A systematic review and meta‐analysis of tertiary interventions in clinical burnout

Clinical burnout is one of the leading causes of work absenteeism in high‐ and middle‐income countries. There is hence a great need for the identification of effective intervention strategies to increase return‐to‐work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety. Four electronic databases (Ovid MEDLINE, PsychINFO, PubMed and CINAHL Plus) were searched in April 2016 for randomized and non‐randomized controlled trials of tertiary interventions in clinical burnout. Article screening and data extraction were conducted independently by two reviewers. Pooled odds ratios (ORs) and hazard ratios (HRs) were estimated with random‐effects meta‐analyses. Eight articles met the inclusion criteria. There was some evidence of publication bias. Included trials were of variable methodological quality. A significant effect of tertiary interventions compared with treatment as usual or wait‐list controls on time until RTW was found, HR = 4.5, 95% confidence interval (CI) = 2.15–9.45; however, considerable heterogeneity was detected. The effect of tertiary interventions on full RTW was not significant, OR = 1.33, 95% CI = 0.59–2.98. No significant effects on psychological symptoms of exhaustion, depression or anxiety were observed. In conclusion, tertiary interventions for individuals with clinically significant burnout may be effective in facilitating RTW. Successful interventions incorporated advice from labor experts and enabled patients to initiate a workplace dialogue with their employers.     

When figure-ground segmentation modulates brightness: the case of phantom illumination

In the phantom illumination illusion, luminance ramps ranging from black to white induce a brightness enhancement on an otherwise homogeneous dark background. The strength of the illusion was tested with regard to the extension of the brightness inducing perimeter, surrounding the target area by manipulating the number of inducers (exp. 1) and the size of the inducers (exp. 2). Participants' task was to rate the difference in brightness between the target area and the background. Results show that the illusion occurs only when the target area is not completely segregated from the background by luminance ramps; vice versa, when the target area is delimited by a continuous gradient, it appears darker than the background. These findings suggest a major role of figure-ground organization in the appearance of the illusion. This hypothesis was tested in a rating task experiment with three types of target area shapes circumscribed by four types of edges: luminance contours, illusory contours, no contours, and ambiguous contours. Illusory contours, just as luminance contours, hinder the illusion and produce a darkening of the target area. A control experiment measured the brightness of the previous stimuli without luminance ramps: all configurations resulted in a darkening of the target area. Results from all experiments suggest that figure-ground segmentation plays a major role in the determination of both illumination and lightness in stimuli with luminance gradients.     

Learning about occlusion: initial assumptions and rapid adjustments

We examined 6-month-olds abilities to represent occluded objects, using a corneal-reflection eye-tracking technique. Experiment 1 compared infants' ability to extrapolate the current pre-occlusion trajectory with their ability to base predictions on recent experiences of novel object motions. In the first condition infants performed at asymptote ( approximately 2/3 accurate predictions) from the first occlusion passage. In the second condition all infants initially failed to make accurate prediction. Performance, however, reached asymptote after two occlusion passages. This is the first study that demonstrates such rapid learning effects during an occlusion task. Experiment 2 replicates these effects and demonstrates a robust memory effect extending 24h. In occlusion tasks such long-term memory effects have previously only been observed in 14-month-olds (Moore & Meltzoff, 2004).     

The effect of semantics on problem solving is to reduce relational complexity

This article reports a study carried out in order to measure how semantic factors affect reductions in the difficulty of the Chinese Ring Puzzle (CRP) that involves removing five objects according to a recursive rule. We hypothesised that semantics would guide inferences about action decision making. The study involved a comparison of problem solving for two semantic isomorphic variants of the CRP ( fish and fleas ) with problem solving for the puzzle's classic variant (the Balls and Boxes problem; Kotovsky & Simon, 1990 Kotovsky, K. and Simon, H. A. 1990. What makes some problems really hard: Exploration in the problem space difficulty. Cognitive Psychology, 22: 143–183. [Crossref], [Web of Science ®] , [Google Scholar]). Our results showed that the number of moves was reduced by 47% in the fish version and by 51% in the flea version. We discuss these results in terms of semantic inferences and reductions in relational complexity. During the exploratory stage of problem solving participants discover the dependent relations between elements in the puzzle. Initially these relations are processed separately; learning involves generalising the relations within a coherent, interconnected whole that makes up the puzzle's rules. It seems that semantics make it easier for the puzzle's elements to be grouped together within coherent, meaningful wholes, which reduces relational complexity and facilitates problem solving.     

Generalized anxiety disorder: acute and chronic treatment

Clinical and epidemiological data suggest that generalized anxiety disorder (GAD) is a chronic illness causing patients to suffer for many years leading to significant distress in daily life functioning. The literature suggests the several conclusions. GAD is a disorder in need of appropriate treatment and often has a chronic course with comorbid conditions, such as major depression and other anxiety disorders. Benzodiazepines, while effective anxiolytic agents acutely, when prescribed for >4 weeks cause rebound anxiety and following prolonged therapy may lead to withdrawal symptoms. Antidepressants cause significant anxiety relief compared with placebo and for psychosocial treatment cognitive-behavioral therapy is an efficacious psychosocial treatment. Many GAD patients are in need of long-term medication management. Furthermore, there is limited data for patients diagnosed with GAD the treatment outcome with the combination of medication and psychotherapy both acutely and long-term; how to best sequence these treatments; for those patients who do not meet remission criteria what is the ideal approach for augmentation; and for patients with treatment-refractory GAD the empirical evidence is lacking on medication switching and augmentation strategies. Research is needed in the area of developing treatment strategies for patients suffering from treatment-refractory GAD. There is still an urgent need to explore treatment combinations and duration strategies in the management of patients suffering with GAD.     

Self-talk and affective problems in college students: valence of thinking and cognitive content specificity

The aim of this study was to develop a Self-Talk Inventory for young adults. This inventory consisted of two scales. The Negative Self-Talk Scale included three categories of self-talk (depressive, anxious, and angry thoughts) and the Positive Self-Talk Scale, three categories (minimization, positive orientation, and coping self-instructions). Participants were 982 undergraduate students (Mean age = 20.35 years, SD = 2.16). They completed the self-talk scales together with the following scales to measure symptoms of affective disorders: the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), and the State-Trait Anger Expression Inventory (STAXI-T). Factor analyses confirmed the hypothesized structure for the Self-Talk Inventory. The relations between self-talk and symptoms of affective disorders (depression, anxiety, and anger) were also evaluated. In general, states-of-mind -SOM- ratios and negative cognitions showed a greater association with psychological symptoms than did positive cognitions. Results concerning the cognitive characteristics of depression, anxiety, and anger were mixed and partially supported the cognitive content specificity theory.     

Is the Motor or the Garage More Important to the Car? The Difference Between Semantic Associations in Single Word and Sentence Production

The aim of the present study was to investigate the impact of part-whole (e.g., car-motor) and functional associations (e.g., car-garage) on single word (Experiment 1) and sentence production (Experiment 2). In Experiment 1, a classical picture-word task was used. In Experiment 2, the same stimuli and distractors were embedded into a sentence. The relation between target and distractor was either part-whole, functional or unrelated. At single word level, part-whole and functional relations facilitate naming. Additionally, the facilitation effect was stronger for part-whole in comparison to functional associations. During sentence production, facilitation shifted to interference. The difference between both relations disappeared. The findings of the different effects between functional and part-whole associations depend on the length of utterances and highlight the divergent impact of associations. The differences between part-whole and functional associations in single word production might reflect a differential organization of associative links at the conceptual level. In contrast, during sentence production the syntactic processing at the lexical level seem to be more important than types of semantic associations at the conceptual level.     

A Person-Environment Fit Approach to Volunteerism: Volunteer Personality Fit and Culture Fit as Predictors of Affective Outcomes

This study employed a person-environment (P-E) fit approach to explaining volunteer satisfaction, affective commitment, and turnover intentions. It was hypothesized that personality fit would explain additional variance in volunteer affective outcomes above and beyond motives to volunteer. This hypothesis was supported. Personality fit but not culture fit was related to satisfaction and affective commitment. Volunteer turnover intentions were predicted by gender and by social and values motives. The implications of the results are discussed with respect to the two literature domains that were combined in this study: the functional approach to volunteerism and P-E fit theory. Functional approaches to volunteerism and paid work should be more strongly linked to each other in future research. Moreover, P-E fit theory should be extended by including conditional determinants that moderate P-E fit effects.     

Marital Problems and Marital Satisfaction Among Brazilian Couples

As the practice of marriage and family therapy is spreading across the world, it is important for knowledge regarding marital processes and patterns to expand to countries outside of North America and Europe. This study examined common marital problems faced by Brazilian couples. The sample consisted of 80 married couples living in Porto Alegre, Brazil. Results showed that money, children, jealousy, and sex were common problems faced by Brazilian couples. There were few gender differences found. Sex and alcohol had a significant impact on marital satisfaction of wives, and sex had a significant impact on marital satisfaction of husbands.