Mental Illness and Chronic Disease in a Random Sample of Newly-Arrived Refugees and Immigrants to the U.S.

The goal of this research is to examine the prevalence of chronic diseases [Hypertension, Heart diseases, Asthma and Diabetes] among newly arrived refugees and immigrants to U.S., to predict the risk factors for each of the four chronic diseases studied, and to discuss whether self-reported mental illnesses [Depression and PTSD] have an impact on the occurrence of chronic diseases

Unemployment in Iraqi Refugees: The Interaction of Pre and Post-Displacement Trauma

Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N = 286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee\u27s country of origin

Predictors of self-rated health: a 12-month prospective study of IT and media workers

OBJECTIVE: The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0–12 months). METHODS: A prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23–64) from four information technology and two media companies. RESULTS: There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression). CONCLUSION: The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes

Refinement and Preliminary Testing of an Imagery-Based Program to Improve Coping and Performance and Prevent Trauma among Urban Police Officers

Police officers are regularly exposed to traumatic critical incidents. The substantial mental, behavioral, and social costs of police trauma indicate a substantial need for prevention. We have refined and enhanced a previously tested Swedish program to the harsh conditions of U.S. inner cities. The program was designed to strengthen resilience during stressful encounters and teach methods of coping after exposure, thereby preventing the emergence of maladaptive symptoms and behaviors with adverse effects on professionalism. In an uncontrolled demonstration project, junior officers were trained by senior officers to engage in imaginal rehearsal of specific dangerous situations while incorporating optimal police tactics and healthy emotional reactions. A class of 32 officers in the police academy engaged in the program, and they and the trainers reported high satisfaction with it. After their first year of field work, 22 officers were reassessed. Compared to pre-training, these officers showed significant increases in the use of positive reframing and humor and significant reductions in anxiety and alcohol use over the year. Trauma symptoms did not increase. These results offer preliminary evidence for the feasibility and effectiveness of this trauma prevention program for new police officers

Kidnapping and Mental Health in Iraqi Refugees: The Role of Resilience

Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms

Children of Iraqi Refugees: Risk Profile for Substance Abuse

What is the risk profile of children of Iraqi refugees? Among adult refugees, higher prevalence of mental disorders has been associated with shorter time since resettlement and exposure to more potential traumatic events (PTE). We hypothesized that similar associations would hold in the children of Iraqi refugees

Psychological, sociological and health behaviour aspects of a long term activation programme for institutionalized elderly people

The present study deals with psychological, sociological and subjective health aspects of social isolation and understimulation in institutional elderly people. In a controlled study over a 6 month period, a programme was devised in collaboration with residents of a senior citizens apartment building and its staff. The aim of the programme was to increase social activation and to encourage among the elderly an enhanced control over their daily lives. It was agreed that the programme implemented should involve no extra costs, overtime work or external resources. Most psychological and sociological variables were stable over the 6 month period. However, social activity level increased 3-fold in the xperimental group compared with the ontrol group. The E-group also started to attend activities outside the actual programme, and in general spent more time out of doors. Seasonal variations were found in feelings of depression, visits to the country/summer houses, as well as visits by children and neighbours. There were no changes in psychosomatic or psychological complaints indices. However, feelings of restlessness decreased significantly in the E-group over the 6 month period compared with the C-group. There was also a non significant decrease over time in complaints of heart palpitations in the E-group.

Causes of change in the health of populations: A biopsychosocial viewpoint

In the current review, a biopsychosocial perspective is applied to current changes in the health of populations. It is proposed that the psychosocial environments either promote health or precipitate disease. Changes in the types of stress that people experience as well as its prevalence over time are discussed. In addition, possible biological mechanisms linking the psychosocial environments to health are presented. "Food for thought" is the possible interaction between the physical/chemical and the psychosocial environments and changes in health of individuals. Clearly, our traditional view of disease mechanisms is not sufficient to understand recent phenomena, such as environmental illness and chronic fatigue syndrome. Issues worthy of further discussions are the role of the "just-in-time" society, where individuals increasingly have to change jobs, cope with reorganizations and increased production pressure, and its impact on health and well-being. Further, in what way can we develop better models to truly assess the impact of an increasingly complex interaction between individual and environmental factors on health? A major obstacle to enhancing our understanding of causes of change in the health of populations is the use of inappropriate or outdated statistical analytical models. Finally, it is suggested that prospectively controlled studies of the impact on health of changes in the health and welfare systems are carried out. This would further add to our understanding of factors contributing to changes in the health of population.public health modern society complex causes

Psychosocial challenges facing physicians of today

Fundamental changes in the organization, financing, and delivery of health care have added new stressors or opportunities to the medical profession. These new potential stressors are in addition to previously recognized external and internal ones. The work environment of physicians poses both psychosocial, ergonomic, and physico-chemical threats. The psychosocial work environment has, if anything, worsened. Demands at work increase at the same time as influence over one's work and intellectual stimulation from work decrease. In addition, violence and the threat of violence is another major occupational health problem physicians increasingly face. Financial constraint, managed care and consumerism in health care are other factors that fundamentally change the role of physicians. The rapid deployment of new information technologies will also change the role of the physician towards being more of an advisor and information provider. Many of the minor health problems will increasingly be managed by patients themselves and by non-physician professionals and practitioners of complementary medicine. Finally, the economic and social status of physicians are challenged which is reflected in a slower salary increase compared to many other professional groups. The picture painted above may be seen as uniformly gloomy. In reality, that is not the case. There is growing interest in and awareness of the importance of the psychosocial work environment for the delivery of high quality care. Physicians under stress are more likely to treat patients poorly, both medically and psychologically. They are also more prone to make errors of judgment. Studies where physicians' work environment in entire hospitals has been assessed, results fed-back, and physicians and management have worked with focused improvement processes, have demonstrated measurable improvements in the ratings of the psychosocial work environment. However, it becomes clear from such studies that quality of the leadership and the physician team impact on the overall work atmosphere. Physicians unaware of the goals of the department as well as the hospital, that do not receive management performance feedback, and who do not get annual performance appraisals and career guidance, rate their psychosocial environment as more adverse than their colleagues. There is also a great need to offer personally targeted competence development plans. Heads of department and senior physicians rate their work environment as of higher quality than more junior and mid-career physicians. More specifically, less senior physicians perceive similar work demands as their senior colleagues but rate influence over work, skills utilization, and intellectual stimulation at work as significantly worse. In order to combat negative stressors in the physicians' work environment, enhancement initiatives should be considered both at the individual, group, and structural level. Successful resources used by physicians to manage the stress of everyday medicine should be identified. Physicians are a key group to ensure a well-functioning health care system. In order to be able to change and adapt to the ongoing evolution of the Western health care system, more focus needs to be put on the psychosocial aspects of physicians' work.Physicians Work environment Psychosocial Stress