Unit Cohesion,Resilience, and Mental Health of Soldiers in Basic Combat Training

Military unit cohesion has been shown to correlate with physical and psychological outcomes. However, little is known about the development of cohesion in the early days of military service during Basic Combat Training (BCT) and how it relates to positive support and the negative stressors of training. The current study assessed the development of unit cohesion across the 10-week BCT period (N = 1,939), and the relation of cohesion to stress, resilience, mental health measures, and BCT outcomes (graduation, passing the Army Physical Fitness Test, and final Basic Rifle Marksmanship scores). The sample was primarily male (62%), under age 25 (88%), and unmarried (88%). All putative mediators showed significant change over time. Unit cohesion increased over time (slope 0.22; p < .001), and these increases were associated with decreases in psychological distress (p < .001), sleep problems (p < .001), and tolerance of BCT stressors (p < .001), as well as increases in resilience (p < .001), confidence managing stress reactions (p < .001), and positive states of mind (p < .001). Unit cohesion was indirectly associated with successful graduation and passing the Army Physical Fitness Test through cohesion-related improvement in psychological distress, resilience, and confidence managing reactions to stress. Sleep problems also mediated BCT graduation. Cohesion effects on the Basic Rifle Marksmanship scores were mediated by psychological distress and tolerance of BCT stressors only. These results suggest that unit cohesion may play a key role in the development of psychological health among new soldiers.     

Findings on the relationship between Internet addiction and psychological symptoms in Brazilian adults

This study evaluated the prevalence of Internet addiction (IA) and its association with negative psychological symptoms in Brazilian adults. A network analysis was conducted to estimate specific variables and their expected influence on IA. In this cross-sectional study, 15,476 adults (M_age = 37.5, SD = 9.59) completed an open web-based survey. Three questionnaires were used: the Internet Addiction Test (IAT), Depression Anxiety and Stress Scale (DASS-21) and Satisfaction With Life Scale (SWLS). Based on IAT scores, participants were classified as No-Risk user (NRU), Low-Risk user (LRU) or High-Risk user (HRU). We observed that 4.8% of the participants were classified in the HRU group. In addition, their risk for severe symptoms of depression was 10 times higher and, for anxiety, seven times higher than that in the NRU group (p < .001). Time spent using smartphones was also significantly higher in the HRU group (M_hours = 5.1, p < .001). The main factors associated with IA were depression, gender and anxiety, but the variable “having children” was the most influential in the IA network. These findings suggest that psychiatric symptoms are the main factors associated with IA among the adult population.     

Reliability and validity of the self‐perception profile for adolescents: An Australian sample

In this study, we explored the psychometric properties and factorial validity of Harter's Self‐Perception Profile for Adolescents (SPPA) with an Australian sample drawn from the Raine study 14‐year follow‐up. Participants, boys (n = 795) and girls (n = 758) from Grades 8, 9, and 10, completed the SPPA. Cronbach's alpha showed good internal reliabilities for seven of the eight subscales and global self‐worth. Boys had significantly higher athletic (p < .001), physical appearance (p < .001), and romantic (p < .05) self‐perceptions, while the girls perceived significantly higher behavioural conduct (p < .001) and close friendships (p < .001). Exploratory factor analysis yielded similar factors to those reported by Harter with North American adolescents, although cross loadings resulted in one additional factor. Our findings generally supported Harter's conceptualisation of the self as a multidimensional construct, and with minor modifications, the use of the SPPA with Australian adolescents.     

Investigators' Affirmation of Ethical,Safeguard, and Scientific Commitments in Human Research

Little is known about how researchers view ethically salient aspects of human studies. As part of a National Institutes of Mental Health-funded study, the authors performed a confidential written survey to assess the attitudes, views, and experiences of researchers with institutional review board approved protocols at the University of New Mexico. A total of 363 researchers (57% response rate) participated. Investigators overall held favorable views of general ethical aspects of research and ethics-based safeguards, and they identified a positive role of ethics training. Investigators with more experience encountering ethical problems (p < .001), more ethics training (p = .001), and a PhD or MD/PhD (p = .003) held more favorable general ethical perspectives. Women investigators (p < .03), nonphysician investigators (p < .001), those whose training had been helpful in resolving ethical dilemmas (p = .006), and those for whom spirituality is important (p = .008) more strongly endorsed ethical safeguards. Investigators perceive the scientific and ethical aspects of their work as valuable and linked, and they affirm the role of safeguards in human studies. Formal ethics preparation and training initiatives were also viewed positively by investigators.     

Does a customer by any other name tip the same?: The effect of forms of address and customers' age on gratuities given to food servers in the United States

This study examined whether different forms of address used by food servers were related to customers' tipping behavior. Food servers addressed diners who paid with credit cards by their first names, titles plus last names, sir/ma'am, or no address. Results indicated that when food servers personalized their service by addressing their customers by name, they earned significantly higher tips than when they used less immediate forms of address, although customers' estimated age mediated these results.     

A Structural Model for Adjustment to Aging among Older Women in Breast Cancer Remission

This study aims to build a structural model to explore the predictors of adjustment to aging (AtA) reported by older women in breast cancer remission. A community-dwelling sample of 771 older women in breast cancer remission aged between 75 and 98 years answered a questionnaire to determine socio-demographic (age, income, marital status, education, household, and living setting), and health-related characteristics (self-reported functional limitations and disabilities, time since remission, other type of cancer, breast reconstruction, perceived health, recent disease and medication). Several measures were employed to assess AtA, sense of coherence and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables. Significant predictors of AtA are self-reported disability (β = .404; p < .001), time since remission (β = .371; p < .001), perceived health (β = .257; p < .001), other type of cancer (β = .231; p < .001), breast reconstruction (β = .153; p = .008), marital status (β = .141; p < .001), sense of coherence (β = .140; p < .001), and living setting (β = .139; p = .006). These variables accounted for 84.3% of the variability of AtA. Self-reported disability and time since remission were the strongest predictors of AtA. Our findings suggest that health care interventions with older women in breast cancer remission still living in the community may benefit from clearly including these predictors of AtA, as they are relevant for promoting older women’ s aging well.

     

Suicide Ideations,Suicide Attempts,and Completed Suicide in Persons with Pathological Gambling and Their First‐Degree Relatives

We examined the relationship between suicidal ideations and attempts in 95 probands with pathological gambling (PG), 91 controls, and 1075 first‐degree relatives. The results were analyzed using logistic regression with generalized estimating equations. Thirty‐four PG probands (35.8%) and 4 controls (4.4%) had attempted suicide (OR = 12.12, p < .001); in 13 probands, the attempt occurred before PG onset. Lifetime suicidal ideations occurred in 60 PG probands (63.2%) and 12 controls (13.2%) (OR = 11.29, p < .001). Suicidality in PG probands is a marker of PG severity and is associated with greater psychiatric comorbidity. Offspring of PG probands had significantly higher rates of suicide attempts than control offspring.     

Predicting Occupational Status for Non-College-Bound Males

In a follow-up of selected 1957 Wisconsin male high school graduates (N = 2,230), a prediction of occupational status was attempted. Of the 17 independent variables used, 3 emerged as highly significant and valid: post-high school education (p < .001), community of residence (p < .001), and high school grade-point average (p < .01). Two multiple coefficients were obtained (R = .32, F = 42.43, p < .001, and R = .26, F = 24.97, p < .001). Results suggest that family background factors and aspiration levels are not as important in predicting occupational status as are further education and training, high school achievement, and community of orientation in a highly industrialized urban technocracy.     

Lupus Symptoms Inventory (LSI): Development and Validation of a Self-evaluation Inventory of the Subjective Symptoms of Systemic Lupus Erythematosus

The goal of this study was to develop a simple, easy, and quick self-report measure, the Lupus Symptom Inventory (LSI), designed to evaluate subjective symptoms of Systemic Lupus Erythematosus (SLE). The internal consistency of the LSI was tested, as well as its concordance with physician reports and serological indicators of disease activity by evaluating the self-reports of 46 patients with SLE who completed the LSI daily for a one-month period. Throughout this one-month period, parameters of serological activity and routine medical check-up were obtained. The results showed a high internal consistency of the LSI, with a Cronbach alpha of .86. Additionally, a contingency analysis showed agreement between medical report and patient self-report on the same day for six of seven lupus symptoms (difficulty breathing (p < .004), joint pain (p < .001), loss of appetite (p < .003), general malaise (p < .005), fatigue (p < .005), and skin rash (p < .018)) but not for abdominal symptoms. Finally, differences were found between LSI scores of patients with high versus low serological activity (χ²(1) = 5.302; p < .021), with the former presenting higher LSI scores than the latter. These results show that the LSI may be a reliable and valid instrument for evaluating the subjective symptoms of the disease as well as its fluctuations.     

Investigating the influence of an effort–reward interaction on cognitive fatigue in individuals with multiple sclerosis

This study examined whether an alteration in the effort–reward relationship, a theoretical framework based on cognitive neuroscience, could explain cognitive fatigue. Forty persons with MS and 40 healthy age- and education-matched cognitively healthy controls (HC) participated in a computerized switching task with orthogonal high- and low-demand (effort) and reward manipulations. We used the Visual Analog Scale of Fatigue (VAS-F) to assess subjective state fatigue before and after each condition during the task. We used mixed-effects models to estimate the association and interaction between effort and reward and their relationship to subjective fatigue and task performance. We found the high-demand condition was associated with increased VAS-F scores (p < .001), longer response times (RT) (p < .001) and lower accuracy (p < .001). The high-reward condition was associated with faster RT (p = .006) and higher accuracy (p = .03). There was no interaction effect between effort and reward on VAS-F scores or performance. Participants with MS reported higher VAS-F scores (p = .02). Across all conditions, participants with MS were slower (p < .001) and slower as a function of condition demand compared with HC (p < .001). This behavioural study did not find evidence that an effort–reward interaction is associated with cognitive fatigue. However, our findings support the role of effort in subjective cognitive fatigue and both effort and reward on task performance. In future studies, more salient reward manipulations could be necessary to identify effort–reward interactions on subjective cognitive fatigue.     

Physical activity: the relative associations with cognitive and affective risk beliefs

Abstract

Objective: The role of affectively oriented risk beliefs in explaining health behaviors has not been examined in the context of physical activity or in diverse study populations. We evaluated whether affective risk beliefs account for unique variance in physical activity intentions and behavior above and beyond that accounted for by cognitive risk beliefs.

Design: A cross-sectional survey of socio-demographically diverse US residents (N?=?835; 46.4% no college training; 46.7% minority racial/ethnic ancestry; 42.6% men).

Main outcome measures: Physical activity intentions and behavior.

Results: Hierarchical linear regressions showed that affective risk beliefs accounted for variance in physical activity intentions beyond that predicted by socio-demographics and cognitive risk beliefs (F-change ps<.001). Specifically, intentions were higher among people with higher anticipated regret (ps<.001) and with higher absolute feelings of risk (ps<.05) or worry (ps<.05). There was an indirect relationship between perceived absolute likelihood and intentions through anticipated regret and feelings of risk. Neither cognitive nor affective risk beliefs accounted for variance in physical activity behavior (F-change ps>.05), but unsurprisingly, behavior was positively associated with physical activity intentions (p<.001).

Conclusion: Future interventions could target affective risk beliefs—particularly anticipated regret—to increase intentions, and then add other intervention components to bridge the intention–behavior gap.     

Relations between symptom severity,illness perceptions,visceral sensitivity,coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ² (8) = 11.91, p = .16, χ²/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.     

Relational and Social Aggression and Reflective Processing in a University Sample

This study examined whether the dimension of reflective processing (e.g., deep and elaborative processing) was connected to the use of relational aggressions, social aggression, or both. A convenience sample of 629 college students (66% female, 91.6% White) was surveyed to ascertain the relation between self-reported relational and social aggression and deep and elaborative processing. The overall multivariate regression model was significant, Wilks’s λ = .12, F(4, 2162) = 1010.80, p < .001. Univariate results were used to show that the two predictors (relational and social aggression) significantly and strongly positively predicted the use of deep processing, R² = .81, p < .001, as well as the use of elaborative processing, R² = .87, p < .001. In summary, higher levels of social and relational aggression were related to higher levels of deep and elaborative processing. Implications for these findings are presented.     

Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

This meta-analysis summarizes the findings of outcome research on the degree to which telehealth treatments reduce posttraumatic stress disorder (PTSD)-related symptoms. In a search of the literature, 13 studies were identified for inclusion in the meta-analysis and were coded for relevant variables. A total of 725 participants were included. Results indicate that telehealth treatments are associated with significant pre- to postreduction in PTSD symptoms (d = 0.99, 95% confidence interval [CI]: 0.87–1.11, p < .001), and result in superior treatment effects relative to a wait-list comparison condition (d = 1.01, 95% CI: 0.76–1.26, p < .001). However, no significant findings were obtained for telehealth intervention relative to a supportive counseling telehealth comparison condition (d = 0.11, 95% CI: ? 0.38 to 0.60, p = .67), and telehealth intervention produced an inferior outcome relative to a face-to-face intervention (d = ? 0.68, 95% CI: ? 0.39 to ? 0.98, p < .001). Findings for depression symptom severity outcome were generally consistent with those for PTSD outcome. Telehealth interventions produced a significant within-group effect size (d = 0.98, 95% CI: 0.86 to 1.10, p < .001) and superior effect relative to wait-list comparison condition (d = 0.80, 95% CI: 0.56–1.05, p < .001). Relative to face-to-face interventions, telehealth treatments produced comparable depression outcome effects (d = 0.13, 95% CI: ? 0.55 to 0.28, p = .53). Taken together, these findings support the use of telehealth treatments for individuals with PTSD-related symptoms.     

Psychophysiological correlates of organizational change and threat of unemployment among police inspectors

The study examined psychosocial work-conditions and physiological reactions among thirty-six police inspectors (median age 45 years, 81% males) who participated in a reorganization. At this time, subjects were threatened by unemployment and had to reapply for their positions in a new police district. Data were collected during the reorganization and at three years follow-up, by means of questionnaires (Stress Profile) and blood samples. The blood samples were used to determine serum levels of gammaglutamyltransferase (GGT), glucose, lipids, prolactin, testosterone and cortisol. The results show a positive association betweenworry about employment and symptoms ofburnout during the reorganization. Mean scores for the Stress Profile sub-scalesworry about employment (p<.01) andwork-load (p<.05) decreased between measurements but an impairment inrelationships with management was noticed (p<.05). No significant changes were observed in terms of self-rated health complaints. Significant decreases in total cholesterol (p<.0001), LDL-cholesterol (p<.0001), LDL/HDL-ratio (p<.01), prolactin (p<.0001), as well as increases in testosterone (p<.01) and cortisol (p<.001) were observed for the whole sample. Glucose decreased with marginal significance (<.07). Controlling for age and gender, multivariate regression analyses showed that subjects who reported deteriorations insatisfaction with work manifested the most modest decreases in prolactin (p<.05). Also, the decrease in glucose was larger for subjects who experienced impairments in,satisfaction with work (p<.05), information (p<.05), task-oriented leadership, (p<.05), andrespect and dignity (p<.05). Subjects who perceived deteriorations in theethical and moral standards of the organization increased their cortisol level to a lower degree than their counterparts (p<.05). Favorable changes in employment status and psychosocial work environment seem to be related to improved physiological functioning.     

Association of Burnout with Emotional Coping Strategies,Friendship, and Institutional Support Among Internal Medicine Physicians

Physician burnout influences physician mental health, staff stress, safety events, and patient outcomes. The association of burnout with compassion satisfaction, secondary stress, emotional coping strategies and many psychosocial variables, such as institutional support, friendship, and spirituality, have not been well studied. A convenience sample of internal medicine physicians was emailed a survey using validated instruments to explore these associations. The response rate was 337/1021 (33%), with a burnout prevalence of 175/337 (52%). Grit, acceptance, active coping, positive reframing, and strategy planning were associated with lower burnout domains and greater compassion satisfaction. Certain emotional coping strategies such as denial, disengagement, self-blame, substance abuse, and venting were associated with greater burnout and lower compassion satisfaction. Greater institutional support was associated with lower burnout (r?=????.35, p?<?.001), secondary stress (r?=????.14, p?<?.05), and compassion satisfaction (r?=?.28, p?<?.0001). Friendship was associated with lower burnout (r?=????.25, p?<?.0001) and greater compassion satisfaction (r?=?.28, p?<?.0001). This study suggests that amelioration of burnout requires both intrinsic strategies that emphasize physician coping skills as well as extrinsic strategies that address institutional support.

     

Increasing Psychological Capital: A Pre-Registered Meta-Analysis of Controlled Interventions

The aim of this meta-analysis was to evaluate the overall effectiveness of interventions designed to enhance psychological capital (PsyCap), well-being, and performance. We used inclusion criteria such as: to have an experimental design, the sample to be formed by employees or students, to contain a measure of PsyCap, and a control group. Forty-one trials (N_total = 3,911) met these criteria. The overall effect of the interventions on all PsyCap variables was significant but small (d = 0.34, k = 41, Z = 6.74, p < .001). Separate analyses on each of the PsyCap variables also revealed significant effects: small effects on developing PsyCap (d = 0.26, k = 9, Z = 4.37, p < .001), hope (d = 0.22, k = 5, Z = 2.26, p < .05), self-efficacy (d = 0.37, k = 18, Z = 4.11, p < .001), and optimism (d = 0.36, k = 12, Z = 2.52, p < .05), and a small to medium effect for resilience (d = 0.49, k = 12, Z = 3.61, p < .001). The effectiveness of the PsyCap interventions on well-being and performance is also significant.