Publications: 1997
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Goldfried, M.R., Castonguay, L.G., Hayes, A.M., Drozd, J.F., & Shapiro, D.A. (1997). A comparative analysis of the therapeutic focus in cognitive-behavioral and psychodynamic-interpersonal sessions. Journal of Consulting and Clinical Psychology, 65, 740-748. This study compared therapeutic foci in a sampling of 30 cognitive-behavioral and 27 psychodynamic-interpersonal manual-driven treatments for depression. High- and low-impact sessions were coded for each client, with the Coding System of Therapeutic Focus. Results indicated that psychodynamic-interpersonal sessions focused more on such variables as emotion, patterns, incongruities, the impact that others made on clients, clients' expected reaction of others, the tendency to avoid therapeutic progress, therapists themselves, clients' parents, and links between people and time periods in clients' lives. Cognitive-behavioral sessions placed greater emphasis on external circumstances and clients' ability to make decisions, gave more support and information and encouraged between-session experiences, and focused more on the future. Relatively few differences emerged as a function of session impact. Results are discussed in terms of the different and similar theoretical conceptions of the change process.
Hardy, G.E., Shapiro, D.A., & Borrill, C.S. (1997). Fatigue in the workforce of National Health Service Trusts: Levels of symptomatology and links with minor psychiatric disorder, demographic, occupational and work role factors. Journal of Psychosomatic Research, 43, 83-92. The aims of this study were: (1) to obtain a systematic estimate of the levels of fatigue in representative samples of the major occupational groups of health care workers; (2) to examine the relationship between fatigue and mental health as a function of occupational and work role factors; and (3) to test the proposition that fatigue arises from a combination of poor mental health and high job stress. Questionnaire data from 7720 NHS Trust staff was used. Higher levels of fatigue were reported among health care workers in comparison with general population figures. Highest levels of general fatigue, the subjective sensation of tiredness, were experienced by doctors (especially women doctors), professions allied to medicine and managers. Highest levels of fatigability, the onset of symptoms after exertion, were experienced by ancillary and nursing staff. Both general fatigue and fatigability were associated with high levels of psychological distress. Support was also found for the proposition that fatigue arises from a combination of poor mental health and high work demands.
Taylor, E., Folkard, S., & Shapiro, D.A. (1997). Shiftwork advantages as predictors of health. International Journal of Occupational and Environmental Health, 3, S20-S29. This study investigated the relationships between shiftwork advantages and subjective health. The Standard Shiftwork Index and a measure of Shiftwork advantages were completed by 175 shift workers. Four advantage subscales were developed, corresponding to family, social/domestic, work, and time for oneself. Family advantages were negatively associated with psychological distress, cognitive and somatic anxiety, chronic fatigue, and digestive and cardiovascular symptoms ( p < 0.05). After family advantages were partialled out, social/domestic advantages were negatively related to psychological distress ( p < 0.05). Variety in work on each shift was significantly related to psychological distress and digestive symptoms. After the effects of shift and personality characteristics were accounted for, family advantages predicted a significant amount of the variance of cognitive anxiety ( p < 0.05) and chronic fatigue ( p < 0.01), and variety in work, family, and social/domestic advantages predicted a significant amount of variance of psychological distress ( p < 0.05). The authors conclude that family advantages are related to psychological health, and to a lesser extent physical health, but that other advantages have little relationship to subjective health.
Wall, T.D., Bolden, R.I., Borrill, C.S., Carter, A.J., Golya, D.A., Hardy, G.E., Haynes, C.E., Rick, J.E., Shapiro, D.A., & West, M.A. (1997). Minor psychiatric disorder in NHS Trust staff: Occupational and gender differences. British Journal of Psychiatry, 171, 519-523. Background It is widely suggested that many National Health Service (NHS) workers experience high levels of minor psychiatric disorder. However, inadequacies of sampling and measurement in studies to date have not allowed this suggestion to be properly evaluated. Method The present study was designed to overcome these methodological weaknesses by using a sample of over 11,000 employees from 19 NHS Trusts and a well-established measure of minor psychiatric disorder for which there are comparative data. Results The findings show that 26.8% of the health service workers reported significant levels of minor psychiatric disorder, compared with 17.8%of people in the general population. Psychiatric morbidity was highest among managers,doctors, nurses and professions allied to medicine, with each of these groups recording higher rates than their professional counterparts outside the health service. It was lower among those in support occupations, such as administrative and ancillary staff. A feature of the findings was that female doctors and managers showed a much higher prevalence of minor psychiatric disorder than their male colleagues. Conclusion Studies are required to establish the organisational, occupational and individual determinants of minor psychiatric disorder among NHS employees.
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