Is mindfulness associated with stress and burnout among mental health professionals in Singapore?

High levels of stress and burnout have been reported among mental health professionals worldwide, including Singapore, with concerning potential implications for the quality of patient care. Mindfulness has been associated with decreased stress and burnout; however, associations between mindfulness, stress, and burnout have not been examined in Singapore. The aim of this study was to investigate whether mindfulness is associated with stress and burnout among healthcare professionals working in a mental health setting in Singapore. A total of 224 Singaporean mental health professionals completed a cross-sectional survey which included measures of: mindfulness (observe, describe, act with awareness, non-judge, and non-react), stress, and burnout (exhaustion and disengagement). Using multiple regression, significant negative associations were found between each of the mindfulness facets and: stress, exhaustion, and disengagement, while controlling for years of experience. Of the five mindfulness facets, act with awareness demonstrated the strongest negative association with all three variables. This study showed that mental health professionals in Singapore who have higher levels of mindfulness also have lower levels stress and burnout (disengagement and exhaustion). Future longitudinal research is warranted to better understand the directionality of these associations, with implications for the development of interventions aimed to reduce stress and burnout within this population.     

The association between adolescent risk behaviours and feelings of sadness or hopelessness: a cross-sectional survey of South African secondary school learners

Poor mental health in adolescents has shown associations with engagement in other risk behaviours. However, evidence of this association in Sub-Saharan Africa, particularly South Africa, is lacking. This study examines the associations between pertinent risk behaviours and feelings of sadness or hopelessness amongst a nationally representative sample of South African school going adolescents. Data was analysed from the South African Youth Risk Behaviour Survey 2011 (n=10,997), a cross-sectional national survey among grades 8–11 school learners. Logistic regression examined the association of demographic, substance use, violent behaviour, sexual activity and suicidal plans and attempts with the primary outcome, feelings of sadness or hopelessness. Having feelings of sadness or hopelessness was significantly associated with more senior grades, being bullied (AOR:1.67, 95% CI: 1.42–1.96), being assaulted by a partner (1.33 [1.05–1.68]), forced sex (1.78 [1.37–2.32]); gang membership (1.32 [1.06–1.65]), binge drinking (1.37 [1.14–1.65]), ever having sex (1.23 [1.02–1.47]), having ≥1 partner/s in preceding three months (1.25 [1.02–1.53]), having made a plan to attempt suicide (2.50 [1.95–3.21]) and suicide attempt (1.49 [1.21–1.85]). Adolescents in South Africa are experiencing a multiple burden of risk. Health promotion strategies targeting adolescent mental health and risk behaviours need to be developed and implemented in a timely and comprehensive manner.     

Latent Trait Modeling with the Common beliefs Survey III: Using Item Response Theory to Evaluate an Irrational Beliefs Inventory

Assessment of irrational beliefs by such measures as the Common Beliefs Survey III (CBS) has traditionally relied upon classical test theory assumptions, in which the properties of specific test items are less important than the total test score as the aggregate of all item responses. An alternative approach using item response theory (IRT) methodology allows one to specify the parameters of difficulty and discrimination for each test item. Difficulty levels of CBS items range along a continuum of irrationality, the implied latent trait measured by responses to the questionnaire as a whole. We evaluated the CBS responses of 605 individuals from clinical and college settings, drawing from current and archival data. The original Likert scale ratings were recoded into dichotomous scores. Fourteen of the 54 items were highly or very highly discriminating in distinguishing respondents with high and low irrationality levels. However, discriminating items exhibited a very narrow range of difficulty; most functioned at a point a little above the halfway mark on the continuum of irrationality. Item characteristic curves and test information curves were very similar for female (n = 424) and male (n = 179) respondents. We derived a 4-item screening test for irrationality from our IRT analyses of the 54 CBS items. Further test development, focused on the selection and scaling of items with a much broader range of difficulty, would facilitate evaluation of the hierarchical structure of irrational beliefs. Portions of this paper were presented at the 39th Annual Convention of the Association for Behavioral and Cognitive Therapies, Washington, DC, November, 2005.     

Temporal reproduction: further evidence for two processes

Some authors have suggested separate mechanisms for the processing of temporal intervals above versus below 2-3s. Given that the evidence is mixed, the present experiment was carried out as a critical test of the separate-mechanism hypothesis. Subjects reproduced five standard durations of 1-5s presented in the auditory and visual modalities. The Corsi-block test was used to assess effects of working-memory span on different interval lengths. Greater working-memory span was associated with longer reproductions of intervals of 3-5s. A factor analysis run on mean reproduced intervals revealed one modality-unspecific factor for durations of 1-2s and two modality-specific factors for longer intervals. These results are interpreted as further indications that two different processes underlie temporal reproductions of shorter and longer intervals.     

Utility of a cognitive-behavioral model to predict fatigue following breast cancer treatment.

The objective of the current study was twofold: (a) to determine whether subgroups of breast cancer patients could be identified on the basis of their distinct trajectory or pattern of fatigue following treatment for early stage cancer using growth mixture modeling and (b) to examine whether the subgroups could be distinguished on the basis of a cognitive-behavioral model. Growth mixture modeling and a prospective longitudinal design were used to examine the course of fatigue after treatment for early stage breast cancer. Women (n = 261; mean age = 55.2 years) provided fatigue ratings for 6 months following treatment. A low-fatigue group (n = 85) and a high-fatigue group (n = 176) were extracted. Women who were not married, had a lower income, had a higher body mass index, engaged in greater fatigue catastrophizing, and were lower in exercise participation were more likely to be in the high-fatigue group. Only body mass index and catastrophizing remained significant predictors in multivariate analysis. Findings suggest considerable heterogeneity in the experience of fatigue following treatment and support the utility of a cognitive-behavioral model in predicting the course of posttreatment fatigue.     

Unstable Embodiments: A Phenomenological Interpretation of Patient Satisfaction with Treatment Outcome

Many patients experience aspects of treatment and care as dehumanizing because the body is considered separate from the self and its life context. An attempt to transcend viewing persons in dualistic terms is posed by phenomenologists who focus not on "the body" as such but on what it means to be "embodied." In this paper, we review the relevance of the phenomenology of the body for health care and report the results of comparing Sally Gadow's phenomenological insights about body-self unity with a qualitative analysis of patients' accounts of satisfaction with the outcome of hand surgery. We illustrate the ways in which our findings were and were not congruent with Gadow's conceptualization of embodiment and highlight aspects that are ambiguous. We conclude that the body-self dialectical relationship should be recast as a body-self-society trialectic and discuss the implications of this new conceptualization for clinical practices.     

Pharmacological dissociation of trace and long-delay fear conditioning in young rats

In most studies comparing trace and delay conditioning, CS duration is kept constant across training conditions but the interstimulus interval (ISI), the time from CS onset to US onset, is confounded. In the infrequently used long-delay condition, however, ISI is kept constant across the trace and delay conditions but CS duration varies. A recent study reported that trace and long-delay fear conditioning have the same developmental trajectory, with both emerging later in development than standard-delay conditioning (). Past studies have shown that trace conditioning is mediated by the cholinergic system; given the parallel developmental emergence of trace and long-delay conditioning, the present study examined whether the cholinergic system also mediates long-delay conditioning. Two experiments, both involving Sprague-Dawley-derived rats and using freezing as a measure of learned fear, showed that the cholinergic system is critically involved in trace conditioning but is not involved in long-delay conditioning. Specifically, pre-training injections of the muscarinic receptor antagonist scopolamine impaired acquisition of a CS-US association in 32-day-old rats trained with a trace procedure but had no effect on rats this age trained with a long-delay procedure (Experiment 1). Similarly, pre-training injections of physostigmine, a cholinesterase inhibitor, enhanced acquisition of trace conditioning in 25-day-old rats but had no effect on long-delay conditioning in rats this age (Experiment 2). Taken together, the results indicate that despite the similarities between trace and long-delay conditioning in terms of developmental emergence and level of conditioned responding, they are mediated by different physiological systems.     

Court populations in need of services: defining the court's role

Court populations frequently include individuals in need of educational, employment, health, housing, mental health, social, and other types of services that are not commonly provided by the judicial system. Courts vary in the ways they address the service needs of these individuals based on a variety of factors specific to their respective jurisdiction. Following a discussion of some of these approaches, the article offers a framework, based on Bronfenbrenner's human development paradigm and its focus on environmental contexts, to help courts more systematically and comprehensively define their role in service issues within the legal and service parameters of their own jurisdiction. © 1998 John Wiley & Sons, Ltd.     

Infant illness severity and family adjustment in the aftermath of NICU hospitalization

Up to 15% of parents have an infant who will spend time in a neonatal intensive care unit (NICU). After discharge, parents may care for a medically fragile infant and worry about their development. The current study examined how infant illness severity is associated with family adjustment. Participants included parents with infants who had been discharged from the NICU 6 months to 3 years prior to study participation (N = 199). Via a Qualtrics online survey, parents reported their infants’ medical history, parenting stress, family burden, couple functioning, and access to resources. Multivariable regression analyses revealed that more severe infant medical issues during hospitalization (e.g., longer length of stay and more medical devices) were associated with greater family burden, but not stress or couple functioning. Infant health issues following hospitalization (i.e., medical diagnosis and more medical specialists) were associated with greater stress, poorer couple functioning, and greater family burden. Less time for parents was associated with increased stress and poorer couple functioning. Surprisingly, parents of infants who were rehospitalized reported less stress and better couple functioning, but greater family burden. Family-focused interventions that incorporate psychoeducation about provider−patient communication, partner support, and self-care may be effective to prevent negative psychosocial sequelae among families.