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The 2013 US Veterans Administration/Department of Defense Clinical Practice Guidelines (VA/DoD CPG) require comprehensive suicide risk assessments for VA/DoD patients with mental disorders but provide minimal guidance on how to carry out these assessments. Given that clinician-based assessments are not known to be strong predictors of suicide, we investigated whether a precision medicine model using administrative data after outpatient mental health specialty visits could be developed to predict suicides among outpatients. We focused on male nondeployed Regular US Army soldiers because they account for the vast majority of such suicides. Four machine learning classifiers (naive Bayes, random forests, support vector regression and elastic net penalized regression) were explored. Of the Army suicides in 2004-2009, 41.5% occurred among 12.0% of soldiers seen as outpatient by mental health specialists, with risk especially high within 26 weeks of visits. An elastic net classifier with 10-14 predictors optimized sensitivity (45.6% of suicide deaths occurring after the 15% of visits with highest predicted risk). Good model stability was found for a model using 2004-2007 data to predict 2008-2009 suicides, although stability decreased in a model using 2008-2009 data to predict 2010-2012 suicides. The 5% of visits with highest risk included only 0.1% of soldiers (1047.1 suicides/100 000 person-years in the 5 weeks after the visit). This is a high enough concentration of risk to have implications for targeting preventive interventions. An even better model might be developed in the future by including the enriched information on clinician-evaluated suicide risk mandated by the VA/DoD CPG to be recorded.

Background: Understanding concordance between informants' and cognitively impaired participants' information reporting is crucial for Alzheimer's and Alzheimer's-related dementia studies., Methods: The Brain Attack Surveillance in Corpus Christi-Cognitive is a community-based cohort study. Households in Nueces County, Texas, USA, were randomly identified. 330 dyads of participants and their named informants answered questions. Models were generated to examine which predictors, including age, gender, ethnicity, cognitive function, and relationship to informant, influenced answer discordance., Results: For demographic items, female participants and participants with spouses/partners as informants had significantly less discordance, with incidence rate rations (IRRs) of 0.65 (CI = 0.44, 0.96) and 0.41 (CI = 0.23, 0.75), respectively. For health items, better cognitive function of the participant was associated with less discordance, with an IRR of 0.85 (CI = 0.76, 0.94)., Conclusions: Demographic information concordance is most associated with gender and informant-participant relationship. Level of cognitive function is most associated with concordance for health information., Clinicaltrials: gov identifier NCT03403257., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Occupational burnout, resulting from long-term exposure to work-related stressors, is a significant risk factor for both physical and mental health of employees. Most research on burnout focuses on routine situations, with less attention given to its causes and manifestations during prolonged national crises such as war. According to the Conservation of Resources theory, wartime conditions are associated with a loss of resources, leading to accelerated burnout. This study aimed to examine burnout among employees during the war in Israel that broke out in October 2023, placing the population nationwide in a state of existential threat and functional crisis. The researchers hypothesized that Stress, work-to-family conflict, family-to-work conflict, sleep disruption, and routine disruption (H1-H5) would be positively associated with occupational burnout. In addition, the study examined whether organizational strategies, such as flexibility and volunteering, would be negatively associated with burnout (H6) and whether they would moderate the relationship between work-family conflict and burnout during wartime (H7). Methods: The study involved 374 employees recruited through social networks via a snowball sampling method during the war. Participants completed a questionnaire assessing demographic details, burnout, stress, routine disruptions, work family conflict (work-to-family and family-to-work conflict), sleep disturbances, and organizational support measures. Hierarchical linear regression and Pearson correlation were utilized to model the outcome variable of occupational burnout and Process Model 1 was utilized for the moderation hypothesis. Results: Findings revealed a notable level of burnout during wartime (M = 3.95, SD = 1.15). Routine disruptions, work-to-family conflict, and sleep disturbances significantly contributed to burnout beyond stress levels, thus hypotheses H1 to H5 were partly supported. Additionally, the organizational resource variable of offering volunteering opportunities was associated with lower burnout levels and moderated the relationship between work-to-family conflict and burnout, thus partially supporting hypotheses H6 and H7. Conclusion: The findings enhance the understanding of burnout during prolonged crises like war, highlighting the importance of maintaining routine as a key resource for order and control. They also emphasize the role of organizational volunteering in preventing burnout. The theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

This study explored the susceptibility of inner-city youth to stressful life events. It employed the Conservation of Resources (COR) theory to elucidate the impact of stressful events on their psychological distress. It tested the applicability of the Conservation of Resources Evaluation (COR-E) scale, previously used only on adults, on an inner-city youth sample comprising 309 Israeli adolescents from high-risk urban schools. Participants completed the Stressful Life Events Screening Questionnaire (SLESQ), an adapted version of the COR-E, and the Short Brief Symptom Inventory (BSI-18). Unique resource categories emerged, grounded in the youths' immediate environment. Positive correlations were established between resource loss and stressful life events, and heightened resource loss was associated with increased psychological distress. The study underscores the utility of the COR framework in comprehending the intricate relationship between psychosocial resource loss and the psychological well-being of inner-city youth. [ABSTRACT FROM AUTHOR]

Background: The period after psychiatric hospital discharge is one of elevated risk for suicide‐related behaviors (SRBs). Post‐discharge clinical outreach, although potentially effective in preventing SRBs, would be more cost‐effective if targeted at high‐risk patients. To this end, a machine learning model was developed to predict post‐discharge suicides among Veterans Health Administration (VHA) psychiatric inpatients and target a high‐risk preventive intervention. Methods: The Veterans Coordinated Community Care (3C) Study is a multicenter randomized controlled trial using this model to identify high‐risk VHA psychiatric inpatients (n = 850) randomized with equal allocation to either the Coping Long Term with Active Suicide Program (CLASP) post‐discharge clinical outreach intervention or treatment‐as‐usual (TAU). The primary outcome is SRBs over a 6‐month follow‐up. We will estimate average treatment effects adjusted for loss to follow‐up and investigate the possibility of heterogeneity of treatment effects. Results: Recruitment is underway and will end September 2024. Six‐month follow‐up will end and analysis will begin in Summer 2025. Conclusion: Results will provide information about the effectiveness of CLASP versus TAU in reducing post‐discharge SRBs and provide guidance to VHA clinicians and policymakers about the implications of targeted use of CLASP among high‐risk psychiatric inpatients in the months after hospital discharge. Clinical trials registration: ClinicalTrials.Gov identifier: NCT05272176 (https://www.clinicaltrials.gov/ct2/show/NCT05272176). [ABSTRACT FROM AUTHOR]

Background Civilian suicide rates vary by occupation in ways related to occupational stress exposure. Comparable military research finds suicide rates elevated in combat arms occupations. However, no research has evaluated variation in this pattern by deployment history, the indicator of occupation stress widely considered responsible for the recent rise in the military suicide rate. Method The joint associations of Army occupation and deployment history in predicting suicides were analysed in an administrative dataset for the 729 337 male enlisted Regular Army soldiers in the US Army between 2004 and 2009. Results There were 496 suicides over the study period (22.4/100 000 person-years). Only two occupational categories, both in combat arms, had significantly elevated suicide rates: infantrymen (37.2/100 000 person-years) and combat engineers (38.2/100 000 person-years). However, the suicide rates in these two categories were significantly lower when currently deployed (30.6/100 000 person-years) than never deployed or previously deployed (41.2–39.1/100 000 person-years), whereas the suicide rate of other soldiers was significantly higher when currently deployed and previously deployed (20.2–22.4/100 000 person-years) than never deployed (14.5/100 000 person-years), resulting in the adjusted suicide rate of infantrymen and combat engineers being most elevated when never deployed [odds ratio (OR) 2.9, 95% confidence interval (CI) 2.1–4.1], less so when previously deployed (OR 1.6, 95% CI 1.1–2.1), and not at all when currently deployed (OR 1.2, 95% CI 0.8–1.8). Adjustment for a differential ‘healthy warrior effect’ cannot explain this variation in the relative suicide rates of never-deployed infantrymen and combat engineers by deployment status. Conclusions Efforts are needed to elucidate the causal mechanisms underlying this interaction to guide preventive interventions for soldiers at high suicide risk., Psychology

Background: Accidents are one of the leading causes of death among U.S. active-duty Army soldiers. Evidence-based approaches to injury prevention could be strengthened by adding person-level characteristics (e.g., demographics) to risk models tested on diverse soldier samples studied over time., Purpose: To identify person-level risk indicators of accident deaths in Regular Army soldiers during a time frame of intense military operations, and to discriminate risk of not-line-of-duty from line-of-duty accident deaths., Methods: Administrative data acquired from multiple Army/Department of Defense sources for active duty Army soldiers during 2004-2009 were analyzed in 2013. Logistic regression modeling was used to identify person-level sociodemographic, service-related, occupational, and mental health predictors of accident deaths., Results: Delayed rank progression or demotion and being male, unmarried, in a combat arms specialty, and of low rank/service length increased odds of accident death for enlisted soldiers. Unique to officers was high risk associated with aviation specialties. Accident death risk decreased over time for currently deployed, enlisted soldiers and increased for those never deployed. Mental health diagnosis was associated with risk only for previous and never-deployed, enlisted soldiers. Models did not discriminate not-line-of-duty from line-of-duty accident deaths., Conclusions: Adding more refined person-level and situational risk indicators to current models could enhance understanding of accident death risk specific to soldier rank and deployment status. Stable predictors could help identify high risk of accident deaths in future cohorts of Regular Army soldiers., (Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.)

The US Army suicide rate has increased sharply in recent years. Identifying significant predictors of Army suicides in Army and Department of Defense (DoD) administrative records might help focus prevention efforts and guide intervention content. Previous studies of administrative data, although documenting significant predictors, were based on limited samples and models. A career history perspective is used here to develop more textured models. The analysis was carried out as part of the Historical Administrative Data Study (HADS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). De-identified data were combined across numerous Army and DoD administrative data systems for all Regular Army soldiers on active duty in 2004–2009. Multivariate associations of sociodemographics and Army career variables with suicide were examined in subgroups defined by time in service, rank and deployment history. Several novel results were found that could have intervention implications. The most notable of these were significantly elevated suicide rates (69.6–80.0 suicides per 100 000 person-years compared with 18.5 suicides per 100 000 person-years in the total Army) among enlisted soldiers deployed either during their first year of service or with less than expected (based on time in service) junior enlisted rank; a substantially greater rise in suicide among women than men during deployment; and a protective effect of marriage against suicide only during deployment. A career history approach produces several actionable insights missed in less textured analyses of administrative data predictors. Expansion of analyses to a richer set of predictors might help refine understanding of intervention implications., Psychology

Background The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) has found that the proportional elevation in the US Army enlisted soldier suicide rate during deployment (compared with the never-deployed or previously deployed) is significantly higher among women than men, raising the possibility of gender differences in the adverse psychological effects of deployment. Method Person-month survival models based on a consolidated administrative database for active duty enlisted Regular Army soldiers in 2004–2009 (n = 975 057) were used to characterize the gender × deployment interaction predicting suicide. Four explanatory hypotheses were explored involving the proportion of females in each soldier’s occupation, the proportion of same-gender soldiers in each soldier’s unit, whether the soldier reported sexual assault victimization in the previous 12 months, and the soldier’s pre-deployment history of treated mental/behavioral disorders. Results The suicide rate of currently deployed women (14.0/100 000 person-years) was 3.1–3.5 times the rates of other (i.e. never-deployed/previously deployed) women. The suicide rate of currently deployed men (22.6/100 000 person-years) was 0.9–1.2 times the rates of other men. The adjusted (for time trends, sociodemographics, and Army career variables) female:male odds ratio comparing the suicide rates of currently deployed v. other women v. men was 2.8 (95% confidence interval 1.1–6.8), became 2.4 after excluding soldiers with Direct Combat Arms occupations, and remained elevated (in the range 1.9–2.8) after adjusting for the hypothesized explanatory variables. Conclusions These results are valuable in excluding otherwise plausible hypotheses for the elevated suicide rate of deployed women and point to the importance of expanding future research on the psychological challenges of deployment for women., Psychology

Introduction: Participation in daily life activities with both the personal and community meaning is an important component of health and well-being. Even though there are mounting reports on the challenges in various aspects of daily-life functioning among individuals with post-traumatic stress disorder (PTSD), to date little research has been conducted on their comprehensive patterns of participation. The study aimed to describe objective and subjective participation dimensions in PTSD compared to healthy controls and investigate the association between personal and environmental factors and participation. Methods: Sixty-one individuals were enrolled in two groups: PTSD (N=31; age: M=34.3; women:77.4%) and healthy controls matched by age and gender. The PTSD group completed standard assessments for symptom severity, general cognition, executive function (EF), sensory processing, self-efficacy, functional capacity, and environmental properties. Both groups completed a participation questionnaire. Results: Individuals with PTSD participated with low intensity and diversity, more occupations were abandoned (-4.73

The aim of this study was to investigate how self-rated health (SRH) reflects ongoing ill-health and how SRH is associated with previous ill-health and/or predicts future ill-health such as burnout, disturbed sleep, and somatic symptoms. The study used two waves from the population-based Västerbotten Environmental and Health Study in which 2 336 adult persons participated by answering a questionnaire at two time points three years apart. Hierarchical and logistic regression analyses were conducted, thus treating all variables both continuously (degree) and categorically (case). The analyses were performed both cross-sectionally and longitudinally. The results showed bidirectionality between suboptimal SRH and burnout, disturbed sleep and somatic severity caseness. Moreover, degree of poor SRH was more likely to occur simultaneously to high degrees of burnout and somatic severity than to degree of poor sleep quality. Also, caseness of burnout, disturbed sleep and somatic severity increased the risk of simultaneous suboptimal SRH. Finally, the results showed that degree of burnout three years earlier, predicted degree of poor SRH, and that degree of poor SRH predicted degree of sleep three years later. In conclusion, in a population-based, normal adult sample there is a bidirectional relationship between suboptimal SRH and caseness of burnout, disturbed sleep quality and somatic symptoms, but not between degree of these symptoms. The results can have implications for health care meeting patients complaining about poor general health. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore the human resource development (HRD) implications of perceived higher education (HEd) leadership effectiveness on academics' quality of worklife (QWL) in the context of COVID-19. Drawing on conservation of resource theory, this study explains the mediating role of resource adequacy (RA); then this study investigates the moderating role of COVID-19-related risk perception (CRP) on the relationship between university leadership (UL) and both academics' turnover intention (TI) and academics' QWL. Design/methodology/approach: This study used a quantitative research exploiting the pandemic experiences and perceptions survey, PEPS, to collect data from 300 academic staff in private and public HEd institutions in Lebanon. The analyses include the test of the mediating effect of RA as well as the moderated mediation effect of CRP through regressions, PROCESS and bootstrapping. Findings: The findings suggest that by enhancing RA, effective UL positively influences the QWL and mitigate the TI in Lebanese HEd. Furthermore, this study found that CRP weakens the direct relationship of UL on RA and the indirect effect of UL on the QWL and TI via RA such that the relationships are weakened when COVID-19 risk perception was high rather than low. Practical implications: The results imply that HEd HRD professionals could think of effective human resource interventions of how to maintain good working environment where academics are facilitated to acquire high level of resources which lead to improving their QWL and mitigating the negative outcome (TIs). Originality/value: To the best of the authors' knowledge, no research has been made to investigate the moderated mediation model of the "pandemic experience and leadership perceptions" (PEPS) in the HEd sector in Lebanon, addressing academics' experiences in business schools. This study is unique because it was conducted during the utmost pandemic outbreak (mid academic year 2021) collecting data in real time. This research contributes to the HRD literature by showing empirical evidence of the relationships in the context of Lebanese HEd institutions. [ABSTRACT FROM AUTHOR]

The military police officers of Rio de Janeiro are often exposed to critical incidents in routine work that may have a potentially traumatic effect on their mental health, such as post-traumatic stress disorder (PTSD). This study aims to explore the protective role of work social support (i.e., emotional, instrumental, and informational) and affective organizational commitment (and its mediation effect) in facing PTSD, considering these variables as essential resources in the work context according to the conservation of resources theory (COR) approach. This is a cross-sectional study, with a sample of 329 military police officers from Rio de Janeiro, Brazil, who were administered a questionnaire of sociodemographic variables, the Critical Incident History Questionnaire (CIHQ), the Post-Traumatic Stress Disorder Checklist 5 (PCL-5), the Perceived Social Support at Work Scale (EPSST), and the Affective Organizational Commitment Scale. It was found that only emotional support showed a significant association with affective commitment and PTSD symptoms. Affective organizational commitment, in turn, partially mediated the relationship between emotional support and PTSD. These findings shed light on the importance of organizations, such as the military police, in promoting the development of psychological resources like emotional support and affective commitment to mitigate PTSD and promote a sustainable work environment. [ABSTRACT FROM AUTHOR]

Purpose: Drawing on conservation of resources theory, this study aims to investigate the impact of online customer engagement on brand love via dual mediating mechanisms, empowerment (bright side) and stress (dark side). The roles of perceived brand quality and extroversion as weakener and facilitator respectively on the dark side effect are also examined. Design/methodology/approach: An online survey is conducted, targeting people who have experience in participating in online engagement activities. The dual mediation and moderation analysis are examined. Findings: The results confirm the proposed dual mediating mechanisms. Perceived brand quality and extroversion also significantly moderate the engagement–stress link. Research limitations/implications: This study explains the mediating mechanisms between online customer engagement and brand love, with a focus on the fast-moving consumer goods industry. This calls for further research on other industries. Practical implications: This study provides marketers with insights that online customer engagement strategies are not always good and that they should be more careful in formulating such strategies. Originality/value: This study advances the understanding of the relationship between customer engagement and brand love in the virtual community especially in the social media context. [ABSTRACT FROM AUTHOR]

Military accidents are often associated with stress and depressive psychological conditions among soldiers, and they often fail to adapt to military life. Therefore, this study analyzes whether there are differences in EEG and pulse wave indices between general soldiers and three groups of soldiers who have not adapted to military life and are at risk of accidents. Data collection was carried out using a questionnaire and a device that can measure EEG and pulse waves, and data analysis was performed using SPSS. The results showed that the concentration level and brain activity indices were higher in the general soldiers and the soldiers in the first stage of accident risk. The body stress index was higher for each stage of accident risk, and the physical vitality index was higher for general soldiers. Therefore, it can be seen that soldiers who have not adapted to military life and are at risk of accidents have somewhat lower concentration and brain activity than general soldiers, and have symptoms of stress and lethargy. The results of this study will contribute to reducing human accidents through EEG and pulse wave measurements not only in the military but also in occupations with a high risk of accidents such as construction. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic Stress Disorder (PTSD) could potentially increase the risk of mortality, and there is a need for a meta-analysis to quantify this association. This study aims to determine the extent to which PTSD is a predictor of mortality. Methods: EMBASE, MEDLINE, and PsycINFO were searched systematically on 12th February 2020, with updated searches conducted in July 2021, and December 2022 (PROSPERO CRD42019142971). Studies involving community-dwelling participants with a diagnosis of PTSD or PTSD symptoms, and a comparator group of individuals without PTSD, and which assessed mortality risk, were included. A random-effects meta-analysis was conducted on studies reporting Odds Ratio (OR), Hazard Ratio (HR), and Risk Ratio (RR), and subgroup analysis was also performed by age, sex, type of trauma experienced, PTSD diagnosis, and cause of death. Results: A total of 30 eligible studies of mostly good methodological quality were identified, with a total of more than 2.1 million participants with PTSD. The majority of studies involved male-dominated, veteran populations. PTSD was associated with a 47% (95% CI: 1.06–2.04) greater risk of mortality across six studies that reported OR/RR, and a 32% increased risk across 18 studies which reported time to death (HR: 1.32, 95% CI: 1.10–1.59). There was very high study heterogeneity (I2 > 94%) and this was not explained by the prespecified subgroup analysis. Conclusion: PTSD is associated with increased mortality risk, however further research is required amongst civilians, involving women, and in individuals from underdeveloped countries. [ABSTRACT FROM AUTHOR]

Suicide is a termite that engulfs close to seven hundred thousand people worldwide each year. Existing work on risk factors that predict suicide lacks statistical associations, does not consider most countries, and has a wide range of risk factor domains. The goal of this systematic review and meta-analysis is to enhance our current understanding of suicidality by identifying risk factors that are most strongly associated with suicide and their impact on developing technological interventions for suicide prevention. A search strategy was carried out on four databases: (1) PsycINFO, (2) IEEE Xplore, (3) the ACM Digital Library, and (4) PubMed, and twenty-five studies were included based on the inclusion criteria. Factors statistically associated with suicide are any diagnosed mental disorder, adverse life events, past suicide attempts, low education level, loneliness or high levels of isolation, bipolar disorder, depression, multiple chronic health conditions, family history of suicide, sexual trauma, and being female. Domain-wise, comorbid disorders, and behavior-related risk factors are most strongly associated with suicide. We present a new hierarchical model of risk factors for suicide that advances our understanding of suicide and its causes. Finally, we present open research directions and considerations for developing suicide prevention technologies. [ABSTRACT FROM AUTHOR]

Purpose: Accidents are the most common cause of death among UK military personnel. It is a common misconception in the general public that accidental injuries are always the result of random events, however research suggests that mental health problems and the increased levels of risky behaviour in military personnel may play a role. The objective of this study was to further our understanding of injuries and deaths not related to deployment by examining the associations of mental health, alcohol misuse and smoking with inpatient admission to hospital for accidents and injuries, and attendance to accident and emergency (A&E) departments. Methods: Data on all hospital admissions for accidents and injuries and A&E attendance at NHS hospitals in England, Scotland and Wales were linked to data on self-reported mental health problems, alcohol misuse and smoking from a large, representative UK military cohort of serving and ex-serving personnel (n = 8,602). Logistic regression was used to examine the associations between having a hospital admission for an accident or injury with self-reported mental health problems, alcohol misuse and smoking. Cox proportional-hazards regression was then conducted to assess the associations of mental health problems, alcohol misuse and smoking with time to hospital admission for an accident or injury. Finally, negative binomial regression was used to examine associations between the number of A&E attendances with mental health problems, alcohol misuse and smoking. Results: Personnel reporting symptoms of common mental disorder (CMD) or probable post-traumatic stress disorder (PTSD) were more likely to have an admission to hospital for an accident or injury (fully adjusted odds ratio 1.39, 95% confidence interval [CI] 1.05–1.84), than those who did not report these symptoms, and also had more attendances to A&E (fully adjusted incidence rate ratio [IRR] 1.32, 95% CI 1.16–1.51). A&E attendances were also more common in personnel who were smokers (fully adjusted IRR 1.21, 95% CI 1.09–1.35) following adjustment for demographic, military and health characteristics. Conclusions: The findings suggest that accidents and injuries among military personnel are not always random events and that there are health and behavioural factors, including poor mental health and smoking, which are associated (with small effect sizes) with an increased risk of being involved in an accident. Clinicians treating individuals attending hospital after an accident should consider their healthcare needs holistically, including issues related to mental health and health damaging behaviours. [ABSTRACT FROM AUTHOR]

Studies have examined burnout and its impact on health, to include its influence on sleep. While many studies report a significant relationship between burnout and insomnia in civilian populations, no studies have examined this relationship in a military population. The United States Air Force (USAF) Pararescue personnel are an elite combat force who are specially trained to conduct both first-line combat and full spectrum personnel recovery and may be at high risk of burnout and insomnia. The current study investigated the association between dimensions of burnout and insomnia, and also examined potential moderators of the associations. A cross-sectional survey was administered to 203 Pararescue personnel (Mean Age = 32.1 years; 100% Male; 90.1% Caucasian) recruited from six US bases. The survey included measures of three dimensions of burnout (emotional exhaustion, depersonalization, personal achievement), insomnia, psychological flexibility, and social support. Emotional exhaustion was significantly associated with insomnia with a moderate to large effect size, when controlling for covariates. Depersonalization, but not personal achievement, was also significantly associated with insomnia. There was no evidence that associations between burnout and insomnia were moderated by psychological flexibility or social support. These findings help to identify individuals at risk of insomnia and may ultimately be useful in developing interventions for insomnia in this population. [ABSTRACT FROM AUTHOR]

Job burnout is one of the most widespread mental problems in today's society and seriously affects the mental health and combat effectiveness of soldiers and officers. Herein, the effect of burnout on individual attention is studied from the perspective of neuroelectrophysiology. A total of 1,155 army soldiers and officers were included in this investigation and completed the Job Burnout Scale for Military Personnel. A total of 42 soldiers and officers were randomly selected from those with and without burnout to participate in an event-related potential (ERP) study using a visual oddball task. The characteristics of visual P3a and P3b at Fz, FCz, Cz, CPz, and Pz were recorded and analyzed by repeated-measures analysis of variance (ANOVA). P < 0.05 was the criterion for a significant difference. The total average score on the Job Burnout Scale for Military Personnel among the participants was 0.74 ± 0.46, and the detection rate of job burnout was 29.85%. In the Oddball task, the average number of target stimuli counted in the burnout group was lower than that in the control group, but no significant difference was found. For P3a, the Fz, FCz, Cz, CPz, and Pz amplitudes in the burnout group were significantly lower than those in the control group. The average amplitude of P3a evoked in the central parietal area was larger than that in the prefrontal area. For P3b, the amplitudes of the five electrodes in the burnout group were significantly lower than those in the control group. The average amplitude of P3b evoked in the parietal region was larger than those in the prefrontal and central parietal regions. A certain degree of job burnout is evident in army soldiers and officers. The voluntary attention and involuntary attention of individuals with burnout are both affected to some extent, as reflected by the lower amplitudes of P3a and P3b. The results suggest that P3a and P3b can be used as indicators to monitor cognitive neural function in soldiers and officers with burnout and can also be used as references for evaluating the effects of cognitive training and screening methods. In this study, ERP was used to research the attention ability of soldiers and officers with job burnout, and related issues were discussed from the aspects of the burnout results, behavioral results, ERP results, compensation effect of cognitive resources, application in the military field, limitations, and prospects. [ABSTRACT FROM AUTHOR]

Employees in high-risk occupations are exposed to tremendous work acute stress or prolonged stress disorders that are likely to undermine the health and organizational effectiveness. Based on positive psychology, courage which refers to behavioral approach despite the experience of fear could buffer the negative effects on stress. However, there is little known about the mechanisms by which courage decreases the risk of stress. Motivational systems may play an underlying role in this process, as behavioral inhibition system (BIS) is inhibited and behavioral activation system (BAS) is evoked by risk or threat. The current study aimed to examine the mediating effects of behavioral inhibition and activation on the relationship between courage and stress in the high-risk occupations. This study recruited 1,761 high-risk employees aged from 18 to 27 (M = 19.32; SD = 4.14) with a cluster sampling method who completed Courage Measure (CM), the BIS/BAS Scales and the Psychological Stress Evaluation Test (PSET). The correlation and mediation analyses examined the inter-variable correlations as well as the underlying mechanism between courage and stress. The results support the hypothesis and reveal that the behavioral inhibition mediates the association between courage and stress (Bindirect = −0.02, p < 0. 01, 95%CI = −0.03 to −0.003). The behavioral activation of fun seeking mediates the association between courage and stress as well (Bindirect = −0.04, p < 0. 01, 95%CI = −0.058 to −0.029). These findings suggest that behavioral inhibition and activation of fun seeking play imperative mechanism underpinning the buffering effect of courage on stress. Other theoretical and applied implications for desensitizing stress in the high-risk occupations are discussed. [ABSTRACT FROM AUTHOR]

Background: Employees in high-risk occupations are exposed to tremendous work stress that hinders organizational effectiveness and personal mental health. Based on positive psychology, courage can be considered a protective factor that buffers the adverse effect of high-risk surroundings on employees. However, little is known about the way courage is simulated or evaluated in response to safety concerns. Virtual reality (VR) is an accessible tool for courage simulation due to its immersive qualities, presence and interactive features and may provide a promising pathway to achieve a scientific, accurate and ecologically valid evaluation of high-risk employees. Methods: The sample consisted of 51 high-risk employees who were recruited voluntarily. Before and after experiencing the VR courage scenarios, the participants completed the VR features questionnaire, the Physical Courage at Work Scale (PCWS), the Courage Measure (CM), and the Positive and Negative Affect Scale (PANAS). During the process of watching the VR courage scenarios, the participants' heart rate and skin conductance at resting-state baseline and during virtual courage scenarios were recorded through HTC VIVE Pro Eye and BioGraph Infiniti 8. Results: The results support the hypothesis and reveal that the interaction, immersion and presence scores of the scenarios were all significantly higher than the median 4 points. The score for the CM in the posttest was significantly higher than that in the pretest. The scared and afraid scores for the posttest were significantly higher than those for the pretest. The heart rate and skin conductance of each scenario showed an increase compared with the baseline. The Pearson's correlation between physiological indicators and the score of the PCWS was 0.28∼ 0.54. Conclusion: This study developed virtual courage for high-risk occupations based on well-established theory and VR technology. Experimental data revealed that the paradigm conformed to the requirements of VR features and was able to activate fear and evoke the quality of courage. Thus, the virtual courage paradigms have good validity in simulating scenarios for high-risk employees, which might accelerate organizational effectiveness while buffering working stress. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The COVID-19 pandemic causes severe stress that disrupts the lives of many people. The presented research, based on the conservation of resources theory, was carried out to identify the areas of gains and losses in resources among adult Poles during the COVID-19 pandemic. Material and methods: The research was based on the quantitative research paradigm. It was conducted using the snowball method. Personal resources were assessed using the Self-Assessment Questionnaire of Gains and Losses by S. Hobfoll. Statistical calculations were made using the Statistica 13 package and in the R statistical environment. RESULTS: The research showed that family resources were the most significant ones for the respondents. Obtained data showed the COVID-19 pandemic affected the balance of gains and losses in resources. During the research, clusters were found differentiating people who balance gains and losses in their resources in various ways. The research did not reveal any correlation between the clusters and socio-demographic variables. Conclusion: It is requested to nurture proper, positive and multidimensional interpersonal relationships that will enhance resources and protect against their loss in challenging, stressful situations such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Machine learning (ML) is increasingly used to predict suicide deaths but their value for suicide prevention has not been established. Our first objective was to identify risk and protective factors in a general population. Our second objective was to identify factors indicating imminent suicide risk. Methods: We used survival and ML models to identify lifetime predictors using the Cohort of Norway (n=173,275) and hospital diagnoses in a Saskatoon clinical sample (n=12,614). The mean follow-up times were 17 years and 3 years for the Cohort of Norway and Saskatoon respectively. People in the clinical sample had a longitudinal record of hospital visits grouped in six-month intervals. We developed models in a training set and these models predicted survival probabilities in held-out test data. Results: In the general population, we found that a higher proportion of low-income residents in a county, mood symptoms, and daily smoking increased the risk of dying from suicide in both genders. In the clinical sample, the only predictors identified were male gender and older age. Conclusion: Suicide prevention probably requires individual actions with governmental incentives. The prediction of imminent suicide remains highly challenging, but machine learning can identify early prevention targets. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the effect of possible late effects of cancer treatment (physical complaints, fatigue, and cognitive complaints) and of two job resources (autonomy and supportive leadership style) on future burnout complaints, among employees living 2–10 years beyond breast cancer diagnosis. Methods: Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287). These data were part of a longitudinal study among Dutch speaking workers with a cancer diagnosis 2–10 years ago. All complaints and job resources were self-reported. Longitudinal multivariate regression analyses were executed, controlling for years since diagnosis, living with cancer (recurrence or metastasis), and other chronic or severe diseases. Mediation by baseline burnout complaints was considered. Results: A higher level of fatigue and cognitive complaints at baseline (T1) resulted in higher future burnout complaints (at T2), with partial mediation by baseline burnout complaints. No effect of physical complaints at T1 was observed. Higher levels of autonomy or a supportive leadership style resulted in lower burnout complaints, with full mediation by baseline burnout complaints. Buffering was observed by autonomy in the relationship of cognitive complaints with future burnout complaints. No moderation was observed by supportive leadership. Conclusion: The level of burnout complaints among employees 2–10 years beyond breast cancer diagnosis may be an effect of fatigue or cognitive complaints, and awareness of this effect is necessary. Interventions to stimulate supportive leadership and autonomy are advisable, the latter especially in the case of cognitive complaints. [ABSTRACT FROM AUTHOR]

COVID-19 survivors who had acute respiratory symptoms might experience prolonged post-traumatic stress disorder (PTSD) due to further rehabilitation, somatic symptoms and related distress. The conservation of resource (COR) theory is a well-developed theory to understand how people develop PTSD symptoms in traumatic events. The current study aimed to examine the potential factors of PTSD symptoms and interrelationships among this factors among COVID-19 survivors based on the COR theory. This cross-sectional telephone survey enrolled 199 COVID-19 patients (Mean age = 42.7; 53.3% females) 6 months after their hospital discharge in five Chinese cities (i.e., Wuhan, Shenzhen, Zhuhai, Dongguan, and Nanning). The results showed that 7% of participants were classified as having probable PTSD. The significant potential factors relating to PTSD symptoms included socio-demographic status, hospitalization experiences, post-hospitalization experiences, and psychological status. Besides, the proposed statistical mediation model based on the COR framework showed good model fit, χ2(df) = 17.286 (5), p = 0.004, CFI = 0.962, NNFI = 0.951, RMSEA = 0.077. Perceived resource loss/gain fully mediated the association between exposure to other patients' suffering during hospitalization and PTSD symptoms, and partially mediated the relationships from somatic symptoms/perceived impact of being infected with COVID-19 after discharge to PTSD symptoms. On the other hand, resilience was a full mediator in the relationship from ICU experience to PTSD symptoms and a partial mediator in the relationship from perceived impact to PTSD symptoms. The results provide preliminary support on applying the COR theory to understand the factors of PTSD symptoms among COVID-19 survivors. Interventions to reduce PTSD symptoms in this population can be developed based on the modifiable psychosocial mediators. [ABSTRACT FROM AUTHOR]

Coping with stress has been primarily investigated as an individual-level phenomenon. In work settings, however, an individual's exposure to demands is often shared with co-workers, and the process of dealing with these demands takes place in the interaction with them. Coping, therefore, may be conceptualized as a multilevel construct. This paper introduces the team coping concept and shows that including coping as a higher-level team property may help explain individual-level outcomes. Specifically, we investigated the effects of exposure to danger during deployment on burnout symptoms in military service members and examined to what extent this relationship was moderated by individual-level and team-level functional coping. We hypothesized that the relationship between individuals' exposure to danger and burnout is contingent on both. In line with our predictions, we found that service members who were highly exposed to danger, and did not engage in much functional coping, suffered most from burnout symptoms, but only when their teammates did not engage in much functional coping either. When their teammates did engage in much functional coping, the effect of exposure to danger on burnout was buffered. Hence, team members' coping efforts functioned as a resilience resource for these service members. [ABSTRACT FROM AUTHOR]

Copyright of Estudos e Pesquisas em Psicologia is the property of Editora da Universidade do Estado do Rio de Janeiro (EdUERJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Functional gastrointestinal disorders (FGIDs) are common among the aircrew due to their arduous working environment. This study investigated the prevalence of FGIDs in Chinese male pilots and assessed the effects of trigger factors on the FGIDs. A cross-sectional study including 212 male pilots was performed in a Chinese large civil airline company. FGIDs were diagnosed according to the Rome IV diagnostic criteria. The psychological performance, dietary pattern, sleep situation, and physical activity of the respondents were assessed. Logistic regression analysis and structural equation modeling were used to explore the association between these trigger factors and FGIDs. FGIDs were observed in 83 (39.22%) respondents, of which 31 (37.35%) had overlap syndromes. Age, flight level, flight time, high-salt food pattern, anxiety, and sleep performance were found to be associated with FGIDs (all P < 0.05). Stepwise logistic regression analysis revealed that the flight level (OR 0.59, 95% CI 0.31–0.080), high-salt food pattern (OR 2.31, 95% CI 1.28–4.16), and sleep performance (OR 2.39, 95% CI 1.11–5.14) were the influencing factors associated with FGIDs. Structural equation modeling confirmed the correlations between FGIDs and the occupational, dietary, and psychological factors with a reasonable fit. The preventive strategies were necessitated according to occupational and psychological characteristics. [ABSTRACT FROM AUTHOR]

The present study explores the influence of challenge stressors on identity orientation directly and via thriving at work and employee investment. Drawing on the broaden–and–build theory of positive emotions, this study proposes challenge stressors as a critical predictor of identity orientation. The purpose of this article is to explore if a particular identity is salient in different contextual factors, and this study suggests that challenge stressors stimulate personal, relational, and collective identities to respond to a situation. The relationships hypothesized in this study were tested using a sample of 225 employees from the banking sector of Pakistan. A time-lagged research design consisting of two waves of data collection was employed. A structural equation modeling technique was used to test the hypotheses regarding the relationship between challenge stressors and identity orientation, including the role of thriving at work and employee investment as intervening mechanisms of this relationship. Results showed that challenge stressors had a significant positive relationship with identity orientation. The results also confirmed the sequential mediation of thriving at work and employee investment in the relationship between challenge stressors and identity orientation. The findings suggest that the positive side of stress as a strength motivates employees for continued self-development. Importantly, challenge stressors enhance employees' ability to thrive at work and, in turn, they invest in the work more and identify themselves strongly with their organization and work. [ABSTRACT FROM AUTHOR]

Objective: Although mental health conditions are risk factors for suicide, limited data are available on suicide mortality associated with specific mental health conditions in the U.S. population. This study aimed to fill this gap.Methods: This study used a case-control design. Patients in the case group were those who died by suicide between 2000 and 2013 and who were patients in eight health care systems in the Mental Health Research Network (N=2,674). Each was matched with 100 general population patients from the same system (N=267,400). Diagnostic codes for five mental health conditions in the year before death were obtained from medical records: anxiety disorders, attention deficit-hyperactivity disorder (ADHD), bipolar disorder, depressive disorders, and schizophrenia spectrum disorder.Results: Among patients in the case group, 51.3% had a recorded psychiatric diagnosis in the year before death, compared with 12.7% of control group patients. Risk of suicide mortality was highest among those with schizophrenia spectrum disorder, after adjustment for age and sociodemographic characteristics (adjusted odds ratio [AOR]=15.0) followed by bipolar disorder (AOR=13.2), depressive disorders (AOR=7.2), anxiety disorders (AOR=5.8), and ADHD (AOR=2.4). The risk of suicide death among those with a diagnosed bipolar disorder was higher in women than men.Conclusions: Half of those who died by suicide had at least one diagnosed mental health condition in the year before death, and most mental health conditions were associated with an increased risk of suicide. Findings suggest the importance of suicide screening and providing an approach to improve awareness of mental health conditions. [ABSTRACT FROM AUTHOR]

Thefts and robberies may be traumatizing experiences for employees. The aim of this study is to explore to what extent experiencing robberies and/or thefts at work affect workers' mental health, coping-self-efficacy, social support seeking, workload and job satisfaction. Drawing on Conservation of Resources theory, this research contributes to our understanding of the psychological sequelae of robbery and theft for employees working in small businesses. The few studies on the effects of robberies and thefts in the past have predominantly focused on bank employees. A sample of Italian tobacconists and jewelers completed an anonymous self-report questionnaire examining the experience of robbery and/or theft, social support seeking (Coping Orientation to Problem Experienced scale, COPE-IV), psycho-somatic well-being (General Health Questionnaire, GHQ-12), job satisfaction (a single item). Victims of thefts and/or robberies reported their PTSD symptoms (Impact of Event- Revised 6, IES-R-6) and trauma-related coping self-efficacy (Coping Self-Efficacy scale, CSE-7), based on the last event (N = 319). Descriptive analyses, ANOVA, ANCOVA and multiple regressions analyses have been carried out. The results indicated that victims of thefts and robberies experienced greater workload, higher psycho-physical complaints and greater tendency to seek social support in comparison with their non-affected counterparts. They additionally experienced more post-traumatic symptomatology and perceived lower coping self-efficacy, when compared to those who experienced thefts "only." Multiple regression analyses revealed that CSE was positively related to job satisfaction, although the presence of psycho-physical symptoms was the main predictor of job satisfaction among both non-affected and affected employees. PTSD was not an independent predictor of job satisfaction. In sum, robberies and/or thefts exposure undermines differently workers' well-being. [ABSTRACT FROM AUTHOR]

A large number of research studies in the stress literature over the previous 20 years have examined how organizational demands influence experienced stress; however, little research has examined how perceptions of organizational fit influence experienced stress and the stress process. In the present study, we use the conservation of resources (COR) theory to examine how perceptions of hindrance stressors, challenge stressors, and organizational fit (i.e., a resource) affect employees’ intrapersonal (i.e., job satisfaction and work intensity) and interpersonal (i.e., interpersonal workplace deviance and work-to-family conflict) outcomes through job strain (i.e., job tension) and motivational (i.e., vigor) cognitive stress processes. Results from three samples of data (nSample 1 = 268, nSample 2 = 259, nSample 3 = 168) largely supported the hypothesized model and suggested that perceptions of organizational fit can be a resource associated with favorable effects on employees’ stress processes. Thus, we contribute to the stress and fit literatures by proposing and demonstrating empirical support for a COR theoretical explanation of why perceptions of organizational fit are a resource for employees. The results are important because they help provide a broader view of the effects of perceptions of organizational fit on employees’ stress processes than offered by prior research and suggest that organizational leaders have the opportunity to help employees manage workplace stress by fostering perceptions of organizational fit. Implications of results for theory and practice, strengths, limitations, and directions for future research are presented. [ABSTRACT FROM AUTHOR]

Background: The U.S. Army suicide attempt rate increased sharply during the wars in Iraq and Afghanistan. Risk may vary according to occupation, which significantly influences the stressors that soldiers experience. Methods: Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records for all active duty Regular Army enlisted soldiers who had a medically documented suicide attempt from 2004 through 2009 (n = 9650) and an equal-probability sample of control person-months (n = 153,528). Logistic regression analyses examined the association of combat occupation (combat arms [CA], special forces [SF], combat medic [CM]) with suicide attempt, adjusting for socio-demographics, servicerelated characteristics, and prior mental health diagnosis. Results: In adjusted models, the odds of attempting suicide were higher in CA (OR = 1.2 [95% CI: 1.1-1.2]) and CM (OR = 1.4 [95% CI: 1.3-1.5]), but lower in SF (OR = 0.3 [95% CI: 0.2-0.5]) compared to all other occupations. CA and CM had higher odds of suicide attempt than other occupations if never deployed (ORs = 1.1-1.5) or previously deployed (ORs = 1.2-1.3), but not when currently deployed. Occupation was associated with suicide attempt in the first ten years of service, but not beyond. In the first year of service, primarily a time of training, CM had higher odds of suicide attempt than both CA (OR = 1.4 [95% CI: 1.2-1.6]) and other occupations (OR = 1.5 [95% CI: 1.3-1.7]). Discrete-time hazard functions revealed that these occupations had distinct patterns of monthly risk during the first year of service. Conclusions: Military occupation can inform the understanding suicide attempt risk among soldiers. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Psicologia del Trabajo y de Las Organizaciones is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a study which outlines the operational definition of psychological resilience by the Australian Defence Force (AFD) It describes the findings on psychological resilience through the examination via a cross-sectional design. It also explores previous methodologies including one on the merits of longitudinal methodology. Details on the LASER study protocol is given, its key challenges, and implementation.

Objective: This study examined the effect of treatment for posttraumatic stress disorder (PTSD) on work-related quality-of-life outcomes and the relationship between clinically significant change during treatment and work-related outcomes. Additional analyses explored whether current depression and employment status moderated the effects of treatment and clinically significant change. Methods: Participants were 218 female veterans and soldiers with current PTSD who participated in a randomized clinical trial of treatment for PTSD. They received ten weekly sessions of prolonged exposure or present-centered therapy and were assessed before and after treatment and at three- and six-month follow-ups. Outcomes were clinician-rated and self-rated occupational impairment and self-rated satisfaction with work. Results: Both treatment groups had improvements in occupational impairment, and the degree of improvement by the two groups was similar. There was no pre- to post-treatment change in work satisfaction. At the end of treatment, participants who no longer met diagnostic criteria for PTSD had greater improvements in all domains of work-related quality of life than participants who still had PTSD. Conclusions: Although prolonged exposure resulted in better PTSD symptom outcomes than present-centered therapy in the randomized clinical trial, it did not result in better work-related quality-of-life outcomes. The improvement in occupational impairment associated with loss of diagnosis suggests the importance of continuing treatment until clinically meaningful change has been attained. [ABSTRACT FROM AUTHOR]

Responding to an unprecedented increase in the suicide rate among soldiers, in 2008 the US Army and US National Institute of Mental Health funded the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), a multicomponent epidemiological and neurobiological study of risk and resilience factors for suicidal thoughts and behaviors, and their psychopathological correlates among Army personnel. Using a combination of administrative records, representative surveys, computerized neurocognitive tests, and blood samples, Army STARRS and its longitudinal follow-up study (STARRS-LS) are designed to identify potentially actionable findings to inform the Army's suicide prevention efforts. The current report presents a broad overview of Army STARRS and its findings to date on suicide deaths, attempts, and ideation, as well as other important outcomes that may increase suicide risk (e.g., mental disorders, sexual assault victimization). The findings highlight the complexity of environmental and genetic risk and protective factors in different settings and contexts, and the importance of life and career history in understanding suicidal thoughts and behaviors.

This study examined the relationships among self-reported health, daily positive mood, and daily emotional exhaustion among employees in health and fitness clubs using residual dynamic structural equation modeling (RDSEM). A questionnaire was completed by 179 employees at recruitment and then a diary survey over 10 consecutive workdays. Results of RDSEM analyses revealed that daily positive mood was negatively associated with daily emotional exhaustion at both within-person and between-person levels. Self-reported health was positively related to the person's mean of daily positive mood and negatively associated with the person's mean of daily emotional exhaustion. Self-reported health moderated the relationship between daily positive mood and daily emotional exhaustion; employees with higher self-reported health levels tend to respond with larger changes in their daily emotional exhaustion when their daily positive mood changes. These findings provide important insights for organizations aiming at their employees' health, happiness, and job burnout. [ABSTRACT FROM AUTHOR]

It has been contended that violence is prevalent in the workplace, and there has been increasing research interest into its potential effects. Human interactions at workplaces are apparent. However, the interactions among humans may have positive or negative dimensions. Usually, the positive or negative interactions between workers lead to different outcomes. Sometimes, they lead to a productive working environment; however, in some cases, they lead to toxicity among workers. In this study, we investigate the impact of workplace violence (WV) on innovative work behavior (IWB). Specifically, it examines the impact of the three dimensions of WV, namely, harassment, mobbing, and sabotage. Moreover, employees' wellbeing mediates the relationship between WV (harassment, mobbing, and sabotage) and IWB. A questionnaire survey approach was used in this study. The target population were the workers of SMEs entrepreneurs located in Guangdong Province (China). The results confirm that, in the direct relationship, WV (harassment, mobbing, and sabotage) has a negative relationship with innovative IWB. Moreover, results also confirm that employee wellbeing is mediated between WV (harassment, mobbing, and sabotage) and IWB. Therefore, the empirical results of this paper identify that workplace violence reduces employees' innovative work behavior by reducing their subjective and eudemonic wellbeing, which further broadens the perspective of IWB's motivation analysis. Practical implications for small and medium enterprise organizations have also been discussed in this paper. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the influence of workplace incivility on the emotional exhaustion of recreational sport/fitness club providers through a cross-level analysis. A total of 200 recreational sport/fitness club providers from Taiwan were selected for the repeated collection of measures and a 10-day diary method was used. The effect of workplace incivility on recreational sport/fitness club employees' emotional exhaustion on a daily basis was analyzed at the intra-personal level, and the relationship between psychological capital and perceived service climate was studied at the inter-personal level. Five hypotheses were developed and tested using hierarchical linear modeling. The results found that employees' emotional exhaustion and burnout highly correlated with workplace incivility and service climate. Based on the results, recommendations for employees and sport/fitness centers are proposed. Furthermore, research limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]