Predicting Health Impacts of the World Trade Center Disaster: 1. Halogenated hydrocarbons, symptom syndromes, secondary victimization, and the burdens of history

The recent attack on the World Trade Center, in addition to direct injury and psychological trauma, has exposed a vast population to dioxins, dibenzofurans, related endocrine disruptors, and a multitude of other physiologically active chemicals arising from the decomposition of the massive quantities of halogenated hydrocarbons and other plastics within the affected buildings. The impacts of these chemical species have been compounded by exposure to asbestos, fiberglass, crushed glass, concrete, plastic, and other irritating dusts. To address the manifold complexities of this incident we combine recent theoretical perspectives on immune, CNS, and sociocultural cognition with empirical studies on survivors of past large toxic fires, other community-scale chemical exposure incidents, and the aftereffects of war. Our analysis suggests the appearance of complex, but distinct and characteristic, spectra of synergistically linked social, psychosocial, psychological and physical symptoms among the 100,000 or so persons most directly affected by the WTC attack. The different 'eigenpatterns' should become increasingly comorbid as a function of exposure. The expected outcome greatly transcends a simple 'Post Traumatic Stress Disorder' model, and may resemble a particularly acute form of Gulf War Syndrome. We explore the role of external social factors in subsequent exacerbation of the syndrome -- secondary victimization -- and study the path-dependent influence of individual and community-level historical patterns of stress. We suggest that workplace and other organizations can act as ameliorating intermediaries. Those without acess to such buffering structures appear to face a particularly bleak future

The Role-Based Performance Scale: Validity Analysis of a Theory-Based Measure

This study introduces a theory-based measure of employee performance (Role Based Performance Scale, RBPS) that is supported with results from a validation study using 10 data sets from six companies. In contrast to traditional, job-related measures of employee performance, we propose an alternative measure of performance based on role theory and identity theory. Because our results support the validity of the scale, we think that the instrument can be used for future research that requires a generalizable measure of performance. The scale demonstrates diagnostic properties that make it useful for practitioners as well as researchers

How Supervisors Influence Performance: A Multilevel Study of Coaching and Group Management in Technology-Mediated Services

This multilevel study examines the role of supervisors in improving employee performance through the use of coaching and group management practices. It examines the individual and synergistic effects of these management practices. The research subjects are call center agents in highly standardized jobs, and the organizational context is one in which calls, or task assignments, are randomly distributed via automated technology, providing a quasi-experimental approach in a real-world context. Results show that the amount of coaching that an employee received each month predicted objective performance improvements over time. Moreover, workers exhibited higher performance where their supervisor emphasized group assignments and group incentives and where technology was more automated. Finally, the positive relationship between coaching and performance was stronger where supervisors made greater use of group incentives, where technology was less automated, and where technological changes were less frequent. Implications and potential limitations of the present study are discussed

Applicants\u27 Experience of the Process of Seeking Therapy

Assessed the process of seeking psychotherapy, conceptualized as 4 steps: recognizing the problem; deciding therapy might help; deciding to seek therapy; and contacting the mental health system. A process of seeking therapy questionnaire was completed by 275 adult therapy applicants. It ascertained problem duration, alternative coping strategies, difficulty achieving and time needed to achieve the steps, and whether the S had informal help achieving the steps. Results indicated that problems tended to be long-standing; Ss attempted a variety of coping strategies before seeking therapy; and informal help was important throughout the process. Problem recognition was the most difficult, time-consuming step. The least and most distressed Ss reported the most difficulty achieving the first 3 steps

Tensions of Data-Driven Reflection: A Case Study of Real-Time Emotional Biosensing

Biosensing displays, increasingly enrolled in emotional reflection, promise authoritative insight by presenting users’ emotions as discrete categories. Rather than machines interpreting emotions, we sought to explore an alternative with emotional biosensing displays in which users formed their own interpretations and felt comfortable critiquing the display. So, we designed, implemented, and deployed, as a technology probe, an emotional biosensory display: Ripple is a shirt whose pattern changes color responding to the wearer’s skin conductance, which is associated with excitement. 17 participants wore Ripple over 2 days of daily life. While some participants appreciated the ‘physical connection’ Ripple provided between body and emotion, for others Ripple fostered insecurities about ‘how much’ feeling they had. Despite our design intentions, we found participants rarely questioned the display’s relation to their feelings. Using biopolitics to speculate on Ripple’s surprising authority, we highlight ethical stakes of biosensory representations for sense of self and ways of feeling

Utility of Fear Severity and Individual Resilience Scoring as a Surge Capacity, Triage Management Tool during Large-Scale, Bio-event Disasters

Threats of bioterrorism and emerging infectious disease pandemics may result in fear related consequences. Fear based signs and symptoms, if left undetected and untreated, may be extremely debilitating and lead to chronic problems with risk of permanent damage to the brain’s locus coeruleus stress response circuits. The triage management of susceptible, exposed, and infectious victims seeking care must be sensitive and specific enough to identify individuals with excessive levels of fear in order to address the nuances of fear-based symptoms at the initial point of contact. These acute conditions, which include hyper-vigilant fear, are best managed by timely and effective information, rapid evaluation, and possibly medication that uniquely addresses the locus-coeruleus driven noradrenalin overactivation. This article recommends that a fear and resilience (FR) checklist be included as an essential triage tool to identify those most at risk. This checklist has the utility of rapid usage and capacity to respond to limitations brought about by surge capacity requirements. Whereas the utility of such a checklist is evident, predictive validity studies will be required in the future. It is important to note that a unique feature of the FR Checklist is that in addition to identifying individuals who are emotionally, medically, and socially hypo-resilient, it simultaneously identifies individuals who are hyper-resilient who can be asked to volunteer and thus rapidly expand the surge capacity

The Long View: Has Anything Really Improved for Children and Families Involved with Child Welfare over 3 Decades?

The overall poor health status and outcomes of children and youth in foster care have been documented in multiple studies over the last 3 decades. During this time, knowledge about brain development, positive parenting, resilience, traumatic stress, and epigenetics has exploded, resulting in demands for child welfare to become trauma-informed, child-centered, and developmentally focused. This special issue affords us the opportunity to reflect on: what’s better or not after 30 years; whether legislation and financing are aligned with child welfare’s goals of safety, permanency and well-being; and what remains to be done to improve the outcomes of children and youth in foster care or otherwise involved with child welfare

Guide to Recruiting Black Men as Mentors for Black Boys

Black men are uniquely positioned to help guide black male youth to educational success and a productive future and through the barriers that stand in their way. But there are almost always more black boys to be mentored than black men to mentor them in formal mentoring programs. This guide helps mentoring programs engage in a productive and inclusive recruitment campaign by: 1) addressing program readiness; and 2) providing guidance on an effective social marketing campaign