Doctor of Philosophy / School of Family Studies and Human Services / Jared A. Durtschi / Chronic pain is one of the most pervasive healthcare conditions being treated today. The onset of chronic pain can start at any age, and can follow a myriad of trajectories. Health conditions like chronic pain have been shown to be associated with increases in depression, anxiety, and other adverse mental health outcomes. The present study utilized a sample of 10,266 adult individuals with chronic conditions where chronic pain was typically present to identify different profiles of chronic pain sufferers and then examine the associations between general health, chronic pain profile membership, and mental health outcomes. Although previous studies have attempted to identify chronic pain profiles, no study has yet explored how pain frequency and intensity, fatigue, duration of chronic condition, and physical limitations caused by this condition may uniquely identify subgroups within the chronic pain population. Utilizing a latent profile analysis, four distinct profiles of chronic pain were identified, including a Constant Companion profile, an Adjustments Needed profile, an Annoying Companion profile, and a No Limitations profile. Through a path analysis, significant associations were found between both general health and changes in general health, chronic pain profile membership, and frequency of anxious, depressed, and hopeless feelings. Results generally were counterintuitive, with better health linked with higher odds of fitting the more extreme chronic pain profiles compared to the no limitations profile; and those in the more extreme chronic pain profiles had significantly less frequent feelings of depression, anxiety, and hopelessness. Ideas for clinical implications and suggestions for future research are provided.

Background: Despite the ongoing pandemic attributed to an infectious disease (SAR-CoV-2), non-infectious diseases-primarily cardiovascular diseases (CVD) remain the leading cause of death globally accounting for 655,000 annual deaths in the United States (U.S.). Additionally, CVD significantly impacts the quality of life attributing to total healthcare expenditure of $214 billion per year, of which $138 billion are attributed to the loss of productivity due to poor quality of life. The study's purpose is to assess the impact of CVD on the general health of adults in the U.S. Question: What is the effect of CVD including angina, coronary heart disease, heart attack, and stroke on the general health of adults residing in the U.S.? Methods: Study data included 418,268 adults who participated in the Behavioral Risk Factor Surveillance System (BRFSS) during 2019. The study outcome was general health status of U.S. adults categorized into excellent, very good, good, fair, and poor groups. Predictor variables included responses to the diagnosis of angina/coronary heart disease (CHD), heart attack (HD), and stroke during the respective years Other covariates included participants' demographics (age, education, and annual household income). Logistic regression models were conducted to estimate the association of CVD and other covariates with general health of U.S. adults adjusting for other confounders. Results: After applying the study criteria, the final study sample included 355,391 participants. Poor general health status was reported among 83,882 study participants (19.6%). The odds of reporting a poor general health status were 2.7 times (adjusted OR (aOR) 2.70, 95% CI 2.56-2.78), 2 times (aOR: 2.04, 95% CI 1.96-2.08), and 2.6 times (aOR 2.56, 95% CI 2.50-2.70) more likely among participants who had CHD, HD, and stroke respectively compared to participants who did not have such conditions. The odds of reporting a poor general health status was 4% less likely among males compared to females (aOR 0.96, 95% CI 0.94-0.98). For every 5-year increase in age, the odds reporting poor general health status increased by 5% (aOR: 1.05, 95% CI 1.045-1.052). Participants earning $50,000 or more income were 68% less likely to report poor general health status compared with those earning less than $50,000 (aOR: 0.32, 95% CI 0.31- 0.33). Furthermore, participants with above high school education were 42% less likely to indicate poor general health status than those with high school or less education (aOR: 0.58, 95% CI 0.57-0.59). Conclusion: The study findings provide subjective evidence about poor health status among U.S. adults diagnosed with CVD. Future studies are warranted to substantiate this evidence using objective measures and adjusting for other unmeasured cofounders. Public Health Implications: While the nation continues to shift its strategies in addressing the COVID-19 pandemic and other emerging infectious diseases, there is a need for continued effort to address the prevention of CVD and other non-communicable diseases and reduce its impact among adults in the United States.

Attention deficit hyperactivity disorder (ADHD) has been the subject of much research and controversy. Although ADHD was once believed to affect only children, recent research indicates that the symptoms of ADHD persist past childhood and adolescence, well into college age and adulthood. ADHD negatively impacts several life domains, such as perceived general health, college education, employment, social life, and psychological health. For some, this negative impact results in lowering the level of quality of life (QOL) or life-satisfaction. The purpose of this study is to describe the experiences that influence the level of QOL among different presentations of adults with ADHD. Information was gathered by using a survey and qualitative interviews with different presentations of adults with ADHD to collect and analyze their perceptions (thoughts, feelings, beliefs, and opinions) about the impact of this condition on their QOL level and different life domains.

<p> Bariatric surgery is not the panacea it was once thought to be for weight loss. Due to patient noncompliance issues, many weight loss surgery patients are relapsing and regaining the significant amounts of weight that bariatric surgery had initially helped them to lose. This failure is costly monetarily, psychologically, and medically to both the patient and to society. Using the narratives of 32 post-weight loss surgery patients, this narrative study explored: (a) whether Erikson's psychosocial stages of development occur after weight loss surgery, (b) whether successful patients (defined as those who are able to maintain their weight loss long term) have successfully navigated Erikson's stages, and (c) whether these patients formed new identities in the process. Recursive analysis and text analysis revealed noticeable trends toward developmental progress among participants after weight loss surgery, with regard to all stages in Erikson's psychosocial developmental theory. This trend suggests that participants are experiencing developmental changes after surgery and that participants who have successfully navigated psychosocial stages are at least beginning to build new identities. These findings may indicate the need for social changes in the way clinicians guide patients through the weight loss surgery process; these findings may also inspire the creation of programs that address developmental milestones, which may increase successes after weight loss surgery.</p>

South African schools are quickly, and progressively, becoming arenas for violent behaviour. These days, schools are no longer considered safe and protected environments where children can go to learn, develop, enjoy themselves, and feel secure. Rather, schools are being defined as unsafe and dangerous settings for teaching and learning, plagued by various forms of school violence (Van Jaarsveld, 2008). According to De Wet (2003), the causes of school violence are numerous and exceptional to each violent incident. Research indicates that most perpetrators of school violence are in the adolescent stage of development (O‟Toole, 2000). Adolescence as a transition stage implies severe changes on both an anatomical and a psychological level, presenting psycho-social adjustment demands that could be too much for certain adolescents and end in dysfunctional adaptive behaviour such as aggression (Louw & Louw, 2007; Sigelman & Rider, 2006). According to Meece and Daniels (2008), there seems to be no single cause for aggression and it is seen as an interaction of the adolescent’s own characteristics, family environment, culture, peer relations and community. The purpose of this study was to investigate whether intra- and inter-psychological factors such as self related well-being, coping self-efficacy, general health and inter-personal relations contribute to manifested anger/hostility/aggression of learners in secondary schools. A quantitative research design of the cross sectional survey type was used to reach the aims of this study. The population included grade nine learners of four secondary schools who fitted the selection criteria. The size of the research group was N=512, which included male (N=217) and female (N=295), African (N=311) and White (N=201) adolescent learners. Quantitative data collection was done by means of the Personal, Home, Social and Formal Relations Questionnaire (PHSF) of Fouché and Grobbelaar (1971), the Coping Self-Efficacy Scale (CSE) of Chesney, Neilands, Chambers, Taylor, and Folkman (2006), the General Health Questionnaire (GHQ-12) of Goldberg and Hillier (1979) and the Aggression Questionnaire (AQ) of Buss and Perry (1992). A biographical questionnaire was also included to collect the participants‟ socio-demographic information. The empirical research was described and results reported in two manuscripts intended for publication. Descriptive statistics, reliability and validity of the measuring instruments used, correlations among the operationalized constructs, significance of differences on the scales for subgroups and regression analyses to identify predictors of aggression and moderating variables, were calculated. The results of the study indicated that although means and standard deviations correspond to those reported in literature for the same scales, the participants in this study manifested only moderate levels of the phenomena measured. The reliability and validity of the measuring instruments were mostly acceptable, with a few exceptions. Correlational results indicated that psychological factors have significantly negative relationships with aspects of aggressive behaviour, suggesting that the more psychological wellness and adjustment youth experience, the less they will experience or express aggressive behaviour. Significance of differences on several of the variables investigated was found between the gender and racial sub-groups with moderate to large practical effect. Furthermore, aspects of personal and social adjustment and of coping self-efficacy and mental health, significantly predicted features of aggression in youth who participated. Intra- and inter-personal aspects of psychological adjustment significantly moderated the strength of the relationships between coping self-efficacy and aggression as well as general mental health and aggression. These findings were theoretically expected and could be explained by means of research findings reported in literature and relevant theories. Conclusions and recommendations were discussed. / Thesis (MA (Psychology))--North-West University, Vaal Triangle Campus, 2013

Organisations throughout the world have to cope with an increasing rate of change. These organisational changes are due to a number of reasons, which include social, technological, economic and political reasons. These result in a change in government regulations. In South Africa, the changes include the merging of higher education institutions and changes in the educational landscape. The public higher education institutions were reduced by the Department of Higher Education and Training from 36 to 23. Same changes include new universities of technologies and mergers of other universities plus more comprehensive universities. Recently, government established two new universities, one in Mpumalanga and another in the Northern Cape. Job insecurity, job satisfaction, occupational stress, sense of coherence, and general health are key aspects of the higher education institutions during and after the transformation process. This study aimed to determine the relationship between job insecurity, job satisfaction, occupational stress, sense of coherence, and general health of employees in a higher education institution. The literature reviewed showed that job insecurity occurs as a result of a merger, which is one of the multiple antecedents in a job insecurity model. However, a merger, as an organisational condition, changes individual perceptions about job insecurity and its consequences. Job satisfaction, occupational stress, and general health are consequences of job insecurity. From the reviewed literature, it is clear that the employees’ lack of resources is a very serious challenge in their endeavour to perform their duties. Lack of resources results in the poor performance of employees and their inability to use their capabilities to deal with every day work-related challenges. A cross-sectional design with employees in higher education institution (N=229) was used. The Job Insecurity Inventory, Minnesota Job Satisfaction Questionnaire, An Organisation Stress Screening Tool, Orientation to Life Questionnaire, and General Health Questionnaire, and a biographical questionnaire were utilised. Statistical analyses were carried out for the three articles in the study with the help of the Statistical Package for Social Sciences (IBM-SPSS) program. Statistical methods used in this article consisted of descriptive statistics (for example, means, standard deviations and frequencies), Cronbach alpha coefficients, explanatory factor analyses, Pearson product-moment correlation coefficients, multiple regression analysis and mediation analysis (Omnibus procedure). The results of article 1 showed that job insecurity was statistically significantly related to general health (somatic symptoms, social dysfunction, hopelessness and worthlessness). This implies that employees who experience high job insecurity also experience problems with their health. General health had a practically significant negative correlation with sense of coherence. Literature reviewed states that a weak sense of coherence leads employees to perceive situations as threatening (that is, high job demands and low job resources), and could lead to ill health. The research findings clearly indicate that sense of coherence does not moderate the relationship between job insecurity and general health. Regarding the results of article 2, a practically significant negative relationship exists between occupational stress and job satisfaction (intrinsic, supervision, extrinsic). This means that employees with high levels of occupational stress display lower job satisfaction and vice versa. Occupational stress and general health have a negative relationship, implying that different occupational stress factors (work demands, insecurity and work relations) relate to the general health of employees. Employees, who experience high work demands, are insecure and experience poor work relations with their colleagues or supervisors, have problems with their health and do not enjoy normal day-to-day activities in the organisation. Job satisfaction displays a practically significant negative correlation with general health. This implies that employees who are not satisfied with the intrinsic satisfaction of their job and working environment experience headaches and lack physical energy. Such employees generally feel sick. They do not enjoy every day activities since they doubt their own competence and the meaning of life. Both occupational stress and job satisfaction are statistically significant predictors of general health. In conclusion, the results of this article report that job satisfaction mediates the relationship between occupational stress and the general health of employees in a higher education institution. The results of article 3 showed that practically significant positive relationships exist between sense of coherence and job satisfaction. Employees with a higher sense of coherence are more satisfied and motivated to work. They are more comfortable with other colleagues and the general working conditions. Employees with a strong sense of coherence are more resourceful in handling different work-related aspects, and they tend to experience higher job satisfaction. It was concluded that sense of coherence moderates the relationship between job satisfaction and some aspects of general health. The results imply that people with lower levels of sense of coherence are more dependent on job satisfaction to experience good health. This has direct implications for vocational and industrial psychologists, as well as higher educational institutions. Recommendations for future research were made. / PhD (Industrial Psychology) North-West University, Vaal Triangle Campus, 2014

The work environment in which South African employees have to function is highly demanding, offering them little in terms of job security, but simultaneously expecting them to give more in terms of inter alia flexibility, competency, and effort. Tracking and addressing chemical industry employees' functioning in areas that could affect their general health and consequent standard of service is essential. Job insecurity, work-based support, job satisfaction, organisational commitment and general health are specific focus areas in this research. It is important to use reliable and valid measuring instruments to measure these constructs. It appears that job insecurity results in reduced organisational commitment as well as reduced job satisfaction. In the long run all this may have a negative impact on the psychological well-being of employees. Therefore, the right kind of support h m the right kind of people can be of significant value in reducing occupational stress, improving health, and buffering the impact of stress on health. A lack of South African research exists regarding job insecurity, work-based support, job satisfaction, organisational commitment and general health - hence the importance of this research. The primary objective of this research was to investigate the relationship between job insecurity, work-based support, job satisfaction, organisational commitment and general health of Human Resources Professionals (N = 114) in a chemical industry. A cross-sectional survey design was used to collect data. It was found that affective and cognitive job insecurity demonstrated a statistically significant negative correlation with emotional social support (supervisor and other), but practically and statistically negative correlation with intrinsic and extrinsic job satisfaction. With regard to affective and cognitive job insecurity and general health, a statistically significant positive correlation was obtained for somatic symptoms, social dysfunction and severe depression, and a practically and statistically significant correlation with anxiety and insomnia. Affective commitment demonstrated a statistically significant negative relationship with cognitive job insecurity. The regression analysis indicated that job insecurity has some predictive value with regard to the intrinsic and extrinsic job satisfaction and general health subscales, namely somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. With regard to the two components of job satisfaction, intrinsic and extrinsic, job insecurity predicted 14% and 5% respectively of the variance. No predictions were found between affective commitment and job insecurity. With regard to general health, job insecurity predicted 5% (somatic symptoms), 11% (anxiety and insomnia), 1 % (social dysfunction) and 8% (severe depression). Conclusions were made, limitations of the cumin research were discussed and recommendations for future research were put forward. / Thesis (M.A. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2006.

Introduction: Health, and well-being of older Canadians have been extensively studied. Less is known about health and well-being of older Canadians with disability. Study Objectives: 1) describe social participation patterns of older Canadian adults with disability; 2) determine the most commonly reported barriers for their participation in leisure and social activities; and 3) examine the independent effect of participation in leisure and social activities on their general health and life satisfaction. Methods: A secondary analysis of cross-sectional data from the 2006 Participation and Activity Limitation Surveys (PALS) was performed. Results: A significant independent effect of participation in leisure and social activities on the positive general health and positive life satisfaction of older Canadians with disability, for both men and women, was confirmed. Conclusions: Participation in leisure and social activities is a potential venue to enhance health, and well-being of older Canadian adults with disability. / October 2016

Objetivo: Investigar a saúde mental de jovens com fissura labiopalatina transforame em atendimento no Hospital de Reabilitação de Anomalias Craniofaciais, USP. Modelo/Pacientes: Estudo observacional transversal, em 60 sujeitos com idade entre 19 e 26 anos: 30 sujeitos com fissura labiopalatina transforame (Grupo 1) e 30 sujeitos sem fissura labiopalatina (Grupo-Controle). O método foi quanti-qualitativo, utilizando como instrumentos a entrevista clínica semiestruturada e o Questionário de Saúde Geral (QSG) de Goldberg, que avalia a presença de transtornos mentais comuns não-psicóticos: stress psíquico, desejo de morte, desconfiança no desempenho, distúrbios do sono, distúrbios psicossomáticos e saúde geral. Local: As entrevistas foram realizadas na Sociedade de Promoção Social do Fissurado Lábio-Palatal (PROFIS), prestadora de assistência aos pacientes em tratamento no Hospital de Reabilitação de Anomalias Craniofaciais. Resultados: Os dados quantitativos obtidos no QSG, pelos Grupos 1 e Controle foram comparados, não se encontrando diferença estatisticamente significativa entre os pacientes com fissura labiopalatina e o Grupo-Controle, nos fatores de Saúde Mental. Quanto aos gêneros, encontrou-se diferença estatisticamente significativa no fator Desejo de Morte, no Grupo 1, gênero feminino, em comparação ao masculino, porém, abaixo do percentil 90, indicativo de transtorno. Quando comparados com a média brasileira, também não houve diferença estatística significativa. Conclusões: Apesar de a análise qualitativa dos dados revelar sujeitos com histórias de sofrimento, discriminação e dificuldades, verificou-se que eles estão conseguindo enfrentar dificuldades e apresentaram características pessoais de desenvolvimento semelhante ao Grupo-Controle. Deste modo, concluiu-se que, neste estudo, não houve correlação entre fissura labiopalatina transforame e transtornos de saúde mental não psicóticos. / Objective: To investigate the mental health of youngsters with untreated cleft lip/palate attended at the Hospital for Rehabilitation of Craniofacial Anomalies, USP. Model / Patients: Studies in 60 subjects aged between 19 and 26 years old (Group 1) and 30 subjects without untreated cleft lip/palate (Group 1) and 30 subjects without cleft palate (Control Group). Using semi-structured clinical interview instruments and the General Health. Questionnaire (GHQ) of Goldberg, which assesses the presence of common non-psychotic mental health: mental stress, death wish, distrust on performance, sleep disturbances, psychosomatic disorders and general health. Location: The interviews were conducted at the Sociedade de Promoção Social do Fissurado Labio Palatal PROFIS (Society for the Promotion of Social Cleft Lip and Palate), a provider of assistance to patients at the Hospital for Rehabilitation of Craniofacial Anomalies. Results: The quantitative data obtained on the GHQ, for Groups 1 and Control were compared, and there are no statistically significant difference between patients with cleft lip and palate and the Control Group, on the factors of Mental Health. Regarding gender, we found a statistically significant difference in factor ¨ Death Wish ¨, in Group 1, females compared to males, but below the 90th percentile, indicative of disorder. When compared with the national average, there were no statistically significant differences. Conclusions: Although the qualitative data analysis revealed subjects records of suffering, discrimination and difficulties, it was found that they are tackling problems and personal development presenting characteristics similar to the control group. Thus, we concluded that in this study, there was no correlation between untreated cleft lip/palate and non-psychotic mental health disorders.

Bilden av personers hälsa som spelar elektroniska spel ser tämligen negativ ut, även om tidigare forskning förklarar att olika nivåer av spelandet kan medföra kognitiva fördelar. Men hur ser den psykiska hälsan ut? Studiens syfte var att jämföra skillnader i psykisk hälsa mellan nivåer av elektroniskt spelande, eSport atleter låg i fokus då tidigare forskning ej undersökt eSport atleters psykiska hälsa. Genom att jämföra tre nivåer av amatörspelare och en grupp eSport atleter i mindfulness, självförmåga och generell hälsa via en enkät fick studien reda på skillnader i psykisk hälsa mellan de olika spelnivåerna. Det signifikanta resultatet studien fann var att atleterna visade högre värden i självförmåga gentemot amatörgrupperna. Det sa emot vad studien förväntade, då atleter förväntades ligga lägre än amatörgrupperna. Däremot visade resultatet att deltagare för de fyra grupperna indikerar en god psykisk hälsa samt nivån av spelanvändning ej resulterade i förhöjd psykiska hälsa. / There are negative attitudes toward people who play electronic games even though different levels of gaming may improve cognitive functions according to previous research. But what about mental health? This study aimed to compare differences in mental health between different levels of gaming since past research hasn’t investigated the mental health amongst eSport athletes. In a survey, three groups of novice gamers and one group of eSport athletes were compared in general health, self-efficacy and mindfulness. The result showed significant higher values of self-efficacy in the eSport group compared to the three novice groups of gamers. This result was unpredicted, since eSport athletes were expected to score lower values than the novice groups. However, all four groups indicated good mental health and higher levels of gaming did not increase mental health cumulatively.