Objective: This study examined the association between three conceptualisations of work-related rumination (affective rumination, problem-solving pondering and detachment) with sleep quality and work-related fatigue. It was hypothesised that affective rumination and poor sleep quality would be associated with increased fatigue; and problem-solving pondering, and detachment would be associated with decreased fatigue. The mediating effect of sleep quality on the relationship between work-related rumination and fatigue was also tested. Method: An on-line questionnaire was completed by a heterogeneous sample of 719 adult workers in diverse occupations. Results: The following variables were entered as predictors in a regression model: affective rumination, problem-solving pondering, detachment, and sleep quality. The dependent variables were chronic work-related fatigue (CF) and acute work-related fatigue (AF). Affective rumination was the strongest predictor of increased CF and AF. Problem-solving pondering was a significant predictor of decreased CF and AF. Poor sleep quality was predictive of increased CF and AF. Detachment was significantly negatively predictive for AF. Sleep quality partially mediated the relationship between affective rumination and fatigue; and between problem-solving pondering and fatigue. Conclusions: Work-related affective rumination appears more detrimental to an individual?s ability to recover from work than problem-solving pondering. In the context of identifying mechanisms by which demands at work are translated into ill-health, this appears to be a key finding; and suggests that it is the type of work-related rumination, not rumination per se, that is important.
Environmental, or ?choice-architecture?, interventions aim to change behaviour by changing properties/contents of the environment and are commonly used in the workplace to promote healthy behaviours in employees. The present review aimed to evaluate and synthesize the evidence surrounding the effectiveness of environmental interventions targeting eating behaviour in the workplace. A systematic search identified 8157 articles, of which 22 were included in the current review. All included studies were coded according to risk of bias and reporting quality and were classified according to the emergent typology of choice-architecture interventions. More than half of included studies (13/22) reported significant changes in primary measures of eating behaviour (increased fruit/veg consumption, increased sales of healthy options and reduction in calories purchased). However, only one study produced a small significant improvement in weight/body mass index. Many studies had a high or unknown risk of bias; reporting of interventions was suboptimal; and the only trial to measure compensatory behaviours found that intervention participants who ate less during the intervention ate more out with the workplace later in the day. Hence, we conclude that more rigorous, well-reported studies that account for compensatory behaviours are needed to fully understand the impact of environmental interventions on diet and importantly on weight/body mass index outcomes.
Perseverative cognitions such as rumination and worry are key components of mental illnesses such as depression and anxiety. Given the frequent comorbidity of conditions in which rumination and worry are present, it is possible that they are underpinned by the same cognitive process. Furthermore, rumination and worry appear to be part of a causal chain that can lead to long-term health consequences, including cardiovascular disease and other chronic conditions. It is important therefore to understand what interventions may be useful in reducing their incidence. This systematic review aimed to assess treatments used to reduce worry and/or rumination. As we were interested in understanding the current treatment landscape, we limited our search from 2002 to 2012. Nineteen studies were included in the review and were assessed for methodological quality and treatment integrity. Results suggested that mindfulness-based and cognitive behavioural interventions may be effective in the reduction of both rumination and worry; with both Internet-delivered and face-to-face delivered formats useful. More broadly, it appears that treatments in which participants are encouraged to change their thinking style, or to disengage from emotional response to rumination and/or worry (e.g., through mindful techniques), could be helpful. Implications for treatment and avenues for future research are discussed.
Querstret D, Cropley M (2011) Why nurses need to unwind from work., Nurs Times 107 (10) pp. 14-17
With increased pressures in the workplace, more people are at risk of poor health. Individuals frequently take stress home with them and ruminate on problems, which can prevent them from recovering from work. More research is needed to identify and understand which factors can enhance or prevent nurses from effectively unwinding after a shift.
This quasi-experimental longitudinal study assessed the effect of a one-day Cognitive Behaviour Therapy (CBT)-based workshop on work-related rumination, chronic fatigue and sleep quality. We hypothesised that participants who attended the workshop would report lower levels of affective work-related rumination and chronic fatigue and improved sleep quality, at follow-up, six months after workshop completion. Two hundred and twenty seven participants took part in the study, with 102 participants attending a one-day workshop delivered in their place of work. Participants completed an online questionnaire at two time-points, with follow-up occurring 6 months after initial survey completion. Results showed that participants who took part in the CBT workshop reported significantly lower levels of affective rumination (p=.03) and chronic fatigue (p=.003), at follow-up in comparison to individuals who did not attend the workshop; however there were no significant differences between the groups in self-reported sleep quality (p=.06). A combination of more effective recovery both at work and outside of work may explain the reductions in both affective rumination and fatigue over time. This study adds to the recovery from work literature by providing initial support for a one-day CBT-based workshop delivered in the workplace.
Querstret D, Robinson OC (2013) Person, Persona, and Personality Modification: An In-Depth Qualitative Exploration of Quantitative Findings, Qualitative Research in Psychology 10 (2) pp. 140-159
Quantitative and qualitative methods can work productively together to explore the conundrum of personality. In this study, a personality questionnaire tool (TIPI-3C) was used to screen for participants with high levels of personality variability across three social contexts. One hundred and twelve participants completed the questionnaire, which assesses the Big-Five traits as they manifest when with parents, friends, and work colleagues. Eight participants between the ages of 20 and 40 whose scores categorised them as high in personality variability were then interviewed using semi-structured interviews. Transcripts were analysed using Thematic Analysis. Participants described personality modification through the adoption of social personae. Motivations for this included a) to make a good impression, b) to protect and suppress emotions, and c) a fear of rejection and social anxiety. Adopting personae was related to feelings of anxiety and insecurity, while acting in line with one's own personality was described as relaxing and preferable. The mixed-methods study shows how qualitative methods can be used to dig underneath quantitative findings to help explain and account for them. © 2013 Copyright Taylor & Francis Group, LLC.
The assessment of children and young people with history of complex developmental trauma presents a significant challenge to services. Traditional diagnostic categories such as post-traumatic stress disorder (PTSD) are argued to be of limited value, and while the proposed ?Developmental Trauma Disorder? definition attempts to address this debate, associated assessment tools have yet to be developed. This review builds on a previous review of assessment measures, undertaken in 2005.
To identify trauma assessment tools developed or evaluated since 2004 and determine which are developmentally appropriate for children or adolescents with histories of complex trauma.
A systematic search of electronic databases was conducted with explicit inclusion and exclusion criteria.
A total of 35 papers were identified evaluating 29 measures assessing general functioning and mental health (N = 10), PTSD (N = 7) and trauma symptomatology outside, or in addition to, PTSD (N = 11). Studies were evaluated on sample quality, trauma/adversity type, as well as demographic and psychometric data. Distinction was made between measures validated for children (0?12 years) and adolescents (12?18 years).
Few instruments could be recommended for immediate use as many required further validation. The Assessment Checklist questionnaires, designed with a developmental and attachment focus, were the most promising tools.
We report the results of a randomized trial (N/=/337) examining the effectiveness of a daily audio-guided MBI in raising academic achievement in 16 volunteer classrooms across two socio-demographically diverse United States primary schools. The study's findings were that, over the intervention period, improvements in Math scores, Social Studies scores and Grade Point Averages (GPA) were generally higher for students in intervention classrooms. However, confidence intervals were wide and there was pre-existing variability between schools and grades, resulting in few significant differences as a result of the intervention and generally low effect sizes. Through a careful discussion of the study's results, the paper contributes to theory by generating a comprehensive agenda for follow-up research. The study also contributes to practice by reporting on the effectiveness of technology-enabled mindfulness training because participating teachers seemed able to implement the intervention with almost no further training or need for hiring external mindfulness experts.
Mindfulness interventions have been shown to be effective for health and wellbeing, and delivering mindfulness programmes online may increase accessibility and reduce waiting times and associated costs; however, research assessing the effectiveness of online interventions is lacking. We sought to: (1) assess the effects of an online mindfulness intervention on perceived stress, depression and anxiety; (2) assess different facets of mindfulness (i.e. acting with awareness, describing, non-judging and non-reacting) as mechanisms of change and (3) assess whether the effect of the intervention was maintained over time. The sample was comprised of 118 adults (female, n = 95) drawn from the general population. Using a randomised waitlist control design, participants were randomised to either an intervention (INT) or waitlist control (WLC) group. Participants completed the online intervention, with the WLC group starting after a 6-week waitlist period. Participants completed measures of depression (PHQ-9), anxiety (GAD-7) and perceived stress (PSS-10) at baseline, post-treatment, 3- and 6-month follow-up. Participants who completed the mindfulness intervention (n = 60) reported significantly lower levels of perceived stress (d = ? 1.25 [? 1.64, ? 0.85]), anxiety (d = ? 1.09 [? 1.47, ? 0.98]) and depression (d = ? 1.06 [? 1.44, ? 0.67]), when compared with waitlist control participants (n = 58), and these effects were maintained at follow-up. The effect of the intervention was primarily explained by increased levels of non-judging. This study provides support for online mindfulness interventions and furthers our understanding with regards to how mindfulness interventions exert their positive effects.
This study aimed to extend our theoretical understanding of how mindfulness-based interventions exert their positive influence on measures of occupational health. Employing a randomised waitlist control study design, we sought to: (1) assess an Internet-based instructor-led mindfulness intervention for its effect on key factors associated with ?recovery from work?, specifically, work-related rumination, fatigue and sleep quality; (2) assess different facets of mindfulness (acting with awareness, describing, non-judging, and non-reacting) as mechanisms of change; and (3) assess whether the effect of the intervention was maintained over time by following up our participants after three and six months. Participants who completed the mindfulness intervention (N=60) reported significantly lower levels of work-related rumination and fatigue, and significantly higher levels of sleep quality, when compared with waitlist control participants (N=58). Effects of the intervention were maintained at three and six month follow-up with medium to large effect sizes. The effect of the intervention was primarily explained by increased levels of only one facet of mindfulness (acting with awareness). This study provides support for online mindfulness interventions to aid recovery from work and furthers our understanding with regards to how mindfulness interventions exert their positive effects.
Work-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centred around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behaviour. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (.33), cognitive flexibility (-.24) and situational awareness at work (-.28). Study II (n = 939), expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with ?lapses of attention? (OR = 4.8), ?lack of focus of attention? (OR = 3.4), and ?absent mindedness? (OR = 4.3). The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3) and finishing projects (OR = 2.4), fidgeting (OR = 1.9), memory (OR = 2.2), pursuing tasks in order (OR = 1.8), and feeling compelled to do things (OR = 2.0). It was argued that work-related rumination may not be related to work demands per se, but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of intervention programmes aimed at helping people to switch off and unwind from work
Background: Psychological difficulties such as anxiety and depression are common post-stroke. Mindfulness-based interventions (MBIs), such as Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) have demonstrated effectiveness in alleviating such difficulties in other clinical health populations and show promise in stroke-related psychological difficulties. Objective and Outcomes: The study aimed to assess the feasibility of recruiting and retaining stroke survivors into a randomised waitlist control trial with an 8-week waitlist period and 3-month follow-up. We also aimed to assess the acceptability of an online mindfulness-based intervention for this population and the use of outcome measures relating to anxiety, depression, perceived stress, health status, quality of life and perseverative thinking. Methods: Stroke survivors were recruited at 6-month post-stroke in an NHS clinical setting. No criteria were set regarding minimum pre-existing psychological difficulties.
Intervention: 10-session online mindfulness course, comprising elements of both MBSR and MBCT. Results: Fifty-four people were screened. Eighteen were deemed ineligible. Of the thirty-six assessed for eligibility, ten declined to participate. Twenty-four others considered participation but ultimately decided not to participate for reasons such as low confidence with computers. Two participants were successfully recruited and randomised (one to waitlist control). The intervention could be delivered as planned. The 8-week waitlist period was tolerated. No adverse effects were reported. Follow-up at 1 and 3-months was feasible.
Reliable and clinically significant improvements were demonstrated in depression for one participant, certain mindfulness domains and quality of life scores. Where reliable deterioration was indicated to perseverative thinking and anxiety measures, low baseline scores prevent us from drawing any substantial inferences.
Thematic analysis of interview data conducted with both participants and the recruiter indicated overall acceptability of the intervention and outcome measures used whilst highlighting difficulties in recruitment such as fears about safety online and the priority of physical rehabilitation. Conclusion: Despite the promise of MBIs for stroke-survivors, our poor recruitment rate indicates a larger trial of the proposed design is not currently feasible as planned.
Background: Looked-after children (LAC) frequently experience greater mental health challenges than the general child population. There has been a call for greater focus on early preventative interventions and priority access to specialist mental health support for this population. Brief mental health screening tools often provide the gateway to services and yet there is a lack of suitable assessment tools available for LAC. The current study is the first to explore the perspectives of foster carers and CAMHS clinicians? in relation to the use of two brief screening tools; the Strengths and Difficulties Questionnaire (SDQ) and the Brief Assessment Checklists (BAC?s).
Method: Qualitative data was collected via semi-structured telephone interviews and face-to-face focus groups with female foster carers (N=13) and clinicians working in a CAMHS setting (N=9).
Results: Thematic analyses generated six themes which were organised into three superordinate themes centred around: 1) relevance to LAC, 2) using measures to inform care planning and; 3) current problems when using psychometric measures within the LAC population. Foster carers and clinicians emphasised the need for a comprehensive understanding of LAC given the complexity of their difficulties. There was acknowledgement that psychometric measures could facilitate and contribute to this by highlighting difficulties, providing accurate feedback to carers and clinicians, and enabling access to support. However, both groups seldom felt that current measures were nuanced enough to adequately capture the needs of LAC.
Conclusion: Screening tools play a crucial role in identifying the mental health needs of LAC and facilitating access to services. Further research is needed to establish the ability of such measures to increase the sensitivity of the complex needs? assessment of LAC. A number of clinical recommendations are also discussed in relation to the assessment of mental health in the LAC population.