Annual Research Review: What is resilience within the social ecology of human development?

BACKGROUND:   The development of Bronfenbrenner's bio-social-ecological systems model of human development parallels advances made to the theory of resilience that progressively moved from a more individual (micro) focus on traits to a multisystemic understanding of person-environment reciprocal processes. METHODS:   This review uses Bronfenbrenner's model and Ungar's social-ecological interpretation of four decades of research on resilience to discuss the results of a purposeful selection of studies of resilience that have been done in different contexts and cultures. RESULTS:   An ecological model of resilience can, and indeed has been shown to help researchers of resilience to conceptualize the child's social and physical ecologies, from caregivers to neighbourhoods, that account for both proximal and distal factors that predict successful development under adversity. Three principles emerged from this review that inform a bio-social-ecological interpretation of resilience: equifinality (there are many proximal processes that can lead to many different, but equally viable, expressions of human development associated with well-being); differential impact (the nature of the risks children face, their perceptions of the resources available to mitigate those risks and the quality of the resources that are accessible make proximal processes more or less influential to children's development); and contextual and cultural moderation (different contexts and cultures provide access to different processes associated with resilience as it is defined locally). CONCLUSION:   As this review shows, using this multisystemic social-ecological theory of resilience can inform a deeper understanding of the processes that contribute to positive development under stress. It can also offer practitioners and policy makers a broader perspective on principles for the design and implementation of effective interventions.

Birth weight, domestic violence, coping, social support, and mental health of young Iranian mothers in Tehran.

The aim of this study was to investigate associations of birth weight with sociodemographic variables, domestic violence, ways of coping, social support, and general mental health of Iranian mothers. Six hundred mothers aged 15 to 29 years participated between June 2009 and November 2010. t-Test, analysis of variance, Spearman's correlation, and multiple regression were used. The results showed that there was no significant association between birth weight and general mental health of the mothers. Prenatal care visits, the mothers' history of having children with low birth weight (LBW), and weight gain during pregnancy were significantly associated with birth weight. The women who reported physical abuse during pregnancy had infants with lower birth weight. Satisfaction with social support and use of positive reappraisal were significantly associated with higher birth weight. In conclusion, a high quality of prenatal care and screening of pregnant women are recommended. Social environments good enough during pregnancy have protective effects against LBW.

Being a top cop in pursuit of a sustainable lifestyle.

Previous research has widely recognized the challenges uniformed police officers face in their working lives. However, little is known about the overall lifestyles of police officers, including what they do in private life. We interviewed 17 officers and used reflexive thematic analysis to explore their experiences. The study sheds light on how uniformed police officers navigate the intersection between their private and professional lives, as well as how their professional role impacts their day-to-day doings and private life roles. The key findings relate to how the demands of their professional role impact their private life, such as the profession becoming a way of life. Furthermore, they highlight the challenges of avoiding certain environments where they might be recognized as police officers. It also entails balancing energy levels in work and private life, as well as how their profession's unpredictability affects their daily routines and roles. The findings also show how their personal choices in private life are frequently influenced by their professional role. The study's findings have theoretical as well as practical implications, contributing to a better understanding of uniformed police officers' challenges and resources for a sustainable and healthy lifestyle.

How police officers juggle work, a life partner, and kids.

Police officers frequently encounter stressful social situations during their working days. Furthermore, previous research on policing and families show that police officers' families are impacted in different ways when at least one member of the family has the role of a police officer. Despite work spilling over to family life there is currently little research on police officers' role-balancing. Thus, the purpose of this study was to explore and describe the challenges that arise at the intersection between police officers' professional roles and their private life roles as parents and life partners, as well as how police officers balance these roles in between. We used qualitative content analysis after interviewing 13 uniformed police officers. The findings show how the police officers' professional roles affect their private life roles within three different sub-themes and are summarized under the theme of "Balancing conflicting roles: Coping with professional and private life commitments". The theme revolves around the various challenges of working as a uniformed police officer, such as hypervigilance and risks, as well as the enrichments and conflicts of working shifts while also juggling private life roles. The results also touch on gender and equality in life-partner relationships. The study raises an important question about how these challenges can be mitigated within Police authorities to enable uniformed police officers to balance their professional and personal lives in a healthy and sustainable manner.

Life contexts among patrolling police officers in the European Union, investigating environmental characteristics and health - A protocol for a scoping review and a systematic review.

INTRODUCTION: The police officer occupation is a high-risk profession, with significantly more traumatic and stressful events than other occupations. Key factors for the health of police officers have been found to be related to intra-interpersonal, occupational, and organizational factors. However, the mechanisms underlying why is inconclusive. This protocol therefore intends to explain the approach for conducting both a scoping review, and systematic review. The overall aim of the reviews is to investigate patrolling police officers' life contexts with the intention to identify barriers and resources that affect their lifestyle and health. METHODS: The protocol is reported according to the PRISMA-P guidelines, with PROSPERO number: CRD42020190583. Searches will be carried out in SCOPUS, Web of Science, PubMed, OpenGrey, and EBSCO (Academic Search Premiere, APA PsychINFO, CINAHL, SocINDEX). Two independent raters will screen articles and conduct the critical appraisal. Analyses include Arksey and O'Malley's methodology for the scoping review, and a narrative synthesis for the systematic review, including critically appraising the total body of evidence in the systematic review. DISCUSSION: The purpose of the reviews is to understand patrolling police officers' life contexts, and support future development of an assessment that measures patrolling police officers' life balance from a contextual viewpoint.

Exploring the life contexts of patrolling police officers in the European Union - A scoping review.

BACKGROUND: Patrolling police officers engage in different mentally, socially, and physically challenging life contexts which may affect their life and health. The aim of this scoping review is twofold, to explore life contexts of patrolling officers in the European Union, and to investigate how their lives and health are affected by environmental characteristics within these contexts. METHODS: The scoping review followed Arksey and O'Malley's methodology and included a critical appraisal. The environmental model within Kielhofner's Model of Human Occupation was used in the thematic analysis. The review was reported following PRISMA-ScR. RESULTS: In the 16 included studies, two contexts (where environments interact with persons on different levels) were discovered: the global and the immediate context. No local contexts were found. Primarily, research on the social, and occupational environments, including qualities identified in these environments were found. However, some environmental characteristics within patrolling officers' physical environments were also discovered. DISCUSSION: This review contributes to the emerging research area of police officers' life contexts, by mapping contexts and environments affecting their life and health. However, to get a deeper understanding of how officers are affected by their environments, interviewing them regarding how their different contexts affect their everyday living, would be important.

A systematic review of lifestyle and health among patrolling police officers.

BACKGROUND: The police profession is a high-strain and high-risk profession, sometimes resulting in poor physical, mental and social health. This systematic review aims to identify and describe crucial areas for a healthy and sustainable lifestyle among patrolling police officers in Europe, an area not previously studied. METHODS: The review was conducted according to the PRISMA guidelines. A protocol was published and registered with PROSPERO beforehand. Searches were carried out in eight databases. Two independent authors screened articles and critically appraised the included studies. A narrative synthesis was conducted to analyse the results. The review's total body of evidence was assessed with GRADE-CERQaul. RESULTS: A total of 16 articles were located, representing 13 studies. Barriers and resources for a healthy and sustainable lifestyle were linked to a theoretical framework of life balance. Subsequently, a linkage model was created to explain different aspects of patrolling police officers' life balance and its relation to health (physical, social and mental). CONCLUSIONS: Several crucial areas for a healthy and sustainable lifestyle were found and described, indicating that patrolling officers' working life affects their possibilities of living a balanced lifestyle, which might disturb different aspects of health, depending on which aspect is compromised.

A comparative study of stress experienced by Swedish and Norwegian police officers.

Introduction: Police officers work in a variable environment under different circumstances and often involves stressful situations. This include working irregular hours, ongoing exposure to critical incidents, confrontations and violence. community police officers are mainly out in the society and have daily contact with the general public. critical incidents can also consist of being criticized and stigmatized as a police officer, both from the public but also lack of support from their own organization. There is evidence on negative impacts of stress on police officers. However, knowledge about the nature of police stress and its various types is insufficient. It is assumed that there are common stress factors which are universal among all police officers in different contexts but there is a lack of comparative studies to provide empirical evidence. The aim of this study is to compare different types of stress among police officers in Norway and Sweden and how the pattern of experiencing stress has changed over time in these countries. Methods: The study population consisted of patrolling police officers from 20 local police districts or units in all seven regions in Sweden (n = 953) and patrolling police officers from four police districts in Norway (n = 678). A 42-item Police Stress Identification Questionnaire was used to measure the stress level. Results: The findings show differences in types of stressful events as well as its severity among police officers in Sweden and Norway. The level of stress decreased over time among Swedish police officers whereas it showed no change or even an increase among the Norwegian participants. Discussion: The results of this study are relevant for policy-makers, police authorities and lay police officers in each country to tailor their efforts to prevent stress among police officers.

Job satisfaction among Swedish police officers: The role of work-related stress, gender-based and sexual harassment.

The aim of this cross-sectional study is to increase our understanding of job satisfaction in Swedish police officers by taking into account work-related stress, and sexual and gender-based harassment. Data were collected from 152 police officers working in vulnerable areas in Stockholm using sociodemographic questions, the Police Stress Identification Questionnaire (PSIQ), Sexual and gender-based harassment questions, and Job Descriptive Index (JDI). The obtained results indicated that male and female police officers reported the highest satisfaction in "people on your present job." The lowest score of job satisfaction in both male and female police officers was related to "opportunity for promotion" and then "pay." There were no significant differences in the subscales of job satisfaction between male and female police officers. The older and more experienced officers, the less satisfaction was reported in "job in general" and more satisfaction reported in "pay." Comparing job satisfaction between patrol officers and those officers who worked in internal services showed police patrol officers had higher job satisfaction in "job in general," "work in the present job," "opportunity for promotion" and "supervision" compared to their counterparts in internal services. There were not any significant differences between the subscales of job satisfaction between male and female police officers. There was not any significant association between job satisfaction subscales and having experience of sexual or gender-based harassment. Among various subscales of police stressors, organizational stress was in negative relation with three domains of job satisfaction; "job in general," "pay" and "supervision." Also, hierarchical multiple regression analyses showed organizational stress was most often of predictive impact related to various job satisfaction domains in police officers.

Testing the WHO responsiveness concept in the Iranian mental healthcare system: a qualitative study of service users.

BACKGROUND: Individuals' experience of interacting with the healthcare system has significant impact on their overall health and well-being. To relate patients' experiences to a common set of standards, the World Health Organization (WHO) developed the concept of health system responsiveness. This study aimed to assess if the WHO responsiveness concept reflected the non-medical expectations of mental healthcare users in Teheran. METHODS: In this qualitative study, four mixed focus group discussions were formed, comprising 53 mental health service users in Tehran, Iran, in 2010. Content analysis was performed for data analysis. Responses were examined in relation to the eight domains of the WHO's responsiveness model. RESULTS: There were many commonalities between the findings of this study and the eight domains of the WHO responsiveness model, although some variations were found. Effective care was a new domain generated from our findings. In addition, the domain of prompt attention was included in two new labelled domains: attention and access to care. Participants could not differentiate autonomy from choice of healthcare provider, believing that free choice is part of autonomy. Therefore these domains were unified under the name of autonomy. The domains of quality of basic amenities, access to social support, dignity and confidentiality were considered to be important for the responsiveness concept. Some differences regarding how these domains should be defined were observed, however. CONCLUSIONS: The results showed that the concept of responsiveness developed by the WHO is applicable to mental health services in Iran. These findings might help policy-makers' better understanding of what is useful for the improvement of mental health services.

Trajectories of Mental Health Status Among Police Recruits in Sweden.

BACKGROUND: The stressful and complex nature of police work and its adverse effects on mental health are well-documented in police research. The mental health of police students however, has not been given the same attention. To the best of our knowledge, studies on the mental health of Swedish police recruits have not been undertaken since 2010. OBJECTIVES: The present study aims to examine whether there are differences in the mental health between two cohorts (2009 and 2020) of Swedish police recruits, as well as to compare the mental health of both cohorts with the general population data collected in 2002. METHODS: Data was collected using the SCL-90-R survey. Data was analyzed using multivariate analysis of variance (MANOVA) and independent sample T-tests. Bi-variate analyses including t-test and chi-square were used to examine differences in sociodemographic variables between the two cohorts. RESULTS: A total of 376 police recruits participated in the study. Results indicated no significant differences between the cohorts with regards to the three global indices of the SCL-90-R: Global Severity Index (GSI), Positive Symptom Total (PST), and Positive Symptom Distress Index (PSDI). Recruits with a college degree had lower scores on GSI and PSDI, similar to respondents that where in a relationship vs. singles. A total of 15 (four female) recruits had GSI scores above the Swedish patient mean. Compared with the general population, males and females from the 2009, as well as females from the 2020 cohorts had lower or insignificantly different mean scores on all global indices, with males from the 2020 cohort having a significantly lower PST score. CONCLUSIONS: While the vast majority of recruits had results that where indicative of a low prevalence and intensity with regards to mental health disorders, some recruits did score above the Swedish patient mean. While mental preparedness is part of the curriculum for Swedish police recruits, interventions targeting the stigmas of poor mental health could be of value. The fact that educational attainment appears to have a positive impact on the mental health of police recruits, could be taken in to consideration when recruiting future police officers.

Continuity from suicidal ideations to suicide attempts? An investigation in 18-55 years old adult Iranian Kurds.

OBJECTIVES: Suicidal ideation as a critical point for the identification of individuals at risk of committing suicide/attempting suicide. METHODS: Cross-sectional study; random sample; n = 1,000; attitudes towards Suicide questionnaire. RESULTS: Iranian Kurds reported very few suicide attempts, whereas the prevalence of reported suicidal thoughts was found to be very high. The reported frequency of suicidal thoughts and the number of suicide attempts during the last year was significantly higher than that from earlier in life. CONCLUSIONS: A continuum of suicidal behaviour is supported; but, this did not include self-reported suicide attempts. The reported frequency of suicidal thoughts and suicide attempts was highly dependent on applied response categories and the considered timeframe, which has to be considered thoroughly when interpreting related results.

Age and gender differences in the use of various poisoning methods for deliberate parasuicide cases admitted to loghman hospital in Tehran (2000-2004).

Different methods of poisoning used by individuals with the diagnosis of parasuicide admitted to the Loghman Hospital, Tehran, from 2000 to 2004 were investigated, with particular focus on gender and age differences. Drugs, pesticides, and other agricultural chemicals (women: 12.7%, men: 9%) were the most commonly used methods. In males, the percentage of use of drugs increased with age, but the frequency of pesticides use decreased with age. In females, drugs were most often used in the youngest age group, whereas the use of pesticides was lowest in the youngest age category. Females outnumbered males, especially in the youngest age group of 10 to 19 years olds. Drugs and pesticides were the substances used most often for parasuicide in each age group regardless of gender.

Personality of South African police trainees.

There have been efforts to identify a "police personality" based on dispositional and socialization models. Personality traits of successful police applicants at the Police College in Pretoria, South Africa (N = 1,145 police trainees), with regard to sex, ethnic group, and English language reading skills, were described in terms of scores on the Temperament and Character Inventory. South African police trainees generally evaluated themselves as substantially lower in Novelty Seeking and Harm Avoidance combined with lower Cooperativeness, but they scored much higher on Self-Directedness, Persistence, and Self-Transcendence compared to South African university students from the same area. These are characteristics expected from future police officers, which supports the dispositional model.

An Iranian (Farsi) version of the Temperament and Character Inventory: a cross-cultural comparison.

The Temperament and Character Inventory is a widely used personality questionnaire. It was developed to measure the four temperament dimensions of Novelty Seeking, Harm Avoidance, Reward Dependence, and Persistence, as well as three character dimensions, such as Self-directedness, Cooperativeness, and Self-transcendence, described in Cloninger's unified biosocial theory of personality. In a sample of 300 Germans, 300 Swedes, and 316 Iranian subjects, a factorial structure analysis using the Procrustes rotation method showed the structure of personality to be generally equivalent across cultures. Noteworthy cultural differences between the overall Asian and European subjects reflected by the data were observed in various Temperament and Character dimensions. Seemingly, there are cultural differences in the expression of the various personality facets that require a replacement of many items in the Iranian version. The Temperament and Character Inventory is sensitive to age, sex, and cultural differences in personality.

Gender differences in the association between cognitive social capital, self-rated health, and depressive symptoms: a comparative analysis of Sweden and Ukraine.

BACKGROUND: Social capital is one of the social determinants of health, but there is still a lack of studies comparing its significance for health in different cultural settings. This study investigates and compares the relations between individual cognitive social capital and depressive symptoms and self-rated health in Sweden and Ukraine for men and women separately. STUDY DESIGN: Two cross-sectional nationally representative surveys of adult populations were used for the analysis. Data from the Ukraine's World Health Survey and the Sweden's National Public Health Survey were analyzed in this comparative study. METHODS: The independent variable, cognitive social capital, was operationalized as institutional trust and feelings of safety. Depressive symptoms and self-rated health were used as the outcome variables. Crude and adjusted odds ratios and the 95 % confidence intervals were calculated using logistic regression. The model also adjusted for socio-demographic and lifestyle variables. RESULTS: Institutional trust is higher in Sweden compared to Ukraine (31 % of the Swedes vs. 12 % of the Ukrainians reported high trust to their national government/parliament). There is a strong association between self-rated health and institutional trust for both sexes in Sweden (odds ratio/OR = 1.99; 95 % CI = 1.58-2.50 for women and OR = 1.82, CI = 1.48-2.24 for men who reported low institutional trust compared with those with high institutional trust) but only for women (OR = 1.88, CI = 1.12-3.15) in Ukraine. Trust thus seems to be more important for self-rated health of women and men in Sweden compared to their counterparts in Ukraine. Significant associations between depressive symptoms and institutional trust were not observed in either country after adjusting for socio-demographic and lifestyle factors. A lack of feeling of safety increased the odds of having depressive symptoms among women (OR = 1.97, CI = 1.41-2.76) and men (OR = 3.91, CI = 2.19-6.97) in Sweden. The same association was observed for poor self-rated health among Swedish women (OR = 2.15, CI = 1.55-2.99) and men (OR = 2.75, CI = 1.58-4.80). In Ukraine, a lack of feeling of safety did not show any significant association with self-rated health or depressive symptoms for men, but it increased the odds of depressive symptoms among women (OR = 1.72, CI = 1.13-2.62). CONCLUSIONS: In general, individual cognitive social capital is higher in Sweden than in Ukraine, and there is a stronger association between cognitive social capital and self-rated health in Sweden than in Ukraine. Interventions aiming to increase cognitive social capital for health promoting purposes might be favorable in Sweden, but this is not evidently the case in Ukraine.

Unaccompanied Asylum-Seeking Refugee Children's Forced Repatriation: Social Workers' and Police Officers' Health and Job Characteristics.

During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working with unaccompanied asylum-seeking refugee children who are due for forced repatriation. In addition, the role of psychosocial job characteristics in such relationships was investigated. A questionnaire including sociodemographic characteristics, the Swedish Demand-Control-Support Questionnaire, and the 12-item General Mental Health Questionnaire were distributed nationally. Univariate and multivariable regression models were used. Poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for general mental health among social workers, while psychological job demand, decision latitude, and marital status were predictors among police officers. Findings are discussed with special regard to the context of social work and police professions in Sweden.

Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran.

As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care, and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Attention and access to care were responsiveness dimensions that performed poorly but were considered to be highly important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health-care systems to become more patient orientated and provide patients with more respect.

Reliability and validity of a Mental Health System Responsiveness Questionnaire in Iran.

BACKGROUND: The Health System Responsiveness Questionnaire is an instrument designed by the World Health Organization (WHO) in 2000 to assess the experience of patients when interacting with the health care system. This investigation aimed to adapt a Mental Health System Responsiveness Questionnaire (MHSRQ) based on the WHO concept and evaluate its validity and reliability to the mental health care system in Iran. DESIGN: In accordance with the WHO health system responsiveness questionnaire and the findings of a qualitative study, a Farsi version of the MHSRQ was tailored to suit the mental health system in Iran. This version was tested in a cross-sectional study at nine public mental health clinics in Tehran. A sample of 500 mental health services patients was recruited and subsequently completed the questionnaire. Item missing rate was used to check the feasibility while the reliability of the scale was determined by assessing the Cronbach's alpha and item total correlations. The factor structure of the questionnaire was investigated by performing confirmatory factor analysis (CFA). RESULTS: The results showed a satisfactory feasibility since the item missing value was lower than 5.2%. With the exception of access domain, reliability of different domains of the questionnaire was within a desirable range. The factor loading showed an acceptable unidimentionality of the scale despite the fact that three items related to access did not perform well. The CFA also indicated good fit indices for the model (CFI=0.99, GFI=0.97, IFI=0.99, AGFI=0.97). CONCLUSIONS: In general, the findings suggest that the Farsi version of the MHSRQ is a feasible, reliable, and valid measure of the mental health system responsiveness in Iran. Changes to the questions related to the access domain should be considered in order to improve the psychometric properties of the measure.

Marital satisfaction: the differential impact of social support dependent on situation and gender in medical staff in Iran.

Stress is unavoidable in everyday life and it can effect on marital relationship. Social support especially from emotionally closed persons as a protective factor can help individuals to deal with stress and buffers the negative effects of life stress on marital satisfaction. In the present cross-sectional study we investigated the relationship between social and spousal support and marital satisfaction in medical staff in Iran. Data collection was performed in 653 medical staff using socio-demographic questions, the ENRICH Marital Satisfaction Inventory, and the Social Support Questionnaire. Women and men did not differ in total social support satisfaction and the total number of supporting people; but, women were more often support providers for their husbands than men were for their wives. Spouse support was a more important indicator of marital satisfaction for women than for men. Also results revealed that spouse support is more important than social support from other resources to explain marital satisfaction. Job satisfaction had an explanatory effect on marital satisfaction especially in men. Furthermore, the findings showed that social support could decrease the explanatory impact of job satisfaction on scales of marital satisfaction. Therefore, focusing on social support, especially spouse support could be an effective approach in family counseling or family education programs to improve marital satisfaction in medical staff.