Behavioral Activation as an Early Intervention for Posttraumatic Stress Disorder and Depression Among Physically Injured Trauma Survivors

This paper describes an adaptation of behavioral activation (BA) for the early intervention of posttraumatic stress disorder (PTSD) and depression among physically injured survivors of traumatic injury, and presents pilot data on a small randomized effectiveness trial (N = 8). The application of BA to PTSD is based on the theory that increases in guided activity may break patterns of avoidance that can maintain PTSD. Compared to treatment as usual (TAU), those who received BA showed improvement in PTSD symptom severity from pre- to posttreatment, and there was a trend for the BA group to score better than the TAU group on physical functioning. Contrary to expectation, this brief adaptation did not have an impact on depression. Implications of these results for the effective early intervention after trauma are discussed.     

Exploring the relationship between compressed work hours satisfaction and absenteeism in front-line service work

There has been an upsurge of interest in compressed workweek schedules because of the opportunities they provide for enhanced organizational efficiency and more balanced work and life roles for employees. This study tested a moderated mediation model of the effects of compressed work hours satisfaction on absenteeism with the purpose of exploring both the mediation effects of emotional exhaustion and physical health and the moderating effects of sex on this relationship. It utilized data drawn from a sample of 236 contact-centre service workers linked to absenteeism data collected for a period of 12 months following the survey. Results indicated that compressed work hours satisfaction was associated with lower absenteeism and that this relationship was mediated sequentially through emotional exhaustion and physical health. Although the indirect effect of compressed work hours satisfaction on absenteeism through emotional exhaustion and physical health was not significantly different between women and men, the relationship between compressed work hours satisfaction and physical health was positive for women but not for men. The implications of these findings are discussed.     

Health-Related Quality of Life in Children and Adolescents Following Traumatic Injury: A Review

This paper comprehensively reviews the published literature investigating health-related quality of life (HRQOL) following general traumatic injury in individuals between birth and 18?years. Studies were not considered if they primarily compared medical treatment options, evaluated physical function but not other aspects of HRQOL, or focused on non-traumatic wounds. Specific injury types (e.g., burn injury) were also not included. A total of 16 studies met criteria. Participants were age 1-18?years, with 12 studies considering children 5?years of age or older. Males were overrepresented. Injury severity averaged mostly in the moderate range. HRQOL deficits were noted in injured samples in all studies except the two with the longest time to follow-up (6-11?years). Some improvement was seen 6?months to 2?years after injury. Factors associated with HRQOL deficits were investigated, with acute and posttraumatic stress disorder symptoms showing the strongest relationship. Research to date in this area is impressive, particularly the number of studies using prospective longitudinal investigations and validated measures. Challenges remain regarding methodologic differences, assessment of preinjury status, retention of participants, and management of missing data. Suggested future directions include extension of follow-up duration, utilization of pediatric self-report when possible, inclusion of younger children, and development of intervention programs.     

Correlates of Suicidal Ideation in Physically Injured Trauma Survivors

Epidemiologic studies have documented that injury survivors are at increased risk for suicide. We evaluated 206 trauma survivors to examine demographic, clinical, and injury characteristics associated with suicidal ideation during hospitalization and across 1 year. Results indicate that mental health functioning, depression symptoms, and history of mental health services were associated with suicidal ideation in the hospital; being a parent was a protective factor. Pre‐injury posttraumatic stress disorder symptoms, assaultive injury mechanism, injury‐related legal proceedings, and physical pain were significantly associated with suicidal ideation across 1 year. Readily identifiable risk factors early after traumatic injury may inform hospital‐based screening and intervention procedures.