Reciprocal relationships between resource loss and psychological distress following exposure to political violence: an empirical investigation of COR theory's loss spirals

Abstract We conducted a four-wave prospective study of Palestinian adults living in the West Bank, Gaza Strip, and East Jerusalem, interviewed between 2007 and 2009 at 6-month interval to explore transactional relationships between resource loss (i.e., intra and interpersonal resource loss) and psychological distress (i.e., posttraumatic stress disorder and depression symptoms). Initially, 1196 Palestinians completed the first wave interview and 752 of these participants completed all four interviews. A cross-lagged panel design was constructed to model the effects of trauma exposure on both resource loss and psychological distress and the subsequent reciprocal effects of resource loss and psychological distress across four time waves. Specifically, resource loss was modeled to predict distress, which in turn was expected to predict further resource loss. Structural equation modeling was used to test this design. We found that psychological distress significantly predicts resource loss across shorter, 6-month time waves, but that resource loss predicts distress across longer, 12-month intervals. These findings support the Conservation of Resources theory's corollary of loss spirals.     

Predicting receipt of social support: a longitudinal study of parents' reactions to their child's illness

A sample of 101 women whose children required medical attention were interviewed at the time of initial hospital contact and again 1 year later. On the second occasion, their spouses were also interviewed for their assessment of their wives' personal and social characteristics. Greater personal resources, more intimate relations, and lower discomfort in seeking support were related to greater receipt of social support 1 year later. Chronic stress conditions were found, however, to diminish the effect of individuals' social characteristics on receipt of support. Spouses assessments showed moderate agreement with that of their wives, lending support to the validity of the findings. Implications for interventions in health-care settings were discussed.     

Conservation of resource caravans and engaged settings

Conservation of resources (COR) theory is a stress and motivational theory that has been applied broadly in the organizational literature. Increasingly, this literature is transforming from a focus on resource‐setting fit to an understanding that ‘fitting’ is an active process that operates dynamically with both individuals and settings altering and metamorphosing. COR theory provides a framework to understand, predict, and examine this transactional relationship that can then be used to shape settings towards more optimal balance of resource cost and benefit. Rather than focusing on single, isolated variables or seeing individuals and settings as independent agents, COR theory suggests that resources exist in caravans. Therefore, employers that hope to ensure employee engagement must maximize the ecology that fosters resource caravan enrichment and challenge that promotes excellence, dedication, and commitment.     

Are community studies of psychological trauma's impact accurate? A study among Jews and Palestinians

We evaluated the accuracy of posttraumatic stress disorder (PTSD) and major depression (MD) diagnoses using brief assessment instruments conducted by phone. PTSD and MD were assessed by telephone interview in a randomly selected sample of Jewish and Palestinian residents of Jerusalem (N = 150) during a period of marked threat of terrorism and war. We utilized the PTSD Symptom Scale Interview Format (Foa, Riggs, Dancu, & Rothbaum, 1993) and the Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001). We then conducted in-depth, in-person interviews within 2 weeks, assessing PTSD and MD using the Composite International Diagnostic Interview (CIDI; Kessler et al., 2004). The prevalence of PTSD and MD diagnosis ascertained by the 2 assessment modalities was similar. Indices of classification accuracy for the phone interview, using the in-person interview as the standard, ranged from modest to high. Brief phone and in-depth in-person measures of PTSD and MD also correlated similarly with other demographic, stress, and coping factors, suggesting convergent validity. Brief phone interviews appear useful for estimating the prevalence of psychological disorders in mass casualty contexts and may have a critical role in both epidemiologic work and guiding public health interventions.     

Perceived lack of training moderates relationship between healthcare providers’ personality and sense of efficacy in trauma-informed care

ABSTRACT

Background and Objectives: Medical patients often have trauma histories that are not routinely assessed, which can adversely affect health outcomes. Despite growing awareness of this issue, there is limited understanding of factors that influence provider competency in trauma-informed care (TIC). The study examined healthcare providers’ personality traits in relation to their sense of TIC efficacy, taking into account perceived barriers to TIC and professional quality of life.

Study Design: The study used cross-sectional survey methods to examine our central hypothesis that provider personality traits and perceived barriers to TIC would be associated with TIC-efficacy, and to explore interactions among study variables.

Methods: Survey data were collected from 172 healthcare providers examining TIC knowledge, TIC-efficacy, perceived barriers to TIC, personality traits, and professional quality of life.

Results: TIC-efficacy was positively correlated with “intellectence/openness” and inversely correlated with “neuroticism” and perceived lack of training as a barrier. “Intellectence/openness” interacted with perceived lack of training to predict TIC-efficacy, suggesting that providers with lower “intellectence/openness” report greater TIC-efficacy when lack of training is not perceived as a barrier.

Conclusions: Provider personality traits and perceived barriers to TIC appear related to providers’ TIC-efficacy. Implications for overcoming barriers to TIC through training and implementation are discussed.     

Effects of social support and battle intensity on loneliness and breakdown during combat

A sample of 382 Israeli soldiers who developed combat stress reactions (CSR) during the 1982 Israel-Lebanon War were compared with groups of carefully matched controls who did not develop CSR. Lack of social support from officers was found to be related to greater feelings of loneliness and greater likelihood of CSR in soldiers. Lack of social support from buddies was found to be related to greater loneliness. Intensity of battle was also found to be related to greater feelings of loneliness and increased likelihood of CSR. A path model was tested and supported. The model suggests that battle intensity and officer support lead to CSR directly and indirectly by causing increased feelings of loneliness. Possible cognitive and psychodynamic explanations for the findings are offered. The limitations of making causal statements from retrospective perceptions is discussed.     

Conservation of resources. A new attempt at conceptualizing stress

Major perspectives concerning stress are presented with the goal of clarifying the nature of what has proved to be a heuristic but vague construct. Current conceptualizations of stress are challenged as being too phenomenological and ambiguous, and consequently, not given to direct empirical testing. Indeed, it is argued that researchers have tended to avoid the problem of defining stress, choosing to study stress without reference to a clear framework. A new stress model called the model of conservation of resources is presented as an alternative. This resource-oriented model is based on the supposition that people strive to retain, project, and build resources and that what is threatening to them is the potential or actual loss of these valued resources. Implications of the model of conservation of resources for new research directions are discussed.     

Personal relationships,personal attributes,and stress resistance: Mothers' reactions to their child's illness

The contribution to emotional distress of mastery, intimacy, received social support, and discomfort in seeking support was examined over a year period among 107 Israeli mothers of well, acutely ill, or chronically ill children. The following was found: (a) Women initially high in mastery experienced less psychological distress and benefited more from social support than did women low in mastery. (b) The greater social support women generally received the lower their psychological distress. (c) Independent of the level of generally received support, women who experienced greater distress received greater social support at the time of crisis. (d) Intimacy with spouse was related to better stress resistance, but the opposite was found for intimacy with family. (e) Women who felt uncomfortable seeking support were more distressed at the time of initial crisis than women who were more comfortable seeking support and became less intimate with significant others.     

Gender differences in stress reactions: Women filling the gaps

Abstract

Competing hypotheses explaining gender differences in depression were compared in a one-year longitudinal study of parents of ill children in Israel. Women were found to have more depressed mood than men when their children were ill or well, but both men and women responded with increased depression when their child was ill. Women were more likely than men to be with an ill child at the hospital, even if employed, suggesting role overload. Women did not report fewer personal or social resources than men, indicating that poverty of resources could not explain sex differences on depression. Nor did women use their resources less effectively than did men. Women were less depressed the greater their intimacy with their spouse and friends, but at all levels of intimacy were more depressed than men. Men, in contrast, isolated themselves from social support at the time of their child's illness and it was argued that men might be avoiding stress contagion. The importance of examining differential responding of men and women to stressors that have common meaning for both sexes was discussed.