Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial

The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder.     

Brain activation patterns in major depressive disorder and work stress-related long-term sick leave among Swedish females

Deficits in executive functioning and working memory associated with frontal lobe dysfunction are prominent in depression and work-related long-term sick leave (LTSL). This study used functional magnetic resonance imaging (fMRI) to investigate potential differences in brain activation patterns in these conditions. In addition, the function of the hypothalamic-pituitary-adrenal (HPA) axis was examined and compared between groups. Since there is a clear overrepresentation of women in these diagnostic groups, and to ensure a more homogenous sample population, only women were included. To examine the neural correlates of relevant cognitive processes in patients on sick leave >90 days due to work-related LTSL, recently diagnosed patients with major depression Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria, untreated), and healthy controls (n?=?10, each group), a 2-back working memory task and a visual long-term memory task were administered during fMRI scanning. HPA axis functioning was investigated using a diurnal curve of saliva cortisol and a dexamethasone suppression test. Task performance was comparable among the three groups. Multivariate image analysis revealed that both memory tasks engaged a similar brain network in all three groups, including the prefrontal and parietal cortex. During the 2-back task, LTSL patients had significant frontal hypoactivation compared to controls and patients with depression. Saliva cortisol measurements showed a flattening of the diurnal rythmicity in LTSL patients compared to patients with depression and healthy contols. Taken together, these findings indicate that work stress-related LTSL and major depression are dissociable in terms of frontal activation and diurnal cortisol rhythmicity.     

Correspondence of back pain patients' self-reports of sick leave and Swedish National Insurance Authority register

While self-reports of sick absenteeism days are often practical for research, it is not clear how accurate these reports are. 192 Swedish participants recorded the number of days they had been off work for all illnesses, as well as for back pain specifically, for each month during the past 6 mo. These data were then compared to records from the National Insurance Authority in Sweden. The similarity between the data sets was very high, with the correspondence for those reporting 0 to 30 days off being 98%. For those with more than 30 days of self-reported sick leave, the correspondence was 81%, but the reason for the discrepancy may have been a lack of clarity in the question. It is concluded that self-reports correspond well with recorded data and that their use in research is justified.     

Assimilation is due to one perceived whole and contrast is due to two perceived wholes

There is evidence that assimilation occurs when stimuli form one perceived whole. The assumption that a single internal event results in both a perceived whole and assimilation follows. There is also evidence that a transition from assimilation to contrast can occur. This assimilation should be due to one internal event, and this contrast is argued to be due to an interaction between the internal events for two perceived wholes. Another proposal is that at any one moment in time all stimuli result in an outcome that has a specific position on a continuum that ranges from one strong perceived whole to two interacting perceived wholes to two independent perceived wholes.     

The relationship between memory complaints,activity and perceived health status

Subjective memory complaints (SMC) is a possible symptom of mild cognitive impairment which may progress to dementia. The present study examines the relationship of physical activity (PA), cognitive activity (CA), social activity (SA), and perceived health status (HS) with SMC for middle age and older adults. Participants were from the MIDUS II study (Midlife in the United States) recruited in 2004–2006 (Mean age = 55.99; N = 3030). Hierarchical multiple regression was performed with SMC as the dependent variable, along with PA, CA, SA, and HS as the independent variables. The study revealed that SMC was strongly related to PA, CA, and HS, while controlling covariates. Further, HS had the strongest link with SMC among these predictors while interaction effects (PA × HS, CA × HS, and SA × HS) were insignificant. In addition, different results were achieved in younger versus older groups. Participants with more CA, PA and perception of better health had lower frequency of memory complaints.     

Personality,risky health behaviour,and perceived susceptibility to health risks

We examined the relations between personality (Five‐Factor Model), risky health behaviours, and perceptions of susceptibility to health risks among 683 university students. The hypothesis was that personality would affect perceptions of susceptibility to health risks in two ways: directly, irrespective of risky health behaviours, and indirectly, through the effects of personality on risky health behaviours. The students were surveyed about smoking, being drunk, drunk driving, risky sexual behaviour, and perceptions of susceptibility to related health risks. In path‐analytical models we found the expected direct and indirect effects. The personality dimensions of Agreeableness and Conscientiousness had negative direct effects on perceptions of susceptibility as well as negative indirect effects through risky health behaviours. Neuroticism was the only personality dimension to show positive direct effects on perceptions of susceptibility as well as negative indirect effects. Copyright © 1999 John Wiley & Sons, Ltd.     

Change in perceived spatial directions due to context

We examined the influence of context on exocentric pointing. In a virtual three-dimensional set-up, we asked our subjects to aim a pointer toward a target in two conditions. The target and the pointer were visible alone, or they were visible with planes through each of them. The planes consisted of a regular grid of horizontal and vertical lines. The presence of the planes had a significant influence on the indicated direction. These changes in indicated direction depended systematically on the orientation of the planes relative to the subject and on the angle between the planes. When the orientation of the (perpendicular) planes varied from asymmetrical to symmetrical to the frontoparallel plane, the indicated direction varied over a range of 15 degrees--from a slightly larger slant to a smaller slant--as compared with the condition without the contextual planes. When the dihedral angle between the two planes varied from 90 degrees to 40 degrees, the indicated direction varied over a range of less than 5 degrees: A smaller angle led to a slightly larger slant. The standard deviations in the indicated directions (about 3 degrees) did not change systematically. The additional structure provided by the planes did not lead to more consistent pointing. The systematic changes in the indicated direction contradict all theories that assume that the perceived distance between any two given points is independent of whatever else is present in the visual field--that is, they contradict all theories of visual space that assume that its geometry is independent of its contents (e.g., Gilinsky, 1951; Luneburg, 1947; Wagner, 1985).     

Exercise, pain, perceived family support, and quality of life in Korean patients with ankylosing spondylitis

Relations of habitual exercise and pain, perceived family support, and the quality of life in patients with functional class II for ankylosing spondylitis were explored. In a cross-sectional study perceived pain, family support, and quality of life were compared for 30 patients (23 women and 7 men whose mean age was 28.3 yr.+/-8.6 yr.) practicing exercise regularly and for 38 sedentary patients (31 women and 7 men whose mean age was 27.2+/-6.7 yr.). Exercising patients reported significantly lower pain, greater perceived family support, and increased quality of life than their sedentary peers. Pain ratings were significantly negatively correlated with the quality of life in both groups (r = -.26 in exercisers and r = -.50 in sedentary patients) and control group's perceived family support was significantly correlated .44 with quality of life. These results encourage further study of the associations of habitual exercise with perceived pain, family support, and quality of life.     

Changes in perceived contrast,reaction time,and pattern-specific evoked potentials due to stimulus duration

Using patterned stimulation without luminance change, the authors manipulated the stimulus duration and measured three variables: the magnitude of contrast experience, simple reaction time, and the amplitude of pattern-specific visual evoked potentials. While contrast experience, measured by the scaling method, indicated no saturation below 85 msec, the other two variables saturated below 40 msec. The lower saturation value of the pattern-specific evoked potential is considered as the limit of the correlation between psychophysical measures and brain electric activity. This suprathreshold divergence can be seen as evidence that processes underlying the pattern-specific visual evoked potential components cannot be considered as mechanisms mediating subjective experience of spatial contrast.     

Examining the relationship between hardiness and perceived stress-related growth in a sport injury context

This study examined the relationship between hardiness, coping and perceived stress-related growth (SRG) in a sport injury context. Due to the exploratory nature of the study, a cross-sectional design was employed, whereby 206 previously injured athletes (148 male, 58 female, M_age = 22.23 years) who had recently returned to sport completed three questionnaires: Dispositional Resilience Scale, Stress-Related Growth Scale, and Brief COPE. Pearson product–moment correlations and Preacher's and Hayes's (2008) bootstrapping procedure were used to analyze the data. Findings revealed a significant positive relationship between hardiness and perceived SRG. Two coping strategies were found to mediate this relationship: emotional support and positive reframing. This would suggest that those higher in hardiness may have fostered SRG by mobilising their social support for emotional reasons (e.g., moral support, sympathy or understanding) and having the ability to construe their injury in positive terms; however, more rigorous methodologies are needed to confirm or refute these observations. These findings support some of the central tenets of Joseph and Linley's (2005) organismic valuing theory and provide implications for professional practice. Future researchers should embrace qualitative inquiry to enhance the interpretability and meaningfulness of these findings (e.g., interpretative phenomenological analysis, narrative analysis), and use prospective, longitudinal pre-to-post sport injury designs to further substantiate them.     

Obesity and obesity-related illnesses in borderline patients

The purpose of this study was to examine the prevalence, risk factors, and consequences of obesity in borderline patients 6 years after an index admission for psychiatric reasons. Two hundred and sixty-four borderline patients who met Revised Diagnostic Interview for Borderlines (DIB-R; Zanarini, Gunderson, Frankenburg, & Chauncy, 1989) and Diagnostic and Statistical Manual of Mental Disorders (3rd ed. ref.) (DSM-III-R; APA, 1987) criteria for BPD were interviewed concerning their body mass index (BMI) and related medical problems. Seventy-four of the 264 borderline patients at 6-year follow up were obese, having a BMI > or = 30 kg/m2. They were significantly more likely than the nonobese patients to report suffering from diabetes, hypertension, osteoarthritis, chronic back pain, carpal tunnel syndrome, urinary incontinence, gastroesophageal reflux disorder, gallstones, and asthma. Four significant risk factors were found: chronic PTSD, lack of exercise, a family history of obesity, and a recent history of psychotropic polypharmacy. These results suggest that obesity is common among heavily treated borderline patients and is associated with a number of chronic medical disorders.     

Relation of perceived health with psychosocial variables in elderly osteoarthritis patients

Self-perceived health is related to physical health status and frequently assessed in research on elderly persons. The association of perceived health with sociodemographic, psychological, social functioning, and physical functioning variables was examined in 86 elderly osteoarthritis patients. Psychological well-being (especially depression and anxiety), size of household, physical activity, and education were the most important predictors of self-perceived health (R = .70). Poor perceived health may suggest problems in elderly patients in several psychosocial areas, but good perceived health does not rule out psychosocial problems.     

Abuse, health locus of control, and perceived health among HIV-positive women.

This study of 230 predominantly poor Hispanic and African American women aged 25 to 61 years living with HIV/AIDS in New York City revealed high levels of both sexual (39%) and physical (44%) trauma before the age of 16. Both types of early trauma were correlated with later trauma, and all forms of trauma were significantly associated with current perceived health. In multivariate analyses controlling for relevant covariates, the Powerful Others and Internal Control subscales of the Multidimensional Health Locus of Control Scales (K. A. Wallston, B. S. Wallston, & R. DeVellis, 1978) acted as independent predictors of perceived health rather than (as hypothesized) mediators of the association between trauma and perceived health. Findings underscore the importance of addressing trauma and perceptions of control over one's physical health in the provision of health services to HIV-positive women.     

Personality vulnerability to stress-related sleep disruption: Pathways to adverse mental and physical health outcomes

This study examined the associations among neuroticism (N), conscientiousness (C), and sleep quality in the context of a life transition. The interactive effects of N and C on the association between sleep quality and mental and physical well-being were also examined. Seventy-seven college freshmen (mean age = 19.5) completed personality measures at the beginning of the academic year, and measures of sleep quality, daily hassles, functional status, depression, and self-assessed health approximately 2 months later. N was negatively and C was positively related to sleep quality, and daily hassles mediated these associations. Poor sleep predicted greater depressive symptoms and poorer functional status for high-N/low-C participants, but not for other N and C profiles. Results suggest that conscientiousness moderates the extent to which high-N individuals are vulnerable to the adverse effects of poor sleep.     

The relationship between instrumental and expressive traits,health behaviors,and perceived physical health

Relations between instrumental and expressive traits, health behaviors, and self-reported physical health were examined among young adults. Individuals (169 men, 167 women) completed two measures of instrumental and expressive traits, the Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Ethnic background of the sample included 72% European Americans, 13% Latin Americans, 6% Asian Americans, 5% African Americans, less than 1% Native American, and 4% did not specify a particular category. Expressive traits from the BSRI, and expressive and instrumental traits from the PAQ were associated with health behaviors, after controlling for neuroticism. Neuroticism explained 43% of the variance in perceived physical health. Separation of individuals into four groups on the basis of instrumental and expressive traits showed that androgynous individuals reported significantly better health practices than other individuals providing support for the androgyny model.     

Linking employees' justice perceptions to organizational commitment and intention to leave: The mediating role of perceived organizational support

Building on the social exchange perspective and organizational support theory, this study examined the relationships among employees' justice perceptions, perceived organizational support (POS), organizational commitment and intention to leave. A hypothesized model was developed and tested using hierarchical regression analyses on a sample of 514 practising solicitors in Hong Kong. The results showed that both procedural and distributive justice contributed to the development of POS, and POS mediated their effects on organizational commitment and intention to leave. As expected, organizational commitment was negatively related to intention to leave. Additional analyses revealed that these relationships held for both partners and non‐partners in law firms.     

Happiness and health: environmental and genetic contributions to the relationship between subjective well-being, perceived health, and somatic illness

The aim was to identify genetic and environmental influences on the covariances between subjective well-being (SWB), perceived health, and somatic illness. Analyses were based on 6576 Norwegian twins aged 18-31. Heritabilities ranged from .24 to.66. SWB correlated .50 with perceived health, -.25 with musculoskeletal pain, and -.07 with allergy. Common genetic factors accounted for 45%-60% of associations. SWB and perceived health was to a high extent influenced by the same genes (r(g)=.72 and.82 for males and females, respectively). For SWB and musculoskeletal pain, r-sub(g) =-.29 and -.42 for males and females, respectively. Effects were partly sex specific. Environmental factors shared by twins did not affect the covariances. Results support a differentiated view of SWB-health relations, and imply that both genes and environment play important roles in the associations between well-being and health.     

Adolescent girls' perceived barriers to participation in physical activity

Research shows a decline in physical activity levels during adolescence, particularly among girls. This study explored perceived barriers to participation in moderate and vigorous physical activity among adolescent girls who live in a large ethnoracially and socioeconomically diverse city. A total of 73 adolescent girls in Toronto participated in 1 of 7 focus group sessions which were audiotaped and transcribed verbatim, and qualitative software was used to facilitate data analysis. A constant comparison approach was used to inductively develop themes. Participants' perceived barriers to participating in physical activity included: lack of time; involvement in technology-related activities; influence peers, parents and teachers; concern about safety; inaccessibility of facilities and cost of using them; competition; and body-centered issues. The results suggest that strategies to address specific intrapersonal, social-environmental, and physical-environmental barriers to physical activity participation should be used in physical activity promotion programs for adolescent girls.     

The effects of gender and leave of absence on attributions for high performance,perceived organizational commitment,and allocation of organizational rewards

The present study examined the effects of gender and type of leave of absence on attributions for high performance, perceptions of organizational commitment, and allocation of organizational rewards. Results of the study, utilizing a predominately white student sample with a mean age of 29 years, indicated that there were no negative effects in terms of perceived organizational commitment or allocation of organizational rewards associated with a leave of absence (medical or parental) of short duration (three months) when taken by a high performing male or female. Causal attributions for performance and perceived level of organizational commitment were, however, related to recommendations of reward allocations. Implications of findings and future research are presented.An earlier version of this paper was presented at the annual meeting of the Southern Management Association, Atlanta, GA, November 1993. We would like to thank Gregory H. Dobbins, Mark L. Poteet and two anonymous reviewers for their insightful comments.     

Personality is associated with perceived health and functional status in older primary care patients

Using data collected on 265 primary care medical patients 60 years of age and older, the authors examined the personality bases of subjective health (perceived health, functional status) after controlling for observer-rated depression and medical burden. Four hypotheses were tested: High Neuroticism is associated with poorer perceived health, low Extraversion is associated with poorer perceived health, low Openness to Experience is associated with worse functional status, and age moderates the relationships between personality and subjective health. Findings supported the notion that personality is associated with subjective health; moreover, this effect appeared to grow more pronounced with increasing age. This study underscores the conceptual and heuristic value of examining moderators of the links between personality variables and health.