Higher-order structure in the trajectories of depression and anxiety following sudden involuntary unemployment

Coping Strategies, well-being and inequalities during the COVID-19 pandemic period

As a response to the outbreak of the COVID-19 pandemic, governments around the globe have carried on strict lockdown measures affecting millions of jobs, public life, and the well-being of people. This study examines people's subjective well-being, such as the perception of the economic situation and mental well-being, who made adjustments to cope with the earning losses. We estimate the well-being cost, which is the money required to compensate people because of the reduction in earnings or employment loss and the coping strategy followed to bring their well-being to the levels of those who have not adopted any coping strategy. We examine two outcomes; the perception of the economic situation and a mental well-being index. We employ data from the ERF COVID-19 MENA Monitor Surveys for Egypt, Jordan, Morocco and Tunisia. The results show that coping strategies with earning losses impact well-being and are associated with high costs. In most cases, the coping strategies of borrowing from banks and selling assets present the highest well-being costs. Furthermore, the estimates highlight significant discrepancies across gender and types of workers, such as those employed in the informal sector and temporary contracts.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04710-1.

How Important is Spirometry for Identifying Patients with COPD Appropriate for Palliative Care?

BACKGROUND

Providing palliative care to patients with chronic obstructive pulmonary disease (COPD) is a priority. Spirometry demonstrating airflow limitation is a diagnostic test for COPD and a common inclusion criterion for palliative care research. However, requiring spirometry with airflow limitation may exclude appropriate patients unable to complete spirometry, or patients with preserved-ratio impaired spirometry and symptoms or imaging consistent with COPD.

MEASURES

To determine differences in quality of life (QOL) and symptoms between patients with COPD identified based on International Classification of Diseases (ICD) codes and spirometry with airflow limitation compared to ICD codes only.

INTERVENTION

Patients with COPD enrolled in a palliative care trial were included. Patients were at high risk of hospitalization and death and reported poor QOL. Baseline measures of QOL (Functional Assessment of Cancer Therapy-General (FACT-G), the Clinical COPD Questionnaire, and Quality of Life at the End of Life), and symptoms (Patient Health Questionnaire-8, Generalized Anxiety Disorder-7, fatigue, Insomnia Severity Index) were compared.

OUTCOMES

Two hundred eight patients with COPD were predominantly male, White, and average age was 68.4. Between patients with ICD codes and spirometry with airflow limitation compared to patients with ICD codes only, there were no significant differences in FACT-G (59.0 vs. 55.0, P = 0.33), other measures of QOL, or symptoms between groups.

CONCLUSION

These results imply that spirometry may not need to be a requirement for inclusion into palliative care research or clinical care for patients with poor quality of life and at high risk for adverse outcomes.

Parallel latent trajectories of mental health and personal earnings among 16- to 20 year-old US labor force participants: a 20-year longitudinal study

PURPOSE

Determine the number of latent parallel trajectories of mental health and employment earnings over two decades among American youth entering the workforce and estimate the association between baseline sociodemographic and health factors on latent trajectory class membership.

METHODS

This study used data of 8173 participants from the National Longitudinal Survey of Youth 1997 who were 13-17 years old in 1997. Surveys occurred annually until 2011 then biennially until 2017, when participants were 33-37 years old. The Mental Health Inventory-5 measured mental health at eight survey cycles between 2000 and 2017. Employment earnings were measured annually between 1998 and 2017. Latent parallel trajectories were estimated using latent growth modeling. Multinomial logistic regression explored the association between baseline factors and trajectory membership.

RESULTS

Four parallel latent classes were identified; all showed stable mental health and increasing earnings. Three percent of the sample showed a good mental health, steep increasing earnings trajectory (average 2017 earnings ~ $196,000); 23% followed a good mental health, medium increasing earnings trajectory (average 2017 earnings ~ $78,100); 50% followed a good mental health, low increasing earnings trajectory (average 2017 earnings ~ $39,500); and 24% followed a poor mental, lowest increasing earnings trajectory (average 2017 earnings ~ $32,000). Participants who were younger, women, Black or Hispanic, from lower socioeconomic households, and reported poorer health behaviors had higher odds of belonging to the poor mental health, low earnings class.

CONCLUSION

Findings highlight the parallel courses of mental health and labor market earnings, and the influence of gender, race/ethnicity, and adolescent circumstances on these processes.

Promoting healthy trajectories for urban middle school youth through county-funded, parks-based after-school programming

Ongoing pressure for public schools to prioritize academics has increased attention on after-school settings as a critical space for social-emotional learning (SEL). After-school programs are uniquely positioned to build protective and promotive factors that contribute to positive future orientation, especially within communities where systemic inequities create barriers to high school graduation, higher education, employment, and earnings. This study examines Fit2Lead Youth Enrichment and Sports (YES), a county-funded, parks-based after-school collaboration for middle schoolers that merges mental health and recreation to promote healthy trajectories. Eight Miami neighborhood parks were selected based on county data indicating high rates of violence. An open trial design (N = 9 parks, 198 youth; ages 9-15; 40.5% female; 66.5% Black/African American, 24.9% Hispanic/Latinx, and 76.3% low-income) tested hypotheses that participation for adolescents exposed to community violence would disrupt a commonly reported decline in self-regulation and self-efficacy, and mitigate risk for anxiety and depression. Youth completed questionnaires at the beginning and end of one school year. Paired t-tests revealed no changes from pre to post, and no differences by baseline levels of youth and parent mental health. Findings highlight the promise of prevention programs to disrupt downward trajectories for youth during the risky time of early adolescence.

COVID-19 and Risk Factors of Anxiety and Depression in South Korea

OBJECTIVE

The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea.

METHODS

The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17-31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression.

RESULTS

Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group.

CONCLUSION

Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

Opioid misuse as a coping behavior for unmet mental health needs among U.S. adults

BACKGROUND

Self-medication theory posits that opioids may be misused to cope with mental or emotional distress, especially if distress is not treated. Opioid misuse may lead to opioid use disorder, overdose, and death. We estimated the risk of opioid misuse associated with unmet mental health treatment needs (UMHN).

METHODS

We used 2015-2018 data on U.S. adults from the National Survey of Drug Use and Health (n = 165,767). UMHN was the perceived need for mental health services in the past year without service receipt. The primary dependent variable was past year prescription opioid misuse (POM). Secondary analyses estimated POM and/or heroin misuse risk. Logistic regressions estimated the predicted probability for POM, controlling for demographics, social factors, a major depressive episode (MDE), and overall health. We also tested whether the association of UMHN on the predicted probability of POM varied by MDE.

RESULTS

UMHN was associated with a 4.6 percentage point higher predicted probability of POM (p < 0.001; 95 % CI 0.04-0.05) and a 4.9 percentage point higher predicted probability of POM and/or heroin (p < 0.001; 95 % CI 0.04-0.06) compared to adults who accessed mental health services. MDE was associated with a significantly greater risk of POM (p < 0.001). POM risk was greater for adults potentially experiencing social isolation.

CONCLUSION

Targeted mental health support strategies may reduce the likelihood of POM initiation and episodes. Future research should investigate the relationship between unmet mental health needs and initiation of POM episodes.

Prevalence and Correlates of Likely Major Depressive Disorder among the Adult Population in Ghana during the COVID-19 Pandemic

Background: Emerging research suggests that the novel coronavirus disease (COVID-19) pandemic and associated public health restrictions have caused psychological distress in many contexts. In order for public health authorities and policy makers to effectively address the psychological distress associated with the pandemic, it is important to determine the prevalence and correlates of mental disorders, including depression. Objectives: We aimed to determine the prevalence, and demographic, social, clinical and other COVID-19 related correlates of major depressive disorder symptoms among the general population in Ghana during the COVID-19 pandemic. Method: The study was a cross-sectional survey using online data collection methods. The survey assessed demographic, social and clinical variables as well as COVID-19 related variables. Major depressive disorder symptoms were assessed using the Patient Health Questionnaire-9. The survey link was distributed primarily through WhatsApp-based platforms. Data were analyzed using descriptive and inferential statistics. Results: The overall prevalence of likely MDD symptoms among the sample population was 12.3%. Variables such as employment, loss of jobs during the pandemic and rate of exposure to COVID-related news were independently and significantly associated with the likelihood that respondents had likely MDD. Variables such as gender, relationship, housing status and having a family member or friend who was sick from COVID-19 were not independently significantly associated with the likelihood that respondents had likely MDD, when all other factors in the model were controlled. Conclusion: This study has identified the prevalence and correlates of depression symptoms in Ghana during the COVID-19 pandemic. There is the urgent need for mental health policy makers and the government of Ghana to have policies in place to alleviate the potential threat to the mental health of the population.

Economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals: A cross-sectional study amid COVID-19 pandemic

BACKGROUND

Mental health symptoms are considered a public health concern by many professionals and are frequently impacted by factors related to occupation, employment opportunities, and economic stressors. This study investigated the relationship between economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals.

METHODS

We conducted a cross-sectional survey of 420 rehabilitation professionals between July 2020 and October 2020. Economic stressors were measured using Economic Hardship Questionnaire, Financial Threat Scale, and Financial Well-Being Scale. Mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Multivariable logistic regression analysis was performed to find associated factors on mental health problems after adjusting confounders.

RESULTS

Among 420 rehabilitation professionals 62.1% were male, 38.6% were post-graduated and 75% were in practice. The overall prevalence of depression, anxiety, and stress was 51.0%, 58.6%, and 33.6%, respectively. The multivariable regression analysis indicated that without a high professional degree, lack of opportunity to practice, and loss of income were the associated factors for mental health symptoms. The modelling of the structural equation showed that financial threat is significantly associated with mental health symptoms.

CONCLUSION

During the era of COVID-19, a high prevalence of mental health symptoms was observed among rehabilitation professionals. To minimize the burden of mental health, we recommend that all rehabilitation organizations and the government come together to create equal opportunities to practice and enable individuals to obtain high professional degrees.

Inconsistent social rhythms are associated with abdominal adiposity after involuntary job loss: An observational study

Objective

Unemployment is an established risk factor for obesity. However, few studies have examined obesity-related health behavior after involuntary job loss specifically. Job loss confers a disruption in daily time structure that could lead to negative metabolic and psychological outcomes through chronobiological mechanisms. This study examines whether individuals with unstable social rhythms after involuntary job loss present with higher abdominal adiposity than individuals with more consistent social rhythms and whether this relationship varies as a function of depressive symptoms.

Methods

Cross-sectional baseline data (n = 191) from the ongoing Assessing Daily Activity Patterns in occupational Transitions (ADAPT) study were analyzed using linear regression techniques. Participants completed the Social Rhythm Metric-17 (SRM) daily over 2 weeks. They also completed the Beck Depression Inventory II (BDI-II) and participated in standardized waist circumference measurements (cm).

Results

A significant interaction emerged between SRM and BDI-II demonstrating that less consistent social rhythms were associated with larger waist circumference at lower levels of depressive symptoms. Additional exploratory analyses demonstrated a positive association between the number of daily activities performed alone and waist circumference when controlling for symptoms of depression.

Conclusion

These findings are the first to demonstrate a relationship between social rhythm stability and abdominal adiposity in adults who have recently, involuntarily lost their jobs. Results highlight the moderating role of depressive symptoms on daily routine in studies of metabolic health. Future prospective analysis is necessary to examine causal pathways.

Financial threat, hardship and distress predict depression, anxiety and stress among the unemployed youths: A Bangladeshi multi-city study

INTRODUCTION

Unemployment has a contributory role in the development of mental health problems and in Bangladesh there is increasing unemployment, particularly among youth. Consequently, the present study investigated depression, anxiety, and stress among recent graduates in a multi-city study across the country.

METHODS

A cross-sectional study was conducted among 988 Bangladeshi graduate jobseekers in six major cities of the country between August to November 2019. The measures included socio-demographics and life-style factors, study and job-related information, Economic Hardship Questionnaire, Financial Threat Scale, Financial Well-Being Scale, and Depression Anxiety Stress Scale-21.

RESULTS

Depression, anxiety and stress rates among the present sample were 81.1% (n = 801), 61.5% (n = 608) and 64.8% (n = 640) respectively. Factors related to gender, age, socioeconomic conditions, educational background, lack of extra-curricular activities, and high screen activity were significant risk factors of depression, anxiety, and stress. Structural equation modeling indicated that (while controlling for age, daily time spent on sleep study, and social media use), financial threat was moderately positively related to depression, anxiety, and stress. Financial hardship was weakly positively associated with depression, anxiety, and stress, whereas financial wellbeing was weakly negatively associated with depression, anxiety, and stress.

LIMITATIONS

Due to the nature of the present study (i.e., cross-sectional study) and sampling method (i.e., convenience sampling), determining causality between the variables is not possible.

CONCLUSIONS

The present results emphasized the important detrimental role of financial troubles on young people's mental health by showing that financial problems among unemployed youth predict elevated psychiatric distress in both men and women.

Association between obstructive sleep apnea and multiple involuntary job loss history among recently unemployed adults

BACKGROUND

Obstructive sleep apnea (OSA) has been associated with negative occupational outcomes including absenteeism and poor work productivity. This analysis explored whether the severity of OSA was associated with multiple involuntary job loss history among recently unemployed adults.

METHODS

This is a cross-sectional analysis of data from the screening visit of the Assessing Daily Activity Patterns Through Occupational Transitions study. Information was collected from 261 participants who recently involuntarily lost their jobs. Data included demographics, employment, medical history, and results from a limited channel home sleep apnea test. The respiratory event index was categorized as <5 events per hour (no-OSA), 5 to <15 (mild OSA), and ≥15 (moderate to severe OSA). Logistic regression and propensity score matching were used to identify factors associated with multiple involuntary job loss.

RESULTS

A total of 44.8% of participants reported multiple involuntary job loss. Those with mild OSA had 1.85 (95%CI: 1.04, 3.28) increased odds of reporting multiple involuntary job loss as compared to participants with no OSA in the unadjusted model; while participants with moderate-to-severe OSA had 2.71 (95%CI: 1.33, 5.70) increased odds. After adjusting for age, sex, ethnicity, beginning work between 7 and 9 AM, job type, and, compensation type, the odds of involuntary job loss among participants with moderate-severe OSA were 2.46 (95%CI: 1.13, 5.52) as compared to having no OSA.

CONCLUSIONS

In a sample of recently unemployed adults, having OSA significantly increased the odds of reporting previous involuntary job losses. This study suggests OSA could be a risk factor for job loss.

Postpartum depressive symptoms in low-income Latinas: Cultural and contextual contributors

OBJECTIVE

Using a conceptual model of postpartum depression risk in Latinas including both contextual and cultural stressors, we tested contributions to depressive symptom levels and trajectories over the course of 1 year following birth in a community sample of Latinas.

METHOD

A multisite sample of low-income U.S.-born and foreign-born Latinas (n = 537; M age = 25.70) was interviewed on many topics including measures of stress and maternal health at 1, 6, and 12 months postpartum. Nested multilevel growth curve models were implemented to test associations of contextual stressors (poverty, domestic violence) with trajectories of depressive symptoms, adjusting for confounds. This model was compared to 1 that added cultural stress variables (everyday discrimination, foreign-born status, language preference, age at immigration) measured 1-month postpartum.

RESULTS

The best fitting model provided evidence for the independent effects of cultural and contextual stressors. Discrimination (β = .13 SE = .02, p = < .001) and domestic violence (β = .39 SE = .09, p = < .001) predicted trajectories with higher levels of depressive symptoms 1 month postpartum, but not linear change in symptoms over the year.

CONCLUSIONS

The present study provides evidence that discrimination, a cultural factor, and domestic violence, a contextual factor, each predict higher levels of early postpartum depressive symptoms. Interventions addressing discrimination and maternal safety are recommended. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Youth unemployment and mental health: prevalence and associated factors of depression among unemployed young adults in Gedeo zone, Southern Ethiopia

Background

The high rate of unemployment among young adults in Ethiopia, which was 25.3% in 2018, is a major social, and public health concern. The risk of mental health problems like depression is higher among the unemployed than among the employed. However, there was no study conducted on the prevalence and associated factors of depression among unemployed young adults in Ethiopia. Hence, this study was aimed to assess the prevalence and associated factors of depression among unemployed young adults in Gedeo zone, Southern Ethiopia.

Methods

Community based cross sectional study design was employed among 1452 unemployed young adults in Gedeo zone, Southern Ethiopia from May to July, 2019. In order to select the study participants, systematic random sampling technique was used. The presence of depression was assessed by using Patient Health Questionnaire-9 (PHQ-9), and data about socio-demographic characteristics of study participants were collected by using structured questionnaire. Data were coded and entered into Epi-Data version 3.1, and analyzed by SPSS version 20. A multivariable logistic regression analysis was carried out to identify factors associated with depression, and variables with p values < 0.05 were considered as statistically significant. The strength of the association was presented by adjusted odds ratio with 95% confidence interval.

Result

The overall prevalence of depression among unemployed young adults in the present study was 30.9% (95% CI: 28.4%, 33.1%). Of the total study participants with depression, 56.7% had mild depression, 36% had moderate depression, and 7.3% had severe depression. Being male (AOR = 1.40, 95% CI: 1.10, 1.80), long duration of unemployment (≥ 1 years) (AOR = 1.56, 95% CI: 1.21, 1.99), low self-esteem (AOR = 1.32, 95% CI: 1.03, 1.68), poor social support (AOR = 1.98, 95% CI: 1.34, 2.93), and current alcohol use (AOR = 1.86, 95% CI: 1.33, 2.59) were significantly associated with depression.

Conclusion

The results of our study indicated that depression is an important public health problem among unemployed young adults in Ethiopia. Therefore, our study suggested that policy makers and program planners should establish appropriate strategy for prevention, early detection and management of depression among this population. Besides, addressing the need of unemployed young people, improving access to care for depression is an important next step. Furthermore, we recommend further studies to understand the nature of depression among unemployed young people, and to strengthen the current results.

Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter

Effective management of the global pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (also known as COVID-19), resulted in the implementation of severe restrictions in movement and enforcement of social distancing measures. This study aimed to understand and characterize the psychosocial effects of the COVID-19 pandemic in the general population and to identify risks and protective factors that predict changes in mental health status. In addition, the study investigated compliance with precautionary measures (PM) to halt the spread of the virus. The online anonymous survey collected information on sociodemographic data, compliance with PM, quality of life (QOL), and mental health via the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). A total of 1642 adult participants (71.6% women, 28.4% men) completed the survey in the European island country, Cyprus. A large percentage (48%) reported significant financial concerns and 66.7% significant changes in their QOL. About 41% reported symptoms associated with mild anxiety; 23.1% reported moderate-severe anxiety symptoms. Concerning depression, 48% reported mild and 9.2% moderate-severe depression symptoms. Women, younger age (18-29), student status, unemployment status, prior psychiatric history, and those reporting greater negative impact on their QOL, were at higher risk for increased anxiety and depression symptoms (p < 0.05). The youngest age group and males also reported lower levels of compliance with PM. Higher compliance with PM predicted lower depression scores (p < 0.001) but higher anxiety for measures related to personal hygiene. The results of this study provide important data on the effects of the COVID-19 outbreak on mental health and QOL and identify a variety of personal and social determinants that serve as risks and protective factors. Furthermore, it has implications for policy makers demonstrating the need for effective mental health programs and guidance for the implementation of PM as a public health strategy.

Attachment to Parents and Peers and Adolescent Mental Health: The Mediating Role of Alexithymia

The current research aims to study the mediating role of alexithymia on the relationship between attachment to parents and peers and mental health problems in a sample of 242 non-referred adolescents. Participants completed the Inventory of Parent and Peer Attachment, the Toronto Alexithymia Scale, and the Symptom Check List-90-R. Mediation analysis shows that alexithymia fully mediates the relations between attachment to peers and mental health problems in both adolescent males and females. Findings suggest the importance to identify promptly vulnerabilities and risks in order to create prevention and intervention programs aimed to foster positive attachment experiences and to support emotional regulation.

Psychological distress in Ghana: Are unemployed people more afflicted?

The detrimental consequences of unemployment to the psychological well-being of people have been well documented. However, much of this research has been conducted for developed countries. This study contributes to the literature by providing empirical evidence on this topic from a Ghanaian perspective. Our results revealed no significant association between unemployment and psychological distress. Rather, we found that part-time and full-time employees who were looking for a job were significantly more likely to suffer psychological distress. When we analysed the association between unemployment and psychological distress for males and females separately, we did not find a statistically significant relationship for either gender group.

Psychological Implications of Unemployment Among Bangladesh Civil Service Job Seekers: A Pilot Study

Background: Recent trends suggest that university graduates seeking jobs are more susceptible to common mental disorders, such as depression, anxiety, or stress. However, the mental health issues among unemployed graduates has not been explored in Bangladesh yet. Aims: This study aimed to assess for the first time the prevalence and associated risk factors of depression, anxiety, and stress among Bangladesh Civil Service (BCS) job seekers. Three hundred four graduates residing in Rajshahi, Bangladesh, who were preparing to attend the 40^th BCS examination, the most sought-after employment opportunity in the country, were surveyed. Methods: Measures included socio-demographics, field of study, and career-related variables, and the Bangla Depression Anxiety Stress Scale (DASS-21). Chi-square test, Fisher exact test, and binary logistic regression with "depression," "anxiety," and "stress" as the dependent variables were carried out to identify the factors associated with these. Results: Overall, the prevalence of moderate to extremely severe depression, anxiety, and stress was 49.3%, 53.6%, and 28.3%, respectively, with no detectable differences between genders. Insecurity related to a BCS job (OR = 0.41; CI = 0.26-0.65, p < 0.001; ref: job insecurity), family and social pressure to obtain a BCS job (OR = 4.58; CI = 1.67-12.56, p < 0.001), and stress (OR = 8.33; CI = 4.47-15.51, p < 0.001) emerged as independent predictors for depression. In addition, having part-time job was associated with anxiety (OR = 2.38; CI = 1.34-4.23, p = 0.003), and security in a BCS job and serving the nation through this job were negatively associated with stress (OR = 0.59; CI = 0.35-0.98, p = 0.042 vs. OR = 0.59; CI = 0.36-1.00, p = 0.05). Conclusion: The relatively high rates of depression, anxiety, and stress among graduate job seekers should prompt implementation of market force initiatives that incorporate interventions related to the major risk factors uncovered herein.

Longitudinal assessment of daily activity patterns on weight change after involuntary job loss: the ADAPT study protocol

Background

The World Health Organization has identified obesity as one of the most visible and neglected public health problems worldwide. Meta-analytic studies suggest that insufficient sleep increases the risk of developing obesity and related serious medical conditions. Unfortunately, the nationwide average sleep duration has steadily declined over the last two decades with 25% of U.S. adults reporting insufficient sleep. Stress is also an important indirect factor in obesity, and chronic stress and laboratory-induced stress negatively impact sleep. Despite what we know from basic sciences about (a) stress and sleep and (b) sleep and obesity, we know very little about how these factors actually manifest in a natural environment. The Assessing Daily Activity Patterns Through Occupational Transitions (ADAPT) study tests whether sleep disruption plays a key role in the development of obesity for individuals exposed to involuntary job loss, a life event that is often stressful and disrupting to an individual’s daily routine.

Methods

This is an 18-month closed, cohort research design examining social rhythms, sleep, dietary intake, energy expenditure, waist circumference, and weight gain over 18 months in individuals who have sustained involuntary job loss. Approximately 332 participants who lost their job within the last 3 months are recruited from flyers within the Arizona Department of Economic Security (AZDES) Unemployment Insurance Administration application packets and other related postings. Multivariate growth curve modeling will be used to investigate the temporal precedence of changes in social rhythms, sleep, and weight gain.

Discussion

It is hypothesized that: (1) unemployed individuals with less consistent social rhythms and worse sleep will have steeper weight gain trajectories over 18 months than unemployed individuals with stable social rhythms and better sleep; (2) disrupted sleep will mediate the relationship between social rhythm disruption and weight gain; and (3) reemployment will be associated with a reversal in the negative trajectories outlined above. Positive findings will provide support for the development of obesity prevention campaigns targeting sleep and social rhythms in an accessible subgroup of vulnerable individuals.

Social stratification of general psychopathology trajectories and young adult social outcomes: A second-order growth mixture analysis over the early life course

BACKGROUND

Research has documented heterogeneous developmental trajectories of specific symptoms, such as anxiety and depression, in late childhood and adolescence. Few studies, however, have examined the heterogeneity of general psychopathology (GPP) trajectories considering symptoms of anxiety, depression, and hostility in adolescence simultaneously. Identifying antecedents for distinct trajectory groups of GPP, and their respective consequences, may provide insight into the etiological underpinnings of social antecedents of different symptoms and inform the targets and timing of intervention.

METHODS

European American target adolescents (N=444, 53% female) evaluated three domain specific symptoms (i.e., symptoms of anxiety, depression, and hostility) as well as psychosocial risks and social consequences over 10 years (from 1990 [Wave 2] to 2001 [Wave 13]). First- and second-order growth mixture models (SOGMMs) were used to identify trajectories of GPP and specific symptoms from mid-adolescence through young adulthood, as well as their predictors and consequences.

RESULTS

A three-class model consisting of high and escalating (10.1%), high and decreasing (23.2%), and consistently low (66.7%) GPP emerged as the preferred solution. More predictors and outcomes were associated with membership in both the high and escalating and the high and declining classes of GPP compared to corresponding classes of the specific symptoms trajectories.

LIMITATIONS

Self-reported information regarding three symptoms may be a source of bias within the current study.

CONCLUSION

Our findings suggest that unified interventions and/or prevention efforts are needed to not only assess specific symptoms, but also to treat GPP in adolescence.

Quality of Life and Its Related Factors in Chinese Unemployed People: A Population-Based Cross-Sectional Study

With the global economic crisis and industrial restructuring, the unemployed are suffering from job loss-related stress and loss of income, which is believed to impair their mental and physical health, while coping and self-efficacy could combat the adverse effects of unemployment on health. Thus, this study aims to describe quality of life (QOL) among unemployed Chinese people and explore the associated factors. A cross-sectional study was conducted by convenience sampling, composed of 1825 unemployed people, from January 2011 to September 2011. Questionnaires pertaining to demographic characteristics, the 36-item Short-Form Health Survey (SF-36), the abbreviated version of the Cope Inventory (Brief COPE) and self-efficacy scales were used to collect information from unemployed people in the eastern, central, and western regions of China. Hierarchical multiple regression analysis was performed to explore the related factors of QOL. A structural equation model (SEM) was used to test the relations among coping, self-efficacy, and QOL. Mental QOL was significantly lower than physical QOL in Chinese unemployed people. Coping had significant effects on both physical component summary (PCS) and mental component summary (MCS), while self-efficacy played the mediating role in the association between Coping and QOL. Unemployed Chinese people’s mental QOL was disrupted more seriously than their physical QOL. An increase in coping could improve QOL by promoting better management of issues brought about by unemployment. In addition, self-efficacy has the ability to reduce the impact of unemployment on QOL, through the mediating path of coping on QOL. This study highlights the need of coping skills training and self-efficacy enhancement for better management of unemployment in order to improve QOL and well-being.

Combining Stress Exposure and Stress Generation: Does Neuroticism Alter the Dynamic Interplay of Stress, Depression, and Anxiety Following Job Loss?

OBJECTIVE

Emerging models of stress point to a dynamic formulation where stressors and internalizing symptoms reciprocally influence each other. This study tested whether this dynamic interplay is the result of a general internalizing process underlying both depression and anxiety, and whether it varies with neuroticism.

METHOD

A total of 426 adults (51% female; 47% White, 42% African American) were assessed five times over 6 months following loss of employment, using repeated measurements of stressors, depression, anxiety, and neuroticism.

RESULTS

Latent growth across 6 months and multilevel cross-lagged regressions across 6 weeks supported the hypothesis that stressors and internalizing symptoms have reciprocal effects after job loss. Findings for unique variation in depression paralleled those for general internalizing, whereas few findings emerged for general or social anxiety after controlling for internalizing. Neuroticism strengthened the association of change in stressors with change in symptoms across 6 months. Those with high neuroticism showed less reduction in internalizing following reemployment and were less likely to be reemployed when starting with higher internalizing.

CONCLUSIONS

The moderated reciprocal effects model helps account for onset, maintenance, and resolution of symptoms following job loss. We speculate that these findings may be due in part to differential emotion regulation and reductions in motivation.

Leisure activities are linked to mental health benefits by providing time structure: comparing employed, unemployed and homemakers

BACKGROUND

Unemployment has consistently been linked to negative mental health outcomes, emphasising the need to characterise the underlying mechanisms. The current study aimed at testing whether compared with other employment groups, fewer leisure activities observed in unemployment may contribute to elevated risk for negative mental health via loss of time structure.

METHODS

Depressive symptoms (Center for Epidemiologic Studies Depression), leisure activities (exercise, self-focused, social), and time structure (Time Structure Questionnaire (TSQ)) were assessed cross-sectionally in 406 participants (unemployed=155, employed=140, homemakers=111) recruited through Amazon Mechanical Turk.

RESULTS

Controlling for gender and age, structural equation modelling revealed time structure partially (employed, homemakers) and fully (unemployed) mediated the relationship between leisure activities and depressive symptoms. With the exception of differential effects for structured routines, all other TSQ factors (sense of purpose, present orientation, effective organisation and persistence) contributed significantly to all models.

CONCLUSIONS

These findings support the idea that especially for the unemployed, leisure activities impose their mental health benefits through increasing individuals' perception of spending their time effectively. Social leisure activities that provide a sense of daily structure may thereby be a particularly promising low-cost intervention to improve mental health in this population.

Differential Links Between Leisure Activities and Depressive Symptoms in Unemployed Individuals

OBJECTIVE

Unemployment has consistently been linked to an elevated risk for depression. Exercise, specifically leisure-based physical activities, has received increasing attention as alternative treatment options. However, because leisure activities are pursued during discretionary time, it is unclear if the mental health benefits of physical and leisure activities apply during times of unemployment as well.

METHOD

Depressive symptoms and participation in recreational activities were assessed in 142 employed and 158 unemployed participants (age = 34 ± 11 years; male = 150).

RESULTS

Independent of employment status, all recreational activities were inversely associated with depressive symptoms. However, social (employed: ηp (2) = .21; unemployed: ηp (2) = .11) and self-focused (employed: ηp (2) = .19; unemployed: ηp (2) = .10) recreational activities were more strongly related to depressive symptoms than exercise (employed: ηp (2) = .12; unemployed: ηp (2) > .05).

CONCLUSION

These findings highlight the strong mental health associations of recreational activities and suggest that, particularly for unemployed individuals, promoting recreational activities, rather than exercise, may leverage the stronger negative relationship with risk of depression.

Addressing Item-Level Missing Data: A Comparison of Proration and Full Information Maximum Likelihood Estimation

Often when participants have missing scores on one or more of the items comprising a scale, researchers compute prorated scale scores by averaging the available items. Methodologists have cautioned that proration may make strict assumptions about the mean and covariance structures of the items comprising the scale (Schafer & Graham, 2002 ; Graham, 2009 ; Enders, 2010 ). We investigated proration empirically and found that it resulted in bias even under a missing completely at random (MCAR) mechanism. To encourage researchers to forgo proration, we describe a full information maximum likelihood (FIML) approach to item-level missing data handling that mitigates the loss in power due to missing scale scores and utilizes the available item-level data without altering the substantive analysis. Specifically, we propose treating the scale score as missing whenever one or more of the items are missing and incorporating items as auxiliary variables. Our simulations suggest that item-level missing data handling drastically increases power relative to scale-level missing data handling. These results have important practical implications, especially when recruiting more participants is prohibitively difficult or expensive. Finally, we illustrate the proposed method with data from an online chronic pain management program.

A longitudinal examination of re-employment quality on internalizing symptoms and job-search intentions

Underemployed workers-those receiving less pay, working fewer hours, or using fewer skills than they would prefer-appear to experience negative mental health outcomes similar to the unemployed. Prior cross-sectional research provides mixed empirical evidence for this conclusion, however. The current study sought to clarify the impact of underemployment longitudinally, assessing mental health 5 times over 8 months after job loss. In addition to the commonly used indicators of underemployment, we designed a measure of cognitive complexity using the Occupational Information Network (O*NET), an extensive government database used to organize and categorize occupational information. Replicating past research, we found concurrent associations between all indexes of reemployment job quality and internalizing symptoms in the period immediately after reemployment. However, when controlling for quality of prior employment, all indicators except our measure for cognitive complexity became nonsignificant. As participants transitioned from unemployment to reemployment, only reductions in cognitive complexity were associated with sustained general internalizing symptoms. We also found that although changes in cognitive complexity had an immediate impact on the well-being of the recently reemployed, only the number of available weekly hours (full-time vs. part-time status) was relevant 6 to 12 weeks later. Our longitudinal model thus provides significant nuance to the current understanding of underemployment and mental health.

Clinically significant weight gain 1 year after occupational back injury

OBJECTIVE

To examine the incidence of clinically significant weight gain 1 year after occupational back injury, and risk factors for that gain.

METHODS

A cohort of Washington State workers with wage-replacement benefits for back injuries completed baseline and 1-year follow-up telephone interviews. We obtained additional measures from claims and medical records.

RESULTS

Among 1263 workers, 174 (13.8%) reported clinically significant weight gain (≥7%) 1 year after occupational back injury. Women and workers who had more than 180 days on wage replacement at 1 year were twice as likely (adjusted odds ratio = 2.17, 95% confidence interval = 1.54 to 3.07; adjusted odds ratio = 2.40, 95% confidence interval = 1.63 to 3.53, respectively; both P < 0.001) to have clinically significant weight gain.

CONCLUSIONS

Women and workers on wage replacement for more than 180 days may be susceptible to clinically significant weight gain after occupational back injury.