Exploring the Emotional Dysregulation Scale-Short Form in isolated, confined, and extreme environments

The Emotional Dysregulation Scale-Short Form (EDS-S) may have potential for assessing emotional dysregulation (ED) both in general clinical mental health environments and in specialised work settings. Before it can be used fairly and appropriately, evidence of its validity in the local South African (SA) context is required. This study thus explored its psychometric characteristics among local working adult samples by pursuing three specific objectives, namely, to investigate its structural validity, its construct validity, and issues around practical use (e.g. priming bias and ability to predict performance). Data were collected across four samples that comprised general workers and specialised naval personnel (total N = 1374), who also completed measures of clinical mental health and other adjustment difficulties. Statistical analysis included examination of socio-demographic effects, internal consistencies, confirmatory factor analysis, measurement invariance, and associations with measures of mental health and adjustment difficulties (including binomial logistic regressions and receiver operating/operator characteristics curve analyses). This study reported evidence of structural and criterion validity, with significant associations to measures of mental health and adjustment difficulties, for the 12-item EDS-S in non-clinical samples of SA workers. The study further provided preliminary support for its predictive utility in specialised work environments. Preliminary evidence of validity of the EDS-S in SA worker samples with sufficient English proficiency was demonstrated.Contribution: There is some support for the use of the EDS-S in clinical research and applied practise. However, caution must be observed for possible effects of language proficiency and further research into the role of language is required. 

Dispositional resilience predicts psychological adaptation of seafarers during and after maritime operations

BACKGROUND

Seafarers, whether on cargo, fishery, or naval ships, may be exposed to unique and unusual psychological demands related to the often isolated, confined, and extreme environments associated with ocean-going vessels. This necessitates optimal psychological adaptation to maintain individual well-being during the mission and afterwards. This study set out to explore whether psychometric measures could predict psychological adaptation of seafarers, specifically navy sailors, during and after maritime operations. It used emotional regulation as marker of adaptation, and examined the role of psychometric measures of dispositional resilience and emotional regulation to predict psychological adaptation at subsequent time-points.

MATERIALS AND METHODS

A total of 168 sailors completed the Brief Sailor Resiliency Scale, Dispositional Resilience Scale 15, and Mental Toughness Questionnaire 18 prior to departing for sea, as well as the Brunel Mood Scale at 5 time points over a 12-month operational cycle.

RESULTS

Higher resilience scores were consistently associated with more adaptive emotional regulation. Multiple linear regressions indicated that the Brief Sailor Resiliency Scale predicted emotional regulation over the shorter term, while the Mental Toughness Questionnaire 18 predicted emotional regulation over the longer term. Further, mid-mission emotional regulation also predicted emotional regulation at the end of deployments.

CONCLUSIONS

The findings support several practical applications. Firstly, formal organizational initiatives to promote resilience could be useful to enhance adaptation during and after missions. Secondly, measuring seafarers' dispositional resilience could allow the streaming of vulnerable individuals towards appropriate mental health support services. Thirdly, past indicators of adaptation could be useful to enhance decision- making regarding subsequent utilisation. This may be applicable to seafarers in both naval services and commercial shipping, and to personnel in remote weather stations or other isolated and inaccessible research facilities.

A Concise Occupational Mental Health Screening Tool for South African Workplaces

Mental health in the workplace is becoming of ever greater importance. General occupational health surveillance programmes are already in widespread use, with established referral systems for treatment and rehabilitation, and the same mechanisms could be expanded to include mental health screening and intervention. This study aimed to develop a concise composite mental health screening tool, based on analysis of existing data, for application in routine occupational health surveillance in South Africa. Data from workplace occupational health surveillance programs from 2,303 participants were analysed. Participants completed a number of questions/scaled items collated into a survey format, and partook in an interview with a psychologist. The data was analysed using frequency of positive self-reports, Chi square to calculate associations with outcomes, Receiver Operator Characteristic curve analysis to explore predictive ability, and binomial logistic regression to calculate the relative contribution of markers to outcomes. An exploratory factor analysis was further conducted on identified items. A general workplace model with 14 markers (and a maritime workplace model with 17 markers) were identified. The factor analysis suggested their organisation into five domains (similar for both models), namely neurocognitive health, common mental disorders, history of adaptation in occupational specific contexts, family-work interface, and stress overload. The study’s data-driven approach proposed a concise composite screener with less than 50 items, comprising five domains. This tool appears useful in identifying employees at risk for workplace injuries or poor mental health outcomes, and could be applied to related workplace settings in South Africa.

Associations Between Adverse Underwater Events and ADHD Diagnosis Among Military Divers

Objective: Adult ADHD (A-ADHD) has been associated with an increased risk of accidents and workplace injuries. ADHD within professional diving may have major potential occupational health and safety implications, as accidents underwater may have severe consequences. The study investigated any association of increased risk for adverse underwater incidents with an ADHD diagnosis. Method: This analysis used retrospective records from 156 navy divers and computed an odds ratio using cases of ADHD and cases of underwater accidents. Results: Although the odds ratio was increased, it failed to reach significance. Conclusion: We do not yet have statistical evidence suggesting that the risk for adverse underwater events is significantly increased among the ADHD group in this sample of navy divers. Sufficiently powered studies are required to further address the potential risk of A-ADHD in working divers.

Common mental health conditions among navy divers: A brief report

INTRODUCTION

A recent article reported on common mental health conditions among recreational scuba divers, and observed that the prevalence mirrored national population figures. This raised the question of the extent to which this might also be the case among professional divers. No data on commercial divers could be located; this paper presents the situation among navy divers.

METHODS

Mental health survey data from 132 South African Navy divers were reviewed to describe the 12-month prevalence of common mood, anxiety, and alcohol misuse disorders.

RESULTS

Prevalence of common mood and anxiety conditions appeared to reflect local general population estimates, and the occurrence of alcohol misuse was higher than local population figures, although the usefulness of the population data could be challenged.

CONCLUSIONS

It appeared that common mental health conditions in both sport and navy divers may generally conform to their respective local general population estimates. If this were to be the case in the broader professional diving environment as well, the inclusion of some form of formal mental health screening during commercial diving medical examinations may be beneficial.

Adult attention-deficit/hyperactivity disorder prevalence among commercial divers in South Africa

INTRODUCTION

Adult attention-deficit/hyperactivity disorder (ADHD) is associated with increased chance of workplace accidents, psychiatric comorbidities, other risky behaviours and sophisticated psychopharmacological treatment. These factors all contribute to a potentially complex risk profile within the commercial diving context. In order to make informed decisions regarding ADHD and commercial diving, further description of this condition among commercial divers is required. This paper reports on a study that aimed to determine the prevalence of adult ADHD among commercial divers.

METHODS

The study used a self-reporting survey-type questionnaire to determine likely diagnosis, based on Diagnostic and Statistical Manual of Mental Disorders, 5th ed. criteria, in a group of 245 commercial divers in South Africa.

RESULTS

Fourteen cases (5.7% of the sample) met criteria for ADHD. The majority of the cases presented with combined type, and reflected mild forms of ADHD. Adult ADHD did not appear to occur in significantly different proportions across the biographical variables of age, education or diving qualification.

CONLCUSION

Based on this small survey, adult ADHD may be over-represented in commercial diving in South Africa, compared to general workplace populations. However, ADHD may not necessarily be a contra-indication to commercial diving.

Adult ADHD in the South African workplace: the usefulness of a self-report screening measure and preliminary prevalence estimates

In the South African context, resource constraints often preclude the comprehensive assessment of large numbers of people for the likelihood of Adult Attention-Deficit/Hyperactivity Disorder (ADHD). Primary screening through a self-report measure may be useful to stream at-risk individuals towards diagnostic assessment services, as well as being useful in population and workplace based research. The present study set out, first, to investigate the usefulness of a self-report ADHD scale to identify at-risk individuals, and, second, to provide preliminary prevalence estimates for Adult ADHD, guided by Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria, in a South African workplace sample. Workers in full-time skilled employment ( N = 1,917), aged 18–44, completed a self-report Adult ADHD scale, and participated in an interview with a psychologist. Their scale data, using three different scoring and interpretation systems, were subjected to statistical analysis. Favourable internal reliability and positive predictive validity were found. Different interpretation systems provided different prevalence estimations: using DSM-5 criteria, a total prevalence estimate of 3.3 % was calculated (attention deficit subtype = 0.9%, hyperactivity-impulsivity subtype = 1.0%, and combined subtype = 1.4%). The positive predictive validity found with this sample suggests that this scale can be used constructively in research or screening contexts to identify at-risk individuals. Furthermore, preliminary prevalence estimates for Adult ADHD, guided by DSM-5 criteria, are now available for a South African workplace sample.

Diving, cannabis use, and techniques of neutralisation: exploring how divers rationalise cannabis use

BACKGROUND

Diving medicine literature often regards the use of cannabis as a potential contra-indicator for fitness to dive. With that said, there has been no empirical research done with cannabis-using divers to examine how they subjectively understand and construct the risks that their cannabis use may have on their diving. This study explored how cannabis-using divers rationalise the pejorative associations of cannabis use through rhetorical techniques of neutralisation (TON) that function to deny the risks that cannabis use may have on their diving.

MATERIALS AND METHODS

Ten medically-fit professional divers from South Africa were individually intervie- wed. The interviews focussed on each diver's reported recreational use of cannabis. The interviews were transcribed and analysed through a framework for TON originally formulated by Sykes and Matza (1957).

RESULTS

Analysis revealed six primary TON employed to refute the pejorative associations of cannabis use on dive work, namely: 1. Denial of responsibility: which denies a diver's direct culpability for their cannabis use; 2. Denial of injury: which asserts that no (serious) harm results from a diver's cannabis use; 3. Denial of victim: which repudiates the potentially deleterious effects that cannabis use may have on a diver; 4. Condemnation of condemners: which minimises cannabis use in relation to other divers' unsafe diving practices; 5. Appeal to loyalties: which situates cannabis use within interpersonal networks to whom a diver has a "higher" allegiance; 6. Denial of penalty: which justifies cannabis use by virtue of a perceived lack of punitive action by a Diving Medical Examiner.

CONCLUSIONS

The findings of this research highlight the TON which potentially inform a diver's cannabis use, particularly in relation to their diving. Identifying such TON carry important implications for the ways in which fitness to dive is assessed.

Psychological considerations in submarine escape training: brief overview and future directions

The inability of a submarine to surface must rate as one of greatest risks to sailors in peacetime. To prepare for such emergencies, many navies provide training to master the procedures required to escape successfully from disabled submarines. This paper provides a brief overview of some of the psychological principles in simulated submarine escape training. It further discusses applicable psychological constructs such as positive outcome expectancies, the role of anxiety, and other personal factors mediating outcomes of such training. It concludes with recommendations for future research aimed at enhancing the safety and impact of submarine escape training. These include enhanced detection of psychological risk factors such as anxiety, as well as investigating the relative contribution of personality variables to in-training safety and positive outcome expectancies. These recommendations do not only apply to submarine escape training, but may also be applicable to high fidelity safety training in other off-shore survival contexts, such as helicopter underwater escape training, freefall lifeboat training and smoke diving.

Diving under the influence: issues in researching personality and inert gas narcosis

BACKGROUND

This paper considers the relationship between measures of personality and mood states, and susceptibility to inert gas narcosis. It briefly reviews the topics of inert gas narcosis affecting personality, and personality affecting the susceptibility to inert gas narcosis. There appears to be is a theoretical argument for a possible relationship between measures of personality, mood states, and susceptibility to narcosis. Practically, such a relationship may speak to issues in selection, training and preparation, risk assessments, and even accident investigation in the diving and/or hyperbaric environment.

MATERIALS AND METHODS

Twenty one divers completed measures of personality and mood states, and were then compressed to 709 kPa (equivalent to 60 msw) in a dry compression chamber, where they completed a task measuring speed of information processing, and a scale measuring subjective narcosis.

RESULTS AND CONCLUSIONS

The main finding was the absence of any significant correlations between measures of personality traits and mood, and susceptibility to inert gas narcosis. Although the study found no evidence of any major relationship, it is presented as a case study to highlight some of the issues and pitfalls involved in such research. The lessons learned - including the careful defining and describing of concepts, and choosing of samples and measurements - are used to discuss some of the methodological and conceptual issues and future directions for researchers to consider.

Effect of a Faith-Based Education Program on Self-Assessed Physical, Mental and Spiritual (Religious) Health Parameters

The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire's (SAQ's) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI). Pre-attendance SAQ (S1) was repeated immediately post-FBEP (S2), at 30 days (S3), 90 days (S4) and after 1 year (S5). Of 655 invited, 274 (42 %) succeeded, 242 (37 %) failed and 139 (21 %) declined to complete S1. Of the 274, 37 (14 %) were excluded at on-site interview; 26 (9 %) never attended the FBEP (i.e., controls: 5♂; 21♀; 27-76 years); and 211 (77 %) participated (i.e., cases: 105♂; 106♀; 18-84 years) and were analyzed over time: 211 (S1); 192 (S2); 99 (S3); 52 (S4); 51 (S5). IRB approval was via the Human Research Ethics Committee of Stellenbosch University. DUREL showed significant, sustained changes in Intrinsic Religiosity. N-RCOPE showed significant, lasting improvement. In others, median values dropped significantly immediately after the FBEP (S1:S2) for STAI-State p < 0.0001; PSS p < 0.0001; BIPQ p < 0.0001; and CES-D p < 0.0001; and at 1 month (S1:S3) for STAI-Trait p < 0.001; all changes were sustained (S3 through S5). This FBEP produced statistically and clinically significant changes; these lasted in those followed up >1 year.

Brunel mood scale: South African norm study

<p><strong>Objective:</strong> The Brunel Mood Scale (BRUMS) has proved useful to assess mood states in a range of clinical settings. Its local utility is restricted by the lack of normative data from South Africa. This paper presents preliminary normative data for the use of the BRUMS in the South African health care setting. <strong></strong></p><p><strong>Method:</strong> Participants (N=2200), ranging from 18 to 59 years, employed in the public sector, and were recruited during routine occupational health surveillance, completed the 24-item self-report BRUMS. They came from all South African race and language groups, and from all nine provinces. <strong></strong></p><p><strong>Results:</strong> Significant differences were found between the scores of women and men, and their results are reported separately. Due to the language dependant nature of the BRUMS, results are also reported separately for respondents with English as first language, and those who have other South African languages as mother tongue. Norm tables with T-scores are presented for the full sample, and per gender X language groups.</p><p><strong>Conclusion:</strong> This study presents normative data for a sample of educated and employed South Africans from various backgrounds. Its brevity, and provisionally language friendly nature makes it a useful measure for screening psychological distress in the SA clinical health care context.</p>