Elena Bilotta

Avoidance coping strategies, alexithymia and alcohol abuse: A mediation analysis

Alexithymia and avoidance coping strategies are both associated with alcohol abuse, but their effects have been seldom studied simultaneously. The present study investigated the interplay between alexithymia and avoidance coping strategies in predicting the severity of alcohol abuse in an alcohol-dependent sample. The TAS-20 and COPE-NVI questionnaires were administered to 110 alcoholic inpatients enrolled into a recovery program at the Center for Alcohol Abuse of the Department of Clinical Medicine, Sapienza University of Rome, Italy. The alcohol abuse index consisted of the mean alcohol units consumed by participants and days of abstinence before being enrolled into the recovery program. Results showed that alexithymic alcoholics consumed significantly more alcohol and were less abstinent than non-alexithymic alcoholics. Concerning the relationship among alexithymia, coping strategies and alcohol abuse, data showed that alexithymia completely mediated the effects of avoidance coping strategies on alcohol abuse, suggesting that avoidance strategies have therefore an indirect effect on alcohol abuse among alcoholics. Theoretical and clinical implications of the results are discussed.

Capturing the Ecology of Workplace Stress With Cumulative Risk Assessment

Most research on occupational stress and health examines singular psychosocial or physical work characteristics. Occasionally, the interactive health effects of multiple psychosocial and physical work characteristics are examined. Most approaches to occupational stress and health, however, do not fully capture the complex, dynamic ecological context of work stress. This article proposes and tests a model of cumulative risk, a concept adapted from developmental psychology, as an alternative perspective on occupational stress and health. Cumulative risk models categorize singular psychosocial or physical work characteristics dichotomously as risks or stressors that are either present or absent for each worker. Cumulative risk is then the simple additive summation of these multiple dichotomous categories. Herein, the authors show in two different work settings (clerical offices and primary care hospitals) that the accumulation of relatively modest, low levels of multiple physical and psychosocial stressors is associated with multiple indicators of well-being, including fatigue, job stress, and psychological distress. The cumulative risk index, unlike singular risk exposures, predicts well-being. Furthermore, these associations replicate in two quite different work settings and are statistically independent of a control for negative affectivity, a general indicator of neuroticism.

Integrated healthscape strategies: an ecological approach to evidence-based design.

Aim: This paper explores some of the premises of evidence-based design (EBD) and suggests that greater attention to and differentiation of the various purposes of research are needed, along with the development of an ecological theory that reflects the complexity of the health systems studied and more varied ways to communicate with and engage practitioners. Background: Problems with the American healthcare system are well known. For the past 20 years, an intervention that has gained increasing attention has been the physical design of healthcare facilities—hospitals in particular. EBD has been advocated as one means of using research to examine the relationship between design and healthcare to improve patient safety and the quality of care. Conclusions: The concept of integrated healthscape strategies is proposed to focus not only on research “evidence” and the methods used to collect and analyze it, but also on the different purposes research serves, the role of theory, and the use of EBD research in practice.