Robert T. Brennan

Gender and the relationship between job experiences and psychological distress : a study of dual-earner couples

This article examines the association between job role quality and psychological distress in a sample of 300 full-time employed dual-earner couples, controlling for such individual level variables as age, education, occupational prestige, and marital quality and for such couple level variables as length of marriage, parental status, and household income. The magnitude of this effect is compared for men and for women. Results indicate that job role quality is significantly negatively associated with psychological distress for women as well as for men and that the magnitude of the effect depends little, if at all, on gender, casting doubt on the widely held view that job experiences more significantly influence mens mental health states than womens. The results are discussed in the context of differentiating between sex differences and gender differences.

Change in job and marital experiences and change in psychological distress: A longitudinal study of dual-earner couples.

Are changes in job quality more closely linked to changes in distress for men than for women? Conversely, are changes in marital quality more closely linked to changes in distress for women than for men? These questions were addressed in a longitudinal analysis of a random sample of 210 full-time employed dual-earner couples. Change over time in job role quality was significantly associated with change over time in distress, and the magnitude of the relationship differed little, if at all, by gender. In contrast, change over time in marital role quality was also associated with change in distress, but the magnitude of the association depended on gender. Among full-time employed married women, change in marital experience was more closely linked to change in distress than among their husbands.

Randomized, controlled trial of video self-instruction versus traditional CPR training

STUDY OBJECTIVE We conducted a prospective, randomized, controlled trial to test the hypothesis that a 34-minute video self-instruction (VSI) training program for adult CPR would yield comparable or better CPR performance than the current community standard, the American Heart Association Heartsaver course. METHODS Incoming freshman medical students were randomly assigned to VSI or the Heartsaver CPR course. Two to 6 months after training, we tested subjects to determine their ability to perform CPR in a simulated cardiac arrest setting. Blinded observers used explicit criteria to assess our primary outcome, CPR performance skill. In addition, we assessed secondary outcomes including sequential performance of individual skills, ventilation and chest compression characteristics, and written tests of CPR-related knowledge and attitudes. RESULTS VSI trainees displayed superior overall performance compared with traditional trainees. Twenty of 47 traditional trainees (43%) were judged not competent in their performance of CPR, compared with only 8 of 42 VSI trainees (19%; absolute difference, 24%; 95% confidence interval, 5% to 42%). CONCLUSION In a group of incoming freshman medical students, we found that a half-hour of VSI resulted in superior overall CPR performance compared with that in traditional trainees. If validated by further research, VSI may provide a simple, quick, and inexpensive alternative to traditional CPR instruction for health care workers and, perhaps, the general population.

A Multilevel Study of Neighborhoods and Parent-to-Child Physical Aggression: Results From the Project on Human Development in Chicago Neighborhoods

The majority of children in the United States experience parent-to-child physical aggression (PCPA), a disciplinary strategy out of favor with many experts. Several decades of research have documented a link between community characteristics and severe child maltreatment. None have taken a multilevel approach to study whether neighborhoods affect the amount of corporal punishment and/or physical abuse used by individual families. Data for this article come from the Project on Human Development in Chicago Neighborhoods and were analyzed using hierarchical linear modeling. An interval scale of PCPA was developed. Values obtained show that several neighborhood characteristics were associated with PCPA. Immigrant concentration remained significant after controlling for family composition. A cross-level interaction was found between neighborhood social networks and Hispanic race/ethnicity. The article’s conclusion is that neighborhood characteristics may influence the amount of PCPA used by families. Neighborhood intervention strategies hold promise.

Fit as a mediator of the relationship between work hours and burnout

The authors studied number of hours worked and estimated its relationship to burnout in a nonrandom sample of 141 married physicians. It was hypothesized that this relationship is mediated by a process called fit, conceptualized as the extent to which workers realize the various components of their work-family strategies. Results of structural equation modeling supported the mediation hypothesis. Employees whose work hours are more or fewer than they and their partner prefer and whose work hours are distributed differently than they and their partner prefer will be more disengaged, distracted, and alienated at work than will their counterparts who are working their preferred schedules. Thus, the relationship between number of hours worked and burnout depends on the extent to which work schedules meet the needs of the worker, her or his partner, and their children, if any.

Sierra Leone’s Former Child Soldiers: A Follow-Up Study of Psychosocial Adjustment and Community Reintegration

This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (ages 10-18; n = 156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the 2-year period of follow-up, youth who had wounded or killed others during the war demonstrated increases in hostility. Youth who survived rape not only had higher levels of anxiety and hostility but also demonstrated greater confidence and prosocial attitudes at follow-up. Of the potential protective resources examined, improved community acceptance was associated with reduced depression at follow-up and improved confidence and prosocial attitudes regardless of levels of violence exposure. Retention in school was also associated with greater prosocial attitudes.

Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health

OBJECTIVE To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. METHOD Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. RESULTS The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems (b = -1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance (b = -0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance (b = 1.93). CONCLUSIONS Psychosocial interventions for former child soldiers may be more effective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended.

The relationship of perceived flexibility, supportive work–life policies, and use of formal flexible arrangements and occasional flexibility to employee engagement and expected retention

This study examines the relationship of perceived workplace flexibility and supportive work–life policies to employee engagement and expectations to remain with the organization (expected retention). It also explores the association of formal and occasional (informal) use of flexibility with these outcomes. Data are from a multi-organization database created by WFD Consulting of studies conducted between 1996 and 2006. Results revealed that perceived flexibility and supportive work–life policies were related to greater employee engagement and longer than expected retention. Employee engagement fully mediated the relationship between perceived flexibility and expected retention and partially mediated the relationship between supportive work–life policies and expected retention. Both formal and occasional use of flexibility were positively associated with perceived flexibility, employee engagement, and expected retention. These analyses provide evidence that workplace flexibility may enhance employee engagement, which may in turn lead to longer job tenure.

Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intentions to leave at 26 representative U.S. medical schools.

Purpose Vital, productive faculty are critical to academic medicine, yet studies indicate high dissatisfaction and attrition. The authors sought to identify key personal and cultural factors associated with intentions to leave one’s institution and/or academic medicine. Method From 2007 through early 2009, the authors surveyed a stratified random sample of 4,578 full-time faculty from 26 representative U.S. medical schools. The survey asked about advancement, engagement, relationships, diversity and equity, leadership, institutional values and practices, and work–life integration. A two-level, multinomial logit model was used to predict leaving intentions. Results A total of 2,381 faculty responded (52%); 1,994 provided complete data for analysis. Of these, 1,062 (53%) were female and 475 (24%) were underrepresented minorities in medicine. Faculty valued their work, but 273 (14%) had seriously considered leaving their own institution during the prior year and 421 (21%) had considered leaving academic medicine altogether because of dissatisfaction; an additional 109 (5%) cited personal/family issues and 49 (2%) retirement as reasons to leave. Negative perceptions of the culture—unrelatedness, feeling moral distress at work, and lack of engagement—were associated with leaving for dissatisfaction. Other significant predictors were perceptions of values incongruence, low institutional support, and low self-efficacy. Institutional characteristics and personal variables (e.g., gender) were not predictive. Conclusions Findings suggest that academic medicine does not support relatedness and a moral culture for many faculty. If these issues are not addressed, academic health centers may find themselves with dissatisfied faculty looking to go elsewhere.

Exploring the relationship of workplace flexibility, gender, and life stage to family-to-work conflict, and stress and burnout

This study explores how the reported use and perceived value of five workplace flexibility options differ by gender and life stage. It also examines the relationship of perceived workplace flexibility, gender, and life stages to family-to-work conflict and stress and burnout. Data are from a multi-company database created by WFD Consulting containing the results of studies conducted in multiple organizations between 1996 and 2006. Results revealed a curvilinear relationship in differences between men and women in the use of workplace flexibility options over the life course. Hierarchical linear modeling (HLM) revealed that perceived flexibility consistently predicted less family-to-work conflict and less stress and burnout. Gender (being female) was also modestly associated with greater family-to-work conflict and greater stress and burnout. The addition of life stage variables significantly increased the proportion of the variance explained in family-to-work conflict and stress and burnout. The addition of the interaction of life stage and gender significantly increased the proportion of the variance explained in family-to-work conflict but not in stress and burnout. These results support the idea that gender, life stage, and their interactions are important variables in research related to workplace flexibility.