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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: Monolingual cognitive assessments are standard for bilinguals; the value of bilingual assessment is unknown. Since declines in animal naming accompany memory declines in dementia, we examined the association between bilingual animal naming and memory among bilingual Mexican American (MA) older adults., Methods: Bilingual MA (n = 155) completed the Harmonized Cognitive Assessment Protocol (HCAP) in a Texas community study. Regressions included HCAP memory score (English) as the outcome and English and Spanish animal naming trials as independent variables; demographics and language dominance were covariates., Results: English animal naming ( b = 0.06, P = 0.004) was more reliably associated with memory than Spanish ( b = 0.05, P = 0.06). Considered together, only English ( b = 0.05, P = 0.02) was associated with memory, not Spanish ( b = 0.01, P = 0.63). Conclusions: Spanish animal naming did not uniquely add to English animal naming in its association with memory among bilingual older MA., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The impact of the COVID-19 pandemic on informal caregiving was examined in a Mexican American (MA) and Non-Hispanic White (NHW) population-based cohort. 395 participants age > 65 years were recruited via door-to-door and phone recruitment as part of the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C) project. Both recipients and caregivers answered questions regarding the recipient's health and the COVID-19 pandemic. 15% of caregivers saw their caregiving recipient less than before the pandemic and 18% saw their recipient more than before. 55% of caregivers reported a slight to severe impact of the pandemic on their caregiving, and 45% reported no impact. For most caregivers, their caregiving role did not change markedly during the pandemic. MA and NHW caregivers had similar survey responses., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: This study examines the associations of ethnicity, caregiver burden, familism, and physical and mental health among Mexican Americans (MAs) and non-Hispanic Whites (NHWs)., Methods: We recruited adults 65+ years with possible cognitive impairment (using the Montreal Cognitive Assessment score<26), and their caregivers living in Nueces County, Texas. We used weighted path analysis to test effects of ethnicity, familism, and caregiver burden on caregiver's mental and physical health., Results: 516 caregivers and care-receivers participated. MA caregivers were younger, more likely female, and less educated compared to NHWs. Increased caregiver burden was associated with worse mental (B = -0.53; p < .001) and physical health (B = -0.15; p = .002). Familism was associated with lower burden (B = -0.14; p = .001). MA caregivers had stronger familism scores (B = 0.49; p < .001)., Discussion: Increased burden is associated with worse caregiver mental and physical health. MA caregivers had stronger familism resulting in better health. Findings can contribute to early identification, intervention, and coordination of services to help reduce caregiver burden., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Little information is available on the prevalence of cognitive impairment in Mexican American persons., Objective: To determine the prevalence of mild cognitive impairment (MCI) and dementia in those 65 years and older among Mexican American and non-Hispanic white individuals in a community., Methods: This was a population-based cohort study in Nueces County, Texas, USA. Participants were recruited using a random housing sample. The Harmonized Cognitive Assessment (HCAP) participant and informant protocol was performed after Montreal Cognitive Assessment (MoCA) screening. An algorithm was used to sort participants into diagnostic categories: no cognitive impairment, MCI, or dementia. Logistic regression determined the association of ethnicity with MCI and dementia controlling for age, gender, and education., Results: 1,901 participants completed the MoCA and 547 the HCAP. Mexican Americans were younger and had less educational attainment than non-Hispanic whites. Overall, dementia prevalence was 11.6% (95% CI 9.2-14.0) and MCI prevalence was 21.2% (95% CI 17.5-24.8). After adjusting for age, gender, and education level, there was no significant ethnic difference in the odds of dementia or MCI. Those with ≤11 compared with ≥16 years of education had much higher dementia [OR = 4.9 (95% CI 2.2-11.1)] and MCI risk [OR = 3.5 (95% CI 1.6-7.5)]., Conclusions: Dementia and MCI prevalence were high in both Mexican American and non-Hispanic white populations. Mexican American persons had double the odds of mild cognitive impairment and this was attenuated when age and educational attainment were considered. Educational attainment was a potent predictor of cognitive impairment.

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.)

Accidents are a leading cause of deaths in U.S. active duty personnel. Understanding accident deaths during wartime could facilitate future operational planning and inform risk prevention efforts. This study expands prior research, identifying health risk factors associated with U.S. Army accident deaths during the Afghanistan and Iraq war. Military records for 2004-2009 enlisted, active duty, Regular Army soldiers were analyzed using logistic regression modeling to identify mental health, injury, and polypharmacy (multiple narcotic and/or psychotropic medications) predictors of accident deaths for current, previously, and never deployed groups. Deployed soldiers with anxiety diagnoses showed higher risk for accident deaths. Over half had anxiety diagnoses prior to being deployed, suggesting anticipatory anxiety or symptom recurrence may contribute to high risk. For previously deployed soldiers, traumatic brain injury (TBI) indicated higher risk. Two-thirds of these soldiers had first TBI medical-encounter while non-deployed, but mild, combat-related TBIs may have been undetected during deployments. Post-Traumatic Stress Disorder (PTSD) predicted higher risk for never deployed soldiers, as did polypharmacy which may relate to reasons for deployment ineligibility. Health risk predictors for Army accident deaths are identified and potential practice and policy implications discussed. Further research could test for replicability and expand models to include unobserved factors or modifiable mechanisms related to high risk. PTSD predicted high risk among those never deployed, suggesting importance of identification, treatment, and prevention of non-combat traumatic events. Finally, risk predictors overlapped with those identified for suicides, suggesting effective intervention might reduce both types of deaths., (Copyright © 2017 Elsevier Inc. All rights reserved.)

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]

Importance: The US Army experienced a sharp increase in soldier suicides beginning in 2004. Administrative data reveal that among those at highest risk are soldiers in the 12 months after inpatient treatment of a psychiatric disorder., Objective: To develop an actuarial risk algorithm predicting suicide in the 12 months after US Army soldier inpatient treatment of a psychiatric disorder to target expanded posthospitalization care., Design, Setting, and Participants: There were 53,769 hospitalizations of active duty soldiers from January 1, 2004, through December 31, 2009, with International Classification of Diseases, Ninth Revision, Clinical Modification psychiatric admission diagnoses. Administrative data available before hospital discharge abstracted from a wide range of data systems (sociodemographic, US Army career, criminal justice, and medical or pharmacy) were used to predict suicides in the subsequent 12 months using machine learning methods (regression trees and penalized regressions) designed to evaluate cross-validated linear, nonlinear, and interactive predictive associations., Main Outcomes and Measures: Suicides of soldiers hospitalized with psychiatric disorders in the 12 months after hospital discharge., Results: Sixty-eight soldiers died by suicide within 12 months of hospital discharge (12.0% of all US Army suicides), equivalent to 263.9 suicides per 100,000 person-years compared with 18.5 suicides per 100,000 person-years in the total US Army. The strongest predictors included sociodemographics (male sex [odds ratio (OR), 7.9; 95% CI, 1.9-32.6] and late age of enlistment [OR, 1.9; 95% CI, 1.0-3.5]), criminal offenses (verbal violence [OR, 2.2; 95% CI, 1.2-4.0] and weapons possession [OR, 5.6; 95% CI, 1.7-18.3]), prior suicidality [OR, 2.9; 95% CI, 1.7-4.9], aspects of prior psychiatric inpatient and outpatient treatment (eg, number of antidepressant prescriptions filled in the past 12 months [OR, 1.3; 95% CI, 1.1-1.7]), and disorders diagnosed during the focal hospitalizations (eg, nonaffective psychosis [OR, 2.9; 95% CI, 1.2-7.0]). A total of 52.9% of posthospitalization suicides occurred after the 5% of hospitalizations with highest predicted suicide risk (3824.1 suicides per 100,000 person-years). These highest-risk hospitalizations also accounted for significantly elevated proportions of several other adverse posthospitalization outcomes (unintentional injury deaths, suicide attempts, and subsequent hospitalizations)., Conclusions and Relevance: The high concentration of risk of suicide and other adverse outcomes might justify targeting expanded posthospitalization interventions to soldiers classified as having highest posthospitalization suicide risk, although final determination requires careful consideration of intervention costs, comparative effectiveness, and possible adverse effects.

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.)

Introduction: Little is known about the effects of combat exposure on women's health after service in Operation Iraqi Freedom (OIF). Our purpose was to describe the incidence and nature of physical heath symptoms reported by deployed women to identify problematic areas where early intervention or better surveillance might be directed., Methods: Using a random, stratified sample (theater vs. non-theater; parent vs. non-parent; and military component including active, guard, and reserve members) of 1,114 Air Force women, we provide descriptive statistics, group comparisons, and multiple regression models to identify health concerns and potential predictors of physical health outcomes., Results: Findings revealed that those in the reserve/guard forces (vs. active duty) and those in the theater of operations (vs. elsewhere during the same time period) reported greater physical health problems (β = -0.07, p < .05 and β = 0.11, p < .001, respectively). Enlisted women reported poorer general health than officers (β = 0.09, p < .01). Women were more likely to report that their physical health was impacted by OIF if deployed to the theater versus deployment elsewhere (β = 0.16, p < .001) or if they were in the reserve forces (β = -0.11, p < .001). Further, women who were parents or deployed to the theater reported greater interference of physical and emotional problems on their social functioning (β = 0.08, p < .05 and β = 0.08, p < .01, respectively)., Conclusion: Deployment to the theater of operations is significantly associated with physical health outcomes although the severity of the self-reported symptoms is low. Our findings suggest that further investigation is needed to explore the war-related predictors of health among women serving in deployed locations around the world., (Copyright © 2011. Published by Elsevier Inc.)

Longitudinal data from a stratified representative sample of U.S. Air Force personnel (N = 1009) deployed to the wars in Iraq, Afghanistan, and other locations were analyzed in this study. Using structural equation models, we examined the effects of war exposure on traumatic experiences, Post Traumatic Stress (PTS) symptoms, resource loss, and on subsequent functioning, perceived health, and on job and organizationally relevant outcomes. The job and organizational outcomes included job burnout, job involvement, job strain, job satisfaction, work-family conflict, organizational commitment, deployment readiness, and intention to reenlist. We found that deployment to the theater of the war increased risk of exposure to trauma, which in turn, predicted elevated PTS symptoms and resource loss. PTS symptoms predicted later loss of resources and deterioration in perceived health and functioning. In turn, resource loss predicted negative job and organizational outcomes. Exposure to trauma fully mediated the effects of deployment to the theater of war on PTS symptoms and resource loss and had additional significant indirect effects on several job and organizational relevant outcomes. For returning veterans, deployment to the theater of war, exposure to trauma, PTS symptoms, and resource loss represents a "cascading" chain of events that over time results in a decline of health and functioning as well as in adverse job and organizationally relevant outcomes that may affect organizational effectiveness.

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]

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Purpose: This study explores the moderated mediation effect, wherein collective mindfulness attenuates the hypothesised relationship between customer incivility, service sabotage and psychological well-being and is supported by the conservation of resources (COR) theory. Design/methodology/approach: Multiwave and multisource data were collected from 315 frontline employees (FLEs) working in 32 Indian bank branches. Using HLM 7.00, the authors tested a multilevel model in which branch-level collective mindfulness moderated the association amongst individual-level customer incivility, psychological well-being and service sabotage. Findings: A higher level of collective mindfulness had a profound cross-level effect on the association between customer incivility and service sabotage through psychological well-being. Originality/value: Distinct from prior research that focussed on individuals' personal resources as a buffer against customer incivility, the authors' study identified branch-level collective mindfulness as a boundary condition that helps employees experiencing customer incivility decrease service sabotage. By uncovering a branch-level variable that reduces the negative impact of customer incivility on service sabotage, the authors' study offers valuable insights for banks to enhance customer service at their branches. [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]

Employees remaining silent about ethical aspects of work or organization-related issues, termed employee ethical silence, perpetuates misconduct in today's business setting. However, how and why it occurs is not yet well specified in the business ethics literature, which is insufficient to manage corporate misconducts. In this research, we investigate how and when exploitative leadership associates with employee ethical silence. We draw from the conservation of resources theory to theorize and test a cognitive resource pathway (i.e., work meaningfulness) and a moral resource pathway (i.e., moral potency) to explain the association between exploitative leadership and employee ethical silence. Results from two studies largely support our hypotheses that work meaningfulness and moral potency mediate the effect of exploitative leadership on ethical silence contingent on performance reward expectancy. Theoretical and practical implications are thoroughly discussed in the paper. [ABSTRACT FROM AUTHOR]

Adolescent suicide has become an increasingly serious social problem in China. Bullying victimization was found to be an influential factor of suicidal tendency, but less attention has been paid to the internal mechanisms of the relationship. This paper examined the relationship between adolescents' bullying victimization and suicidal tendency, and the mediating effects of internalizing problems and non-suicidal self-injury (NSSI). Generalized Structural Equation Model was employed to a sample of 3,575 Chinese secondary school students. Bullying victimization has a direct positive impact on adolescents' suicidal tendency, but also has an indirect impact on suicidal tendency through three paths: the independent mediating role of internalizing problems and NSSI, and the chain mediating role of internalizing problems and NSSI. The results suggested that students who are bullied tend to have a higher risk of suicidal tendency, and internalizing problems and NSSI are usually the prelude to suicidal behaviors. [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]

According to the Congress of Unions of Employees in the Public and Civil Service of Malaysia (CUEPACS), nearly 500,000 Malaysian civil servants have been identified as experiencing work stress. By investigating the effects of work stress on civil servants in Malaysia's federal agencies, the relationship between leadership (LS), team conflict (TC), and work stress (WS) in the Malaysian public sector was examined and the mediating effect of job demands (JD) was tested. The sample comprised 626 respondents who worked in Putrajaya, Kuala Lumpur. Data were collected through survey method and quantitative analysis were done employing the structural equation modeling (SEM) to analyze direct and indirect effect. According to the findings, there was a significant positive impact of TC on WS, TC on JD, and LS on JD. Contrarily, the impact of LS on WS was not significant. The JD constructs was identified as mediator of the aforementioned relationships. The practical implications suggested that organizations should place greater emphasis on cultivating a learning culture to successfully adapt and respond to novel external challenges. Leaders could reduce WS by being honest and empathetic towards the employees and granting them the flexibility to spend precious time with their loved ones. In addition, supervisors and managers should use more transformational approaches in their interactions with subordinates. Team members could stay in touch for social support. The findings extended previous research and strengthened the antecedents of WS, namely LS, TC, and JD, in public organization. [ABSTRACT FROM AUTHOR]

This was a daily diary study using intensive longitudinal methods to evaluate the dynamic structure of relationships among employees' self-reported health, psychological capital, daily workplace incivility, and daily emotional exhaustion. We recruited 200 participants working in health and fitness clubs for experience sampling and had them file the same questionnaires for 10 consecutive working days. A total of 179 participants (men = 57, 31.85%; women = 122, 68.15%) completed the questionnaires, with a response rate of 89.5%, leading to 1790 data points at the within-person level. We used a multilevel location-scale model of dynamic structural equation modeling (DSEM) for data analysis. We ran the model in Mplus software (version 8.4) and found an autoregressive 'carry over' relationship between the previous day's emotional exhaustion changes on current emotional exhaustion changes ( γ 10 = 0.067, CI = [0.003, 0.132]). Daily workplace incivility significantly and positively predicted daily emotional exhaustion at the within-person level ( γ 20 = 0.953, CI = [0.465, 1.489]). Self-reported health was negatively associated with a person's mean ratings of daily emotional exhaustion ( γ 20 = −0.256, CI = [0.465, 1.489]) and moderated the strength of the workplace incivility effect on emotional exhaustion ( γ 21 = −0.201, CI = [−0.292, −0.121]). Finally, psychological capital was negatively related to a person's mean ratings of daily emotional exhaustion ( γ 02 = −0.240, CI = [−0.377, −0.102]). [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]

The purpose of this study is to test the factors that impact the effects that compulsory citizenship behaviour (CCB) has on work-family conflict based on the theory of Conservation of Resources. Data were collected from 505 employees in 13 high-tech enterprises in China. It revealed that (1) employees' compulsory citizenship behaviour is positively related to levels of work-family conflict, (2) work stress mediates the relationship between CCB and work-family conflict, and (3) proactive personality moderates the effects of CCB on employees' work stress and work-family conflict, with the relationship more positive when proactive personality is high. The study contributes to the CCB literature through its identification of work stress as an important psychological mediation mechanism that amplifies the mechanism through which CCB has an effect on employees. The results provide a deeper understanding of important boundary conditions (in this case proactive personality) that impact the CCB to employee's work-family conflict relationship. The findings also enrich the proactive personality literature. Paradoxically, if organizations attempt to foster citizenship behaviors by selecting people with the sort of proactive personality that might assist citizenship, they end up exacerbating the impact on work stress and work-family conflict. Theoretical and practical implications, limitations and promising avenues for future study are discussed. [ABSTRACT FROM AUTHOR]

Suicide is an important cause of death in patients with mental health disorders, but little is known about the occurrence of suicidal ideation and attempts in outpatient psychotherapy patients. The aim of this study was to identify the proportion of patients with and correlates of suicidal ideation and attempts in community‐based psychotherapy practices. Using 983 applications for reimbursement of psychotherapy from individual patients, reports about suicidal thoughts and suicide attempts were extracted along with demographic, biographic and clinical data. Multivariate logistic regression analysis was used to identify correlates of suicidal ideation and attempts by calculating odds ratios (ORs). Among the patients, 19% presented with suicidal thoughts (11% currently and 8% in the past) and 6% with suicide attempts. Important correlates of suicidal thoughts were male gender (OR 1.7), lower education (OR 1.8), early retirement (OR 2.9), death of a parent when younger than 5 years old (OR 3.3), violence experienced from various people (OR 2.1), self‐harm behaviour (OR 7.9) and alcohol misuse (OR 1.7). Suicide attempts were associated with male gender (OR 5.6), lower education (OR 4.2), violence experienced from partner (OR 2.5) or from various people (OR 9.5) and self‐harm behaviour (OR 15.0). These results show that the proportion of suicidal patients seeking outpatient psychotherapy is high. It should therefore be a central topic in clinical training. Biographic data such as the loss of a parent at an early age or experiencing violence are associated with who is at increased risk and should be explored in detail. [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]

Relying on Conservation of Resources theory and a sample of 23,439 workers in 26 countries, we develop and test a multilevel moderated mediation of the effects of perceived job autonomy on work–life balance, engagement, and turnover intentions, depending on employee gender and country‐level gender egalitarianism (GE), and indirectly through stress. We find that perceived job autonomy relates to these outcomes indirectly through stress such that these effects are stronger for women in lower GE countries compared with women in higher GE countries and are not significant for men. Practical implications for engaging and retaining global female talent are discussed. [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]

In this conceptual article, we seek to extend the domain of the conservation of resources (COR) theory to the collegiate student-- athlete population in the context of academic--athletic role conflict and stress. Aside from reviewing the direct effects academic--athletic role conflict may have on psychological strain, this conceptual study also continues to build on the theory by proposing mediational pathways of role conflict, and the moderating effects of personal characteristics and social support on the stressor--strain relationship. Although this theoretical framework has been mainly applied in the work--family context, it could be proven useful in alleviating the pressures resulting from student--athletes' competing roles by providing stress-coping strategies. Focusing on addressing student--athletes' challenges in managing their college careers, the study provides a theoretical foundation for enhancing student--athletes' well-being and collegiate experiences. Implications for managerial practices and research are discussed. [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]

Increasing attention has been focused on suicidal behavior among military personnel. Exposure to deployment‐related traumatic events (DRTEs) and child abuse (CA) both have been associated with mental disorders and suicidal behaviors among military personnel. Thus, the primary objectives of this study were to examine (a) sex differences in CA history and DRTEs, past‐year mental disorders, and past‐year suicide‐related outcomes and (b) independent, cumulative, and interactive effects of CA history and DRTEs on past‐year mental disorders and suicide outcomes among Canadian military personnel. Data were from the representative Canadian Forces Mental Health Survey collected in 2013 (N = 8,161; response rate = 79.8%). The results indicated a high prevalence of trauma exposure, with sex differences noted for specific trauma types. Both CA history and DRTEs were strongly associated with mental disorders, CA history: aORs = 1.60–2.44; DRTEs; aORs = 1.67–3.88. Cumulative, but not interactive, effects were noted for the effects of CA history and DRTEs on most mental disorders. Associations between CA history and DRTEs on suicide outcomes were largely indirect via their impact on mental disorders. Information regarding the role of specific types of predeployment trauma on mental disorders and suicidal behavior can be used to develop more targeted prevention and intervention strategies aimed at improving the mental health of military personnel. [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]

The article discusses the issue of coping behavior as a form of behavior that reflects an individual's readiness to solve life problems. What is especially relevant in times of trials from military threats in the country. This behavior is aimed at adapting to circumstances and involves the developed ability to use certain means to overcome emotional stress. When choosing active actions, the probability of eliminating the effect of stressors on a person increases. The theoretical analysis showed that coping strategies are necessary when a person gets into a crisis situation. Any crisis situation presupposes the presence of some objective circumstances and a certain attitude of a person to them, depending on the degree of their significance, which is accompanied by emotional and behavioral reactions of various nature and degree of intensity. The leading characteristics of a crisis situation are mental tension, significant experiences as a special internal work to overcome life events or traumas, a change in self-esteem and motivation, as well as a pronounced need for their correction and psychological support from the outside. It was found that the motivational orientation of the individual determines the features of coping strategies in crisis situations. Thus, subjects with a pronounced motivation to avoid failure are more likely to use passive behavioral strategies in stressful situations - social support and avoidance, which reflects their weak efforts in solving any problem situation. And the subjects with a high level of motivation for success mainly use the strategy of finding a solution in stressful situations, aimed at solving the problem and adequately responding to the stressful situation. It was established that almost half of the researched use the strategy of finding a solution in stressful situations. That is, they have the highest level of development of adaptive coping mechanisms, tend to analyze stressful situations and find ways to solve them, have high confidence in their own resources to overcome stressful situations. The application of practical steps aimed at solving the situation significantly increases the constructiveness and effectiveness of overcoming it. [ABSTRACT FROM AUTHOR]