The association between pain-related factors and psychological distress in patients with temporomandibular disorder.

Chronic pain is associated with high levels of psychological distress, which can have implications for general functioning, acceptance, quality of life, and compliance with health-promoting behaviour. This study explored the association between pain-related factors and psychological distress in a sample of patients with long lasting temporomandibular disorder (TMD). In this cross-sectional study design, psychological distress was measured in 133 Norwegian patients with long lasting and severe TMD. Participants completed a survey including the hospital anxiety and depression scale (HADS), and questions about pain intensity, pain duration, catastrophizing, and causal attributions of their TMD symptoms along with a clinical interdisciplinary investigation. Higher levels of catastrophizing were associated with psychological distress. Pain intensity was associated with psychological distress in the unadjusted model, but not when controlling for the other variables. The majority attributed their TMD symptoms to physical factors. The findings support psychological interventions aimed at reducing catastrophizing in treatment of TMD. However, the patients emphasized physical causes for their TMD symptoms, suggesting that psychological interventions alone are not sufficient. The findings support a multidisciplinary approach to the treatment of TMD.

Objectively measured physical activity among treatment seeking children and adolescents with severe obesity and normal weight peers.

Background: Treatment seeking children and adolescents with severe obesity often experience barriers to physical activity. Studies objectively measuring physical activity in this group and investigating explanatory factors for physical activity levels could inform clinical practice. Objectives: This study aimed to compare objectively measured physical activity levels among treatment seeking children and adolescents with severe obesity and normal weight peers, and to investigate explanatory factors for time spent in moderate physical activity and vigorous physical activity among children and adolescents with severe obesity. Methods: Children with severe obesity (n = 85) were matched 1:1 by age, gender, and the season for accelerometer measurements with normal weight peers (n = 85). Children wore accelerometers for seven consecutive days, yielding measures of physical activity, sleep duration and timing. Parents reported on screen time, parental body mass index and participation in organized sports. Results: Children and adolescents with severe obesity spent significantly less time in moderate physical activity (12 min, p < 0.001) and vigorous physical activity (21 min, p < 0.001) per day compared to normal weight peers. No difference for time spent in sedentary activity was found between groups. For participants with severe obesity, age ≤12 years (p = 0.009) and participation in organized sports (p = 0.023) were related to more moderate physical activity, while age ≤12 years (p = 0.038) and early sleep timing (p = 0.019) were related to more vigorous physical activity. Conclusion: Children and adolescents with severe obesity were less physically active than their normal weight peers. Factors related to more moderate and vigorous physical activity in children with severe obesity were lower age, participation in organized sports and earlier sleep timing.

Family-based treatment of children with severe obesity in a public healthcare setting: Results from a randomized controlled trial.

To compare the effectiveness of family-based behavioural social facilitation treatment (FBSFT) versus treatment as usual (TAU) in children with severe obesity. Parallel-design, nonblinded, randomized controlled trial conducted at a Norwegian obesity outpatient clinic. Children aged 6-18 years referred to the clinic between 2014 and 2018 were invited to participate. Participants were randomly allocated using sequentially numbered, opaqued, sealed envelopes. FBSFT (n = 59) entailed 17 sessions of structured cognitive behavioural treatment, TAU (n = 55) entailed standard lifestyle counselling sessions every third month for 1 year. Primary outcomes included changes in body mass index standard deviation score (BMI SDS) and percentage above the International Obesity Task Force cut-off for overweight (%IOTF-25). Secondary outcomes included changes in sleep, physical activity, and eating behaviour. From pre- to posttreatment there was a statistically significant difference in change in both BMI SDS (0.19 units, 95% confidence interval [CI]: 0.10-0.28, p < .001) and %IOTF-25 (5.48%, 95%CI: 2.74-8.22, p < .001) between FBSFT and TAU groups. FBSFT participants achieved significant reductions in mean BMI SDS (0.16 units, (95%CI: -0.22 to -0.10, p < .001) and %IOTF-25 (6.53%, 95% CI: -8.45 to -4.60, p < .001), whereas in TAU nonsignificant changes were observed in BMI SDS (0.03 units, 95% CI: -0.03 to 0.09, p = .30) and %IOTF-25 (-1.04%, 95% CI: -2.99 to -0.90, p = .29). More FBSFT participants (31.5%) had clinically meaningful BMI SDS reductions of ≥0.25 from pre- to posttreatment than in TAU (13.0%, p = .021). Regarding secondary outcomes, only changes in sleep timing differed significantly between groups. FBSFT improved weight-related outcomes compared to TAU.

Avoidance coping mediates the effect of hardiness on mental distress symptoms for both male and female subjects.

The personality disposition hardiness has been shown to be associated with adaptive coping strategies and is considered an important protective factor against development of mental health symptoms. One of the criticisms found in the hardiness literature concerns the question whether the construct is equally important for men and women. Using a prospective design in a moderated mediation model, regression analyses were performed to examine the effect of avoidance coping in the association between hardiness and mental distress. The effect of biological sex was examined in the association between hardiness and avoidance coping. Our sample included 410 civilian personnel employed in a military organization. The results showed that higher hardiness levels were associated with lower reported use of avoidance coping, which in turn was associated with lower levels of distress symptoms. Avoidance coping mediated the effect of hardiness on anxiety symptoms and this indirect effect was not moderated by biological sex. These results indicate that hardiness operates similarly for women and men as a factor influencing mental distress symptoms.

Beyond sleep duration: Sleep timing as a risk factor for childhood obesity.

BACKGROUND: Ample evidence attests to the relationship between short sleep duration, sleep problems and childhood obesity. However, few studies have examined the association between sleep timing and obesity in children. OBJECTIVES: To investigate how sleep duration, problems and timing relate to obesity and obesogenic behaviours in children. METHODS: Eighty-five children (58.8% girls) with severe obesity and mean (SD) age of 12.1 (2.9) years, were matched by age and sex with peers with normal weight (n = 85,12.0 [2.8] years). Sleep and moderate-to-vigorous physical activity (MVPA) were measured via accelerometer for seven consecutive days. Children self-reported emotional eating on the Dutch eating behavior questionnaire. Parents reported children's screen time and sleep problems. RESULTS: Children with severe obesity had significantly later mean mid-sleep time, overall (36 minutes later, P < .001), on school nights (36 minutes later, P < .001) and weekend nights (39 minutes later, P = .002) compared to children with normal weight. Children with obesity had more sleep problems (P = .030), but no differences emerged in sleep duration or social jetlag. After adjusting for demographic factors, mid-sleep time was positively related to screen time (P = .030). Mid-sleep time and sleep duration were inversely related to time in MVPA (Ps ≤ .041). There were no other significant associations between the sleep variables and the obesogenic behaviours. CONCLUSIONS: Later sleep timing was related to obesogenic behaviours in children and may represent an obesity risk factor.

The Dimensionality of the 12-Item General Health Questionnaire (GHQ-12): Comparisons of Factor Structures and Invariance Across Samples and Time.

Because of its brevity, the 12-item General Health Questionnaire (GHQ-12) has become one of the most popular and used measure for detecting psychological distress. Originally intended as a unidimensional measure, the majority of subsequent factor-analytic studies have failed to support GHQ-12 as a unitary construct and have instead proposed a plethora of multidimensional structures. In this study, we further examined the factor structure in two different military samples, one consisting of crewmembers from four different frigates deployed in anti-piracy operations and Standing NATO Maritime Group deployments (N = 591) and one consisting of crewmember from three different minehunters/sweepers serving in Standing NATO Mine Counter-Measures Group deployments (N = 196). Results from confirmatory factor analyses (CFA) performed in the first sample supported a bifactor model, consisting of a general factor representing communality among all items and two specific factors reflecting common variance due to wording effects (negatively and positively phrased items). A multi-group CFA further confirmed this structure to be invariant across our second sample. Structural equation modeling also showed that the general factor was strongly associated with symptoms of insomnia and mental health, whereas the specific factors were either non-significantly or considerably weaker associated with the criterion variables. Overall, our results are congruent with the notion that the multidimensionality demonstrated in many previous investigations is most likely an expression of method-specific variance caused by item wording. The explained unique variance associated with these specific factors was further relatively small. Ignoring the multidimensionality and treating GHQ-12 as a unitary construct will therefore most likely introduce minimal bias to most practical applications.

A Randomized Controlled Trial of Concentrated ERP, Self-Help and Waiting List for Obsessive- Compulsive Disorder: The Bergen 4-Day Treatment.

BACKGROUND: The Bergen 4-day treatment (B4DT) is a concentrated exposure-based treatment for patients with Obsessive-Compulsive Disorder (OCD) delivered during four consecutive days. The B4DT has in a number of effectiveness studies demonstrated promising results as approximately 90% of patients gain reliable clinical change post-treatment and nearly 70% are recovered on a long-term basis. METHODS: The current study is the first randomized controlled trial evaluating the effects of the B4DT. Forty-eight patients diagnosed with OCD were randomized to B4DT, self-help (SH), or waiting list (WL) with 16 patients in each condition. All participants randomized to the B4DT underwent the treatment without any attrition. RESULTS: The B4DT yielded significantly better effects than control conditions on measures of OCD, depression, and generalized anxiety. The response rate (≥35% reduction of the individual patient's pre-treatment Y-BOCS score) was 93.8% in B4DT, 12.5% in SH and 0% in WL, while remission rate (response criterion is fulfilled and the post-treatment Y-BOCS score is ≤12 points) was 62.5%, 6.3%, and 0%, respectively. Furthermore, patients who had received the B4DT, showed improved work- and social functioning. None of the patients treated with B4DT showed signs of deterioration. In comparison, one patient in the SH condition was in remission, and one showed significant clinical improvement, whereas the remaining showed no change. CONCLUSION: The results indicate that the B4DT is an effective treatment for patients suffering from OCD. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT02886780.

Trust After Just 45 Seconds? An Experimental Vignette Study of How Leader Behavior and Emotional States Influence Immediate Trust in Strangers.

Many critical and unexpected situations are handled by people that have never met. In the literature, development of immediate trust has been identified as a prerequisite for such temporary groups and leadership to function well. Limited experimental research has studied what leadership stimulates immediate trust between strangers. The present study investigate how four leadership styles, combining autocratic or democratic leadership behavior with low or high emotional stability, is related to immediate trust in a leader displayed through a 45-s video vignette of a car accident. A sample of 280 adults, randomly assigned to one of four conditions (1, autocratic/stable; 2, autocratic/unstable; 3, democratic/stable; 4, democratic/unstable) rated immediate trust after watching the vignette. The results show that autocratic and emotionally stable leaders were on average rated higher on immediate trust than all other leadership styles, after controlling for generalized trust.

Hardiness, avoidance coping, and alcohol consumption in war veterans: A moderated-mediation study.

Military personnel often engage in excessive alcohol use after returning from deployments. Thus far, research has paid scant attention to personality factors that may increase or diminish the risk for increased alcohol consumption in this population. The present study explores how psychological hardiness, avoidance coping, and stress exposure may interact to influence alcohol consumption patterns in soldiers following deployment. U.S. Army National Guard soldiers (N = 357) were surveyed shortly after returning from combat operations in Afghanistan. Conditional process analysis was used to test for mediation and moderation effects. Mediation effects were further tested in a replication sample of Norwegian Army soldiers (N = 230) deployed to Kosovo. Findings show that hardiness is a significant (negative) predictor of increased alcohol use and that this relation is mediated by avoidance coping. Further, this effect was moderated by combat stress exposure in the U.S. sample, such that the mediation is stronger for those with greater exposure (moderated-mediation). Avoidance coping also mediated the effects of hardiness on alcohol consumption in the Norwegian sample. These findings suggest that avoidance coping and hardiness may be fruitful areas for interventions aimed at reducing risky drinking in high-stress groups like the military.

Sleep and Fatigue Among Seafarers: The Role of Environmental Stressors, Duration at Sea and Psychological Capital.

BACKGROUND: Seafaring is an inherently stressful environment. Because working time and leisure time is spent in the same confined environment for a prolonged period of time, many stressors present in seafaring can also be conceived of as chronic. We explored the effects of duration at sea, seafaring experience, environmental stressors, and psychological capital (PsyCap) on the sleep quality and fatigue of seafarers. PsyCap is a construct that draws upon ideas from positive psychology and positive organizational behavior, and is intended to capture an individual's psychological capacities that can be developed and utilized for performance improvements. METHODS: We collected survey data from a sample of seafarers working in the offshore re-supply industry (n = 402) and a sample of seafarers working on board combined passenger and cargo ships (n = 340). RESULTS: PsyCap emerged as a robust predictor with statistically significant relations to fatigue and sleep quality in both samples. PsyCap also interacted with duration at sea in explaining fatigue in seafarers working on board the passenger and cargo ships. Seafarers on passenger and cargo ships also reported significantly higher levels of fatigue than those working in the offshore re-supply industry. CONCLUSION: Coupled with emerging research showing that PsyCap is trainable, our results suggest that maritime organizations could have much to gain by being cognizant of and developing routines for continually developing the PsyCap of their employees.

The combined influence of hardiness and cohesion on mental health in a military peacekeeping mission: A prospective study.

A large number of studies have shown that hardiness and cohesion are associated with mental health in a military context. However, most of them are presented without controlling for baseline mental health symptoms, which is their most significant source of error. The present study investigates the combined effect of hardiness and cohesion in a prospective design, controlling for baseline levels of symptoms among Norwegian personnel serving in a peacekeeping operation in Kosovo. Multivariate regression analyses were performed in which self-reported mental health complaints were regressed on our explanatory variables. Our findings suggest that both cohesion and hardiness contributed to increased stress resiliency, as measured by a lower level of reported mental health complaints. Our baseline measure of mental health accounted for a larger proportion of the variance than our other predictors. A significant interaction between cohesion and hardiness suggested a combined effect, over and above the individual contributions of the predictors. For individuals who scored high on hardiness, cohesion levels did not influence levels of mental health complaints. Individuals who scored low on hardiness, on the other hand, reported lower levels of mental health complaints when cohesion levels were high.

Distributed situation awareness in complex collaborative systems: A field study of bridge operations on platform supply vessels.

This study provides empirical data about shipboard practices in bridge operations on board a selection of platform supply vessels (PSVs). Using the theoretical concept of distributed situation awareness, the study examines how situation awareness (SA)-related information is distributed and coordinated at the bridge. This study thus favours a systems approach to studying SA, viewing it not as a phenomenon that solely happens in each individual's mind but rather as something that happens between individuals and the tools that they use in a collaborative system. Thus, this study adds to our understanding of SA as a distributed phenomenon. Data were collected in four field studies that lasted between 8 and 14 days on PSVs that operate on the Norwegian continental shelf and UK continental shelf. The study revealed pronounced variations in shipboard practices regarding how the bridge team attended to operational planning, communication procedures, and distracting/interrupting factors during operations. These findings shed new light on how SA might decrease in bridge teams during platform supply operations. The findings from this study emphasize the need to assess and establish shipboard practices that support the bridge teams' SA needs in day-to-day operations. PRACTITIONER POINTS: Provides insights into how shipboard practices that are relevant to planning, communication and the occurrence of distracting/interrupting factors are realized in bridge operations.Notes possible areas for improvement to enhance distributed SA in bridge operations.

Cross-language consistency of the Comprehensive Assessment of Psychopathic Personality (CAPP) model.

This study is the first to our knowledge to examine the cross-language consistency across the original version of the Comprehensive Assessment of Psychopathy (CAPP) and a translated version. The CAPP is a lexically based construct map of psychopathy comprising 33 symptoms from 6 broad domains of personality functioning. English-language CAPP prototypicality ratings from 124 mental health workers were compared with ratings from 211 Norwegian mental health workers using the Norwegian translation. High agreement was found across languages in regard to which symptoms where perceived as central to psychopathy or not. Multigroup confirmatory factor analyses (MGCFA) indicated that, overall, the symptoms had similar associations with the 6 proposed underlying dimensions across the 2 language versions. Finally, in general, the probability for a given prototypicality rating on an individual symptom was similar across language version samples at the same level of the underlying trait, as analyzed with Item Response Theory (IRT). Together these findings lend support to the validity of the construct of psychopathy, the validity of the CAPP as a concept map of psychopathy, and the validity of the Norwegian translation of the CAPP.

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate.

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents.

Fatigue in seafarers working in the offshore oil and gas re-supply industry: effects of safety climate, psychosocial work environment and shift arrangement.

This study examined the influence of safety climate and psychosocial work environment on the reported fatigue of seafarers working in the offshore oil and gas re-supply industry (n = 402). We found that seafarers who reported high psychological demands and perceived the organisational-level safety climate negatively,reported significantly more mental fatigue, physical fatigue, and lack of energy. In addition, seafarers who reported having high levels of job control reported being significantly less mentally fatigued. We also found some combined effects of safety climate and shift arrangement. Organisational-level safety climate did not influence the levels of physical fatigue in seafarers working on the night shift. On the contrary, seafarers working during the days reported to be more physically fatigued when they perceived the organisational-level climate to be negative compared with the positive. The opposite effect was found for group-level safety climate: seafarers working during the nights reported to be more physically fatigued when they perceived the group-level climate to be negative compared with the positive. The results from this study point to the importance of taking into consideration aspects of the psychosocial work environment and safety climate,and their potential impact on fatigue and safety in the maritime organisations.

Psychological hardiness and coping style as risk/resilience factors for alcohol abuse.

Alcohol abuse is a growing problem in the military, and a costly one. The present study evaluates the potential role of psychological hardiness, an individual resilience resource, to stress-related problem drinking in a military population. We assess the association of psychological hardiness and avoidance coping style with alcohol use patterns in a large national sample of Norwegian military defense personnel. Results show that low hardiness and high avoidance coping are significant predictors of alcohol abuse. Also, the challenge facet of hardiness predicts risk of alcohol abuse among respondents with recent deployment experience, and this effect is greater for those with harsh deployment experiences. Older defense workers are also at higher risk, suggesting cumulative occupational stress may take a toll. This research indicates that hardiness and avoidance coping measures may serve as useful adjunct screening tools for alcohol abuse in the military.

Psychometric properties of a four-component Norwegian Organizational Justice Scale.

Organizational justice has attracted attention as a predictor of employees' mental and physical health as well as commitment and work outcomes. The lack of a Norwegian translation of an organizational justice scale has precluded its use in Norway. Four dimensions of the organizational justice construct were examined in a Norwegian military context, including facet measures of distributional, interpersonal, and informational justice developed by Colquitt in 2001, in addition to procedural justice developed by Moorman in 1991. Confirmatory factor analyses supported a four-dimensional structure with good internal consistency. Follow-up analyses have suggested that the four dimensions were nested beneath a general, latent organizational justice factor. A positive relationship between organizational justice and self-sacrificial behavior was found, indicating satisfactory construct validity. The results demonstrate that the Norwegian Organizational Justice Scale is a reliable and construct-valid measure of organizational justice in a Norwegian setting.

Effects of psychological hardiness, job demands, and job control on sickness absence: a prospective study.

This study prospectively investigated the effects of psychological hardiness, job control, and job demands on medically certified sickness absence. Data from a questionnaire survey were combined with archival data for sickness absence among 7,239 civilian and military employees of the Norwegian Armed Forces (84.3% male, 69.8% military). A 2-component hurdle regression was used in the statistical analyses of the sickness absence data. After controlling for age, sex, and baseline absence, hardiness predicted both the likelihood of having any sickness absence (odds ratio = 0.97) and the number of absence spells (a 6.5% decrease in the expected count for 1 standard deviation change in hardiness). In addition, an interaction was found among hardiness, job control, and psychological demands. When demands were high, high job control was associated with more absence among employees with low levels of hardiness. Together, these findings point to hardiness as an important individual resource in relation to health, and that it is necessary to consider individual differences when examining the effects of work characteristics.

An exploratory study of differences in emotional intelligence in U.S. and Norwegian undergraduate students.

The present study explored sex and cultural differences in Emotional Intelligence scores in samples from Norway (n = 297) and the United States (n = 234). Significant main effects for sex were found in overall Emotional Intelligence scores and the Empathy factor. In addition, results revealed a small but significant effect for culture in the Self-control factor, as well as support for an interaction between sex and culture in the Handling Relationships factor. The results are discussed in light of cultural differences between U.S. and Norwegian societies.