The job demand-control(-support) model and physical health outcomes: A review of the strain and buffer hypotheses

Abstract

This review of the Job Demand-Control (JDC) model and the expanded Job Demand-Control-Support (JDCS) model and employees' physical health, focuses on the two prevalent views on these models. According to their view on the models researchers study different hypotheses: (a) the (iso)strain hypothesis, stating that the highest level of ill health is expected when the job is characterized by high demand and low control (and low social sup port), ot (b) the buffer hypothesis, predicting that control (and social support) can buffer the potential negative effects of high demands on physical health. It is argued that these hypotheses reflect theoretical distinct models, and that the practical implications associated with these models differ.

The review of 51 studies on the JDC(S) model reveals that the “strain” hypothesis predominates in studies of all-cause mortality, cardiovascular disease (CVD) related and specific non-CVD related health outcomes. In contrast, the “buffer” hypothesis is most prevalent in research on self-reported (psycho)somatic complaints. For the strain hypothesis as well as the buffer hypothesis the results are equivocal. Working in a high (iso)strain job appears to be associated with an elevated risk for cardiovascular disease and negative pregnancy outcomes, and increased (psycho)somatic complaints. Conclusions on other physical outcomes seem premature, considering the limited number of studies. The buffer hypothesis is supported in the few studies on CVD endpoints and in some studies on (psycho)somatic complaints.

A comparison of the validity of the two hypotheses is problematic, because they are mostly applied to a different set of outcomes. Furthermore, the analyses employed in the testing of the two hypotheses are of a different nature (non-linear versus linear).

The main recommendation for future research is to examine the validity of the strain and the buffer hypothesis concurrently, and to further explore the nature of the relationships.     

Psychological intervention with couples coping with breast cancer: A systematic review

Objective: Information about psychological intervention with couples coping with breast cancer is not well-disseminated. This can be explained, at least in part, by the absence of knowledge about the efficacy of this kind of intervention. The aim of the present systematic review is to identify and describe psychological interventions for couples coping with breast cancer and evaluate their efficacy.

Design: Studies identified by a searching multiple literature databases related to health and psychology between 1975 and 2013. Rigorous inclusion and exclusion criteria were utilised.

Results: Of 129 abstracts, 13 were extracted for further analysis and a final ten studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, results and methodological limitations. The results obtained were mixed in regard to efficacy, although the overwhelming majority of studies (eight studies) found benefits for both women and their partners in some dimensions, such as quality of life, psychological distress, relationship functioning and physical symptoms associated with cancer.

Conclusion: Psychological interventions for couples coping with breast cancer appear to be effective for both women and their partners. However, further studies are needed to evaluate the efficacy of couple-based interventions and, to identify for whom and how they are more effective.     

Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P): Test Review and Clinical Guidelines for Use

The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) is a standardized questionnaire that measures executive functioning in preschoolers. This test review provides an overview of the BRIEF-P, including scale structure, administration, norms, score interpretation, current reliability and validity evidence, and provides general guidelines for clinical use.     

Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multicenter study

Objective

There has been uncertainty about whether refugees and asylum seekers with PTSD can be treated effectively in standard psychiatric settings in industrialized countries. In this study, Narrative Exposure Therapy (NET) was compared to Treatment As Usual (TAU) in 11 general psychiatric health care units in Norway. The focus was on changes in symptom severity and in the diagnostic status for PTSD and depression.

Method

Refugees and asylum seekers fulfilling the DSM-IV criteria for PTSD (N = 81) were randomized with an a-priori probability of 2:1 to either NET (N = 51) or TAU (N = 30). The patients were assessed with Clinician Administered PTSD Scale, Hamilton rating scale for depression and the MINI Neuropsychiatric Interview before treatment, and again at one and six months after the completion.

Results

Both NET and TAU gave clinically relevant symptom reduction both in PTSD and in depression. NET gave significantly more symptom reduction compared to TAU as well as significantly more reduction in participants with PTSD diagnoses. No difference in treatment efficacy was found between refugees and asylum seekers.

Conclusions

The study indicated that refugees and asylum seekers can be treated successfully for PTSD and depression in the general psychiatric health care system; NET appeared to be a promising treatment for both groups.

ClinicalTrials.gov registry number

NCT00218959.     

A Review of Reviews Examining Neurological Processes Relevant to Impact of Parental PTSD on Military Children: Implications for Supporting Resilience

In this study, 10 recent meta-analytic and systematic review studies were synthesized on the neurological underpinnings of stress and trauma with implications for the impact of parental post-traumatic stress disorder (PTSD) and resilience among military children. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group guidelines and utilizing a validated quality assessment tool, this systematic review of reviews incorporated results from more than 35,971 individuals with stress exposures, effects, or disorders and healthy controls. This synthesis found support for important gene, physiology, and environment correlations and interactions that predict increased risk for stressful life events and PTSD, but not direct transmission, among military children. Future research is needed to determine if these constitute indirect pathways of intergenerational transmission in military children.     

The Role of Trauma in Conduct Disorder

Summary

Trauma is proposed as a key to understanding the development and persistence of conduct disorder, in conjunction with other contributing factors. Trauma history is ubiquitous in the conduct disordered population, and trauma effects can help to account for many features of conduct disorder, including lack of empathy, impulsivity, anger, acting-out, and resistance to treatment. The current standard of care fails to fully address trauma, which may partially explain the low success rate of extant treatment approaches. A trauma-informed perspective is introduced to current models of conduct disorder. Research, prevention, and treatment implications are discussed.     

The prevalence,risk factors and outcomes of workplace bullying among junior doctors: a systematic review

ABSTRACT

Junior doctors’ exposure to bullying may impact their training and compromise quality healthcare, yet little is known in relation to its predictors and effects. The aim of this paper is to assess the prevalence, factors and outcomes of workplace bullying among junior doctors. Literature search was performed to identify all primary studies examining workplace bullying among junior doctors using the following electronic databases: Medline, Scopus, Web of Science, PsycINFO and Cochrane Library. A total of 18 articles were included, reporting on a total of 9,597 junior doctors. The quality of evidence can be rated as moderate according to the Newcastle Ottawa Scale. From the review, a wide range (30–95%) of bullying prevalence, significant differences in bullying rates according to gender, age, height, ethnicity and subspecialty, and significant associations between bullying and mental strain, job dissatisfaction, burnout, and increased accidents at work were observed. Concurrently, heterogeneity in the terms and methodologies used to examine workplace bullying as well as definitional issues in relation to the persistency of negative interactions were noted. Evidence suggests that workplace bullying is a serious occupational hazard for junior doctors, and more research is warranted to better understand this phenomenon and address its definitional and methodological issues.     

Consulting with gargoyles: applying narrative ideas and practices in counselling supervision

This article explores waysin which narrative ideas and practices might influence supervisory relationships in counselling and psychotherapy,and questions some of the taken-for-granted assumptions implicit within counselling supervision. This paper, which represents ‘work in progress’ towards further conversations, rather than an exhaustive study,is illustrated with stories from the author'sown practice as a supervisor and trainer and educator of supervisors.     

Examining the role and functions of self-development in healthcare therapy trainings: A review of the literature with a modest proposal for the use of learning agreements

Many healthcare trainings with a psychodynamic orientation encourage or require students to commit to a process of personal development, such as provided through attending individual psychotherapy and/or an experiential ‘as if therapy’ group. This paper reviews recent literature about training in psychodynamically oriented practices within counselling psychotherapy, psychiatry, the creative arts therapies and clinical psychology. The results indicate that the mandatory personal development dimension of therapy training needs urgent reassessment. Results of studies consistently call for further research about the direct benefits of personal development on students’ development of skills for therapy practice. There is minimal evidence to indicate what self-development through individual psychotherapy can specifically deliver in terms of eventual professional competence. To address some aspects of the current lacuna, this paper summarises the recommendations for training programmes available from the current research, and makes a modest proposal for the use of learning agreements, rather than only mandated hurdle requirements, to ensure that the incremental steps by which the student attains expected requirements is negotiated and agreed within regularised, and widely accepted university course procedures.