Elizabeth M. Altmaier

Job-related stress, social support, and burnout among classroom teachers.

In this study we examined the effects of job-related stressful events and social support on burnout among teachers. We conducted a mail survey of a random sample of public school teachers in Iowa. Consistent with findings in previous research, teacher characteristics such as age, sex, and grade level taught were predictive of burnout. We also found that the number of stressful events experienced and social support were predictive of teacher burnout. Some evidence of the stress-moderating role of social support was also found. Teachers who reported that they had supportive supervisors and indicated that they received positive feedback concerning their skills and abilities from others were less vulnerable to burnout. We discuss the implications of these findings for programs aimed at preventing teacher bumouL

Analyzing data from experimental studies: A latent variable structural equation modeling approach.

This article illustrates the use of structural equation modeling (SEM) procedures with latent variables to analyze data from experimental studies. These procedures allow the researcher to remove the biasing effects of random and correlated measurement error on the outcomes of the experiment and to examine processes that may account for changes in the outcome variables that are observed. Analyses of data from a Project Family study, an experimental intervention project with rural families that strives to improve parenting skills, are presented to illustrate the use of these modeling procedures. Issues that arise in applying SEM procedures, such as sample size and distributional characteristics of the measures, are discussed.

The Relationship of Prior Training and Previous Teaching Experience to Self-Efficacy among Graduate Teaching Assistants.

This study, based on the theoretical model of Teacher Self-Efficacy proposed by Denham and Michael (1981), explored the effects of prior training, previous teaching experience, and certain demographic variables on the teaching self-efficacy of graduate teaching assistants. An adapted version of the Self-Efficacy Toward Teaching Inventory (Tollerud, 1990) was administered to a sample of graduate teaching assistants. Graduate teaching assistants with prior training endorsed a significantly higher level of self-efficacy than those with no training. Correlational analyses demonstrated significant positive relationships between prior training and previous teaching experience with level of self-efficacy. Multiple regression analysis indicated that previous teaching experience explained a significant amount of variance in self-efficacy. Results are discussed in light of the current training and utilization of graduate teaching assistants, and suggestions for future research are offered.

The effectiveness of psychological interventions for the rehabilitation of low back pain: a randomized controlled trial evaluation.

&NA; Forty‐five low back pain patients were randomly assigned to either a standard inpatient rehabilitation program or the standard program with additional psychological components. The standard program emphasized education, support, and physical reconditioning through exercise. Patients receiving the psychological program were given additional training in relaxation and other coping skills and received contingent reinforcement for exercise. Both programs included reduction of medication intake and an emphasis on family involvement after discharge. Measures of functional status were taken prior to the program, at discharge from the 3‐week inpatient program, and at a 6‐month follow‐up appointment. These data revealed that patients improved their overall functioning at discharge and maintained these gains at the follow‐up assessment. A similar pattern of findings was obtained for self‐reported pain and interference. Furthermore, 81% of the patients had returned to work or were engaged in active job retraining by the follow‐up. Using a conservative measure of full‐time return to the same or an equivalent job, 57% were employed by the follow‐up. Patient improvement, however, was not differentially affected by treatment group assignment, suggesting that the psychological treatment failed to add to the effectiveness obtained by the standard rehabilitation program. Results are discussed in the context of improving patient outcomes from rehabilitation for low back pain.

Long-term Outcomes in Multidisciplinary Treatment of Chronic Low Back Pain: Results of a 13-year Follow-up

Study Design. Patients completing a multidisciplinary pain treatment were contacted to obtain 13-year follow-up information on pain, mood, employment, and general health. Objectives. Study objectives were to determine if post-treatment improvements were maintained over a lengthy follow-up period and to compare patients’ general health to norms of comparably aged persons. Summary of Background Data. Although many studies have demonstrated the short-term effectiveness of multidisciplinary pain treatment programs for chronic low back pain, few studies have documented that these treatment gains are maintained over time. Only two studies have reported patient outcomes on a long-term basis (10+ years). Those studies have documented that patient gains during treatment are generally maintained during follow-up. Methods. An attempt was made to contact all patients completing an inpatient chronic back pain rehabilitation program at the University of Iowa’s Spine Diagnostic and Treatment Center. Of the 45 participants, 28 were located and 26 agreed to participate in a telephone interview. Analyses of pretreatment and posttreatment data revealed these follow-up participants did not differ from the larger study sample. Results. Patients maintained their treatment gains in all areas (pain intensity and interference, negative mood). Additionally, patients showed levels of general health comparable to similarly aged peers with the exceptions of pain (more pain) and physical functioning (lower functioning, more pain interference). More than half the sample was employed; of those not employed, few reported this was due to pain. Conclusions. The data lend support to the long-term effectiveness of multidisciplinary treatment programs for chronic low back pain.

Neurocognitive deficits related to poor decision making in people behind bars.

Using a novel quantitative model of repeated choice behavior, we investigated the cognitive processes of criminal offenders incarcerated for various crimes. Eighty-one criminals, including violent offenders, drug and sex offenders, drivers operating a vehicle while impaired, and 18 matched controls were tested. The results were also contrasted with those obtained from neurological patients with focal brain lesions in the orbitofrontal cortex and from drug abusers. Participants performed the computerized version of the Iowa gambling task (Bechara, Damasio, Damasio, & Anderson, 1994), and the results were decomposed into specific component processes, using the expectancy valence model (Busemeyer & Stout, 2002). The findings indicated that whereas all the criminal groups tended to select disadvantageously, the cognitive profiles exhibited by different groups were considerably different. Certain subpopulations—most significantly, drug and sex offenders—overweighted potential gains as compared with losses, similar to chronic cocaine abusers. In contrast, assault/murder criminals tended to make less consistent choices and to focus on immediate outcomes and, in these respects, were more similar to patients with orbitofrontal damage. The present cognitive model provides a novel way for building a bridge between cognitive neuroscience and complex human behaviors.

The effects of perceived versus enacted social support on the discriminative cue function of spouses for pain behaviors

&NA; This study examined the effects of spouse social support on patient displays of pain behaviors. A standardized behavioral observation method was used to record pain behaviors in 110 chronic pain patients while the spouse was present and while the spouse was absent. Patients and their spouses also completed paper and pencil measures of spouse‐provided social support as well as a demographic questionnaire. Results indicated that pain behaviors varied as a function of spouse presence and the type, or dimension, of support considered. Patients reporting higher levels of enacted support displayed a greater number of pain behaviors irrespective of spouse presence, consistent with the operant theory. When a measure of perceived support was used, the pain behaviors displayed differed, depending upon the level of support and spouse presence. Results are consistent with support‐seeking and cognitive‐behavioral models of the effects of social support on outcome. We discuss our findings within the context of a multidimensional model of support and pain and we caution against strict application of the operant model in treatment programs. Additional research is warranted to better understand the impact of support on the rehabilitation of patients with chronic pain.

Social Support and Depression among Bone Marrow Transplant Patients

This study considered the role of social support in mitigating depression among bone marrow transplant (BMT) patients. Eighty-six BMT patients completed the Medical Outcomes Study Social Support Scale (MOS-SSS) and the Centers for Epidemiological Studies of Depression Scale (CES-D) before transplant and again at one year posttransplant. Results showed moderate levels of depressive symptoms in BMT patients, with 29.1 percent and 27.6 percent meeting the suggested criterion for clinical depression at pre-BMT and one year post-BMT, respectively. Overall, patients experienced a reduced level of depression post-BMT, although females reported more depression than males. Social support pre-BMT predicted depression levels post-BMT controlling for initial levels of depression. Clinical implications for health care providers working with cancer patients and their families are discussed.

Social Support, Optimism, and Self-Efficacy Predict Physical and Emotional Well-Being After Bone Marrow Transplantation

Abstract This study examined whether three psychosocial variables (social support, self-efficacy, and optimism) assessed prior to bone marrow transplantation (BMT) predicted physical and emotional well-being one year post-BMT. Data were gathered on 87 participants enrolled in a multicenter, randomized trial examining the impact of exvivo T-cell depletion on disease-free survival in leukemia patients receiving allogeneic BMT. Social support, optimism, and selfefficacy significantly predicted emotional and physical well-being one year post-BMT, controlling for age, gender, maximum grade of acute GVHD, and treatment arm. Attention to psychosocial factors prior to BMT and during recovery appears critical for physical and mental well-being, especially considering the influence of psychosocial variables independent of medical risk factors.

Finding Benefit from Cancer.

Being diagnosed with and treated for cancer is a traumatic experience. Many cancer patients undergoing treatment manifest psychological distress and physical impairment. But this experience may also serve as a stimulus for positive growth. A growing body of literature addresses the possibility of positive growth through difficult events, a concept known as finding benefit. In the current study, the authors investigate finding benefit among 56 adult cancer patients over a period of 3 years, examining the role of optimism and the effects of finding benefit on later depression and physical functioning. The results demonstrated that finding benefit 1 year after treatment was related to both depression and physical functioning at a 3-year follow-up.