The General Factors of Personality Disorder, Psychopathology, and Personality

There is considerable interest in the study of the general factors of personality disorder (g-PD), psychopathology (p factor), and personality (GFP). One prominent interpretation of the g-PD is that it is defined by the self-interpersonal impairments of Criterion A of the DSM-5 Section III. However, no study has directly tested this hypothesis as no prior g-PD study has included a measure of Criterion A. The current study provides a direct test of this hypothesis, along with comparing g-PD with the general factors of psychopathology and personality. Also extracted was a common general factor across all three domains. Suggested herein is that the g-PD, the p factor, and the GFP reflect the impairments (e.g., social and occupational dysfunction) that are secondary to the traits and disorders rather than the traits and/or disorders themselves.

Association between Occupational Dysfunction and Social Isolation in Japanese Older Adults: A Cross-Sectional Study

We clarified the relationship between occupational dysfunction and social isolation among community-dwelling adults. We used a self-administered questionnaire with a cross-sectional study for 2879 independently living older adults in Kasama City, Japan. Participants responded to a self-reported questionnaire in November 2019. Occupational dysfunction and social isolation were assessed. The participants were classified into two groups: healthy occupational function group, and occupational dysfunction group. To examine the relationship between occupational dysfunction and social isolation, we performed a logistic regression analysis with social isolation as a dependent variable and occupational dysfunction as an independent variable. In the crude model, the occupational dysfunction group had a higher risk of social isolation than the healthy occupational function group (odds ratio (OR) = 2.04; 95% confidence interval (CI), 1.63–2.55; p < 0.001). In the adjusted model, the occupational dysfunction group had a higher risk of social isolation than the healthy occupational function group (OR = 1.51; 95% CI, 1.17–1.94; p = 0.001). The results showed that occupational dysfunction was significantly associated with social isolation. These results can be used in constructing a support method for social isolation from a new perspective.

Integrating Rehabilitation and Psychoanalysis in the Form of Object Relation Therapy in a Case with Marital Disharmony

Psychoanalysis and psychiatric rehabilitation are two vastly different theoretical concepts in psychiatry which can be used in patient’s interest when the resources are scarce. This case was approached with the objective of studying a case and its management using the psychoanalytic approach towards psychosocial rehabilitation in the low resource countries. A 37-year-old female presented with the chief complaint of stress and severe IPR issues with husband resulting in the socio-occupational dysfunction. Via psychoanalysis, the issues were resolved, and couple was rehabilitated in society with restoration of normal functioning. This study puts forward the concept of applying and integrating psychoanalysis as an approach towards rehabilitation.

Association between Occupational Dysfunction and Metabolic Syndrome in Community-Dwelling Japanese Adults in a Cross-Sectional Study: Ibara Study

The purpose of this study was to investigate the relationship between occupational dysfunction and metabolic syndrome (MetS) and its component factors in community-dwelling Japanese adults (N = 1,514). Self-reported lifestyle behaviors, Classification and Assessment of Occupational Dysfunction (CAOD) scores, and metabolic traits were measured. CAOD levels were divided into tertiles (low, moderate, and high), and their associations with MetS and its components were evaluated through logistic regression analysis. The association of MetS with CAOD was demonstrated in the total number of individuals [OR = 1.92 (95% CI 1.17–3.17)] and in older individuals [OR = 1.90 (95% CI 1.04–3.46)]. The association of dyslipidemia and CAOD was evident for overweight individuals [OR = 2.08 (95% CI 1.17–3.68)]. A higher association of high blood pressure with CAOD was evidenced in younger individuals [OR = 2.02 (95% CI 1.05–3.89)] who belonged to the highest-CAOD-score group in comparison to those who registered the lowest-CAOD-score group. The evaluation of MetS and interventions related to its prevention may be more effective if the viewpoint of occupational dysfunction is taken into account.

An analysis of the structural relationship between job stress, coping, belief conflict, and occupational dysfunction in healthcare workers involved in dialysis treatment

Background. Job stress can be high in healthcare workers involved in dialysis treatment. This study intended to verify the structural relationship among job stress, coping, belief conflict, and occupational dysfunction in healthcare workers involved in dialysis treatment.Methods. Participants completed a composite questionnaire combining the Brief Job Stress Questionnaires, Coping Scale, Assessment of Belief Conflict in Relationship–14, and Classification and Assessment of Occupational Dysfunction. Hypothetical models were compared using Bayesian structural equation modeling (BSEM). Results. The 185 participants included 22 physicians, 46 nurses, 38 medical engineers, 50 physical therapists, and 25 occupational therapists. As a result of the BSEM, the following type A of hypothetical model 1 was selected as the most suitable through comparison of the deviance and Bayesian information criteria (DIC = 5033.848, BIC = 5312.447). Belief conflict had a significant direct effect on occupational dysfunction (direct effect = 0.441, p = 0.000), and occupational dysfunction had a direct effect on stress response (direct effect = 0.406, p = 0.000). Discussion. This result suggests that belief conflict has the potential to increase job stress via occupational dysfunction in healthcare workers involved in dialysis treatment. To reduce job stress, belief conflict should be evaluated and appropriate interventions performed.

The structural relationship among occupational dysfunction, stress coping, and occupational participation for healthcare workers in Japan

Purpose: The purpose of this study was to analyze the structural relationship among occupational dysfunction, stress coping, and occupational participation in healthcare workers.Method: This cross-sectional study included 601 subjects. Personal characteristics (such as age, gender, job category, opportunities for refreshment, time spent on leisure activities, and work relationships) were obtained. The Classification and Assessment of Occupational Dysfunction (CAOD), Coping Scale (CS), and Self-completed Occupational Performance Index (SOPI) were used for measurements. Descriptive statistics were analyzed, and item analysis, confirmatory factor analysis (CFA), correlation analysis, and path analysis using a structural equation modeling (SEM) were performed. CFA was performed to determine the factor structure for CAOD, CS, and SOPI. Correlation analysis was performed to determine the correlation among the factor scores of CAOD, CS, and SOPI. Path analysis was performed to examine the structural relationship among CS, SOPI, and CAOD. Results: CFA of CAOD, CS, and SOPI indicated a good fit to the predicted models. Correlation analysis of CAOD and SOPI showed a strong negative correlation and a moderate negative correlation. CAOD and emotion-focused coping showed a weak negative correlation. Path analysis suggested that SOPI (self-care, leisure, and productivity) and CS (emotion-focused coping) had a negative structural relationship with occupational dysfunction (RMSEA = 0.053, CFI = 0.958, and TLI = 0.954, χ2 = 1808.032, df = 677, p = 0.000). Conclusion: Occupational participation and stress coping can decrease occupational dysfunction. Occupational therapists can contribute to the reduction of occupational dysfunction in healthcare workers by instigating preventive occupational therapy.

Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling

Purpose.The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression) in healthcare workers.Method.Three cross sectional studies were conducted to assess the following relations: (1) occupational dysfunction on stress response (n= 468), (2) occupational dysfunction on burnout syndrome (n= 1,142), and (3) occupational dysfunction on depression (n= 687). Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships) as well as the Classification and Assessment of Occupational Dysfunction (CAOD). Furthermore, study 1 included the Stress Response Scale-18 (SRS-18), study 2 used the Japanese Burnout Scale (JBS), and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D). The Kolmogorov–Smirnov test, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and path analysis of structural equation modeling (SEM) analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1), burnout syndrome (Study 2), and depression (Study 3) were also analyzed.Results.In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure activities, and work relationships (p< 0.01). The hypothesis model results suggest that the classification of occupational dysfunction had good fit on the stress response (RMSEA = 0.061, CFI = 0.947, and TLI = 0.943), burnout syndrome (RMSEA = 0.076, CFI = 0.919, and TLI = 0.913), and depression (RMSEA = 0.060, CFI = 0.922, TLI = 0.917). Moreover, the detected covariates include opportunities for refreshment, time spent on leisure activities, and work relationships on occupational dysfunction.Conclusion.Our findings indicate that psychological problems are associated with occupational dysfunction in healthcare workers. Reduction of occupational dysfunction might be a strategy of better preventive occupational therapies for healthcare workers with psychological problems. However, longitudinal studies will be needed to determine a causal relationship.