Employee Job Satisfaction and Performance in Association With Workplace Responses to the 9/11 Attacks on New York City's World Trade Center.

OBJECTIVE: Research is needed on disaster-affected workplaces, particularly on employee job satisfaction and performance, to inform workplace responses promoting employee postdisaster adjustment and wellbeing. METHODS: Quantitative and qualitative data were collected from a volunteer sample of 255 employees of eight workplaces affected by the 9/11 attacks on New York City's World Trade Center nearly 3 years post disaster. RESULTS: The effects of 9/11 on both job satisfaction and job performance were more negative than positive, especially for the Ground Zero employees. Effects on job satisfaction and job performance were generally congruent. Workplace responses focused on individual needs were perceived as positive and those focused on workplace needs as negative. CONCLUSIONS: Workplace responses focused on business improvement intended to improve workplace performance may not have the desired effect and may reduce employee job satisfaction and performance.

The Association between Child and Parent Psychiatric Disorders in Families Exposed to Flood and/or Dioxin.

Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of 169 families exposed to floods and/or dioxin or no disaster were assessed in 1986-1987 with structured diagnostic interviews. This vintage dataset collected several decades ago provides new information to this field because of the methodological rigor that is unparalleled in this literature. Disaster-related PTSD and incident postdisaster disorders in children were associated, respectively with disaster-related PTSD and incident postdisaster disorders in the chief caregiver and mother. More flood-only than dioxin-only exposed parents reported great harm by the disaster, but neither children nor parents in these two groups differed in incident psychiatric disorders. Although this study did not determine the direction of causal influences, its findings suggest that clinicians working with disaster-exposed families should work with children and adult members together, as their mental health outcomes may be intertwined.

Outdoor thermal perception and comfort conditions in the Köppen-Geiger climate category BSk. One-year field survey and measurement campaign in Konya, Turkey.

This study presents an analysis of the thermo-hygrometric conditions in the city of Konya (Turkey). A one-year transversal field survey was carried out in the Selçuk University campus and 2295 valid questionnaires were collected. In each questionnaire, randomly selected interviewees provided personal information and judged their perception and thermal preference according to the ASHRAE 7-point and McIntyre scales, respectively. For each interviewee, a value of the Physiological Equivalent Temperature (PET) was calculated based on the values of operational variables obtained from the questionnaires and the environmental variables measured during the survey. This allowed to calculate the seasonal preferred and neutral PETs and the annual PET comfort range. Also, the scale of the PET thermal perception was determined for the Konya population and, more generally, for the inhabitants of the BSk Köppen-Geiger climate zone. Statistical analyzes carried out in terms of Variance Inflationary Factor, multicollinearity assessment and Best Subsets Analysis led to the identification of the Turkish Outdoor Comfort Index, an empirical index able to predict the average value of the thermal perception of a large group of individuals living in the aforementioned climate zone. Moreover, the equations of the Predicted Percentage of Dissatisfied (PPD) were obtained for each season.

The Association between General and Pathological Dissociation and Disaster-Related Psychopathology in Directly Exposed Survivors.

Objective: Dissociation and trauma have a well-documented relationship, and dissociation is assumed to result from trauma exposure. If trauma generates dissociative psychopathology, it should be observed after exposure to disaster and be associated with disaster-related psychopathology. Few studies have focused specifically on dissociation as an outcome of disaster trauma. This study examined dissociation and its association with disaster-related psychopathology in survivors of five different disasters. Methods: In the first 6 postdisaster months, directly exposed survivors (N = 216) of mass shootings, floods, or a firestorm completed structured diagnostic interviews providing lifetime predisaster and postdisaster prevalent/incident psychiatric diagnoses and the Dissociative Experiences Scale (DES) 1-3 years after baseline. Results: DES scores were very low; only 1% met the DES Taxon signifying pathological dissociation. In multivariate models including predisaster lifetime major depression, lifetime panic disorder, lifetime generalized anxiety disorder, and lifetime alcohol use disorder; disaster-related PTSD; and number of incident somatoform symptoms as independent covariates, predisaster lifetime major depression and alcohol use disorder were independently associated with both general (DES score) and pathological (DES Taxon) dissociation, and postdisaster incident somatization symptoms were also associated with general dissociation, but postdisaster psychopathology including disaster-related PTSD was not associated with general or pathological dissociation. Conclusions: Neither general nor pathological dissociation was independently associated with disaster-related PTSD or other incident psychopathology. The only psychiatric disorders associated with dissociation were present before the disasters. Coupled with the low dissociation rates, these findings indicate that dissociation does not appear to be a mental health outcome of disaster trauma.

Dissociation and disasters: A systematic review.

BACKGROUND: Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an integrated whole, has long been assumed to be generated by trauma. If dissociation is a product of trauma exposure, then dissociation would be a major mental health outcome observed in studies of disaster survivors. Although some studies have examined dissociation in disasters, no systematic literature reviews have been conducted to date on the topic. AIM: To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship. METHODS: EMBASE, Medline, and PsychINFO were searched from inception to January 1, 2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders. Studies of military conflicts and war, articles not in English, and those with samples of 30 or more participants were excluded. Search terms used were "disaster*" and dissociation ("dissociat*," "multiple personality," "fugue," "psychogenic amnesia," "derealization," and "depersonalization"). Reference lists of identified articles were scrutinized to identify studies for additional articles. RESULTS: The final number of articles in the review was 53, including 36 articles with samples of adults aged 18 and above, 5 of children/adolescents under age 18, and 12 of disaster workers. Included articles studied several types of disasters that occurred between 1989 and 2017, more than one-third (38%) from the United States. Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders. All of the studies used self-report symptom scales; none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology. Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups. Studies examining associations between dissociation and disaster exposure have been inconclusive. The majority (75%) of the studies compared dissociation with posttraumatic stress, with inconsistent findings. Dissociation was found to be associated with a wide range of other psychiatric disorders, symptoms, and negative emotional, cognitive, and functional states. CONCLUSION: The studies reviewed had serious methodological limitations including problems with measurement of psychopathology, sampling, and generation of unwarranted conclusions, precluding conclusions that dissociation is an established outcome of disaster.

The 2nd to 4th digit ratios (2D:4D) in patients with bipolar disorder.

BACKGROUND: The ratio of the index finger to the ring finger (2D:4D) is a reflection of the intrauterine hormonal environment and a lower ratio has been shown to be associated with male gender, impulsive behaviors, substance abuse, and aggression. Bipolar illness is characterized by increased impulsivity and increased rates of co-morbid substance abuse, but the 2D:4D ratios have not been examined in this disorder. METHODS: We measured digit length of both hands in subjects with bipolar disorder and age- and gender-matched non-bipolar controls (n = 50 in each group). Diagnosis was confirmed with structured diagnostic interviews (MINI) and all subjects also completed Barratt Impulsivity Scale-version 11. RESULTS: The patients did not vary significantly from the controls in demographic variables. Subjects with bipolar disorder had a higher right hand 2D:4D ratio compared to controls (0.967 ± .029 vs. 0.953 ± .035, t = 2.18, p = .03). Despite clearly higher measures of impulsivity in the bipolar group, no relationship could be documented between digit ratio and measures of impulsivity in either group. However, the right hand 2D:4D ratios and total impulsivity scores predicted bipolar disorder diagnosis status. LIMITATIONS: The predominantly white racial composition of the study sample may limit generalizability to other groups. Only three patients were diagnosed with bipolar type 2, limiting the generalizability of the findings to all bipolar disorder types. CONCLUSIONS: The data confirm previous observations of increased measures of impulsivity in euthymic bipolar individuals, and suggest that the mechanism of this increased impulsivity is different than in impulsivity seen in other conditions such as personality disorders.

A study of dissociation in survivors of 5 disasters.

This study examined dissociation as an outcome to disaster in dissociative data collected from 423 highly-exposed survivors of 5 different disasters using consistent methodology. Ten items selected for conceptual relevance to disaster experience were administered from the Dissociative Disorders Interview Schedule, a structured interview for lifetime dissociative disorders. Structured psychiatric interviews provided data on incident somatization symptoms, disaster-related PTSD, and lifetime predisaster psychopathology. The Temperament and Character Inventory assessed personality. Observed levels of dissociation were low and not usually postdisaster. Dissociation level was associated with female sex, number of incident somatization symptoms, personality (underdeveloped executive functioning), PTSD, and predisaster psychopathology in bivariate analyses. In multiple linear regression models, dissociation was associated with the low number of incident somatoform symptoms observed independent of the effects of PTSD, hyperarousal specifically (but not intrusion or avoidance/numbing), personality, predisaster psychopathology, and demographic variables which were not independently associated with dissociation. The low levels of dissociation found in this study and the lack of association between dissociation and indicators of psychopathology point to a largely nonpathological nature of the dissociative phenomena measured. These findings do not indicate the development of dissociative psychopathology as a prevalent mental health outcome of disasters.

Factors Statistically Predicting At-Risk/Problematic Internet Use in a Sample of Young Adolescent Boys and Girls in South Korea.

Aims: This study aimed to investigate in a gender-sensitive manner factors related to at-risk/problematic Internet use (ARPIU) in a sample of young Korean adolescents. Given prior findings, we hypothesized we would observe specific temperamental, social and biological measures that would statistically predict ARPIU in boys and girls, respectively. Method: Subjects included 653 middle-school students from Chuncheon, Korea who completed measures assessing Internet addiction, mood, temperament, and social interactions. Finger digit (2D:4D) ratios were also assessed. Chi-square and logistic regression models were conducted. Results: Among boys and girls, the ARPIU and non-ARPIU groups showed differences in temperament, mood, social tendencies, and gaming behaviors. In boys, IAT correlated inversely with the 2D:4D digit ratio and novelty-seeking and positively with reward-dependence scores when controlling for BDI scores; these relationships were not found in girls. Multivariate analyses showed that among boys, novelty-seeking, harm avoidance, self-transcendence, and daily time spent gaming statistically predicted ARPIU. Among girls, daily time spent gaming, number of best friends, self-directedness, and cooperation statistically predicted ARPIU. Conclusion: ARPIU was linked to specific temperamental, behavioral and biological characteristics, with specific relationships observed in boys and girls. Specific risk factors may exist for boys and girls with respect to their propensities to developing ARPIU, suggesting the need for gender-sensitive approaches to prevent ARPIU in youth.

Evaluation of Subclinical Left Ventricular Systolic Dysfunction in Chronic Asymptomatic Alcoholics by Speckle Tracking Echocardiography.

By using two-dimensional speckle tracking echocardiography, we aimed to investigate the structural and functional changes on myocardium in chronic asymptomatic alcoholics without any cardiovascular disease. Forty-one consecutive asymptomatic male alcoholics who were admitted to the outpatient alcoholism unit and 30 age matched healthy male volunteers selected as the control group were enrolled in the study. The study group were investigated by using standard two-dimensional echocardiography and speckle tracking echocardiography. The left ventricular (LV) global longitudinal strain and LV global circumferential strain were significantly lower in alcoholics when compared with control subjects. There was no difference in global radial strain between the two groups. To demonstrate the effect of total life time dose of ethanol (TLDE) on echocardiographic abnormalities, we assessed the correlation analysis. There was a nonsignificant weak correlation between global LV circumferential strain and TLDE (r = 0.27, p = 0.083). Speckle tracking echocardiography derived left ventricular systolic function was impaired in chronic alcoholic patients when compared with healthy controls.

Eating disorders and food addiction in men with heroin use disorder: a controlled study.

PURPOSE: We aimed to determine the prevalence estimates of binge eating disorder, bulimia nervosa, anorexia nervosa, and food addiction in men with heroin use disorder and a matched sample of control participants. METHODS: A group of 100 men with heroin use disorder, consecutively admitted to a detoxification and therapy unit, were screened for DSM-5 eating disorders, along with a group of 100 male controls of similar age, education, and body mass index. The Yale Food Addiction Scale (YFAS), the Barratt Impulsivity Scale-version 11, and the Eating Attitudes Test were used for data collection. Patients were also evaluated for various aspects of heroin use disorder (e.g., craving) using the Addiction Profile Index. RESULTS: Binge eating disorder that met DSM-5 criteria was more prevalent in patients with heroin use disorder (21%) than in control subjects (8%) (odds ratio 3.1, 95% confidence interval 1.3-7.3; p < 0.01). Food addiction based on the YFAS was also more common among men with heroin use disorder (28%) than among control participants (12%) (odds ratio 2.9, 95% confidence interval 1.4-6.1; p < 0.01). A current food addiction was associated with more severe craving and having a history of suicide attempts in the patients. CONCLUSIONS: Co-occurring binge eating disorder and food addiction are highly frequent in men with heroin use disorder. Screening for binge eating disorder and food addiction in patients with substance use disorder is important, as interventions may improve treatment outcome in this patient group.

The relationship between second-to-fourth digit (2D:4D) ratios and problematic and pathological Internet use among Turkish university students.

Background and aims The ratio of the second and fourth fingers (2D:4D ratio) is a sexually dimorphic trait, with men tending to have lower values than women. This ratio has been related to prenatal testosterone concentrations and addictive behaviors including problematic video-gaming. We aimed to investigate the possible association between 2D:4D ratios and Internet addiction and whether such a relationship would be independent of impulsivity. Methods A total of 652 university students (369 women, 283 men), aged 17-27 years, were enrolled in the study. Problematic and pathological Internet use (PPIU) was assessed using the Internet Addiction Test (IAT). The participants also completed the Barratt Impulsiveness Scale (version 11; BIS-11) and had their 2D:4D ratios measured. Results 2D:4D ratios were not significantly different in women with PPIU and in those with adaptive Internet use (AIU). Men with PPIU exhibited lower 2D:4D ratios on both hands when compared with those with AIU. Correlation analysis revealed that 2D:4D ratios on both hands were negatively correlated with IAT scores among men, but not among women. The multiple linear regression analysis revealed that age, duration of weekly Internet use, impulsiveness, and 2D:4D ratios on the right hand were independently associated with IAT scores among men, and impulsivity did not mediate the relationship between 2D:4D ratios and PPIU. Conclusions For men, 2D:4D ratios on the right hand were inversely correlated with Internet addiction severity even after controlling for individual differences in impulsivity. These findings suggest that high prenatal testosterone levels may contribute to the occurrence of PPIU among men.

Temperament and character profiles of patients with chronic idiopathic urticaria.

INTRODUCTION: Psychosocial factors have been implicated as being important in the onset and/or exacerbation of urticaria. AIM: To examine both personality factors of patients with chronic idiopathic urticaria (CIU) and the correlations between illness duration, severity of itching, urticaria activity score (UAS) and temperament-character dimensions. MATERIAL AND METHODS: A total number of 70 CIU patients and 60 healthy individuals were included in the study. The Temperament and Character Inventory (TCI) was administered individually. The relationship between UAS, illness duration and severity of pruritus and TCI subscales were evaluated. RESULTS: The CIU group had significantly higher scores of novelty seeking and lower scores of cooperativeness, reward dependence and self-directedness than the control group. CONCLUSIONS: The current study shows that CIU patients have distinctive temperament and character dimensions when compared with the control group. We suggest that evaluation and treatment of CIU should also include psychosomatic approaches in clinical practice.

Effect of refractive error on temperament and character properties.

AIM: To determine the effect of refractive error on temperament and character properties using Cloninger's psychobiological model of personality. METHODS: Using the Temperament and Character Inventory (TCI), the temperament and character profiles of 41 participants with refractive errors (17 with myopia, 12 with hyperopia, and 12 with myopic astigmatism) were compared to those of 30 healthy control participants. Here, temperament comprised the traits of novelty seeking, harm-avoidance, and reward dependence, while character comprised traits of self-directedness, cooperativeness, and self-transcendence. RESULTS: Participants with refractive error showed significantly lower scores on purposefulness, cooperativeness, empathy, helpfulness, and compassion (P<0.05, P<0.01, P<0.05, P<0.05, and P<0.01, respectively). CONCLUSION: Refractive error might have a negative influence on some character traits, and different types of refractive error might have different temperament and character properties. These personality traits may be implicated in the onset and/or perpetuation of refractive errors and may be a productive focus for psychotherapy.

Paliperidone palmitate use in pregnancy in a woman with schizophrenia.

Long-acting antipsychotic use in schizophrenia has become an advantage for treatment compliance and convenient administration of the drugs. There is no data on paliperidone palmitate (PP) use in pregnancy, which is the longest-acting (i.e., 1 month) atypical antipsychotic. In this case report, we aim to present a patient diagnosed with schizophrenia who had been using PP before and during her pregnancy until week 28 of gestation and gave birth to a male baby that weighed 3000 g at 39 weeks. As far as we know, this is the first case report on PP use during pregnancy.

The impact of type D personality on health-related quality of life in patients with symptomatic haemorrhoids.

INTRODUCTION: Haemorrhoids are one of the most common reasons that patients seek consultation from a colon and rectal surgeon. Health-related quality of life (HrQoL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition. AIM: To assess the prevalence of type D personality in patients with haemorrhoids and to investigate whether the presence of a type D personality would affect HrQoL in patients with haemorrhoids. MATERIAL AND METHODS: One hundred and six outpatients with symptomatic haemorrhoids with no psychiatric comorbidity were consecutively enrolled, along with 96 healthy controls. The Type D Scale (DS14) and the General Health Survey Short Form-36 (SF-36) were used in the collection of data. RESULTS: Of 106 patients evaluated, 29.2% met criteria for type D personality. Patients with haemorrhoids scored lower on bodily pain and vitality dimensions of SF-36 than did healthy subjects (p < 0.001). Patients with a type D personality were found to score lower on bodily pain domain of HrQoL than patients without a type D personality. Linear regression analysis revealed a significant independent association of type D personality with bodily pain dimension of the SF-36 in patients with symptomatic haemorrhoids (r = -0.315, p < 0.01). CONCLUSIONS: Type D personality was associated with increased perceived bodily pain in patients with haemorrhoids. Consideration of type D personality construct personality traits could improve risk stratification in research and clinical practice in this patient group.

Elevated neutrophil/lymphocyte ratio in patients with schizophrenia.

BACKGROUND: Inflammatory mechanisms are reported to play important roles in the pathophysiology of schizophrenia. The neutrophil-lymphocyte ratio (NLR) is a simple and easily accessible indicator of the systemic inflammatory response. Our goal was to investigate whether NLR was higher in patients with schizophrenia than in healthy comparison subjects similar in age, sex, and body mass index. SUBJECTS AND METHODS: In this multicenter cross-sectional study, we analyzed 156 non-obese patients with schizophrenia and 89 healthy control subjects for complete blood count. The Brief Psychiatric Rating Scale was used to determine the severity of clinical pathology. RESULTS: The mean ± SD NLR of patients with schizophrenia was significantly higher than that of healthy controls (2.6 ± 1.1 vs. 1.9 ± 0.6, respectively, p < 0.001). NLR did not significantly correlate with severity and duration of schizophrenia (r = 0.065. p > 0.05). CONCLUSIONS: Our findings suggest that NLR levels are increased in physically healthy, non-obese, patients with schizophrenia when compared with physically and mentally healthy individuals. To our knowledge, this is the first study that demonstrated the association between NLR and schizophrenia.

Health-related quality of life in patients with anal fissure: effect of type D personality.

INTRODUCTION: Health-related quality of life (HRQL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition. AIM: To assess the prevalence of type D personality in patients with anal fissure and to investigate whether the presence of a type D personality would affect HRQL in patients with anal fissure. MATERIAL AND METHODS: One hundred outpatients with anal fissure with no psychiatric comorbidity were consecutively enrolled, along with 100 healthy controls. Type D Scale (DS14) and General Health Survey Short Form-36 (SF-36) were used in the collection of data. RESULTS: Patients with anal fissure scored lower on physical roles and bodily pain dimensions of SF-36 than healthy subjects (p < 0.05). Thirty-three patients with anal fissure (33%) and 16 controls (16%) had scored above the cut-off score of the DS14 (p < 0.05). Patients with a type D personality were found to score lower on bodily pain and social roles domains of HRQL than patients without a type D personality. CONCLUSIONS: Type D personality was associated with increased perceived bodily pain and social roles in patients with anal fissure. Type D personality construct may be an important consideration when assessing HRQL outcomes. A multidimensional approach may be valuable in the assessment of patients presenting with anal fissure, because a subgroup with type-D personality might benefit from psychological therapies.