Quality of life and coping with schizophrenia symptoms.

The question addressed in this paper is whether different coping styles mediate the relationship between psychopathology and related distress and the quality of life (QOL) among patients with schizophrenia. In a cross-sectional design, 161 schizophrenia inpatients were comprehensively evaluated with standardized measures of QOL, psychopathology, psychological distress and coping styles. Correlations and regression analyses were performed to examine the relationship among parameters and to estimate the mediating effect of coping styles on QOL in the framework of a distress/protection model. Life quality correlated positively with task- and avoidance-oriented coping styles and slightly negatively with emotion-oriented coping. Emotion-oriented coping mediated the relationship between the severity of activation, anxiety/depression symptoms, and QOL, while avoidance-oriented (distraction) coping was mediated between QOL and paranoid symptoms. Coping styles accounted for 25% of the variance in subjective QOL scores compared with 15% for psychological distress, and only 3% for clinical variables. The ability to cope with symptoms and associated distress substantially contributes to QOL appraisal in schizophrenia. Thus, different coping strategies may reduce the negative influence of specific symptoms and related distress on the subjective QOL of schizophrenia patients.

Malingering assessment in behavioral toxicology: what, why, and how.

Neurobehavioral assessment is frequently made in a forensic context. The cognitive assessment may be biased due to an international manipulation of data by the patient motivated by attainment of compensation, that is, malingering. Although malingering is highly relevant in behavioral toxicology, the issue and its assessment are underrepresented in the literature. A routine assessment of malingering is important to reduce false-positive and false-negative errors in assessment, thereby establishing the credibility and validity of behavioral assessment. In the long run, the routine inclusion of malingering measurements might reduce claims and encourage employers to be more cooperative in behavioral toxicology studies. Guidelines for malingering assessment and research, inferred from the clinical and research literature, are discussed. Sensitivity to the problematic issues involved in assessing malingering behavior is an important step toward malingering detection in the clinical setting and to the establishment of assessment methods that are less confounded by these issues.

Objective and subjective work monotony: effects on job satisfaction, psychological distress, and absenteeism in blue-collar workers.

The relation of objective work conditions (work underload, repetitive or varied work) and subjective monotony to job satisfaction, psychological distress, and sickness absence was examined in 1,278 male and female workers. Subjective monotony was moderately related to the objective work conditions. Hierarchical regression analyses showed that the effects on all outcomes were partially mediated by subjective monotony and were also directly related to repetitive work and work underload. Job satisfaction and psychological distress were mainly related to subjective monotony, whereas sickness absence was equally related to the work conditions and subjective monotony. The highest impact was observed for short-cycle repetitive work. Testing sex interactions revealed that sickness absence was related to the work conditions in women but not in men. The findings highlight the significance of noting the actual work conditions in predicting employee outcomes.

Repetitive work, work underload and coronary heart disease risk factors among blue-collar workers--the CORDIS study. Cardiovascular Occupational Risk Factors Determination in Israel.

Evidence from survey-based studies suggests that monotonous work increases the risk of coronary heart disease (CHD). In this study of 1944 male and 832 female blue-collar workers aged 20-64 yr, we examined the association of CHD risk factors with two distinct objective work conditions--repetitive work (3 levels) and work underload-compared to varied work. After controlling for shift work, high ambient noise exposure and four other possible confounders, repetitive work was positively associated with both blood pressure and serum lipid levels in women, and with blood pressure in men. However, elevated levels of these risk factors were obtained only for those in short-cycle (< 1 min) repetitive work. In women this was manifested in higher mean systolic (p = 0.003), diastolic (p = 0.01) blood pressure (BP), total cholesterol (p = 0.03) and serum glucose (p = 0.05) levels; and in men in higher systolic BP only (p = 0.002). Inconsistent results were obtained for those engaged in work underload. It was associated in men with higher mean systolic BP (p = 0.05) and in women with higher cholesterol (p = 0.05) and high density lipoprotein (p = 0.03) levels. These findings suggest that objective monotonous work conditions are more consistently related to CHD risk factors in women, especially those engaged in short-cycle (hectic) repetitive work.