Burnout, Depression, and Anxiety Levels among Healthcare Workers Serving Children with Autism Spectrum Disorder

Burnout in healthcare workers (HCWs) is defined as a state of emotional, physical, and mental exhaustion that results from unmanaged, excessive, and long-term workplace stressors. This study aims to assess the prevalence of burnout and the levels of anxiety and depression among HCWs who primarily work with children who have autism spectrum disorder (ASD). A quantitative cross-sectional survey was conducted utilizing the Arabic version of the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS), Patient Health Questionnaire for Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire for Depression (PHQ-9). Among the 381 participants working in autism centers, the majority were young Saudi females (326) working full-time as specialists in the private sector with less than five years of experience. The HCWs’ overall mean scores on the three Maslach Burnout Inventory (MBI) subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were 62%, 23.7%, and 76.5%, respectively. A total of 51.4% of HCWs reported moderate to high anxiety levels on GAD-7, and 47.8% showed moderate to very high levels of depression on PHQ-9. The mean perceived EE converged significantly but negatively on their overall mean perceived satisfaction with AWS (p-value < 0.001), demonstrating that greater emotional fatigue predicts less satisfaction with their work. The PA scores correlated significantly and positively with their overall mean satisfaction with their AWS score (p-value < 0.001). Considering sociodemographic variables, HCWs aged between 20–29 years have significantly lower mean PA scores than HCWs aged thirty and older (p = 0.007). Also, male HCWs perceived significantly higher work-related DP than females. More research is required to determine the nature of variables that contribute to burnout, depression, and anxiety in HCWs helping children with ASD.

COVID-19 Pandemic in a Vulnerable Population: Prevalence and Correlates of Anxiety

Background: The COVID-19 pandemic has produced negative mental health outcomes. These effects were more prominent in vulnerable communities that experienced prior similar disasters. The study aimed to examine the likelihood and correlates of anxiety symptoms among Fort McMurray (FMM) residents, during the COVID-19 pandemic. Methods: A cross-sectional online survey questionnaire was applied between 24 April and 2 June 2021, at FMM, to gather sociodemographic, COVID-19, and clinical information, including generalized anxiety disorder (using GAD-7 scale). Results: Overall, 186 individuals completed the survey (response rate 74.7%). Most of the respondents were females (159, 85.5%); above 40 years (98, 52.7%); employed (175, 94.1%); and in relationship (132, 71%). The prevalence of moderate-to-severe anxiety was (42.5%, 71) on GAD-7 self-reported scale. Subscribers who reported that they would like to receive mental health support; have received no family support since COVID-19 declaration; and have lost their job during the pandemic were all more likely to report moderate-to-severe anxiety (OR = 3.39; 95% CI: 1.29–8.88), (OR = 4.85; 95% CI: 1.56–15.03), and (OR = 4.40; 95% CI: 1.01–19.24), respectively. Conclusions: Anxiety levels were high among FMM residents, compared to levels before COVID-19. Clinical and social factors significantly predicted likely anxiety in the Fort McMurray population, during the COVID-19 pandemic. It is imperative that resources are mobilized to support vulnerable communities during the COVID-19 pandemic.

People’s Experience of Shared Decision Making in Musculoskeletal Physiotherapy: A Systematic Review and Thematic Synthesis

(1) Shared decision making (SDM) has been advocated as a way of improving prudency in healthcare and has been linked to self-efficacy and empowerment of service users. The evaluation of its use in musculoskeletal (MSK) physiotherapy has been vague, but articles suggest that trust and communication are integral. (2) ENTREQ guidelines informed this systematic review and thematic synthesis. PRISMA recommendations steered a systematic literature search of AHMED, CINAHL, MEDLNE, EMBASE and Cochrane databases from inception to September 2021. COREQ was used for quality appraisal of articles alongside critical discussions. Analysis and synthesis included five stages: outlining study characteristics, coding of data, development of descriptive themes, development of analytical themes and integration and refinement. The review aim was to explore people’s experiences of SDM in MSK physiotherapy and to inform our understanding of the conditions needed for successful SDM. (3) Out of 1508 studies, 9 articles were included. Four main themes (trust, communication, decision preferences and decision ability) demonstrated that the majority of people want to participate in decision-making. As described in the capacity and capability model, three core conditions were needed to facilitate someone’s’ ability to participate. (4) People want to be involved in SDM in MSK physiotherapy. For successful SDM, physiotherapists should look to develop mutual trust, utilise two-way communication and share power.

Can Dance and Music Make the Transition to a Sustainable Society More Feasible?

Transition to sustainability is a process that requires change on all levels of society from the physical to the psychological. This review takes an interdisciplinary view of the landscapes of research that contribute to the development of pro-social behaviors that align with sustainability goals, or what we call ‘inner sustainability’. Engaging in musical and dance activities can make people feel trust and connectedness, promote prosocial behavior within a group, and also reduce prejudices between groups. Sustained engagement in these art forms brings change in a matter of seconds (such as hormonal changes and associated stress relief), months (such as improved emotional wellbeing and learning outcomes), and decades (such as structural changes to the brains of musicians and dancers and superior skills in expressing and understanding emotion). In this review, we bridge the often-separate domains of the arts and sciences by presenting evidence that suggests music and dance promote self-awareness, learning, care for others and wellbeing at individual and group levels. In doing so, we argue that artistic practices have a key role to play in leading the transformations necessary for a sustainable society. We require a movement of action that provides dance and music within a constructive framework for stimulating social sustainability.

Personality, Defense Mechanisms and Psychological Distress in Women with Fibromyalgia

Background: Previous studies have shown that many personality traits are associated with fibromyalgia (FM), worsening both the quality of life and psychological distress of patients. Despite the high comorbidity of psychopathological disorders in this syndrome and their association with immature defense styles, few studies have examined the defense mechanisms used by FM patients. The main aim of our study was to investigate personality traits and defense mechanisms in FM patients compared to in a healthy control group (HC). Moreover, we investigated the effect of personality traits and defense mechanisms on psychological distress in both FM and HC groups. Methods: A total of 54 women with FM and 54 healthy women completed the (1) Temperament and Character Inventory—Revised; (2) the Toronto Alexithymia Scale; (3) the Defense Style Questionnaire; and (4) the Hospital Anxiety and Depression Scale. Results: The results indicated that FM patients display higher alexithymia, higher harm avoidance, lower self-directedness, lower persistence, and the higher use of a maladaptive defense style compared to HC. We found that alexithymia, harm avoidance, and maladaptive defense style are significant predictors of patients’ psychological distress. Moreover, harm avoidance and adaptive defense style significantly predicted psychological distress in the HC group. Conclusion: The present study is the first to explore the contribution of both defense mechanisms and personality characteristics on the psychological distress of FM patients. Our findings have important clinical implications and may help diagnose and treat FM patients more in depth.

Relationship between Breast Cancer Surgical Treatment and Psychiatric Symptomatology: Which Sociodemographic and Clinical Factors Could Influence It? A Preliminary Study

This study aimed to investigate psychiatric symptomatology in a sample of patients affected by breast cancer undergoing surgery, evaluating the potential mediators on perceived stress levels, depression and hopelessness. The study was conducted on eighty-five patients with breast cancer, admitted consecutively to the Breast Unit of the IRCCS Ospedale Policlinico San Martino, between May 2018 and December 2019. Sociodemographic (age of diagnosis, gender, marital and occupational status, educational level, having children) and clinical (type and side of surgery, previous breast surgery, neoadjuvant chemotherapy and axillary dissection) characteristics were investigated through a semi-structured interview. The following rating scales were administered: Beck Depression Inventory, Beck Hopelessness Scale, and Perceived Stress Scale. Our findings indicate that the presence of children and of a partner was associated with a lower total score on the clinical dimensions evaluated. Furthermore, we found demolitive surgery to be a mediator between perceived stress and hopelessness, while history of previous breast surgery was found to be a mediator between demolitive surgery and perceived stress. In conclusion, patients affected by breast cancer undergoing more complex and demolitive surgery or with history of previous breast surgery should be mostly monitored from a psychological and psychiatric point of view from the beginning of treatments to evaluate the first manifestations of psychiatric symptomatology.

Shall I Show My Emotions? The Effects of Facial Expressions in the Ultimatum Game

Over the past fifteen years, research has demonstrated the central role of interpersonal emotions in communicating intentions, goals and desires. These emotions can be conveyed through facial expressions during specific social interactions, such as in the context of coordination between economic agents, where information inferred from them can influence certain decision-making processes. We investigated whether four facial expressions (happiness, neutral, angry and disgusted) can affect decision-making in the Ultimatum Game (UG). In this economic game, one player (proposer) plays the first move and proposes how to allocate a given amount of money in an anonymous one-shot interaction. If the other player (responder) accepts the proposal, each player receives the allocated amount of money; if he/she rejects the offer, both players receive nothing. During the task, participants acted as the responder (Experiment 1) or the proposer (Experiment 2) while seeing the opponent’s facial expression. For the responders, the results show that the decision was mainly driven by the fairness of the offer, with a small main effect of emotion. No interaction effect was found between emotion and offer. For the proposers, the results show that participants modulated their offers on the basis of the responders’ expressed emotions. The most generous/fair offers were proposed to happy responders. Less generous/fair offers were proposed to neutral responders. Finally, the least generous/fair offers were proposed to angry and disgusted responders.

A Study on Instructional Humor: How Much Humor Is Used in Presentations?

Humor is applied in pedagogy to create a positive learning environment. Recent research focuses on the theories, effects, individual differences, and qualitative aspects of humor for instruction. However, there is a lack of studies focusing on quantitative features. Therefore, this research explored the quantitative characteristics of instructional humor in a naturalistic setting and applied techniques from natural language processing (NLP). This paper describes the results of two studies. The first study focused on instructional humor frequency and the placement of humor, while the linguistic features of instructional humor and non-instructional humor were compared in the second study. Two corpora were used in this research: TED Talks and user-submitted jokes from “stupidstuff.org” The results found that educators used humor 12.92 times for popular talks, while less popular talks only had 3.92 times. Humor is also more commonly placed during the first parts of the talk and lessens toward the end. There were also significant differences between the linguistic features of instructional and non-instructional humor in terms of readability scores and sentiment. These results provide a substantial update on quantitative instructional humor research and help educators understand how to use humor in the classroom in terms of quantitative and linguistic features.

In-Organization Ethics Power-Allocation Mechanisms and Members’ Decision-Making Behavior

This study examines experimental evidence showing how ethics power allocation mechanisms affect an individual’s in-organization resource division and ethical behavior. We used two two-stage lab experiments to explore power seeking and usage; the experiments contained two stages of power contending and power usage. Stage one used two different power-seeking mechanisms in the honesty game. Stage two was based on the dictator game and the ultimatum game to measure an individual’s power usage. The results show that the decisions taken by power-holders could influence the optimization of collective resources, and power-holders who gain power with unethical methods could result in collective resource allocation inequities. With more balanced in-organization power, members tend to be more honest. Subjects also adjust their unethical behavior to adapt to the environment, which could cause the diffusion of unethical behavior. This paper re-designed the dictator game and the ultimatum game by adding an ethically vulnerable power acquisition mechanism. For organizations to prevent the disproportionate dispersion of resources and achieve more public benefits, it is meaningful for managers to create a proper in-organization ethical power allocation mechanism.

Personality Traits, Cognitive Styles, Coping Strategies, and Psychological Impact of the COVID-19 Pandemic Lockdown on Healthy Youngsters

The objective of the present study was to explore possible changes in the psychological wellbeing of young healthy students during the initial 14 days of the COVID-19 general lockdown that occurred in March of 2020, and if there was any relation with specific personality traits (neuroticism, psychoticism, and extraversion), cognitive styles (internal and external locus of control and intolerance of uncertainty), and coping strategies. One hundred twenty-two university students aged from 18 to 29 years participated in the study. The dispositional factors were assessed at the beginning of the study, while measures of psychological adjustment (anxiety, depression, and self-perceived health) were taken in three different assessment stages, employing validated questionnaires and scales. Anxiety and depression scores significantly increased after one week of lockdown, reaching a plateau pattern by the second week. The levels of self-perceived mental health, vitality, and quality of life showed a pattern of sustained progressive decrease, with a more acute lessening during the first week. Neuroticism, intolerance of uncertainty, and negative autofocus were associated to worse levels of psychological adjustment. These individual differences might be taken into consideration when designing prevention programs aiming to dampen the psychological impact of a general lockdown in healthy population.