David Bunce

The role of acceptance and job control in mental health, job satisfaction, and work performance

Acceptance, the willingness to experience thoughts, feelings, and physiological sensations without having to control them or let them determine ones actions, is a major individual determinant of mental health and behavioral effectiveness in a more recent theory of psychopathology. This 2-wave panel study examined the ability of acceptance also to explain mental health, job satisfaction, and performance in the work domain. The authors hypothesized that acceptance would predict these 3 outcomes 1 year later in a sample of customer service center workers in the United Kingdom (N = 412). Results indicated that acceptance predicted mental health and an objective measure of performance over and above job control, negative affectivity, and locus of control. These beneficial effects of having more job control were enhanced when people had higher levels of acceptance. The authors discuss the theoretical and practical relevance of this individual characteristic to occupational health and performance.

Mediators of change in emotion-focused and problem-focused worksite stress management interventions.

Ninety volunteers in a media organization were randomly allocated to an Acceptance and Commitment Therapy (ACT, n = 30) group that sought to enhance peoples ability to cope with work-related strain, an Innovation Promotion Program (IPP, n = 30) that helped individuals to identify and then innovatively change causes of occupational strain, or a waitlist control group (n = 30). Both interventions lasted 9 hr, spread over 3 months. Improvements in mental health and work-related variables were found following both interventions. As hypothesized, changes in outcome variables in the ACT condition were mediated only by the acceptance of undesirable thoughts and feelings. In the IPP condition, outcome change was mediated only by attempts to modify stressors. Discussion focused on the importance of understanding the mechanisms underpinning change in occupational stress management interventions.

Job control mediates change in a work reorganization: intervention for stress reduction

This longitudinal, quasi-experiment tested whether a work reorganization intervention can improve stress-related outcomes by increasing peoples job control. To this end, the authors used a participative action research (PAR) intervention that had the goal of reorganizing work to increase the extent to which people had discretion and choice in their work. Results indicated that the PAR intervention significantly improved peoples mental health, sickness absence rates, and self-rated performance at a 1-year follow-up. Consistent with occupational health psychology theories, increase in job control served as the mechanism, or mediator, by which these improvements occurred. Discussion focuses on the need to understand the mechanisms by which work reorganization interventions affect change.

Rethinking Clinical Trials of Transcranial Direct Current Stimulation: Participant and Assessor Blinding Is Inadequate at Intensities of 2mA

Background Many double-blind clinical trials of transcranial direct current stimulation (tDCS) use stimulus intensities of 2 mA despite the fact that blinding has not been formally validated under these conditions. The aim of this study was to test the assumption that sham 2 mA tDCS achieves effective blinding. Methods A randomised double blind crossover trial. 100 tDCS-naïve healthy volunteers were incorrectly advised that they there were taking part in a trial of tDCS on word memory. Participants attended for two separate sessions. In each session, they completed a word memory task, then received active or sham tDCS (order randomised) at 2 mA stimulation intensity for 20 minutes and then repeated the word memory task. They then judged whether they believed they had received active stimulation and rated their confidence in that judgement. The blinded assessor noted when red marks were observed at the electrode sites post-stimulation. Results tDCS at 2 mA was not effectively blinded. That is, participants correctly judged the stimulation condition greater than would be expected to by chance at both the first session (kappa level of agreement (κ) 0.28, 95% confidence interval (CI) 0.09 to 0.47 p = 0.005) and the second session (κ = 0.77, 95%CI 0.64 to 0.90), p = <0.001) indicating inadequate participant blinding. Redness at the reference electrode site was noticeable following active stimulation more than sham stimulation (session one, κ = 0.512, 95%CI 0.363 to 0.66, p<0.001; session two, κ = 0.677, 95%CI 0.534 to 0.82) indicating inadequate assessor blinding. Conclusions Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution.

The influence of psychological flexibility on work redesign: mediated moderation of a work reorganization intervention.

This quasi-experiment tested the extent to which an individual characteristic, psychological flexibility, moderated the effects of a control-enhancing work reorganization intervention in a call center. Results indicated that, compared with a control group, this intervention produced improvements in mental health and absence rates, particularly for individuals with higher levels of psychological flexibility. Findings also showed that these moderated intervention effects were mediated by job control. Specifically, the intervention enhanced perceptions of job control, and hence its outcomes, for the people who received it, especially for those who had greater psychological flexibility. Discussion highlights the benefits of understanding the processes (e.g., mediators, moderators, and mediated moderators) involved in work reorganization interventions.

Functional Abilities in Older Adults with Mild Cognitive Impairment

Background: A classification scheme and general set of criteria for diagnosing mild cognitive impairment (MCI) were recently proposed by a multidisciplinary group of experts who met at an international symposium on MCI. One of the proposed criteria included preserved basic activities of daily living and minimal impairment in complex instrumental activities of daily living (IADLs). Objective: To investigate whether older adults with MCI classified according to the subtypes identified by the Working Group (i.e. amnestic, single non-memory domain, and multiple domain with or without a memory component) differed from cognitively intact older adults on a variety of measures indexing IADLs and to examine how well measures of IADL predict concurrent MCI status. Methods: Two hundred and fifty community-dwelling older adults, ranging in age from 66 to 92, completed self-report measures of IADLs (Lawton and Brody IADL Scale, Scales of Independent Behaviour-Revised – SIB-R) and a measure of everyday problem solving indexing IADLs (Everyday Problems Test – EPT). Ratings of participants’ IADL functioning were also obtained from informants (e.g. spouse, adult child and friend). Results: Older adults with multiple-domain MCI demonstrated poorer IADL functioning than older adults with no cognitive impairment on the EPT and the SIB-R (both self- and informant-report versions). The multiple-domain MCI participants also demonstrated poorer IADLs than MCI participants with impairments in a single cognitive domain on the self-reported SIB-R and EPT. The single-domain MCI groups demonstrated poorer IADLs than older adults without cognitive impairment on the informant-reported SIB-R and EPT. No significant group differences were found on the Lawton and Brody IADL Scale. Using the EPT and SIB-R as predictors in a multinomial regression analysis, MCI group status was reliably predicted, but the classification rate was poor. Conclusion: Individuals with MCI demonstrated poorer IADL functioning compared to cognitively intact older adults. However, the changes in IADL functioning observed in MCI may be too subtle to be detected by certain measures, such as the Lawton and Brody IADL Scale.

Stress Management and Innovation Interventions at Work

A study among health-care workers is reported where a traditional stress management program (n = 66) was compared with an intervention promoting innovation at work as a form of stress management (n = 52), and a control group (n = 84). Measures relating to both the process of participation in the respective interventions, and outcome in terms of psychological well-being were taken. The traditional program, emphasizing cognitive-behavioral and arousal reduction techniques, was associated with improvements in general psychological strain and job satisfaction. The intervention promoting innovative responses to stressors (e.g., changing work methods, modifying working relations with colleagues) was associated with improvements in work-related stress, and innovation. Statistical analysis suggested session process variables, in addition to the theoretical orientations of the respective interventions, were associated with outcome variance. Follow-up data, 1 year post-intervention, suggested short-term gains on outcome variables relating to psychological well-being were not maintained. However, increases in levels of innovation, although not apparent post-intervention (3 months), were significant after 1 year. It is concluded that stress management research should focus more on process variables, and that interventions promoting innovation at work, show some promise in addressing occupational strain.

White matter hyperintensities and within-person variability in community-dwelling adults aged 60-64 years.

Estimates of white matter hyperintensities (WMH) derived from T2-weighted MRI were investigated in relation to cognitive performance in 469 healthy community-dwelling adults aged 60-64 years. Frontal lobe WMH but not WMH from other brain regions (temporal, parietal, and occipital lobes, anterior and posterior horn, periventricular body) were associated with elevated within-person reaction time (RT) variability (trial to trial fluctuations in RT performance) but not performance on several other cognitive tasks including psychomotor speed, memory, and global cognition. The findings are consistent with the view that elevated within-person variability is related to neurobiological disturbance, and that attentional mechanisms supported by the frontal cortex play a key role in this type of variability.

APOE and cognitive decline in preclinical Alzheimer disease and non-demented aging

Objective: To investigate whether presence of the APOE ε4 allele is related to the pathologic progression of preclinical Alzheimer disease (AD), as reflected by change in Mini-Mental State Examination (MMSE) scores among persons in the preclinical phase of AD, and cognitively intact adults confirmed as dementia-free during the 6-year assessment period. Method: In a population-based sample, participants were stratified according to APOE genotype (ε4 or non-ε4) and whether they received a diagnosis of AD at the end of either a 3- or 6-year assessment period. Participants were aged 75 years and older, and were nondemented at baseline. At the end of the 3-year period, 17.2% of non-ε4 and 26.7% of ε4 carriers became demented. For the 6-year period those percentages were 11.2% for non-ε4 carriers and 16.9% for ε4-carriers. Results: Individuals in the preclinical phase of AD showed greater decline on the MMSE as compared to nondemented adults. However, the decline was most marked in the 3 years prior to clinical diagnosis. Further, APOE-ε4 genotype did not modify the rate of decline among to-be-demented participants, as well as individuals who would remain free of AD. Conclusions: Although possession of the APOE ε4 allele is a risk factor for AD in old age, it does not modify the progression of the disease during the preclinical period. Further, in the absence of preclinical dementia, APOE did not influence global cognitive change in nondemented persons.

Inconsistency in serial choice decision and motor reaction times dissociate in younger and older adults

Intraindividual variability (inconsistency) in reaction time (RT) latencies was investigated in a group of younger (M=25.46 years) and older (M=69.29 years) men. Both groups performed 300 trials in 2-, 4-, and 8-choice RT conditions where RTs for decision and motor components of the task were recorded separately. A dissociation was evident in that inconsistency was greater in older adults for decision RTs when task demands relating to the number of choices and fatigue arising from time-on-task were high. For younger persons, a weak trend toward greater inconsistency in motor RTs was evident. The results are consistent with accounts suggesting that inconsistency in neurobiological mechanisms increases with age, and that attentional lapses or fluctuations in executive control contribute to RT inconsistency.