Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.     

Associations between job burnout and self-efficacy: a meta-analysis

Background and Objectives: This study aimed at systematically reviewing and meta-analyzing the strength of associations between self-efficacy and job burnout (the global index and its components). We investigated whether these associations would be moderated by: (a) the type of measurement of burnout and self-efficacy, (b) the type of occupation, (c) the number of years of work experience and age, and (d) culture. Design and Methods: We systematically reviewed and analyzed 57 original studies (N?=?22,773) conducted among teachers (k?=?29), health-care providers (k?=?17), and other professionals (k?=?11). Results: The average effect size estimate for the association between self-efficacy and burnout was of medium size (?.33). Regarding the three burnout components, the largest estimate of the average effect (?.49) was found for the lack of accomplishment. The estimates of the average effect were similar, regardless of the type of measures of burnout and self-efficacy measurement (general vs. context-specific). Significantly larger estimates of the average effects were found among teachers (compared to health-care providers), older workers, and those with longer work experience. Conclusions: Significant self-efficacy–burnout relationships were observed across countries, although the strength of associations varied across burnout components, participants' profession, and their age.     

Coping self-efficacy mediates the effects of negative cognitions on posttraumatic distress

Although cognitive distortions have predicted posttraumatic distress after various types of traumatic events, the mechanisms through which cognitive distortions influence posttraumatic distress remain unclear. We hypothesized that coping self-efficacy, the belief in one's own ability to manage posttraumatic recovery demands, would operate as a mediator between negative cognitions (about self, about the world, and self-blame beliefs) and posttraumatic distress. In the cross-sectional Study 1, data collected among 66 adult female victims of child sexual abuse indicated that coping self-efficacy mediated the effects of negative cognitions about self and about the world on posttraumatic distress. The same pattern of results was found in a longitudinal Study 2, conducted among 70 survivors of motor vehicle accidents. Coping self-efficacy measured at 1 month after the trauma mediated the effects of 7-day negative cognitions about self and about the world on 3-month posttraumatic distress. In both studies self-blame was not related to posttraumatic distress and the effect of self-blame on posttraumatic distress was not mediated by coping self-efficacy. The results provide insight into a mechanism through which negative cognitions may affect posttraumatic distress and highlight the potential importance of interventions aimed at enhancing coping self-efficacy beliefs.     

Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy

The present article integrates findings from diverse studies on the generalized role of perceived coping self-efficacy in recovery from different types of traumatic experiences. They include natural disasters, technological catastrophes, terrorist attacks, military combat, and sexual and criminal assaults. The various studies apply multiple controls for diverse sets of potential contributors to posttraumatic recovery. In these different multivariate analyses, perceived coping self-efficacy emerges as a focal mediator of posttraumatic recovery. Verification of its independent contribution to posttraumatic recovery across a wide range of traumas lends support to the centrality of the enabling and protective function of belief in one's capability to exercise some measure of control over traumatic adversity.     

Coping Self-Efficacy as a Mediator of Distress Following a Natural Disaster

Social-cognitive theory and conservation-of-resources theory were utilized to understand individual differences in psychological response to natural disaster. Coping self-efficacy, lost resources, social support, and optimism were assessed along with demographic variables in predicting distress following Hurricane Opal. Participants included 67 residents of Okaloosa County, Florida. Multiple regression analyses indicated that coping self-efficacy was the strongest predictor of general distress and trauma-related distress. Loss of resources and gender were also important predictors of general distress. Path analyses demonstrated that lost resources directly influenced general distress, social support, optimism, and coping self-efficacy. These analyses also indicated that coping self-efficacy perceptions mediated the relationships between loss of resources and trauma-related distress, social support and both trauma and general distress, and optimism and both types of distress. Theoretical implications are discussed.     

Repression following a series of natural disasters: Immune and Neuroendocrine correlates

The influence of repression on peripheral blood lymphocyte surface markers and diurnal decline in salivary cortisol following multiple disasters was examined. Participants were sampled at 2 to 8 weeks after a severe fire and flood, and again 1 year later. High distress, low distress, and repression groups were formed utilizing self-reported distress and systolic blood pressure during a disaster recall interview. A main effect for group was identified for CD56⁺ cells (NK cells), with repressors and high distress participants demonstrating lower percentage of NK cells than low distress participants. At Time 1 repressors demonstrated significantly higher percentage of CD56⁺CD69⁺ cells (activated NK cells) than high and low distress participants. From Time 1 to Time 2, repressor participants showed a significant decline in the percentage of activated NK cells. Repressors demonstrated attenuated decline in salivary cortisol compared to low distress participants. Health implications for disaster recovery are discussed.     

Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy,social support,and PTSD symptoms

Abstract

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.     

My Disaster Recovery: a pilot randomized controlled trial of an Internet intervention

This pilot study tested the efficacy of the My Disaster Recovery (MDR) website to decrease negative affect and increase coping self-efficacy. Fifty-six survivors of Hurricane Ike were recruited from a larger study being conducted at the University of Texas Medical Branch at the first anniversary of the storm. Restricted randomization was used to assign participants to the MDR website, an information-only website, or a usual care condition. Group×time interactions indicated that MDR reduced participant worry more than the other conditions. A similar trend was also identified for depression. Both websites were accessed a small to moderate amount and participants reported mixed satisfaction for both websites. Although the effect sizes for worry and depression were in the moderate to large range, small sample size and timing of the intervention qualify the findings. These preliminary findings encourage further evaluation of MDR with a larger, demographically diverse sample and indicate that the MDR website might be helpful in reducing worry and depression.     

Explaining Counterproductive Work Behaviors Among Police Officers: The Indirect Effects of Job Demands Are Mediated by Job Burnout and Moderated by Job Control and Social Support

The present study applied two theoretical frameworks (the demands–control–support model and the conservation of resources model) to investigate associations between job demands, job burnout, and counterproductive work behaviors (CWB) in the context of social support and job control. Data were collected among 625 police officers. Moderated mediation analysis showed that high job demands were indirectly related to high CWB, with job burnout acting as the mediator. These indirect effects were moderated by work-related resources (social support and job control). Job demands were associated with higher job burnout when social support was low. High job burnout was related to more frequent CWB when support was low and control was high. Finally, the job demands–CWB association was significant when support was low and control was high.     

Social Support and Postdeployment Coping Self-Efficacy as Predictors of Distress Among Combat Veterans

This study evaluated the indirect effect of received social support on distress severity (i.e., posttraumatic stress and depression symptom severity) among 89 combat veterans. Through integrating the social support deterioration deterrence model and the enabling hypothesis, mediating roles of perceived social support and self-efficacy specific to postdeployment adaptation were investigated. Results showed that (a) received social support and perceived social support were not related, and (b) both received and perceived social support indirectly predicted distress severity (posttraumatic stress and depression symptom severity) through postdeployment coping self-efficacy. Specifically, high received and perceived social support independently predicted high postdeployment coping self-efficacy, and high postdeployment coping self-efficacy predicted lower distress severity levels. Theory enhancement and future research needs are discussed.