Identifying Return to Work Self-Efficacy Trajectories in Employees with Mental Health Problems.

Purpose Return to work self-efficacy (RTW-SE) is a strong predictor of return to work (RTW) in employees with mental health problems (MHPs). However, little is known about the development of RTW-SE during the RTW process. In this study, we aimed to identify RTW-SE trajectories in the year following sick leave in employees with MHPs and provided a description of the trajectories in terms of personal and work characteristics, and RTW status. Methods This multi-wave study included 111 employees with MHPs. RTW-SE was measured at baseline, and at 3, 6, and 12 months follow-up with the RTW-SE scale for employees with MHPs. Results Latent class growth analysis revealed six trajectories. In three trajectories employees had increasing RTW-SE scores, namely (class 1) low start, moderate increase, (class 3) moderate start, small increase and (class 5) moderate start, steep increase. The other trajectories were defined by (class 2) persistently high, (class 6) persistently low, and (class 4) decreasing RTW-SE scores over time. Employees across the various trajectories differed significantly with respect to RTW status, and personal and work characteristics measured at baseline, including age, gender, and type of MHP. Less favorable trajectories (class 4 and 6) were characterized by higher age, a higher prevalence of anxiety disorder and lower RTW rates. The most favorable trajectory (class 2) was characterized by a higher proportion of stress-related disorders and less major depression diagnoses. Conclusions Large heterogeneity exists in terms of RTW-SE trajectories in employees with MHPs and significant differences were found across the trajectories regarding personal and work characteristics, and RTW status. Insights into RTW-SE trajectories and their attributes are important to advance more effective and personalized RTW treatment for employees with MHPs.

Identifying return to work trajectories among employees on sick leave due to mental health problems using latent class transition analysis.

OBJECTIVES: To develop effective return to work (RTW) interventions for employees on sick leave due to mental health problems (MHPs), a better understanding of individual variation in the RTW process is needed. We investigated which RTW trajectories can be identified among employees with MHPs in terms of RTW duration and relapse occurrence during the RTW process. Additionally, we examined how different RTW trajectories can be described in terms of personal and work characteristics. METHODS: Longitudinal sickness absence registry data were collected retrospectively from the largest Dutch occupational health service. Quantitative RTW information as well as personal and work characteristics were extracted. In total, 9517 employees with a sickness absence due to MHPs were included in the analyses (62 938 data points; RTW durations from 29 to 730 days). RESULTS: A latent class transition analysis revealed five distinct RTW trajectories, namely (1) fast RTW with little chance of relapse, (2) slow RTW with little chance of relapse, (3) fast RTW with considerable chance of relapse, (4) slow RTW with considerable chance of relapse and (5) very fast RTW with very small chance of relapse. Differences between employees in the slower and faster trajectories were observed regarding gender, age, type of MHP, organisation sector and organisation size but not regarding part-time work. CONCLUSIONS: RTW trajectories among employees with MHPs showed large individual variability and differed on personal and work characteristics. Knowledge on different RTW trajectories and their characteristics contributes to the development of personalised RTW treatments, tailored to specific individuals and organisations.

Temporal focus, temporal distance, and mind-wandering valence: Results from an experience sampling and an experimental study.

When mind-wandering, people may think about events that happened in the past, or events that may happen in the future. Using experience sampling, we first aimed to replicate the finding that future-oriented thoughts show a greater positivity bias than past-oriented thoughts. Furthermore, we investigated whether there is a relation between the temporal distance of past- and future-oriented thoughts and the frequency of positive thoughts, a factor that has received little attention in previous work. Second, we experimentally investigated the relation between temporal focus, temporal distance, and thought valence. Both studies showed that future-oriented thoughts were more positive compared to past-oriented thoughts. Regarding temporal distance, thoughts about the distant past and future were more positive than thoughts about the near past and future in the experiment. However, the experience sampling study did not provide clear insight into this relation. Potential theoretical and methodological explanations for these findings are discussed.

Prevention praised, cure preferred: results of between-subjects experimental studies comparing (monetary) appreciation for preventive and curative interventions.

BACKGROUND: 'An ounce of prevention is worth a pound of cure' is a common saying, and indeed, most health economic studies conclude that people are more willing to pay for preventive measures than for treatment activities. This may be because most health economic studies ask respondents to compare preventive measures with treatment, and thus prompt respondents to consider other uses of resources. However, psychological theorizing suggests that, when methods do not challenge subjects to consider other uses of resources, curative treatment is favored over prevention. Could it be that while prevention is praised, cure is preferred? METHODS: In two experimental studies, we investigated, from a psychological perspective and using a between-subjects design, whether prevention or treatment is preferred and why. In both studies, participants first read a lung cancer prevention or treatment intervention scenario that varied on the prevention-treatment dimension, but that were the same on factors like 'costs per saved life' and kind of disease. Then participants completed a survey measuring appreciation (general and monetary) as well as a number of potential mediating variables. RESULTS: Both studies clearly demonstrated that, when the design was between-subjects, participants had greater (general and monetary) appreciation for treatment interventions than for preventive interventions with perceived urgency of the intervention quite consistently mediating this effect. Differences in appreciation of treatment over preventive treatment were shown to be .59 (Study 1) and .45 (Study 2) on a 5-point scale. Furthermore, participants thought that health insurance should compensate more for the treatment than for preventive measures, differences of 16% (Study 1), and 22% (Study 2). When participants were asked to directly compare both interventions on the basis of a short description, they preferred the preventive intervention. CONCLUSION: It appears that people claim to prefer prevention when they are asked to consider other use of resources, but otherwise they prefer treatment. This preference is related to perceived urgency. The preference for treatment may be related to the prevention-treatment dimension itself, but also to variations on other dimensions that are inherently linked to prevention and treatment (like different efficacy rates and costs per treatment).