Emin Altintas

Inmates-to-staff Assaults, PTSD and Burnout: profiles of risk and vulnerability

Prison employees are often confronted with critical incidents and chronic stressors that may lead to trauma or burnout symptoms. However, most of the research on clinical aspects of interpersonal violence in prisons (inmates-to-staff violence, specifically) focuses either on trauma or on burnout. The purpose of the present study is (a) to examine both burnout and posttraumatic stress among prison staff and (b) to examine the influences of inmates-to-staff violent relations on posttraumatic stress in terms of risk profile to develop PTSD. A random sample of French correctional employees has completed various self-reported questionnaires assessing burnout, posttraumatic stress, and stress as well as victimization and demographic characteristics. Correctional employees demonstrated high levels of PTSD symptoms, burnout, and stress. Violent interactions with inmates lead to experienced trauma of all types (PTSD, secondary, or vicarious trauma). Results have highlighted a prison worker’s profile prone to PTSD: he or she expresses high levels of emotional exhaustion, intense levels of stress, high levels of depersonalization, and high levels of intrusion, avoidance, and hyperreactivity. This study contributes to an understanding of the literature by explaining the complex association between burnout and posttraumatic stress after interpersonal violence. These findings suggest a need to support prison workers and to address inmates-to-staff relational dynamics.

Burnout Among Occupational Physicians: A Threat to Occupational Health Systems?—A Nationwide Cross-sectional Survey

OBJECTIVES Burnout among occupational health physicians in France was measured in a nationwide cross-sectional survey. The relationships between each dimension of burnout (emotional exhaustion, depersonalization, and feelings of low personal accomplishment) and stress level, identity threat, and job characteristics were analysed. METHODS E-mails were sent out to all occupational physicians working in France by the French Ministry of Labour, inviting them to fill out an online questionnaire. This questionnaire included the Maslach Burnout Inventory, the Perceived Stress Scale, and the Primary Appraisal of Identity scale. Job characteristics were measured with survey-specific questions. RESULTS Of the 5010 occupational physicians who were potentially contacted, 1670 (33%) completed the online questionnaire. The estimated prevalence of burnout was 11.8%, twice as high as in a sample of French general practitioners (5%). The main characteristic of the burnout pattern was feelings of very low personal accomplishment (63.9%). Job characteristics were only weakly correlated with burnout, but stress level and identity threat were correlated with all three dimensions of burnout. The perceived stress was the main risk factor for emotional exhaustion and identity threat for feelings of low personal accomplishment. CONCLUSIONS The health status of occupational physicians is important for both the individual physicians and for the occupational health system. Occupational physicians are unwell, and we probably need to change the way we currently cope with burnout. This is not only a stress-induced syndrome, resulting from high workloads, but a low self-esteem-induced syndrome, too.

Orientation motivationnelle et symptomatologie dépressive chez la personne âgée

This article is focused on motivation and depression in later life. For about 20 years, research on the motivation of elders has underlined the importance of the cognitive evaluation of life contexts, notably in terms of self-determination. This cognitive evaluation determines the motivational orientation for daily activities (notably the levels of intrinsic and extrinsic motivation). The purpose of this research was specifically to study the relationships between the existence of four types of motivation (intrinsic, self-determined extrinsic, nonself-determined extrinsic and amotivation) and the consequences for adaptation and well-being. The study, therefore, focused on the possible links between motivation and geriatric-depression level and explored the nature of this link. Forty persons aged 60 or over (31 women: 80.48+/-9.24; nine men: 80.56+/-9.48) who live in nursing homes (20 elderly) or in their own homes (20 elderly) were enrolled. Elderly persons were assessed with specific and standardized tools: the Elderly Motivation Scale (EMS, in the French version: EMPA) and the Geriatric Depression Scale (GDS). For the statistical analyses of the results, correlations and Mann-Whitney test were used. We found that in elderly people, the motivational styles (the four types of motivation) can be reliably measured and are related to geriatric depression. First, significant positive links were noticed between intrinsic motivation and depression scores and between self-determined extrinsic motivation and depression scores. Conversely, significant negative links were noticed between nonself-determined extrinsic motivation and depression scores and between amotivation and depression scores. The most self-determined elders presented low-depression levels, whereas the more nonself-determined elders showed high-depression levels. Moreover, motivational styles significantly differed in the two groups (depressive or not depressive). The most depressive elders showed significantly lower-intrinsic and self-determined motivation levels. Our results support the hypothesis that motivational styles are related to important aspects (adaptation, well-being and depression) of the life of elderly people. Self-determination theory appears of high interest in research on aging and especially on the determinants of well-being in the elders.

Adaptation to nursing home: The role of leisure activities in light of motivation and relatedness

Based on the motivational sequence described in Self-Determination Theory, this study explored the relationship between relatedness, motivation, adaptation and leisure in nursing homes. We formulated the hypothesis that the variables of the study would be found in an integrative mediational sequence: Participation in leisure activities→Relatedness→Self-determined motivation→Adaptation to nursing homes. Participants (N=112, mean age=84.17) were invited to complete questionnaires assessing these variables. Results of the path analysis found an unsatisfactory fit for this model but revealed another model (Model 2) with a good fit index: Relatedness→Participation in leisure activities→Self-determined motivation→Adaptation to nursing homes→Relatedness. Model 2 fitted better than model 1: the Chi-square values were not significant, Chi2 (df=2)=5.1, p=0.078 and other indices were satisfactory (CFI=0.930, RMSEA=0.049 and NFI=0.918). These results suggest that feeling connected and secure in the relationships with others, and integrated as an individual to the group contribute to enhance leisure practice, self-determined motivation, and finally adaptation to life environment. Consequently, the relatedness promotes leisure activities practice which represents a central adaptive behavior in nursing homes.

The Impact of Work Stressors on Identity Threats and Perceived Stress

This aim of this study was to explore which kinds of working situations are regarded by psychologists as being particularly detrimental to their identity (personal and professional), how these situations are appraised in terms of threat and/or challenge, and what their impact is on perceived stress, work satisfaction, and perceived threat to occupational status. In all, 842 French psychologists answered an open format question requesting them to report a situation that was particularly difficult for them as a person and/or as a psychologist (analyzed by the way of a content analysis), and a questionnaire containing our dependant variables. Four major categories of situations were highlighted. While the first three were positively linked to threat, the “patient relations” category was negatively correlated with it. “Threat to personal identity” mediated the relationship between difficult situations and perceived stress. Situations appraised as being identity-threatening are mostly the same than those found in the stress literature and are stressful because of their impact on personal identity. Moreover, for psychologists, relations to patients, which are at the heart of the profession, seem to be protective regarding stress and identity threats.

Conséquences d’une catastrophe naturelle touchant le lieu de travail sur l’épuisement professionnel : Le cas du personnel d’un hôpital gériatrique

Resume Suite a une tornade de force 4 survenue le 03 aout 2008, la ville d’Hautmont et son centre hospitalier ont ete particulierement touches. Dans la litterature, la survenue de catastrophes naturelles et leurs consequences destructrices sont associees a l’emergence de troubles psycho-traumatiques : etat de stress post-traumatique (ESPT). L’objectif de cette etude etait de rechercher l’impact psychologique d’une catastrophe naturelle survenue en situation de travail en termes d’ESPT et d’epuisement professionnel, chez une population particulierement vulnerable, les personnels hospitaliers. Cette recherche a porte sur un groupe de 38 personnels hospitaliers, un an apres la survenue de la Tornade d’Hautmont. Les resultats de cette recherche montrent que cette catastrophe naturelle s’accompagne de plusieurs consequences. En effet, plusieurs cas d’ESPT et d’epuisement professionnel sont retrouves, aucun effet sur le niveau de stress au travail n’est releve.