability pension was 21, but this increased after the assessment from 104 days to an average of 272 days five years after the assessment. There were age differences regarding number of compensated days, and these were particularly pronounced for disability days after the assessment. Further, there were significant differences between types of diagnosis in relation to average days on disability pension after the assessment.

CONCLUSION

The study shows that after a multidisciplinary medical assessment there is a rapid increase in disability pension and a dramatic decrease in sickness benefits. The results indicate that for a large number of persons, a Social Insurance Office referral to an assessment does not improve their chances of returning to work, but rather seems to justify disability pension.

Exposure-in-vivo containing interventions to improve work functioning of workers with anxiety disorder: a systematic review

BACKGROUND

Anxiety disorders are associated with functional disability, sickness absence, and decreased productivity. Effective treatments of anxiety disorders can result in remission of symptoms. However the effects on work related outcomes are largely unknown. Exposure in vivo is potentially well fit to improve work-related outcomes. This study systematically reviews the effectiveness of exposure-in-vivo containing interventions in reducing work-related adverse outcomes in workers with anxiety disorders.

METHODS

A systematic study search was conducted in Medline, Cinahl, Embase and Psycinfo. Two reviewers independently extracted data and from each study assessed the quality of evidence by using the GRADE approach. We performed a meta-analysis if data showed sufficient clinical homogeneity.

RESULTS

Seven studies containing 11 exposure-in-vivo interventions were included. Four studies were focused on Obsessive Compulsive Disorder (OCD), two on Post Traumatic Stress Disorder (PTSD), and one on a mixed group of OCD and severe phobias. The studies were grouped according to type of anxiety disorder and subsequently according to type of comparisons. For OCD, exposure-in-vivo containing interventions can yield better work-related outcomes compared to medication (SSRIs) and relaxation but not better compared to response prevention. The results on anxiety outcomes were similar. The net contribution of exposure in vivo in two OCD intervention programs is also presented as a meta-analysis and shows significant positive results on work role limitations. The calculated pooled effect size with 95% confidence interval was 0.72 (0.28, 1.15). For PTSD, exposure-in-vivo containing interventions can yield better work-related and anxiety-related outcomes compared to a waiting-list but not better compared to imaginal exposure.

CONCLUSIONS

Exposure in vivo as part of an anxiety treatment can reduce work-related adverse outcomes in workers with OCD and PTSD better than various other anxiety treatments or a waiting-list. We recommend that it should be studied how the results of these studies can be transferred to the practice of occupational health professionals and how clinicians can make better use of them to improve work-related outcomes. In future research, priority should be given to high-quality randomised controlled trials (RCTs) in which exposure-in-vivo containing interventions are applied to a variety of anxiety disorders and compared with other clinical anxiety treatments such as SSRIs. Work-related outcomes, in particular work functioning and sickness absence, need to be assessed with reliable and valid measures.

The relationship between job-anxiety and trait-anxiety--a differential diagnostic investigation with the Job-Anxiety-Scale and the State-Trait-Anxiety-Inventory

Job-related anxiety, in contrast to general trait-anxiety, is by its very nature associated with problems of participation at work. The aim of this study is to investigate the relation between general trait-anxiety and specific job-related anxiety and to examine whether job-anxiety and trait-anxiety are differently associated with sick leave. 190 inpatients of a psychosomatic and orthopaedic rehabilitation center with mental and somatic disorders filled in the Job-Anxiety-Scale (JAS) and the State-Trait-Anxiety-Inventory (STAI-T). Additionally, informations on age, gender, the current duration of sick leave in weeks, employment status, duration of unemployment, and position at the workplace were collected. Highest scores of job-anxiety were found for the JAS-dimensions "job-related worries" and "health anxieties", followed by "cognitions of insufficiency," "stimulus-related anxieties," and "social anxieties." JAS and STAI-T were significantly correlated. Job-anxiety, in contrast to trait-anxiety, was significantly related to duration of sick leave. Women showed higher scores on the STAI-T but not on the JAS. It can be concluded that job-anxiety is related to but not identical with trait-anxiety. Job-anxiety is important to understand sick leave and appears as a multidimensional and clinically important phenomenon.

Die Job-Angst-Skala (JAS). Ein Fragebogen zur Erfassung arbeitsplatzbezogener Ängste

Die „Job-Angst-Skala (JAS)“ ist ein neuer Fragebogen zur Erfassung und klinischen Differenzierung verschiedener Formen arbeitsplatzbezogener Ängste. Die Skala besteht aus 70 Items mit 14 Subskalen, die in fünf Hauptdimensionen zusammengefasst werden können: Stimulusbezogene Ängste und Vermeidungsverhalten; Soziale Ängste und Beeinträchtigungskognitionen; Gesundheits- und körperbezogene Ängste; Insuffizienzerleben; Arbeitsplatzbezogene generalisierte Sorgen. Eine Untersuchung der psychometrischen Qualität erfolgte an 190 Patienten einer orthopädischen und psychosomatischen Rehabilitationsklinik. Die interne Konsistenz (Cronbachs alpha) beträgt .98. Die Retestreliabilität der Gesamtskala beträgt .815. Faktorenanalytisch ergeben sich fünf inhaltlich interpretierbare Dimensionen entsprechend der zugrunde liegenden Theorie. Die durchschnittliche Inter-Item-Korrelation der Gesamtskala beträgt .389. Es fand sich ein signifikanter Zusammenhang zwischen der JAS und dem generelle Ängstlichkeit messenden STAI-Trait, was als Hinweis auf die Validität der JAS angesehen werden kann.

Arbeitsplatzbezogene Ängste und Arbeitsplatzphobie

Work is an important aspect of life. Problems at the workplace must therefore have negative consequences on the mental status and mental problems will interfere with the working place. The relation between anxiety and the workplace is especially important because the workplace causes anxiety due to its very nature. A common final pathway of mental disorders in general, and work related anxieties in particular, are workplace phobias, with panic when approaching or even thinking of the workplace. This is a serious complication with negative consequences for the further course of illness. It makes special therapeutic intervention necessary. This paper describes the phenomenon of workplace related anxieties and phobia and provides a conceptual framework for their understanding.