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This chapter summarizes primary care principles for recognizing psychologically traumatized patients and engaging them in treatment. Psychological trauma is a psychiatric injury that occurs in response to severely stressful events and can become chronic if not treated. Trauma-informed clinicians understand how psychological trauma changes how people feel, think, and behave. Recognizing and engaging a psychologically traumatized patient for diagnosis and treatment is one of the most satisfying clinical experiences in primary care, opening doors for both patient and provider. While posttraumatic stress disorder (PTSD) is a common psychiatric disorder, the condition tends to be under-recognized. PTSD recognition is challenging owing to stigma, the variety of presentations, the non-specific nature, and range of severity of PTSD symptoms, and high co-occurrence with other conditions. Patients can be reluctant to seek care, disclose traumatizing events, or remember events. PTSD is more prevalent in people with addictions, chronic physical health conditions, chronic pain, medically unexplained symptoms, other psychiatric disorders, and occupations such as military and public safety personnel. Fourteen diverse case examples demonstrate some of the many faces of PTSD in adults. Barriers and facilitators to recognizing PTSD in primary care and targeted use of screening tools are discussed.

Canadian Public Safety Personnel (e.g., correctional workers, dispatchers, firefighters, paramedics, and police) are regularly exposed to potentially traumatic events, some of which are highlighted as critical incidents warranting additional resources. Unfortunately, available Canadian public safety personnel data measuring associations between potentially traumatic events and mental health remains sparse. The current research quantifies estimates for diverse event exposures within and between several categories of public safety personnel. Participants were 4,441 public safety personnel (31.7% women) in 1 of 6 categories (i.e., dispatchers, correctional workers, firefighters, municipal/provincial police, paramedics, and Royal Canadian Mounted Police). Participants reported exposures to diverse events including sudden violent (93.8%) or accidental deaths (93.7%), serious transportation accidents (93.2%), and physical assaults (90.6%), often 11+ times per event. There were significant relationships between potentially traumatic event exposures and all mental disorders. Sudden violent death and severe human suffering appeared particularly related to mental disorder symptoms, and therein potentially defensible as critical incidents. The current results offer initial evidence that (a) potentially traumatic event exposures are diverse and frequent among diverse Canadian public safety personnel; (b) many different types of exposure can be associated with mental disorders; (c) event exposures are associated with diverse mental disorders, including but not limited to posttraumatic stress disorder, and mental disorder screens would be substantially reduced in the absence of exposures; and (d) population attributable fractions indicated a substantial reduction in positive mental disorder screens (i.e., between 29.0 and 79.5%) if all traumatic event exposures were eliminated among Canadian public safety personnel.

Public Safety Personnel (PSP, e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps &lt, 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health, however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health.

The Operational and Organizational Police Stress Questionnaires (PSQ-Op and PSQ-Org) are useful tools for understanding individual differences in the perception of policing-specific stress. However, two of the limitations of the PSQ-Op and PSQ-Org are their lack of normative values that provide organizations with a baseline with which to judge the effectiveness of stress-reduction interventions or new resilience-based training initiatives and cut-offs that can identify the percentage of employees who might be experiencing high, moderate, and low levels of policing-specific stress. Specifically, they do not allow individual departments or policing organizations to assess the relative degree of work-related stress their members are experiencing, or to determine whether that level of stress is excessive. To address this gap in knowledge, we developed gender-based norms and cut-off values for the two PSQ measures. These norms are provided for both overall scale scores and individual items, and implica...

The Intensions Health-Related Masculine Values Scale (IHRMVS) was recently developed to address the growing interest in examining the associations between strengths-based masculinity and men’s health. However, while the original development and validation work was promising, replication and extension of several aspects of the scale’s validity should be undertaken before the scale can be adopted for widespread use. Using a large sample of British men, aged 18-80 years, exploratory factor analyses revealed a single factor for both the original age grouping (18-29 years, n = 166) and an older group of men (? 30 years, n = 404), failing to replicate the two-factor structure proposed in the parent study. Additionally, correla-tions between scores on the IHRMVS and scores on a measure of traditional male role norms were mostly non-significant or very small. Similar findings emerged in our analyses of the associations between scores on the IHRMVS and indices of depression, anxiety, help-seeking attitudes, sleep disturbance, and smok-ing. These findings draw into question the utility of the IHRMVS as a measure of positive, health-related masculine values.

BACKGROUND Although evaluation studies confirm the strong potential of men’s electronic health (eHealth) programs, there have been calls to more fully understand acceptability, engagement, and behavior change to guide future work. Relatedly, mapping of behavior changes using health promotion theories including the transtheoretical model (or stages of change) has been recommended to build a translatable empirical base to advance design and evaluation considerations for men’s eHealth programs. OBJECTIVE This study aimed to use a benchmark sample as a reference group to map the recent and intended health behavior changes in Canadian men who use the Don’t Change Much (DCM) eHealth program. The hypothesis being tested was that increased exposure to DCM would be positively associated with men’s recent and intended health behavior changes. METHODS DCM users (n=863) were sampled for demographic data and self-reported recent and intended health behavior changes. Respondents also reported their usage (frequency and duration) for each of the 3 DCM components (web, newsletter, and social media) and were allocated to limited exposure (257/863, 29.8%), low exposure (431/863, 49.9%), and high exposure (175/863, 20.3%) subgroups. A benchmark sample (n=2000), comprising respondents who had not accessed DCM provided a reference group. Bivariate analysis of recent and intended health behavior changes and DCM exposure levels were used to compute the strength of association between the independent variables (exposure levels) and the 10 categorical dependent variables (recent and intended health behavior changes). Binary logistic regression models were computed for each of the 10 recent and intended health behavior changes. Linear regression was used to model the association between the number of recent and intended changes and the level of exposure to DCM. RESULTS Compared with the benchmark reference group, DCM high-exposure respondents had significantly increased odds for 9 of the 10 health behavior changes, with the largest effect size observed for Changed diet or Improved eating habits (odds ratio [OR] 5.628, 95% CI 3.932-8.055). High-exposure respondents also had significantly increased odds for 9 intended health changes, with the largest effect sizes observed for Reduce stress level (OR 4.282, 95% CI 3.086-5.941). Moderate effect size (goodness of fit) was observed for increased total number of recent (F12,2850=25.52; P.001; adjusted R2=.093) and intended health behavior changes (F12,2850=36.30; P.001; adjusted R2=.129) among high-exposure respondents. CONCLUSIONS DCM respondents contrasted the predominately precontemplative benchmark sample mapping across the contemplative, preparation, and action stages of the transtheoretical health behavior change model. Almost 10% of variation in the recent and 13% of variation in the intended health behavior changes can be explained by DCM exposure and demographic factors, indicating the acceptability of this men’s eHealth resource.

Men are at high risk for both morbidity and premature mortality from several of the most common serious diseases. Although numerous factors have been identified to explain men’s risk, this study focused on the relationship between lifestyle behaviors, health-related self-stigma and masculine role norms. An age and location stratified sample of 2000 Canadian men completed measures assessing five lifestyle behaviors (smoking, alcohol use, sleep, diet and exercise), a screen for depression, and measures of self-stigma and masculine role norms. The results showed that elements of both health-related self-stigma and masculine role norms were associated with increased risk for being above the clinical threshold for four of the lifestyle behaviors and depression. The most frequent and largest relationships were associated with exercise and depression. The total number of lifestyle behaviors for which participants were above the clinical cut-points was also associated with self-stigma and masculine role norms. These findings demonstrate the importance of health-related self-stigma and masculine role norms as potential barriers to men’s health and well-being.

Though men’s health promotion has attracted increased research attention, conspicuously absent have been empirical insights to health literacy levels within and across male subgroups. Recent advancements in the measurement of health literacy have made available avenues for evaluating individual and social determinants of health literacy. Important insights can be drawn to detail patterns and diversity among men as a means to informing the design, implementation, and evaluation of tailored health promotion programs. Drawing on 2000 Canada-based men’s responses to the Health Literacy Questionnaire, correlations between demographic variables and six health literacy scales are described. Low income, low education, and living alone were associated with men’s low health literacy, with the strongest effect sizes for the “Social support for health” and “Actively engaged with health care professionals” scales. Multiple linear regressions confirmed low income as the strongest predictor of men’s low health literacy in all the scales except “Appraisal of health information.” Low income, self-identifying as gay, bisexual, or other, and living alone were strongly predictive of low scores on the “Social support for health” scale. The findings affirm the importance of considering men’s health literacy and inequities to advance effective men’s health promotion programs.

Background Although evaluation studies confirm the strong potential of men’s electronic health (eHealth) programs, there have been calls to more fully understand acceptability, engagement, and behavior change to guide future work. Relatedly, mapping of behavior changes using health promotion theories including the transtheoretical model (or stages of change) has been recommended to build a translatable empirical base to advance design and evaluation considerations for men’s eHealth programs. Objective This study aimed to use a benchmark sample as a reference group to map the recent and intended health behavior changes in Canadian men who use the Don’t Change Much (DCM) eHealth program. The hypothesis being tested was that increased exposure to DCM would be positively associated with men’s recent and intended health behavior changes. Methods DCM users (n=863) were sampled for demographic data and self-reported recent and intended health behavior changes. Respondents also reported their usage (frequency and duration) for each of the 3 DCM components (web, newsletter, and social media) and were allocated to limited exposure (257/863, 29.8%), low exposure (431/863, 49.9%), and high exposure (175/863, 20.3%) subgroups. A benchmark sample (n=2000), comprising respondents who had not accessed DCM provided a reference group. Bivariate analysis of recent and intended health behavior changes and DCM exposure levels were used to compute the strength of association between the independent variables (exposure levels) and the 10 categorical dependent variables (recent and intended health behavior changes). Binary logistic regression models were computed for each of the 10 recent and intended health behavior changes. Linear regression was used to model the association between the number of recent and intended changes and the level of exposure to DCM. Results Compared with the benchmark reference group, DCM high-exposure respondents had significantly increased odds for 9 of the 10 health behavior changes, with the largest effect size observed for Changed diet or Improved eating habits (odds ratio [OR] 5.628, 95% CI 3.932-8.055). High-exposure respondents also had significantly increased odds for 9 intended health changes, with the largest effect sizes observed for Reduce stress level (OR 4.282, 95% CI 3.086-5.941). Moderate effect size (goodness of fit) was observed for increased total number of recent (F12,2850=25.52; P.001; adjusted R2=.093) and intended health behavior changes (F12,2850=36.30; P.001; adjusted R2=.129) among high-exposure respondents. Conclusions DCM respondents contrasted the predominately precontemplative benchmark sample mapping across the contemplative, preparation, and action stages of the transtheoretical health behavior change model. Almost 10% of variation in the recent and 13% of variation in the intended health behavior changes can be explained by DCM exposure and demographic factors, indicating the acceptability of this men’s eHealth resource.

Introduction: Lifestyle-related diseases are the leading cause of death among North American men. We evaluated health behaviours and their predictors that contribute to morbidity and mortality among Canadian men as a means to making recommendations for targeted interventions. Methods: A cross-sectional analysis of Canadian men drawn from 5362 visitors to our online survey page was conducted. The current study sample of 2000 men (inclusion: male and >18 years; exclusion: incomplete surveys) were stratified to the 2016 Canadian census. The primary outcome was the number of unhealthy men classified using our Canadian Composite Classification of Health Behaviour (CCCHB) score. Secondary outcomes included the number of men with unhealthy exercise, diet, smoking, sleep, and alcohol intake, as well as socioeconomic and demographic factors associated with unhealthy behaviours to be used for targeting future interventions. Results: Only 118/2000 (5.9%) men demonstrated 5/5 healthy behaviours, and 829 (41.5%) had 3/5 unhealthy behaviours; 391 (19.6%) men currently smoked, 773 (38.7%) demonstrated alcohol overuse, 1077 (53.9%) did not get optimal sleep (9 hours per night), 977 (48.9%) failed to exercise >150 minutes/week, and 1235 (61.8%) had an unhealthy diet. Multivariate analysis indicated that men with high school education were at increased risk of unhealthy behaviours (odds ratio [OR] 1.58; 95% confidence interval [CI] 1.15–2.18; p=0.005), as were men living with relatives (OR 2.10; 95% CI1.04–4.26; p=0.039), or with their partner and children (OR 1.34; 95% CI 1.02–1.76; p=0.034). Conclusions: An overwhelming 41.5% of Canadian men had 3/5 unhealthy behaviours, affirming the need for targeted lifestyle interventions. Significant health inequities within vulnerable subgroups of Canadian men were identified and may guide the content and delivery of future interventions.

Background There are conflicting reports regarding seasonal sleep difficulties in polar regions. Herein we report differences in actigraphic sleep measures between two summer trials (collected at Canadian Forces Station Alert, 82.5°N, in 2012 and 2014) and evaluate exogenous melatonin for preventing/treating circadian phase delay due to nocturnal light exposure. Methods Subjects wore actigraphs continuously to obtain sleep data. Following seven days of actigraphic recording the subjects filled out questionnaires regarding sleep difficulty and psychosocial parameters and subsequently remained in dim light conditions for 24 hours, during which saliva was collected bihourly to measure melatonin. During Trial 2, individuals who reported difficulty sleeping were prescribed melatonin, and a second saliva collection was conducted to evaluate the effect of melatonin on the circadian system. Results Trial 1 subjects collectively had late dim light melatonin onsets and difficulty sleeping; however, the Trial 2 subjects had normally timed melatonin rhythms, and obtained a good quantity of high-quality sleep. Nocturnal light exposure was significantly different between the trials, with Trial 1 subjects exposed to significantly more light between 2200 and 0200h. Melatonin treatment during Trial 2 led to an improvement in the subjective sleep difficulty between the pre- and post-treatment surveys; however there were no significant differences in the objective measures of sleep. Conclusions The difference in sleep and melatonin rhythms between research participants in June 2012 and June 2014 is attributed to the higher levels of nocturnal light exposure in 2012. The avoidance of nocturnal light is likely to improve sleep during the Arctic summer.

The seasonal extremes of photoperiod in the high Arctic place particular strain on the human circadian system, which leads to trouble sleeping and increased feelings of negative affect in the winter months. To qualify for our study, potential participants had to have been at Canadian Forces Station (CFS) Alert (82° 30' 00″ N) for at least 2 weeks. Subjects filled out questionnaires regarding sleep difficulty, psychological well-being and mood and wore Actigraphs to obtain objective sleep data. Saliva was collected at regular intervals on two occasions, 2 weeks apart, to measure melatonin and assess melatonin onset. Individuals with a melatonin rhythm that was in disaccord with their sleep schedule were given individualized daily light treatment interventions based on their pretreatment salivary melatonin profile. The light treatment prescribed to seven of the twelve subjects was effective in improving sleep quality both subjectively, based on questionnaire results, and objectively, based on the actigraphic data. The treatment also caused a significant reduction in negative affect among the participants. Since the treatment is noninvasive and has minimal associated side effects, our results support the use of the light visors at CFS Alert and other northern outposts during the winter for individuals who are experiencing sleep difficulty or low mood.

Previous studies have documented associations between sexuality and body image, but the directionality of this association is unclear among men. This study examined whether men's drive for muscularity can be considered a correlate of their sexuality. A community-based sample of 292 heterosexual men from London, UK, completed a survey consisting of measures of drive for muscularity, sociosexuality, sexual assertiveness, sexual esteem, and sexual sensation seeking. A multiple regression analysis showed that greater drive for muscularity was predicted by more unrestricted sociosexuality (i.e., a greater proclivity for short-term, transient relationships), greater sexual sensation seeking, and greater sexual assertiveness, once the effects of participant age and body mass index had been accounted for. Possible avenues for intervention based on a sex-positive approach are discussed in conclusion.

The present study tested the hypothesis that men's drive for muscularity would be associated with their valuation of domination, power, status, and aggression over others. A community sample of 359 men from London, UK, completed measures of drive for muscularity, social dominance orientation, right-wing authoritarianism, trait aggression, and need for power, as well as their demographic details. Bivariate correlations showed that greater drive for muscularity was significantly correlated with most of the measures and their subscales. However, in a multiple regression analysis, the only significant predictor of drive for muscularity was support for group-based dominance hierarchies (Adj. R(2)=.17). These results suggest that men's drive for muscularity is associated with a socio-political ideology that favours social dominance.

Psychological resilience is an important construct for those who work in high-stress, potentiallytraumatic occupations. Using data collected as part of the Canadian Forces (CF) Recruit HealthQuestionnaire (RHQ), structural equation modelling analyses were performed to test the fit of amodel of resilience comprised of several intrapersonal resilience factors (i.e., Big Five personalitytraits, dispositional affect, dispositional optimism, hardiness, mastery, self-esteem) and one inter-personal resilience factor (i.e., social support). An initial model showed that all lower-orderintrapersonal variables loaded significantly onto a higher-order intrapersonal resilience latent factor,and that this factor was significantly correlated with social support. However, the strong intercor-relations between a few of the intrapersonal variables pointed to some redundancy. Based onempirical data and on a conceptual analysis, an alternative, more parsimonious model of resiliencewas developed. This model consisted of the Big Five personality traits, positive affect, and masteryas lower-order factors of dispositional resilience, which was hypothesised to be correlated withsocial support. This analysis is an important first step to developing an approach to conceptualiseand measure resilience. One benefit of being able to assess resilience is that doing so can inform thedevelopment of programs to enhance mental health, readiness and recovery. However, more researchis needed to understand the processes through which these psychological factors influence occupa-tional as well as health outcomes before relevant policies may be developed.Keywords: psychological resilience, hardiness, mastery, military psychology

In this study, we examined whether aspects of the masculine gender role predict the distortion of self-reported height in men. The sample of men (N = 220) were from a mid-sized university in Ontario, Canada and ranged in age from 17.92 through 29.25 years. The men reported their height and completed scales measuring masculine, gender-related characteristics (Agency, Unmitigated Agency, gender-typed Occupational Preferences and Conformity to Male Norms). An experimenter also measured the men’s height using a standardized scale. As expected, the men over-reported their height. Shorter men exaggerated their height more than taller men. Also, as expected, a linear regression analysis revealed that certain masculine, gender-related characteristics (Unmitigated Agency and Occupational Preferences) predicted an over-reporting of height. These results suggest that men higher in some stereotypically masculine gender role characteristics have an elevated need to achieve socially desirable masculine physical characteristics, and do so to such a degree that they are prone to distorting this important aspect of their body size. Implications of these results (e.g., the reliability of self-report height) are discussed.

John L. Oliffe, RN,MEd, PhDAssociate Professor,School of Nursing,University of BritishColumbia, 302-6190Agronomy Road,Vancouver, BritishColumbia V6T 1Z3,CanadaSteve Robertson, PhD,BSc (hons), RN, RHVReader, Men’s Health,Centre for Men’s Health,Leeds MetropolitanUniversity, UKBlye Frank, PhDProfessor and Head of theDivision of MedicalEducation, Faculty ofMedicine, DalhousieUniversity, Nova Scotia,CanadaDonald R. McCreary,PhDAdjunct Professor ofPsychology, BrockUniversity, St. Catharines,ON, CanadaAdjunct Professor ofPsychology,YorkUniversity,Toronto, ON, CanadaGilles Tremblay, PhDProfessor in the School ofSocial Work, LavalUniversity, Quebec, CanadaS. Larry Goldenberg,CM, OBC, MD, FRCSCProfessor and Head, UBCDepartment of UrologicSciences, Faculty ofMedicine, University ofBritish ColumbiaE-mail:john.oliffe@nursing.ubc.caOnline 21 August 2010

The Childhood Anxiety Sensitivity Index (CASI) is an 18-item self-report tool designed to measure the construct of anxiety sensitivity (i.e. the belief that anxiety may have harmful consequences such as sickness, embarrassment, or loss of control) in children and adolescents. Previous factor analytic examinations of the CASI have produced varied results. Gender may play a role in this observed variability. In an effort to confirm the factor structure of the measure across gender, CASI items for 671 children and adolescents were subjected to confirmatory factor analysis. Results indicated that for boys two-, three-, and four-factor structures provided a relatively good fit to the data, with the three-factor structure emerging as having the best fit overall. In contrast, for girls only the three-factor structure fitted the data well. Direct comparison of fit of the three-factor model across gender provided evidence to support the notion that childhood anxiety sensitivity is similar in structure across gender.

This study examined gender differences on body image measures, and tested a model where self-esteem influences social physique anxiety (SPA), which in turn influences drive for muscularity and drive for thinness in a sample of adolescents (N=329; 58% boys). Multi-group invariance analyses indicated that the measurement and structural models were partially invariant for boys and girls, allowing for gender comparisons. Results indicated that boys reported significantly lower drive for thinness and SPA, and higher drive for muscularity and self-esteem compared to girls. The measurement and structural models were an adequate fit for the total sample. Findings supported the proposed sequence in which self-esteem significantly influenced SPA, and SPA significantly influenced the drives for muscularity and thinness. Interventions aimed at decreasing SPA, by promoting self-esteem, may be helpful in decreasing adolescent boys' and girls' drive for muscularity and thinness.

This study reports results from the first International Body Project (IBP-I), which surveyed 7,434 individuals in 10 major world regions about body weight ideals and body dissatisfaction. Participants completed the female Contour Drawing Figure Rating Scale (CDFRS) and self-reported their exposure to Western and local media. Results indicated there were significant cross-regional differences in the ideal female figure and body dissatisfaction, but effect sizes were small across high-socioeconomic-status (SES) sites. Within cultures, heavier bodies were preferred in low-SES sites compared to high-SES sites in Malaysia and South Africa ( ds = 1.94-2.49) but not in Austria. Participant age, body mass index (BMI), and Western media exposure predicted body weight ideals. BMI and Western media exposure predicted body dissatisfaction among women. Our results show that body dissatisfaction and desire for thinness is commonplace in high-SES settings across world regions, highlighting the need for international attention to this problem.

The issue of ‘men’s health’, and how best to promote it, has been gaining increasing attention in both academic and media arenas across the globe. Whilst commentaries on the state of health promotion for men have been provided in countries including Australia and the United Kingdom, no corresponding Canadian-specific insights have yet been published. This article provides such an overview, focusing on research, policy and practice and suggesting what future direction men’s health promotion in Canada might take.

For military personnel, the post-deployment period can be associated with changes affecting their quality of life, the quality of their close relationships, and their attitudes concerning their military careers. There is, however, little published research concerning this process, and a major weakness of the previous work is the lack of an established measuring instrument. This article describes the development of the Army Post-deployment Reintegration Scale assessing the attitudes of military personnel in three key areas. Study 1 found support for a multidimensional model of post-deployment reintegration attitudes. Study 2 refined the dimensionality of the model to the positive and negative aspects of personal, family, and work reintegration and reduced the length of the scale to 36 items and provided preliminary evidence of its factorial validity and internal consistency reliabilities. Finally, in Study 3, the subscales were correlated in predicted ways with personal- and organizational-level outcomes (...

The presented study tested a model of the relationship between the drive for muscularity (DM), three aspects of body comparison (general, weight-, and muscle-related), and social physique anxiety in college men and women. The findings demonstrated that those with higher levels of DM engaged in more frequent body-related comparisons in all three areas. Greater frequency of both Weight- and Muscle-Related Body Comparison was then predictive of higher levels of social physique anxiety. Constraints placed on the path coefficients showed that the association between DM and Muscle-Related Comparisons was significantly stronger than the association between DM and Weight-Related Comparisons. The model was similar for both genders. The results from the structural models were discussed in terms of Cash's (2002) cognitive-behavioral model of body image and the dual pathway model of boys' and men's body image (Jones & Crawford, 2005).

Empirical research increasingly suggests that post-traumatic stress disorder (PTSD) is comprised of four factors: re-experiencing, avoidance, numbing, and hyperarousal. Nonetheless, there remains some inconsistency in the findings of factor analyses that form the bulk of this empirical literature. One source of such inconsistency may be assessment measure idiosyncrasies. To examine this issue, we conducted confirmatory factor analyses of interview and self-report data across three trauma samples. Analyses of the interview data indicated a good fit for a four-factor model across all samples; analyses of the self-report data indicated an adequate fit in two of three samples. Overall, findings suggest that measure idiosyncrasies may account for some of the inconsistency in previous factor analyses of PTSD symptoms.

Men's fitness goals are influenced by the lens through which they view their bodies, which is different from the way women view their bodies. Their increased focus on a muscular, hairless body means that they exercise to enhance their physical bulk and are more likely to engage in depilatory behaviors. In addition, the drive for muscularity may be associated with an increased risk anabolic-androgenic steroids and other nutritional supplements whose utility not clearly demonstrated. In the extreme, the drive for muscularity may manifest itself as a form of body dysmorphic disorder referred to as muscle dysmorphia. However, not all men focus on their muscularity. Gay men are more likely than heterosexual men to experience a desire to be thin and are at greater risk for eating and body image disorders. These issues are discussed in this article.

This article describes the development and validation of the Operational Police Stress Questionnaire (PSQ-Op) and the Organizational Police Stress Questionnaire (PSQ-Org). In Study 1, a series of focus groups were used to elicit the most common stressors associated with policing. During this study

The purpose of this study was to examine gender differences in cancer mortality risk perceptions and preventive screening behaviors as well as perceptions of gender differences in types of cancer risks. A telephone survey was administered to 300 men and 300 women between 40 and 60 years of age, all of whom were contacted via a random digit dialing procedure. Findings showed that 62% of respondents believed that prostate cancer was the most frequent cause of cancer mortality among men (12% actual) while breast cancer was thought to be the most frequent cause reported among 80% of women (17% actual). It was determined that 79% of men and women are discussing or receiving preventive screening for prostate and breast cancer, respectively, and that these frequencies increase significantly after age 50. Finally, most respondents believed that women had higher rates of cancer morbidity and mortality than men. These results suggest that an increase in cancer mortality risk awareness is needed among both men and women. The elevated risks among men need to be made salient, and prevention campaigns that target men’s mortality risks need to be developed.

The female drive for thinness [DT] and the male drive for muscularity [DM] reflect the pursuit of two culturally explicit, gender-specific, body shape ideals. While a large body of research has confirmed a set of personality vulnerability traits related to DT in women, little is known about the personality correlates of DM. We hypothesised that a similar psychological profile would characterize both. We assessed a sample of young men on measures of neuroticism, perfectionism, narcissism, and appearance and fitness orientation, and used multiple regression procedures to determine the utility of each in predicting DM. Our hypothesis was strongly supported; results indicated that all the traits except narcissism were significantly and simultaneously related to DM, together accounting for 40% of the variance. Given the strong links among DM, steroid use, and excessive weight training, we can infer that these psychological characteristics also increase the risk of potentially risky and unhealthy behaviours in young men as they do in young women.

Prior qualitative research has suggested that people assume muscular men are more masculine. This assumption was tested quantitatively in 2 studies. In Study 1, men and women completed measures of gender-role traits and behaviors, whereas in Study 2, men completed measures of gender-role conflict and traditional attitudes about men. Study 1 revealed a correlation between self-rated male-typed traits and behaviors, with a need to be more muscular for both men and women. In Study 2, men with more traditional attitudes about men also wanted to be more muscular; men who wanted to be more muscular were experiencing conflict with regard to society’s expectations that they be successful, powerful, and competitive, and they reported that finding a balance between workand leisure is difficult.

BACKGROUND: The fear-avoidance model of pain accounts for the debilitating consequences of strong fear as a component of reactions to painful conditions (eg, movements become anxiety-provoking because they cause pain). The model, which is supported in the literature, posits that fear of pain interferes with recovery because it leads to avoidance of beneficial activity. Despite the high prevalence of pain among the elderly, investigations of fear of pain in this population are scarce. A related construct, fear of falling, has been studied among elderly (but not younger) adults as an age-specific concern.OBJECTIVES: To examine the relationship between fear of pain and fear of falling. Specifically, it is hypothesized that fear of pain and fear of falling are distinct constructs. Moreover, the authors investigated whether fear of falling becomes more relevant with increasing age in a sample of seniors and younger adults with musculoskeletal conditions.METHODS: A convenience sample of younger and older adult physiotherapy outpatients (n=226) receiving treatment for musculoskeletal conditions were recruited for the study. Fear of pain and fear of falling were assessed using self-report measures.RESULTS: There were no age differences with respect to fear of pain and fear of falling. Regression analyses showed that fear of pain measures contribute substantial unique variance to the prediction of each other; however, they only make minor unique contributions to the prediction of fear of falling. Similar results were obtained through confirmatory analyses using structural modelling techniques.CONCLUSIONS: The analyses supported the distinctiveness of fear of pain and fear of falling. Moreover, among physiotherapy outpatients with musculoskeletal pain conditions, fear of falling and fear of pain are distinct constructs that appear to represent the concerns of both seniors and younger pain patients.

This Internet research project examined the relationship between consumption of muscle and fitness magazines and/or various indices of pornography and body satisfaction in gay and heterosexual men. Participants (N = 101) were asked to complete body satisfaction questionnaires that addressed maladaptive eating attitudes, the drive for muscularity, and social physique anxiety. Participants also completed scales measuring self-esteem, depression, and socially desirable responding. Finally, respondents were asked about their consumption of muscle and fitness magazines and pornography. Results indicated that viewing and purchasing of muscle and fitness magazines correlated positively with levels of body dissatisfaction for both gay and heterosexual men. Pornography exposure was positively correlated with social physique anxiety for gay men. The limitations of this study and directions for future research are outlined.

This study examined the influence of gender role transgressions on perceptions of men and women's social status, homosexual orientation, and value dissimilarity. Because past research has shown tha...

Despite widespread use of the Center for Epidemiologic Studies Depression Scale [CES-D], there are no investigations that examine its factor structure in a military sample. Separate confirmatory factor analyses were performed on responses to the CES-D obtained from 102 female and 102 male Canadian military peacekeepers in order to compare the fit of a four-factor intercorrelated (lower-order) model to a four-factor hierarchical (higher-order) model. The intercorrelated and hierarchical models fit the data well for both women and men, with hierarchical models fitting the data slightly better for women than men. These findings suggest that, for military women and men, the CES-D can be used to measure a set of distinct but interrelated depressive symptoms as well as a global construct of depression. Implications and future directions are discussed.

Recent factor analytic investigations of post-traumatic stress disorder in military veterans suggest that symptoms are best described by either a hierarchical 2-factor model or a 4-factor inter-correlated model. Other recent evidence suggests that post-traumatic stress disorder and chronic pain are intricately related; however, the nature of this relationship is not well understood. Factor analysis provides one method for clarifying this relationship. In study 1, we compared competing models of post-traumatic stress disorder symptom structure in a sample of 400 male United Nations peacekeepers using confirmatory factor analysis. Results indicated that both the hierarchical 2-factor and the 4-factor inter-correlated models provided good fit to the data. In study 2, the reliability of these models was assessed in 427 male United Nations peacekeepers with chronic back pain and 341 without. Group comparisons of the confirmatory factor analysis results revealed that the structure of the hierarchical 2-factor and 4-factor inter-correlated models both provided good fit to the data in both the chronic back pain and the group without. However, the structure of the models for the group with chronic back pain group differed in significant ways from that of the group without chronic back pain. Post-traumatic stress disorder symptoms in military veterans can be adequately conceptualized using either a hierarchical 2-factor or 4-factor inter-correlated model. Chronic pain has a minimal influence on overall factor structure. The hierarchical 2-factor model, while parsimonious, does not provide the degree of symptom detail provided by the 4-factor inter-correlated model. Implications for conceptualization of post-traumatic stress disorder symptoms for patients with chronic back pain and significant post-traumatic stress disorder symptomatology are discussed.

Past research has shown that men, young adults, and beer drinkers engage in the highest rates of binge drinking behavior. However, studies of binge drinking have tended to focus on main effects over interactions, especially in samples of college students and other young adults. The present study used the 1994 Canada’s Alcohol and Other Drugs Survey to explore the interactions among gender, age, and beverage exclusivity when studying heavy drinking behavior. The findings replicated prior main effects research and extended the age findings to later adulthood. The interactions, however, revealed that gender differences were smaller in older adults and were entirely absent in wine drinkers; age differences also were found across beverage exclusivity categories. However, the amount of variability explained by the model suggests that other factors have more power in explaining binge drinking behavior. The need to study binge drinking in more heterogenous samples, with other variables, is discussed.

In this study, we explored the relationships among gender and diet type (weight loss, weight gain, not dieting) on body image perceptions and psychological well-being in a sample of high school students. Our findings showed (1) that young women were more likely to be dieting to lose weight while young men were more likely to be dieting to gain weight and (2) that those high in the drive for thinness were most likely to be dieting to lose weight while those high in the drive for muscularity were most likely to be dieting to gain weight. The data also revealed that dieting to lose weight was associated with reporting significantly more depressive symptoms than dieting to gain weight or not being on a diet at all. The importance of distinguishing between boys’ and girls’ body image concerns was discussed.

This study explored the extent to which college men and women of various racial and ethnic groups differ in their health beliefs and behaviors. Exploratory factor analyses of survey responses from a diverse sample of 1816 undergraduate students identified 21 items in six cohesive domains: Diet; Anger and Stress; Preventive Care; Medical Compliance; Substance Use; and Beliefs about Masculinity. Analyses of variance explored group differences across these domains. Findings revealed consistent gender differences, with men engaging in riskier behaviors and holding riskier beliefs than women. Main effects for ethnicity were also observed, but only for the diet domain was a gender by ethnicity interaction found. Implications for establishing gender- and ethnicity-based health promotion and disease prevention interventions are discussed.

Prior research has shown strong sex differences in spatial ability and some researchers have argued that gender role socialization (i.e. the degree to which men and women internalize gender-related personality traits or act in gender-typed ways) mediates this relationship. This study provides a direct examination of the extent to which trait and behavioural components of gender role socialization mediate sex differences in spatial ability. The results of two path analyses show that, while sex is a significant predictor of spatial ability, only agentic personality traits significantly mediated that relationship.

The Sex Role Behavior Scale (SRBS; Orlofsky & O'Heron, 1987; Orlofsky, Ramsden, & Cohen, 1982) is the only measure of the extent to which people engage in male- and female-valued behaviors, as well as sex-specific behaviors. Because of this, researchers must be assured of its reliability and validity. Although the SRBS has demonstrated good reliability, validity tests have been limited to examinations of scale intercorrelations, correlations with other gender role measures, and tests of gender differences. Tests of the SRBS's construct validity have not been performed. Thus, a scale-based confirmatory factor analysis of the short form SRBS was undertaken to determine the validity of its proposed 12-factor, lower-order and 3-factor, higher-order factor structures. In this sample of undergraduates, both lower-order and higher-order models failed to provide a good fit to the data, which suggests that a new version of the SRBS may be required. Discussion focussed on possible directions for a revision, potential limitations, as well as the need for more measures like the SRBS.

Past research has shown a gender-based paradox in the relationship between body mass index (BMI) and perceived weight. That is, even though males are more likely than females to be overweight, between 28% and 68% of normalweight boys and young men perceive themselves to be underweight, while 30-67% of normal weight adolescent girls and young women perceive themselves to be overweight. It also has been suggested that these weight misperceptions may be stable in adult women, but may fluctuate in men, as they get older. The present study explored this possibility using a randomly selected subsample from the 1996-97 Canadian National Population Health Survey. Gender differences in perceived weight were examined separately for 3,000 men and 3,000 women between 20 and 64 years of age whose BMI classed them as either normal weight or overweight. Findings showed that, across age groups, an average of 43% of overweight men felt they were of normal weight, while, on average, 29% of normal weight women felt they were overweight. Implications for the study of men’s and women’s body image are discussed.

Coping is a cyclical process in which an individual evaluates stressful events, chooses and implements coping strategies, re-evaluates the outcome of the coping effort and modifies the strategy if necessary. The intent of the present study was to evaluate the extent to which pain-related adjustment (i.e. pain severity, pain interference, negative affect) and perceptions of control are associated with the implementation of particular coping strategies. Participants were 136 patients assessed at an interdisciplinary pain clinic for cervical sprain injuries. As part of a routine assessment, participants completed a questionnaire package regarding background, pain severity, pain interference, negative affect, perceived control and use of particular coping strategies. Results of hierarchical multiple regression analyses revealed that pain interference, after controlling for all other variables, was associated with greater use of less physically demanding strategies (i.e. resting, guarding, asking for assistance, seeking social support and coping self-statements). Negative affect, on the other hand, after controlling for other variables, was associated with reduced use of task persistence. Finally, perceived control, independent of other variables, was associated with greater use of cognitive and social coping strategies (i.e. asking for assistance, seeking social support and coping self-statements). The results of the study shed light on the complex relationship between use of particular coping strategies and situational variables of pain-related adjustment and perceived control. Implications for clinicians who assist patients via implementation or modification of particular coping techniques are discussed.