Oncologists' psychological flourishing: A driving force for positive attitudes at work.

OBJECTIVE: Oncologists' psychological health is a major challenge due to the consequential concerning the quality of the care they provide. However, only critical states of their health have been really examined by scientists. This study sought to plug this gap by investigating the mediating role of psychological flourishing in the relationship between the perception of the professional social context (i.e., perceived workplace isolation and organizational support) and positive attitudes at work among oncologists (i.e., work engagement, task adjustment and empathy). METHODS: The study was a cross-sectional, including 541 French oncologists. Participants completed a self-report questionnaire. Structural Equation Modeling was employed to test the hypotheses. RESULTS: The analysis revealed that workplace isolation and organizational support perceptions were related to oncologists' work engagement, task adjustment and empathy. Additionally, psychological flourishing acted as a partial mediator between these perceptions of professional social context and oncologists' work-related attitudes. CONCLUSIONS: This research underlined the potential of enhancing the psychological flourishing of oncologists by improving organizational support and mitigating their sense of isolation, and in turn, to enhance some dimensions of their positive attitudes at work.

Bullying, supervisor support, relaxation, and personal and work outcomes: Testing a moderated mediation model.

AIM: To test a mediated moderation model in which bullying and supervisor support interact to predict nurses' personal and work outcomes with relaxation during off-job time mediating these effects. BACKGROUND: Bullying is a pervasive problem in the nursing profession. We integrate and extend past research addressing the question of how bullying and perceived supervisor support affect nurses' functioning. METHOD: Cross-sectional data were collected from a sample of 290 nurses who completed measures of bullying, perceived supervisor support, relaxation, need for recovery, sleeping problems, job satisfaction, emotional exhaustion and work performance. RESULTS: Results revealed that bullying was significantly linked to job satisfaction, sleeping problems, need for recovery and emotional exhaustion through relaxation, but only among nurses who perceived high levels of supervisor support. CONCLUSION: These results revealed that high supervisor support may be detrimental for nurses adding up to a negative cycle of stressors to maladaptive outcomes through lack of relaxation. IMPLICATIONS FOR NURSING MANAGEMENT: Health care organisations and managers should consider addressing work environment factors, such as bullying, in addition to supervisor support in their efforts to facilitate the positive effects of nurses' relaxation during non-work time.

Validation of the French Psychological Capital Questionnaire (F-PCQ-24) and its measurement invariance using bifactor exploratory structural equation modeling framework.

The general purpose of this study was to validate the French Psychological Capital Questionnaire (F-PCQ-24) in a French Air Force sample (N = 3,665). One specific aim was to verify what the best measurement model is for PsyCap, notably by using Bifactor Exploratory Structural Equation Modeling (B-ESEM). Another specific aim was to examine the measurement invariance of the best fitting model for the F-PCQ-24 across gender, rank and tenure. Results supported the superiority of the B-ESEM model of PsyCap with the hope dimension divided into its two components (will-power and way-power). Moreover, multi-group confirmatory factor analyses indicated the measurement invariance of F-PCQ-24 for gender and tenure, while there was a small problem with measurement invariance for rank. Overall, these findings confirm that the F-PCQ-24 is a stable measure of PsyCap and support previous theoretical considerations that PsyCap is a core construct. Implications of these findings, limitations and directions for future research are discussed.

The effects of job demands on nurses' burnout and presenteeism through sleep quality and relaxation.

AIMS AND OBJECTIVES: The main aim of this study was to investigate the indirect effects of emotional dissonance and workload on presenteeism and emotional exhaustion through sleep quality and relaxation. BACKGROUND: Numerous investigations have found that job demands are related to employees' health and behaviours, but additional studies are needed among nurse samples. Specifically, little is known about the relationships between nurses' emotional dissonance and workload on one hand, and presenteeism and emotional exhaustion on the other hand. Moreover, research is needed to further explore the psychological mechanisms underlying these relationships. DESIGN: We used a cross-sectional design. Our study was carried out between October 2015-February 2016. Precisely, we asked nurses from various French healthcare centres to fill out a questionnaire survey. We ensured to meticulously follow the STROBE guidelines for cross-sectional research in designing and reporting this study. METHOD: An empirical study with a sample of 378 nurses was conducted. RESULTS: In line with our hypotheses, our findings revealed that emotional dissonance and workload were negatively linked to sleep quality and relaxation, which were, in turn, related to lower levels of presenteeism and emotional exhaustion. Workload and emotional dissonance were also directly and positively related to emotional exhaustion, while emotional dissonance was associated with higher levels of presenteeism. Finally, the indirect effects of emotional dissonance and workload on emotional exhaustion through sleep quality as well as the indirect effects of emotional dissonance on emotional exhaustion through relaxation were significant and positive. CONCLUSIONS: Overall, our results provide insight into the effects of emotional dissonance and workload on presenteeism and emotional exhaustion through recovery processes. RELEVANCE TO CLINICAL PRACTICE: The present findings have some practical implications for reducing nurses' emotional exhaustion and presenteeism. Specifically, managers and organisations should try to design and craft jobs to decrease the presence of negative work characteristics (i.e., workload and emotional dissonance). Our results also suggest that recovery processes may be important factors to focus on.

The Forest and the Trees: Investigating the Globality and Specificity of Employees' Basic Need Satisfaction at Work.

This research assessed the underlying psychometric multidimensionality and nomological validity of 523 employees' responses to the Work-related Basic Need Satisfaction (W-BNS) scale using bifactor-exploratory structural equation modeling (bifactor-ESEM). Our results first showed the superiority of a bifactor-ESEM representation when compared to alternative representations of the data. Thus, employees' ratings of psychological need satisfaction simultaneously reflected a global need satisfaction construct, which coexisted with specific autonomy, competence, and relatedness needs satisfaction. Importantly, our findings also supported the nomological validity of employees' ratings of psychological need satisfaction in relation to measures of positive affect, negative affect, job satisfaction, perceived organizational support, organizational citizenship behaviors, work engagement, and burnout. In addition, our results also supported the presence of indirect (mediated) effects between perceived organizational support and some of the outcome variables as mediated by employees' levels of need satisfaction.

Perceived career opportunities, commitment to the supervisor, social isolation: Their effects on nurses' well-being and turnover.

AIM: This research investigated the relationship between perceived career opportunities, affective commitment to the supervisor, and social isolation from colleagues on the one hand and nurses' well-being and turnover intentions on the other. In addition, this study explored the mediating role of affective commitment to the organisation in these relationships. BACKGROUND: Previous research suggested that organisational commitment explained the effect of nurses' work environment on their turnover intentions. However, less is known about how organisational commitment may contribute to explain nurses' well-being. METHOD: This research used a cross-sectional design. A sample of 244 nurses completed a questionnaire survey. RESULTS: Results indicated that affective commitment to the organisation partially mediates the relationships between perceived career opportunities, affective commitment to the supervisor, and social isolation on one hand, and turnover intentions and well-being on the other hand. CONCLUSION: This study showed that the way nurses assess various aspects of their work experience transposes to their emotional bond to their organisation, which in turn explains their well-being and turnover intentions. IMPLICATIONS FOR NURSING MANAGEMENT: This paper identifies factors that could contribute to reduce nurses' intent to quit and promote their well-being.

The effects of work factors on nurses' job satisfaction, quality of care and turnover intentions in oncology.

AIMS: We examined the effects of perceived supervisor support, value congruence and hospital nurse staffing on nurses' job satisfaction through the satisfaction of the three psychological needs for autonomy, competence and relatedness. Then, we examined the links between job satisfaction and quality of care as well as turnover intentions from the workplace. BACKGROUND: There is growing interest in the relationships between work factors and nurses' job satisfaction. However, minimal research has investigated the effects of perceived supervisor support, value congruence and staffing on nurses' job satisfaction and the psychological mechanisms by which these factors lead to positive outcomes. DESIGN: A cross-sectional questionnaire was distributed in 11 oncology units between September 2015 - February 2016. METHOD: Data were collected from a sample of 144 French nurses who completed measures of perceived supervisor support, value congruence, staffing adequacy, psychological need satisfaction, job satisfaction, quality of care and turnover intentions. RESULTS: The hypothesized model was tested with path analyses. Results revealed that psychological need satisfaction partially mediated the effects of perceived supervisor support, value congruence and hospital nurse staffing on job satisfaction. Moreover, job satisfaction was positively associated with quality of care and negatively linked to turnover intentions. CONCLUSION: Overall, these findings provide insight into the influence of perceived supervisor support, value congruence and staffing on nurses' attitudes and behaviours.

Examining the effect of affective commitment to the supervisor on nurses' psychological health as a function of internal locus of control.

AIM: This research aimed to examine how affective commitment to the supervisor related to nurses' well- and ill-being, and to explore the moderating function of internal locus of control in these relationships. BACKGROUND: Little is known about the effects of affective commitment to the supervisor on well- and ill-being, even less so in the nursing profession. Moreover, previous studies suggested that nurses' psychological reactions to their work environment might vary as a function of their individual characteristics. METHODS: This cross-sectional research used a questionnaire survey to explore the hypothesised relationships in a sample of 100 female certified nursing assistants. RESULTS: The results revealed that affective commitment to the supervisor was most strongly related to job satisfaction and well-being, and associated with lower levels of emotional exhaustion, when the internal locus of control was high. CONCLUSIONS: The present study emphasises the importance of a high quality relationship between nurses and their supervisors in order to promote their psychological health, and underscores the importance of individual characteristics. IMPLICATIONS FOR NURSING MANAGEMENT: This research indicates how nurses' psychological health could be promoted by fostering their affective commitment to the supervisor. It also emphasises that managers' relationships with their subordinates should be adjusted as a function of nurses' individual characteristics.

Curvilinear effects of job characteristics on ill-being in the nursing profession: a cross-sectional study.

AIMS: To investigate the curvilinear associations between two job characteristics (i.e. task identity and information processing) and negative outcomes (i.e. nurse need for recovery and negative affect). BACKGROUND: Research has historically demonstrated the beneficial effects of motivational job characteristics on several individual and organizational consequences. These job characteristics were indeed found to be positively and linearly related to positive outcomes such as job satisfaction. However, another stream of research contends that job characteristics may have curvilinear effects on employee well-being. DESIGN: A cross-sectional correlational design was used. METHOD: Data were collected during June 2014, using a questionnaire survey. A convenience sample of French nurses and assistant nurses was recruited (n = 269). All participants were working in centres specialized in providing care to people with disabilities. RESULTS: This study demonstrated statistically significant curvilinear effects of job characteristics on nurses' ill-being, while controlling for their linear effects. CONCLUSIONS: These findings support that nurses' job characteristics are associated with their ill-being in complex ways and provide organizational and managerial applications for healthcare centres.

The Participatory Approach in Healthcare Establishments as a Specific French Organizational Model at Hospital Department Level to Prevent Burnout among Caregivers: What Are the Perceptions of Its Implementation and Its Potential Contributions by These Caregivers?

(1) Background: Manifestations of burnout are regularly observed in the healthcare population. The participatory approach (PA) is a specific organization in the French health service aimed at preserving and improving the psychological health of these staff at work. The main objective of this study was to explore with healthcare professionals their perceptions of the effectiveness of the four PA components (multi-professional team meetings, in-service training, team support meetings and the project approach) implemented to date within French hospital departments, the methods of their implementation and the potential contributions of such an approach to their quality of working life and working conditions (QWLWC), and the quality of care provided. (2) Methods: Semi-structured qualitative interviews were conducted with 21 healthcare professionals in French hospital departments between March and April 2021. After they were recorded, the collected data was transcribed in full and subjected to thematic analysis. (3) Results: According to care providers, PA is only partially deployed in these departments today. Nevertheless, it is helping to develop multi-professional communication, and improves the quality of life at work as well as quality of care. (4) Conclusions: In the light of these results, the creation of a tool for the large-scale evaluation of PA implementation in hospitals emerges as essential, as its deployment in all hospital departments could help reduce the suffering of care professionals. In addition, a better articulation between the concepts of Magnet Hospitals and those of PA would prove heuristically promising.

Development of a revised version of the transdiagnostic skills scale (T2S-R).

Introduction: The transdiagnostic approach has been shown to offer promising prospects in psychopathology, based on the observation that common factors may be involved in different psychiatric disorders. The transdiagnostic skills scale (T2S) was developed recently to assess the skills that are disrupted in these disorders. However, studies have shown that the T2S has lower predictive power for externalizing than internalizing disorders. This may be due to the fact that the skills assessed do not include the control of urges and cravings. The aims of the current study are thus to develop a revised version of the T2S (T2S-R) integrating this dimension, and to assess its factor structure and invariance across employment status (workers vs. students) and the level of psychopathology. Method: We recruited 1,298 French participants online through social media. They completed the revised version of the T2S and the symptomatic transdiagnostic test (S2T), which evaluates 11 clusters of psychiatric symptoms. We assessed the factor structure, internal consistency, invariance, and predictive validity of the revised T2S. Results: We found a good fit for a bifactor exploratory structural equation modeling (B-ESEM) approach including a global skills factor and seven specific factors. The results also indicate that the new dimension (i.e., control of urges and cravings) has good predictive value, especially for externalizing problems. We also found total invariance of the scale across employment status and partial invariance across the level of psychopathology. Conclusion: The revised version of the T2S-R has good psychometric properties. It predicts better externalizing problems than the original version. However, the scale remains more correlated with internalizing than externalizing problems. We discuss the implications of the results on the transdiagnostic conceptualization and the interest of using a mixed approach combining transdiagnostic and diagnostic analyses.

Procedural justice, supervisor autonomy support, work satisfaction, organizational identification and job performance: the mediating role of need satisfaction and perceived organizational support.

AIM: To test a model linking procedural justice, supervisor autonomy support, need satisfaction, organizational support, work satisfaction, organizational identification and job performance. BACKGROUND: Research in industrial and organizational psychology has shown that procedural justice and supervisor autonomy support lead to positive outcomes. However, very little research related to this subject has been conducted in healthcare settings. Moreover, few studies have examined mechanisms that could account for these positive relationships. DESIGN: A cross-sectional correlational design was used. METHOD: Convenience sampling was used and a sample of 500 nurses working in haematology, oncology and haematology/oncology units in France was surveyed in 2011. The final sample consisted of 323 nurses (64.6% response rate). The hypothesized model was tested using structural equation modelling. RESULTS: Procedural justice and supervisor autonomy support significantly and positively influenced need satisfaction and perceived organizational support, which in turn positively predicted work satisfaction, organizational identification and job performance. CONCLUSION: Organizations could deliver training programmes for their managers aimed at enhancing the use of fair procedures in allocating outcomes and developing their autonomy-supportive behaviours to improve nurses' work satisfaction, organizational identification and job performance.

Toward a new conceptualization of resilience at work as a meta-construct?

Organizations of all kinds are faced with multiple demands for adaptation of increasing frequency and amplitude due to such factors as reorganizations, climate change, pandemics, and labor shortages. This new reality requires our organizations to anticipate, adjust, and demonstrate resilience. The study of resilience at work relies on the comprehension of how organizational systems, as well as their work collectives and members, manage to overcome adversity without suffering from irreversible damage. However, the study of this phenomenon of interest contains grey areas concerning both its definition, its conceptualization, and the dynamic processes that underlie it. This theoretical paper addresses these different issues by providing first, a conceptual content analysis of the most frequently used definitions and second, a new conceptualization of resilience at work as a resource, either individual or collective. Moreover, we suggest a multilevel, dynamic, and virtuous conceptual approach to resilience at work, relying on both bottom-up and top-down flows. Accordingly, we formulate different theoretical propositions upon which future empirical research can draw to analyze the relationships between individual, team, and organizational resilience. Building on a conservation of resources lens, we offer a novel contribution to the resilience in the workplace literature, by providing an integrative and multilevel theory of resilience at work that highlights both the processual and interpersonal nature of its emergence, and the organizational levers that can foster it.

A New Gain Spiral at Work: Relationships between Virtuous Organizational Practices, Psychological Capital, and Well-Being of Workers.

Identifying antecedents of well-being at work is an active field of research, focusing notably on organizational practices that promote employees' optimal health. To date, whereas studies have demonstrated that some organizational practices, considered in isolation, are positively associated with indicators of well-being, none tested the joint effect of a bundle of practices on these. Moreover, few studies have examined the psychological mechanisms underlying these relationships. The present study aimed to identify the relationships between virtuous organizational practices, a new psychological integrative construct, and three indicators of workers' hedonic, eudaimonic, and social well-being, namely job satisfaction, thriving at work, and work-life balance, and to test the mediational role of psychological capital in these relationships. The sample comprised 400 French employees working in non-profit, private, and public organizations. Structural equation modeling confirmed the direct effects of virtuous organizational practices on the three indicators of well-being, and a bootstrapping procedure demonstrated that psychological capital partially mediates these relationships. The results of this study have many practical applications because virtuous organizational practices can easily be implemented and optimized in work organizations to develop the individual resources of workers and, in detail, to promote their psychological well-being. Finally, the contributions of this study, avenues for future research, and limitations are discussed.

Relationships between the characteristics of oncohematology services providing palliative care and the sociodemographic characteristics of caregivers using health indicators: social support, perceived stress, coping strategies, and quality of work life.

OBJECTIVE: The aim of this study was to analyze the relationships between the characteristics of the management of oncohematology services and the psychosocial determinants of caregivers' health at work including social support, stress, and coping strategies. DESIGN: Investigation using questionnaires was carried out about nurses and nurse aides in hematology and oncology services. SETTING: All hematology and oncology services of Western France were requested. Five questionnaires concerning sociodemographic characteristics, measurements of quality of work life, of social support, of perceived stress, and of coping strategies and quality of work life were delivered among health professionals. PARTICIPANTS: Five hundred seventy-four questionnaires from 53 different services were analyzed. There were 57.4% nurses and 42.6% nurse aides. Some 94.1% were female and 33.5% were older than 40 years. RESULTS: Several characteristics of oncohematology services were significantly linked to health indicators, as the need for time and recognition, the importance of training (in palliative care, pain management, and help relationship), the care of patients and their families, the interdisciplinary efficiency, and external interventions (psychologists and volunteers). We showed that participative management which includes implementation of service projects and of multidisciplinary staff influence the quality of work life of health professionals. We showed also how much the characteristics of services organized around an effective social support (need for recognition) favor a better quality of work life among caregivers, influencing their perceived stress and their coping strategies. CONCLUSION: To our knowledge, it is the first study showing a relationship between participative management (including multidisciplinary staffs, approach with a service project, and internal training) and the quality of work life in the domain of health care. The implementation of this model should be promoted in health care services.

How Can Students' Entrepreneurial Intention Be Increased? The Role of Psychological Capital, Perceived Learning From an Entrepreneurship Education Program, Emotions and Their Relationships.

Entrepreneurship education has become a major focus of interest for researchers and national policy makers to encourage students to pursue entrepreneurial careers. The research on entrepreneurship education-entrepreneurial intentions (EIs) has yielded mixed results, and indicates the need to focus on antecedents of EI. More precisely, the aim of this paper was to examine antecedents of students' EI in French entrepreneurship education programs. Participants were 460 French university undergraduates. Structural equation modeling results revealed that students' Psychological Capital (PsyCap) had a significant positive relationship with perceived learning from the program and a significant negative relationship with negative emotions related to entrepreneurial actions. They also show that PsyCap indirectly enhanced EI. More precisely, students with high PsyCap learned more from the program in terms of perceived skills and knowledge and in turn had a higher EI. Moreover, students with high PsyCap had less entrepreneurial action-related doubt, fear and aversion, which also increased EI. This decrease in negative emotions can be explained notably by what students perceived they had learned from the program. This article concludes with the implications of these findings for future research and practical applications.

Investigating a Participatory Intervention in Multidisciplinary Cancer Care Teams Using an Integrative Organizational Model: A Study Protocol.

Multidisciplinary teams encounter many challenges that can lead to higher levels of distress and burnout. This trend is acutely prevalent among multidisciplinary cancer care teams who frequently contend with increased task complexity and numbers of patients. Resilience is emerging as a critical resource that may optimize team members' psychological health and wellbeing, work efficiency, and organizational agility, while reducing burnout. Accordingly, the proposed study aims to implement and evaluate a promising participatory interventional approach that fosters team resilience. Specifically, the effects of the intervention on participating team members will be compared to a control group of non-participating team members. This intervention's core components include skills training, patient-centered meetings, talking spaces, and an agile problem-solving approach. The proposed study also seeks to determine whether enhanced resilience improves team mental health status and organizational outcomes. A participatory interventional approach will be implemented and assessed at three-time intervals [i.e., pre-intervention deployment (N = 375), 12 months post-deployment (N = 236), and 24 months post-deployment (N = 146)] across five cancer care teams in three Quebec healthcare institutions. A mixed methods design will be used that includes observations, semi-structured interviews, focus groups, and self-report questionnaires. Direct observation will document team functioning and structural resources (e.g., meetings, conflict management, and leadership). Semi-structured interviews will explore participants' experience with activities related to the participatory interventional approach, its perceived benefits and potential challenges. Focus groups will explore participants' perceptions of their team's resilience and the effectiveness of the intervention. Questionnaires will assess support, recognition, empowerment, organizational justice, individual resilience, psychological safety, work climate, team resilience, workplace burnout, engagement, quality of work life, wellbeing, and organizational citizenship behaviors, and sociodemographic variables. Moreover, objective measures including absenteeism and staff turnover will be obtained via human resource records. Structural equation modeling will be used to test the study's hypotheses. The proposed protocol and related findings will provide stakeholders with quantitative and qualitative data concerning a participatory interventional approach to optimize team effectiveness. It will also identify critical factors implicated in favorable organizational outcomes in connection with multidisciplinary cancer care teams. Expected results and future directions are also presented herein.

An explanatory model of authentic leadership, flourishing and work-family balance of nurses in French hospitals.

PURPOSE: This study aims to investigate the relationship between a positive leadership style [i.e. authentic leadership (AL)] and nurses' psychological health (i.e. nurses' flourishing and satisfaction with work-family balance), including psychological capital (PsyCap) as a mediational variable. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study was conducted with a self-report questionnaire including 1,076 nurses from public and private hospitals in France. FINDINGS: Structural equation modeling results revealed that AL is related to nurses' flourishing and satisfaction with work-family balance and that PsyCap acted as a partial mediator between this leadership style and positive outcomes. PRACTICAL IMPLICATIONS: This research indicated that hospitals can enhance nurses' psychological health not only in their work but also in their lives in general by improving leaders' authentic management style and developing PsyCap (e.g. staffing, training and development). ORIGINALITY/VALUE: An original feature of this paper concerns its focus on the mediating role of PsyCap in the relationship between AL and these positive outcomes. Moreover, this study underlined the influence of leadership style on nurses' psychological health beyond occupational health. The research makes a valuable contribution to the existing AL literature by establishing a new explanatory model of AL and nurses' psychological health in the French context. It also highlights the interest in developing this leadership style in health-care settings.

Virtuous Organizational Practices: A New Construct and a New Inventory.

Research on the identification of organizational practices that promote individual and organizational performance is now very extensive. However, several studies have revealed the dark side of these practices on employees' psychological health. Consequently, researchers have called on the scientific community to focus on the well-being of workers and to identify the organizational practices that promote it. Thus, the aim of the present research was to fill this gap by introducing a new conceptualization of organizational practices supporting the psychological health of employees and proposing a new improved measure to assess them. Drawing on the American Psychological Association's model of Psychologically healthy workplace, we first conceptualized the innovative multidimensional construct of virtuous organizational practices. We then conducted four studies (N = 1,407) to develop and validate the Virtuous Organizational Practices inventory. Results of exploratory statistical analyses provide strong evidence of the second-order factor structure of the inventory in different French samples and of the convergent, predictive and incremental validity of this tool. Implications for researchers, organizations and practitioners and avenues for future research are discussed.

A person-centered perspective on the factors associated with the work recovery process.

BACKGROUND AND OBJECTIVES: This research identified profiles characterized by distinct levels of overcommitment, rumination, psychological detachment (Studies 1 and 2), and need for recovery (Study 2). This research also considers the role of hindrance demands and resources in the prediction of profile membership, and the outcomes of these profiles. METHODS: These objectives were addressed in two empirical cross-sectional studies relying on self-reported questionnaires. Study 1 relies on a convenience sample of French workers from a variety of occupations. Study 2 relies on a convenience sample of French nurses and nursing assistants. RESULTS: Latent profile analyses revealed four identical profiles in both studies (High Ability to Achieve Recovery, Moderately High Ability to Achieve Recovery, Moderately Low Ability to Achieve Recovery, and Low Ability to Achieve Recovery), accompanied by an additional (Normative) profile in Study 2. The results from both studies revealed well-differentiated outcome associations, which generally matched the theoretical desirability of the identified profiles. Likewise, hindrance demands were associated with a decreased likelihood of membership into the High Ability to Achieve Recovery profile, as well as an increased likelihood of membership into the Low Ability to Achieve Recovery profile across studies. CONCLUSIONS: Theoretical contributions and implications for practice are discussed.