Explanatory models and help-seeking for symptoms of PTSD and depression among Syrian refugees.

OBJECTIVE: This study investigates how Syrian refugees explain and prefer to seek help for symptoms of post-traumatic stress disorder (PTSD) and depression. METHODS: We conducted five semi-structured focus group interviews based on a vignette-technique with Syrian refugees (n = 21 men, n = 10 women). The vignettes describe a fictional person suffering from symptoms of PTSD or depression in line with DSM-5 and ICD-10 criteria. RESULTS: Despite never mentioning PTSD, participants in the PTSD-interviews recognized the symptoms. They perceived them as a common reaction to extreme situations, mainly the war, the flight, and post-migratory stressors. Depression was labeled as either depression or feelings caused by social problems, and the participants were more hesitant to identify with these symptoms. Despite some differences, both the PTSD and depression vignettes were explained in terms of situational explanatory models and externally caused stress. The main finding is how participants described changing stressors resulting from migration and resettlement leading to a difference in how they would seek help in Syria and in Norway. Specifically, we found that preferred help-seeking and coping strategies are contextual. CONCLUSIONS: These findings point to the need to consider transformations following forced migration when studying aspects of explanatory models, preferred help-seeking, and coping strategies in refugee groups.

Monitoring daily events, coping strategies, and emotion during a desert expedition in the Middle East.

Personnel operating in extreme environmental conditions are exposed to a variety of stressors. Whether a person adjusts to the conditions and is able to cope has implications for their psychological health. In previous extreme-environment work, temporal changes in stress, coping, and emotion have been reported. Building on previous studies, we used a diary methodology to explore temporal changes in and associations between daily events, coping strategies, and affect during a unique hyperarid desert expedition. Four participants undertaking a crossing of the Empty Quarter desert were recruited to the study. Participants completed pre-expedition, postexpedition, and 4-month follow-up questionnaires. A daily self-report diary was used to collect situational data. Time-based changes were analysed before testing predictive models linking events and coping strategies with affective responses. Findings suggest that participants had an overall positive experience. There were changes in both the events experienced and coping strategies used during the expedition. Variation in events and coping strategies significantly predicted fluctuations in positive and negative affect. Results offer valuable mechanistic information that could inform monitoring systems aimed at tracking psychological variables during operations in extreme environments. Results are discussed in relation to the novel context, diary methodology, and implications for those operating in extremes.

Personal values, subjective well-being and destination-loyalty intention of international students.

What are the factors that predict international students' destination-loyalty intention? This is the main question this paper addresses, using an online survey among 396 (short-term, N = 182) and (long-term, N = 214) international students at a Norwegian university. Structural equation model-AMOS was conducted to examine relationships among personal values, subjective well-being and destination-loyalty intentions. The results showed that: (1) universalism was positively related to subjective well-being for short-term students; and (2) subjective well-being was positively related to destination-loyalty intention for all groups. We found that relatively stable and happy individuals might be important for ensuring destination-loyalty intentions. Results also indicated that personal values that emphasize justice and equity are also important for short-term international students' well-being.

Improving subjective health at the worksite: a randomized controlled trial of stress management training, physical exercise and an integrated health programme.

Our objective was to evaluate the effect of 12 weeks of stress management training (SMT), physical exercise (PE) and an integrated health programme (IHP) in a worksite setting on subjective health complaints. To do this, we randomly split 860 employees into the following groups: control (n = 344), PE (n = 189), IHP (comprising physical exercise and health information) (n = 165) and SMT (n = 162). There were no significant effects on subjective health complaints, sick leave or job stress. However, strong and specific positive effects were experienced for the particular goal areas defined for each intervention. The PE group showed improved general health, physical fitness and muscle pain, while the SMT group showed improved stress management. The IHP group showed the strongest effects, affecting most goals set for treatment.

Crew tension during a space station simulation.

Two space simulation studies for the European Space Agency found that interpersonal tension increased in the beginning, around the middle, and toward the end of the confinement. This article reports data from a third study where this issue was further examined. Three subjects were confined in the MIR space station simulator in Moscow for 135 days. Communication analysis, peer rating, questionnaires, and interviews were used to assess crew tension. The temporal pattern found in this study corresponds to the previous findings. The beginning of the period was characterized by competition over leadership. Decreased crew cohesion and aggression toward the mission control marked the middle of the confinement. In the final weeks, open conflicts emerged, and one member was socially excluded. Joking occurred frequently in the first half of the confinement, whereas negative emotional expressions increased in the second half. These results might assist planners in anticipating behavioral problems during space missions.

Psychosocial issues in space: future challenges.

As the duration of space flights increases and crews become more heterogeneous, psychosocial factors are likely to play an increasingly important role in determining mission success. The operations of the International Space Station and planning of interplanetary missions represent important future challenges for how to select, train and monitor crews. So far, empirical evidence about psychological factors in space is based on simulations and personnel in analog environments (i.e. polar expeditions, submarines). It is apparent that attempts to transfer from these environments to space requires a thorough analysis of the human behavior specific to the fields. Recommendations for research include the effects of multi-nationality on crew interaction, development of tension within crews and between Mission Control, and prediction of critical phases in adaptation over time. Selection of interpersonally compatible crews, pre-mission team training and implementation of tools for self-monitoring of psychological parameters ensure that changes in mission requirements maximize crew performance.

Coping in Antarctica: is it possible to generalize results across settings?

BACKGROUND: To gain knowledge about psychological issues in space, data have been collected from groups in isolated and confined settings on Earth. This study examines the possibility of generalizing psychological findings across such environments. HYPOTHESIS: Psychological reactions among personnel in different Antarctic environments show similar time patterns. Antarctic personnel differ in personality from submariners to crews confined in hyperbaric chambers to military recruits. METHOD: Psychological reactions were evaluated by the Revised Antarctic Questionnaire. The Personality Characteristic Inventory was used to measure personality. RESULTS: Personnel stationed on a ship (n = 19) showed high coping during the whole mission, whereas personnel on land bases (n = 18) showed a marked decline around the third quarter. Reduced coping in the land-based groups was associated with stress from interpersonal relationships. Compared with submariners (n = 54) and hyperbaric chamber crews (n = 20), Antarctic personnel scored lower on competitiveness and higher on achievement striving. CONCLUSIONS: Similarities in physical, individual and group characteristics should be considered before extrapolating psychological findings across settings.

Personality and coping strategies during submarine missions.

Relations between personality profiles, measured by the Personality Characteristics Inventory (PCI), and habitual coping strategies, measured by the Utrecht Coping List (UCL), were investigated in a sample of submarine personnel and office employees. The predictive validity of these instruments were examined for reported stress, health complaints, and salivary cortisone measures during 3 submarine missions. PCI and UCL were completed before the missions, and questionnaires and saliva were collected weekly. The results showed no significant relations between PCI profiles and coping strategies. Interpersonal orientation, achievement motivation, and habitual coping strategies were predictors for coping during the submarine missions. Problem-directed strategies and interpersonal sensitivity combined with strong achievement motivation were related to low indicated stress from social factors (lack of privacy, interpersonal tension, and crowding) and homesickness. The findings suggest that interpersonal characteristics need to be considered in the selection of submariners and personnel for other military settings in which units are exposed to prolonged stress and isolation.

The effects of personality and interpersonal relations on crew performance during space simulation studies.

There has been a substantial increase in the number of people living and operating in isolated, confined, and artificially engineered environments, such as spacecraft, deep diving, weather stations, submarines, and polar outposts. This article gives an overview of research undertaken in a variety of extreme environments in an effort to better understand how semiautonomous, task-oriented groups operating within these environments develop over time, as well as identification of the individual characteristics that promote performance under such circumstances. Research reviewed includes space simulation studies for the European Space Agency (ESA) where groups were isolated in hyperbaric chambers, as well as findings from polar expeditions, space missions, submarine missions, and other military settings. Findings from the space simulation studies in hyperbaric chambers provided empirical evidence for interpersonal issues anecdotally reported in Antarctica and in other isolated, operational team environments, such as "scapegoating" of deviant crew members, displacement of aggression to outside personnel, and time patterns in psychological reactions. No indications of a "psychological limit" for how long people can tolerate remaining in isolation and confinement were found. Certain personality characteristics were consistently associated with coping, and individuals characterized by strong achievement motivation combined with interpersonal sensitivity seemed to adapt better than others. Together, these results have implications for selection and training of people operating within extreme environments.

Psychological reactions during polar expeditions and isolation in hyperbaric chambers.

BACKGROUND: Psychological data from environments that are considered as analog to space was collected from 68 subjects; 18 in hyperbaric chambers, 16 in polar expeditions, and 34 on Arctic stations. The objective was to identify psychological reactions expected in different phases of spaceflights and examine personality variables associated with superior adaptation. METHOD: Helmreich Personality Characteristic Inventory was administered before the isolation. Adaptation to the environment was assessed through a questionnaire once a week. RESULTS: Crews in hyperbaric chambers indicated a steady increase in coping over the isolation. Polar expeditions members reported high aggressiveness and anxiety in the first quarter and an increase in homesickness over time. A personality characterized by strong expressiveness and instrumentality ("the right stuff") predicted superior adaptation in hyperbaric chambers. CONCLUSION: The data suggest that isolation in hyperbaric chambers and polar expeditions should be considered as models for different aspects of the space environment.

Crew compatibility and interaction.

A crew of four (three males and one male) were isolated for 60 days in hyperbaric chambers at DLR, Cologne, Germany. The aim of the study was to investigate how group functioning, relations with ground control, and interaction between crew members would change during isolation. A broad array of methods was used, including analysis of communication, peer ratings, questionnaires, and a post-isolation interview. The main findings are: 1. Group functioning declined at three times, immediately before and after the start of isolation, and in weeks 2 and 5; 2. Conflicts were often focused on project management. 3. Crew members showed a marked tendency to deny team conflicts, making them vulnerable to "group think;" 4. Towards the end of isolation, social factors were given more importance than task-related factors; 5. Lasting antagonism between two of the male crew members were noted, which made one of them withdraw from interaction, while the other one--the most dominant crew member--developed an alliance with the Commander. Several findings in this study are consistent with our earlier results from the ISEMSI study. The existence of several interpersonal issues has been identified, which are also likely to occur during actual space missions. Many of the interpersonal problems could probably be prevented or reduced through behavioral and sensitivity training, composition of crews according to compatibility, and monitoring of group functioning during the flight. We suggest that future simulation studies should be directed towards gaining practical experience in how to influence interpersonal relations in a desirable way. The joint training of ground crew and chamber crew created good co-operation between the two crews, but the adjustment to management requires more experience and new training procedures. The lack of formalized rules caused serious frustrations and negative feelings in both crews towards project management. Data from management and principal investigators were not available, but we suggest that such information should be collected in future simulation studies.

Interpersonal relations during simulated space missions.

The present article derives from two isolation studies performed for the European Space Agency (ESA) as simulations of space travels, lasting for 4 and 9 weeks. The aim was to study how interpersonal relations were affected by time, and how individual characteristics related to conflicts and tension among crewmembers. A broad battery of methods was used, including video-recording, peer-ratings and self-reports. In both studies, group-functioning declined in the middle of the isolation and towards the end of the stay. Dominance and task motivation seemed to be important characteristics for compatibility between crewmembers, and negative relations established early in the isolation remained stable over time. These findings have implications for composition, training, and support of crews for extended spaceflights.