Self-stigma of incarceration and its impact on health and community integration.

BACKGROUND: Individuals returning to the wider community from incarceration face many re-entry barriers, including stigmatising beliefs regarding past criminal record, that have impact on health and re-entry. Understanding the development and impact of self-stigma on health can inform re-entry and rehabilitation services. AIMS: The two aims of this study were first, to evaluate a previously established model of self-stigma applied to individuals who have experienced incarceration and, secondly, to study the impact of self-stigma on physical and mental health as well as community integration on re-entry. METHODS: This is a cross-sectional study of 129 formerly incarcerated adults recruited using an online platform and asked to complete online rating scales about self-stigmatisation, health and sense of community integration. Repeated-measures analysis of variance, correlation analysis, and path analyses were used to evaluate the model. RESULTS: There was support for the four distinct stages of self-stigmatisation apparent in mental health research. There was a relationship between self-stigma harm and sense of community integration, mediated by mental but not physical health status scores. CONCLUSION: Our findings add to work on self-stigmatisation in the field of mental health by showing that the concept appears relevant and appears in similar staging among formerly incarcerated individuals and that self-stigmatisation is likely to be important for their community reintegration. Our sample was not typical of the wider prison population for race and gender distribution, in particular having fewer than expected those minority groups likely to be especially vulnerable to stigmatisation by others. Our findings nevertheless suggest that further, preferably, longitudinal research on self-stigma to enable better understanding of pathways could substantially help treatment and rehabilitation of individuals after release from a correctional facility.

Effectiveness of internet-based behavioral activation on quality of life among young adult survivors of childhood brain tumor: a randomized controlled trial.

PURPOSE: Diagnosis and treatment of childhood brain tumor have detrimental effects on physical, neurocognitive, psychological, and social functioning that lasts into adulthood and effects quality of life (QOL). To address diminished QOL, an Internet-based behavioral activation (BA) intervention was developed. Behavioral activation aims to increase activities and behaviors likely to improve thoughts, mood, and QOL. METHODS: Participants included 127 young adult survivors of childhood brain tumor (SCBT) randomized into the experimental group (n= 64) or the waitlist control group (n= 63). The dependent variables included: life satisfaction, stress, and activation and were assessed with a two-way mixed analysis of variance (ANOVA). RESULTS: Results revealed a significant interaction between the intervention and time on life satisfaction, F(1, 125)=4.793, p = 0.03. There were no significant main effects over time for perceived stress and activation. CONCLUSIONS: Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult SCBT. Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.Implications for rehabilitationBehavioral activation (BA) is aimed at increasing positively reinforcing overt behaviors that are likely to promote improved thoughts, mood, and quality of life (QOL).Results indicated study participants in the experimental group demonstrated a significant gain in life satisfaction compared to the control group after receiving the Internet-based BA intervention; and provides support that the intervention was associated with positive changes across time.Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult survivors of childhood brain tumor (SCBT).Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.

Impact of childhood maltreatment on psychosomatic outcomes among men and women with disabilities.

PURPOSE: This project examined the impact of childhood maltreatment types on psychosomatic outcomes among adults with a range of self-reported disabilities. MATERIALS AND METHODS: Participants (n = 643) were recruited using Amazon Mechanical Turk and Cloud Research. Single-item questions assessed sociodemographic information. The Childhood Trauma Questionnaire measured childhood maltreatment types (emotional, physical, and sexual abuse, and emotional and physical neglect) and the RAND-36 Item Health Survey evaluated physical functioning, pain, and energy/fatigue. Logistic regressions determined associations between childhood trauma and psychosomatic outcomes; stratified models compared men and women. RESULTS: Multivariate-adjusted models indicated physical abuse was positively associated with poor physical functioning (OR: 2.03; 95%CI: 1.35-3.06) with this relationship being stronger for men (OR: 3.25; 95%CI: 1.42-7.43) than women (OR: 1.91; 95%CI: 1.17-3.13). Adjusted models showed that physical neglect was protective against fatigue (OR: 0.58; 95% CI: 0.36-0.94), while emotional neglect increased the risk of fatigue (OR: 1.74; 95%CI: 1.02-2.95). Lastly, physical abuse was positively associated with pain (OR: 1.53; 95%CI: 1.01-2.33). This relationship was stronger in men (OR: 4.99; 95%CI: 1.91-12.99). CONCLUSIONS: Results improve our understanding of risk factors for poor physical health outcomes and can guide the development of trauma-sensitive rehabilitation services.Implications for RehabilitationIndividuals with disabilities who report childhood maltreatment may experience poor psychosomatic outcomes in adulthood.Consequences of experiencing childhood maltreatment may manifest differently between men and women over the course of the lifespan.It is essential to integrate trauma-informed principles into treatment plans for individuals with poor psychosomatic health.Rehabilitation professionals should screen for abuse and refer individuals to the appropriate mental and physical health services.

Work Personality, Core Self-evaluation and Perceived Career Barriers in Young Adult Central Nervous System Cancer Survivors.

PURPOSE: The purpose of this study is to examine the relationship between work personality, core self-evaluation (CSE), and perceived internal and external barriers to employment in a group of young adult CNS survivors. METHODS: The participants consisted of 110 young adult survivors of pediatric central nervous system (CNS) tumors aged between 18 and 30 years old (M = 23.05, SD = 3.36). Mediation analysis with structural equational modeling (SEM) technique was used to correlate a number of different measures (Work Personality [WP], Perceived Employment Barriers [PEB], and Core-Self Evaluation [CSE]). RESULTS: Results revealed an exceptionally well-fitting model to our data with work personality predicting CSE positively: ß = 0.34, SE = 0.07, 95% CI (0.18, 0.47) while CSE inversely predicts Perceived Barriers to Employment, ß = - 0.60, SE = 0.06, 95% CI (- 0.70, - 0.49). There is a direct pathway from WP to PEB once CSE was accounted for ß = - 0.20, SE = 0.07, 95% CI (- 0.33, - 0.06). The presence of both significant direct and indirect effects of WP on PEB implied that there was a partial mediating effect of CSE on the association between WP and PEB. CONCLUSIONS: Work personality is a robust construct that can be applied to young adult CNS survivors in effort to gain more insight into the personality and psychological factors that impact career development and employment in this group. The major finding of this study was that work personality and CSE had a significant direct effect on perceived career barriers and that there was a significant indirect effect with CSE acting as a mediator between developmental work personality and perceived career barriers.

Company Characteristics, Disability Inclusion Practices, and Employment of People with Disabilities in the Post COVID-19 Job Economy: A Cross Sectional Survey Study.

Purpose In the post coronavirus disease 2019 (COVID-19) recession economy, rehabilitation counselors, transition specialists, and other disability service providers must redouble their efforts to connect with employers to create employment opportunities for people with physical and mental impairments. The purpose of the present study was to investigate company characteristics and effective disability inclusion practices that are related to employment of people with disabilities. Methods Four hundred sixty-six employers completed a demographic questionnaire and the Disability Inclusion Profiler. Results Results indicated company characteristics and disability practices were positively related to employment of people with disabilities. Conclusions Findings of the present study can be used by transition specialists, rehabilitation counselors, and other disability service providers to engage and connect with employers to increase employment opportunity for people with disabilities in the post COVID-19 economy. Future research and practice implications are provided.

The employment discrimination experiences of younger and older Americans with cancer under Title I of the Americans with Disabilities Act.

PURPOSE: The goal of the research was to describe discrimination, both actual and perceived, that has occurred against younger individuals with cancer (i.e., 35 years of age and under) in comparison with older individuals with cancer (i.e., over age 35) through analysis of the US Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database. METHODS: An ex post facto, causal comparative quantitative design was used to examine Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints received by the EEOC from younger people with cancer from 2009 through 2016 (n = 1001) in comparison with older people with cancer over the same time period (n = 8874). RESULTS: Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared with older charging parties with cancer, the younger charging parties with cancer had proportionally more individuals who were male and who identified as African American and proportionally fewer individuals who identified as Caucasian. CONCLUSIONS: Younger people with cancer were more likely to allege discrimination in the areas of promotion, training, reinstatement, and referrals to other employers. They were less likely to allege discrimination in the area of benefits. The younger group was also significantly less likely than the older group to find that EEOC investigations of their allegations resulted in merit-based case resolutions, that is, discrimination had indeed occurred. IMPLICATIONS FOR CANCER SURVIVORS: Psychosocial programs and vocational programming assisting young adults with career development should focus on the types of discrimination that young adults experience, which is unique compared with older adult cancer survivors.

A conceptual framework to promote career development for vocational rehabilitation consumers with traumatic brain injuries.

The purpose of this article is to describe the Illinois Work and Well-being Model (ILW2M), a multi-domain framework for conceptualizing the employment development of people with traumatic brain injuries (TBIs). The model emphasizes the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A brief discussion of potential implications regarding vocational rehabilitation research and service is offered with the overall goal of reinforcing employment development as the foundation of vocational rehabilitation services for adults with TBIs.

The Workplace Discrimination Experiences of Individuals with Cancer in the Americans with Disabilities Act Amendments Act Era.

Background The purpose of this study was to investigate the patterns in allegations of workplace discrimination filed by individuals with cancer. Objective The goal of the research was to describe discrimination, both actual and perceived, that has occurred against individuals with cancer in comparison to a group of individuals with other general disabilities (GENDIS) through analyses of the United States Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database. Methods An ex post facto, causal comparative quantitative design was used to examine Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints received by the EEOC from people with cancer from 2009 through 2016 (n = 10,848) in comparison to the GENDIS group over the same time period (n = 13,338). Results Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared to the GENDIS group, the cancer group was significantly older and had proportionally more individuals who identified as Asian than the GENDIS group. People with cancer were more likely to allege discrimination in the areas of unlawful discharge, demotion, wages, layoff, benefits, and referrals. They were less likely to allege discrimination in areas of reasonable accommodation, hiring, and suspension. Also, the cancer group was more likely than the GENDIS group to file allegations against smaller employers and employers in the Southeast region of the United States, while employers in the Mid-Atlantic and Rocky Mountain regions were less likely to be named in allegations by people with cancer. The cancer group was also significantly more likely than the GENDIS group to find that EEOC investigations of their allegations resulted in merit-based case resolution, that is, discrimination had indeed occurred. Owing to the large sample size, some of these between-group differences were small in magnitude. Conclusion The workplace discrimination experiences of people with cancer are substantially different from those of people with other disabilities.

Determinants of Employment Outcome for the People with Schizophrenia Using the WHODAS 2.0.

Purpose Since the vocational outcomes of people with schizophrenia should be viewed in a holistic way, the second edition of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) might provide an evaluation regarding employment potential. To determine whether the WHODAS 2.0 scores can be used to predict employment status, we examined the probabilistic cut-off values of the scores and analyzed the relationship between work status and demographic characteristics. Methods We selected 31,793 people aged between 18 and 65 with schizophrenia or schizoaffective disorder from the disability evaluation database in Taiwan and separated them into two groups based on employment status (employed and unemployed). We used logistic regression to explore the association between employment and demographic characteristics. Moreover, we conducted a receiver operating characteristic (ROC) analysis to determine the cut-off point to assist in determining employment potential based on the WHODAS 2.0 score. Results Among the 31,793 participants, 3367 were employed and 18,801 were unemployed. The unemployed participants accounted for a higher percentage of disability in each domain of the WHODAS. The ROC analysis revealed that the optimal cut-off point of the WHODAS score to distinguish the people who were employed and unemployed was 25.78 (area under curve = 0.80). Conclusions The present study indicated that work status can be determined by the total score across the six domains of the WHODAS score. Furthermore, the probability of employment may be determined initially by the cut-off point of the WHODAS score in order to economize evaluation time and prepare prevocational training for those with scores above 25.78.

Development of the perceived barriers scale: a new instrument identifying barriers to career development and employment for young adult survivors of pediatric CNS tumors.

PURPOSE: Given the significant employment disparities for survivors of pediatric brain tumors, there is increased need to conduct vocational and career research with this group. The purpose of the present study was to construct an instrument, the Perceived Barriers Scale, that is psychometrically sound and has both clinical and research application related to career and employment issues of pediatric brain tumor survivors. METHOD: The participants consisted of 110 young adult central nervous system survivors of childhood cancer aged between 18 and 30 years old (M = 23.05, SD = 3.36) who were identified by the DFCI Pediatric Brain Tumor Clinic. The 12-item Perceived Barriers Scale was developed from a comprehensive literature review, clinical interviews conducted with survivors of pediatric brain tumors, and feedback from multidisciplinary providers. Exploratory factor analysis and correlations were completed to examine the initial psychometric properties of the scale. RESULTS: Exploratory factors analysis identified two factors that accounted for 57.92% with the two factors labeled as internal barriers and external barriers. All factors loaded significantly onto their respective factors (.48 to .88). The results of the correlational analysis found significant relationships between both internal barrier and external barrier subscales and CSE and WHODAS-2 providing initial support for the construct validity of the Perceived Barriers Scale. CONCLUSIONS: Overall, the study findings indicate good psychometrics with the brevity of the scale increasing potential application and utilization in both research and clinical settings. IMPLICATIONS FOR CANCER SURVIVORS: Identification of employment barriers for brain tumor survivors provides opportunity for more targeted vocational intervention.

Vocational identity, positive affect, and career thoughts in a group of young adult central nervous system cancer survivors.

The aims of this study were as follows: (a) to compare levels of career thoughts and vocational identity between young adult childhood central nervous system (CNS) cancer survivors and noncancer peers and (b) to investigate the contribution of vocational identity and affect on career thoughts among cancer survivors. Participants included 45 young adult CNS cancer survivors and a comparison sample of 60 college students. Participants completed Career Thoughts Inventory, My Vocational Situation, and the Positive and Negative Affect Schedule. Multivariate analysis of variance and multiple regression analysis were used to analyze the data in this study. CNS cancer survivors had a higher level of decision-making confusion than the college students. Multiple regression analysis indicated that vocational identity and positive affect significantly predicted the career thoughts of CNS survivors. The differences in decision-making confusion suggest that young adult CNS survivors would benefit from interventions that focus on providing knowledge of how to make decisions, while increasing vocational identity and positive affect for this specific population could also be beneficial.

Enhancing psychosocial outcomes for young adult childhood CNS cancer survivors: importance of addressing vocational identity and community integration.

The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years (mean=22, SD=3.62), with a mean age at diagnosis of 8.8 years. Four standardized instruments were used to assess the individual's affect, satisfaction with life, vocational identity, and self-perceived level of community integration. Pearson correlation analyses were carried out to examine the relationships between the satisfaction with life and positive and negative affect, vocational identify, and community integration. A hierarchical linear regression was then performed to determine how well these variables predict satisfaction with life among CNS cancer survivors. Significant positive correlations were found between life satisfaction and positive affect (r=0.423, P<0.01), as well as life satisfaction and community integration (r=-505, P<0.001). A positive correlation between life satisfaction and vocational identity was only marginally significant (r=0.312, P<0.05). Regression results indicate that the model explained 29% of the variance with community integration making a unique contribution. The largest contribution of this study is that the findings provide initial evidence that addressing vocational identity and community integration may be important constructs in improving young adult CNS survivors' overall levels of satisfaction with life. These constructs have not been typically addressed in psychosocial cancer treatment programs.

Examining differences in developmental work personality across disability category: Implications for individuals with psychiatric disabilities.

OBJECTIVE: The purpose of this exploratory study was to examine the differences in levels of work personality for persons with psychiatric disabilities compared to persons with other types of disabilities. PARTICIPANTS: Seventy one adults eligible to receive Vocational Rehabilitation services participated; 30 reported a physical disability, 26 reported a psychiatric disability, and 15 reported a learning disability. METHODS: Eligible participants were recruited through VR offices and volunteered to participate. RESULTS: Results indicate that persons with psychiatric disabilities scored significantly lower on the Work Task and Social Skills subscales of the Developmental Work Personality Scale (DWPS) when compared to individuals with physical disabilities, but scored higher than individuals with physical and learning disabilities on the Role Model subscale. CONCLUSIONS: The results of this study provide some initial clarity regarding developmental work personality differences among three broad categories of disability. Recommendations for future research are provided.

Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial.

The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n = 47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d = 0.68) than the control condition (d = 0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r = 0.62) and barriers self-efficacy (r = 0.63) and decreases in depression (r = -0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.

The relationship between contextual work behaviours self-efficacy and work personality: an exploratory analysis.

BACKGROUND: Work personality and contextual work behaviours have been identified as constructs that play critical roles in developing the foundation for effective vocational and career behaviour for persons with disabilities. METHOD: For this study, we used a sample of 84 individuals with disabilities who were eligible to receive vocational rehabilitation services. Demographic variables and questions concerning work personality, contextual work behaviours self-efficacy, employment status and longest time employed were obtained and analysed to determine the relationship between contextual work behaviours self-efficacy, work personality and employment outcomes. RESULTS: The results indicate that work personality explained 24% (F = 2.73; p = 0.013) of the variance of contextual work behaviours self-efficacy with the subscale of Personal Presentation (ß = 0.466) making a significant and unique contribution to CWB total score. Results of a correlation between the work personality profile scale and the contextual work behaviours self-efficacy scale revealed a significant and positive relationship. Levels of work personality and contextual work behaviours self-efficacy were unable to discriminate between employed and unemployed individuals. However, a post-hoc regression analysis did find that work personality and contextual work behaviours self-efficacy accounted for approximately 24% of the variance of longest time employed. CONCLUSIONS: The results of this study provide initial support for the relationship between work personality and contextual work behaviours self-efficacy. Overall, work personality appears to be an important construct related to individual's confidence to meet the contextual demand of the work environment and length of employment tenure.

Working alliance and vocational outcomes for cancer survivors: an initial analysis.

This study examines the sex differences in the perception of working alliance and the perceptions of optimism regarding future employment and job satisfaction with adult cancer survivors receiving vocational rehabilitation services. No significant differences were found between males and females in terms of the three components of the working alliance. However, examination of effect sizes indicated that the females reported higher levels of tasks (d=0.40) and goals (d=0.55) than their male counterparts. The three components of working alliance explained 60% of the variance with bonds (ß=0.865) making a significant and unique contribution to employment prospects. Working alliance was not associated with current job satisfaction in the employed group. Overall results of this study suggest that working alliance seems to be an important variable in the vocational outcomes for cancer survivors receiving vocational services.

Using attribution theory to examine community rehabilitation provider stigma.

This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences in their stigmatizing tendencies on subscales of controllability and stability for different categories of disabilities. Specifically, service providers with a master's degree had more stigmatizing beliefs for psychosis and cocaine addiction, compared with service providers with a bachelor's degree. Service providers with either a bachelor's degree or master's degree reported lower levels of stigma overall for five of the six categories of disability compared with their community college student counterparts. No differences were found for length of time working with persons with psychiatric disabilities.

The role of developmental work personality in the employment of individuals with psychiatric disabilities.

Due to the current demands of today's competitive and team-oriented workplaces, organizations are becoming increasingly dependent on assessing potential and current employee traits that go beyond skills and education. Contextual work behaviors, such as getting along with others, accepting supervision, and ability to adapt to changes, are proving to be salient factors in predicting overall successful employment outcomes. These contextual behaviors are often learned in childhood during the school years and by watching parents and role models demonstrate behaviors related to work. Individuals with psychiatric disabilities often have a harder time than individuals who do not experience symptoms of psychiatric disabilities demonstrating positive contextual work behaviors. This paper will outline the importance of evaluating work personality using the Developmental Work Personality Scale for individuals with psychiatric disabilities.

Examining the impact of physical and sexual abuse on the employment of women with disabilities in the United States: an exploratory analysis.

PURPOSE: The relationship between the employment status of women with disabilities and the incidence of physical and sexual abuse in the United States was examined. METHOD: Data from the 2005 Behavioural Risk Factor Surveillance System (BRFSS) were analyzed using descriptive analysis and proportional analysis to determine the significance of the relationship between the experience of abuse and employment status for women with disabilities. Due to the large sample size, effect size was examined through Cohen's h. Logistic regression analysis was also used to examine the risk of unemployment for women with disabilities who are abused. RESULTS: Women with disabilities who have been abused have higher levels of unemployment than women without disabilities who have not been abused. In addition, women with disabilities who have been abused have higher levels of unemployment than women without disabilities who have not been abused. Finally, experiencing physical and sexual abuse increases the risk of unemployment for women with disabilities. CONCLUSION: Unemployment increases the disadvantage for an already vulnerable population and potentially prevents women with disabilities from being able to break the cycle of violence they are experiencing. Recommendations are discussed with regard to intervention by rehabilitation professionals to assist women with disabilities who experience abuse.

Trauma symptomatology: implications for return to work.

Research has suggested that individuals who experience work related injuries may be at an increased risk for developing trauma symptoms or Posttraumatic Stress Disorder (PTSD). The purpose of this article is to provide a brief overview of PTSD from both a categorical and dimensional perspective and discuss implications for rehabilitation planning with workers with industrial injuries. The negative impact of trauma symptoms and PTSD is profiled according the following four areas that are important for effective career and vocational behavior: (a) making occupational adjustments, (b) adjusting performance to meet specific work demands, (c) utilizing appropriate social and interpersonal skills in the work setting, and (d) meeting the production and time requirements associated with the specific job. Recommendations are then offered to increase the effectiveness of rehabilitation professionals working with industrial injured workers who may be experiencing trauma symptoms or PTSD.