Objectives
Given the complex demands of many workplaces, there is growing interest in the potential beneficial effects of mindfulness-based programs (MBPs) for employees. This meta-analysis ...systematically synthesizes the results of randomized controlled studies conducted in various workplace settings.
Methods
Eligible studies were identified by a systematic literature search in four electronic databases and complementary manual search strategies through 11/2018. Random-effects models were used to synthesize data across 56 studies including
n
= 2689 participants and
n
= 2472 controls. The validity of synthesized effect size estimates was analyzed for heterogeneity and influential cases (outliers). Risk of bias was assessed following Cochrane recommendations.
Results
Analyses of between-group effects indicated that MBPs effectively reduce stress, burnout, mental distress, and somatic complaints, while improving mindfulness, well-being, compassion, and job satisfaction—all with small to large effect sizes ranging from Hedge’s
g
= 0.32 to 0.77. Results were maintained in follow-up assessments ≤ 12 weeks. Heterogeneity among primary studies was not explained consistently by program or participant characteristics in the exploratory moderator analyses. Results on work engagement and productivity were limited by low numbers of primary studies with outliers among their effect sizes.
Conclusions
Our meta-analysis provides evidence that MBPs effectively promote the health and well-being of employees in various occupational settings. Further research is needed to investigate potential benefits on work-related outcomes and effects for longer-term follow-ups.
During the Covid-19 pandemic, the negative effects of wearing a mouth-nose cover (MNC) on interpersonal functioning have been discussed in public media but empirical studies on how wearing MNCs ...affect social judgements are sparse. In the present study, we investigated the effects of MNCs on trustworthiness appraisals, the influence of changes due to MNCs in evaluating joy, and the relationship between a social-cognitive appraisal bias and a participant's characteristics.
All participants (N = 165) judged the intensity of happiness and trustworthiness in calm facial stimuli presented with and without a surgical mask covering part of the face. We analysed the relationship of changes in judgements evoked by MNCs to participants' evaluations of MNCs as protective tools and explored their associations with the burden experienced by wearing MNCs, compliance to behaviour recommendations, their risk associated with the pandemic, and their levels of psychological distress.
Overall, calm facial stimuli covered with MNCs were evaluated as less trustworthy and, to an even stronger extent, less happy than uncovered facial stimuli. However, participants varied in whether they showed a negative or positive evaluation of faces with MNCs; the negative bias was stronger in those participants who attributed lower protective potential to MNCs, experienced a higher burden while wearing MNCs, wore MNCs less often, and experienced a higher level of psychological distress.
A negative bias in trustworthiness appraisals of faces with a positive emotional expression covered by MNCs is linked to a participant's evaluation of MNCs as inefficient and burdening and their experience of high psychological distress.
While previous research has mainly focused on the impact of the first acute phase of the COVID-19 pandemic on mental health, little empirical knowledge exists about depression, anxiety, and somatic ...symptom levels and possible predictors of symptom levels in the pandemic's recovery phase. The present study aimed to analyze the mental burden of a convenience ample of the general German population during the first recovery phase of the pandemic and to identify significant predictors of symptom levels.
Standardized measures of anxiety (GAD-2), depression (PHQ-2), somatic symptoms (PHQ-15), and health anxiety, as well as measures of COVID-19 fears and possible vulnerability factors, were administered through a national, cross-sectional online survey (
= 2160, mean age 42.7 years, 75% female), asking participants for their current symptom levels and their symptom levels prior to the COVID-19 pandemic.
Our findings show significantly elevated levels of depression, anxiety, somatic symptoms, and health anxiety in the recovery period compared to before the pandemic. The current prevalence rates based on self-reporting were 26.7% for depression, 24.5% for anxiety, and 29% for somatization. The strongest predictors of these symptom reports included domain-specific pre-existing symptom levels, neuroticism, biological COVID-19 risk factors, avoidance of illness information, and younger age. The most important predictors of COVID-19 fears were subjective COVID-19 risk perception, followed by pre-existing health anxiety, the number of biological COVID-19 risk factors, older age, neuroticism, avoidance of illness information and female gender.
These findings indicate the need for specific psychological programs to help individuals with enhanced psychological and biological vulnerability to cope better with the mental distress experienced during all phases of the ongoing COVID-19 crisis.
The link between leadership and mental health at the workplace is well established by prior research. However, most of the studies have addressed this relationship from a single-source perspective. ...The aim of this study was to examine how supervisor and employee ratings of health-oriented leadership correspond to each other and which sources are predictive for employee mental health. We assessed data within 99 teams (headed by 99 supervisors) containing 713 employees in 11 different companies in Southern Germany. Supervisors and their staff completed questionnaires on the supervisors' health-oriented staff-care dimensions awareness, value of health and health behavior (Health-Oriented Leadership Scale, HoL) and current mental distress (Hospital Anxiety and Depression Scale, HADS). Hierarchical linear models revealed that supervisors' self-ratings were significantly related to their employees' ratings (at the team level) only on the health behavior dimension, but not on the health awareness and value of health dimensions. Also, supervisors rated themselves significantly higher on HoL compared to their employees. Employee ratings of HoL significantly predicted their own level of mental distress (direct within-level effect), whereas supervisor ratings of HoL did not predict employees' mental distress at the team level (direct cross-level effect). Supervisors' self-ratings of HoL did not influence the relationship between employee ratings of HoL and their mental distress on an individual level (cross-level interaction). These results highlight the complex relationship between multisource assessments of HoL and employee mental health, emphasizing the importance of subjective perception for mental health. Future studies should investigate under which conditions supervisor and employee ratings correspond to each other and are predictive for mental health at the workplace.
A markedly negative self-image and pervasive shame proneness have consistently been associated with borderline personality disorder (BPD). The present experimental study investigated the intensity of ...negative emotional responses with a focus on shame in BPD compared to healthy control persons (HCs) during an experimental paradigm promoting self-awareness, self-reflection, and self-evaluation. Furthermore, the relationship between levels of state shame during the experiment and shame proneness in BPD compared to HCs was examined.
A sample of 62 individuals with BPD and 47 HCs participated in the study. During the experimental paradigm, participants were presented with photos of (i) the own face, (ii) the face of a well-known person, and (iii) of an unknown person. They were asked to describe positive facets of these faces. Participants rated the intensity of negative emotions induced by the experimental task as well the pleasantness of the presented faces. Shame-proneness was assessed using the Test of the Self-Conscious Affect (TOSCA-3).
Individuals with BPD experienced significantly higher levels of negative emotions than HCs both before and during the experimental task. While HC participants responded to their own face particularly with an increase in shame compared to the other-referential condition, the BPD patients responded above all with a strong increase of disgust. Furthermore, the confrontation with an unknown or well-known face resulted in a strong increase of envy in BPD compared to HC. Individuals with BPD reported higher levels of shame-proneness than HCs. Higher levels of shame-proneness were related to higher levels of state shame during the experiment across all participants.
Our study is the first experimental study on negative emotional responses and its relationship to shame proneness in BPD compared to HC using the own face as a cue promoting self-awareness, self-reflection, and self-evaluation. Our data confirm a prominent role of shame when describing positive features of the own face, but they emphasize also disgust and envy as distinct emotional experience characterizing individuals with BPD when being confronted with the self.
Background
Interpersonal impairments in borderline personality disorder (BPD) are characterised by a lack in the sense of belonging and the fear of being excluded. One feature of interactions that ...can promote a sense of social belonging is interpersonal touch. While some studies suggest that individuals with BPD experience social touch as less pleasurable than healthy individuals (HCs), there are no studies that investigated whether this difference is associated with feeling less socially connected. This question is particularly important during the COVID-19 pandemic, since one central behavioural recommendation is “social distancing”. An increase in loneliness has been discussed as a consequence and it has been suggested that individuals with BPD may be particularly burdened. However, the primary goal of “social distancing” is not preventing social contacts, but physical proximity. In our study we investigated the interplay between feeling close to others, contact frequency and the appraisal of social touch in BPD. We were additionally interested in whether these factors contribute to the burden through “physical distancing”.
Methods
We assessed subjective and objective social isolation, the need, importance, and liking of social touch, as well as the burden through “physical distancing” policies in 130 women (61 BPD and 69 HCs).
Results
Participants of the BPD group reported higher loneliness, less social contacts and a lower need for, importance and liking of social touch compared to HCs. Larger social networks, higher frequency of in-person contacts and higher liking and importance of social touch were associated with lower levels of loneliness. Both groups did not differ regarding their burden through “physical distancing”. A higher need for and lower importance of social touch predicted a higher burden through “physical distancing”.
Conclusions
A positive appraisal of social touch was associated with less loneliness, independently of an individual's objective social isolation. In BPD, impairments of this fundamental facet of social interaction might hamper forming and strengthening of social bonds and contribute to the patients' interpersonal dysfunction. Changing the attitude towards social touch and in consequence its liking and importance in social interaction might provide one avenue to improve the sense of social connectedness in these patients.
Background Judging positive emotional states or the trustworthiness of others is important for forming and maintaining social affiliations. Past studies have described alterations in these appraisal ...processes in Borderline Personality Disorder (BPD), which might have been exacerbated during the Covid-19 pandemic by the requirement to wear face masks. In the present study, we investigated in an online-survey a) whether social judgments are particularly strongly affected in individuals with BPD when they have to judge happiness and trustworthiness in facial stimuli covered by a mask, b) whether appraising a positive emotional state affects trustworthiness appraisals differentially in BPD and healthy individuals and c) whether social judgments are related to how individuals with BPD experience wearing masks during the pandemic. Methods Participants (67 HC, 75 BPD) judged happiness and trustworthiness of faces with calm expression with and without masks. Additionally, data on participants' confidence in their judgments, the experience of the burden induced by wearing masks, the protective benefits of masks, and compliance to wearing masks were collected. Results Happiness and trustworthiness were evaluated less confidently and less intense in the BPD group compared to HC. Masks reduced happiness and trustworthiness ratings in both groups. Lower happiness appraisals contributed to lower trustworthiness appraisals except for those with BPD and low levels of symptom severity. Lower trustworthiness ratings were associated with a higher burden, attributing a lower benefit to masks and lower compliance with wearing masks in BPD. Conclusions Masks do not exacerbate deficits in social judgments. However, lower trustworthiness appraisals in general were linked with more negative evaluations of wearing masks in the BPD group. Trial registration The aims and hypotheses were preregistered together with the design and planned analyses ( Keywords: Trustworthiness, Emotion recognition, Face masks, Borderline personality, Corona pandemic, Social judgments
Acknowledging increasing demands for workforce health, new theoretical concepts of health-oriented leadership (HoL) have been introduced, emphasizing the supervisor's direct and explicit engagement ...in workplace health by focusing on their self- and staff-care. However, empirical evidence of the effectiveness of HoL interventions for supervisors and their staff is still scarce. We developed a mindfulness- and skill-based HoL intervention and investigated its effectiveness in a quasi-experimental multisite field study including supervisor and employee ratings from 12 German companies. A total of n = 117 supervisors and their employees (n = 744) completed assessments on mental distress and perceived HoL before and after the intervention as well as during the 3-month follow-up period. The intervention group was compared to a passive control cohort based on propensity score matching. Hierarchical linear models showed that the supervisors who had participated in the HoL intervention experienced a significantly larger decrease in mental distress and an increase in health-oriented self-care as well as staff-care than did their matched controls (g = 0.18-0.59). These results were confirmed by intent-to-treat analyses. The effect on supervisors' mental distress was mediated by an increase of their health-oriented self-care and moderated by the frequency of their mindfulness practice. No significant effects appeared between groups regarding outcomes at the employee level. Overall, these findings indicate how HoL can be effectively trained to increase supervisors' self- and staff-care and reduce their mental distress. Future research should explore additional moderator variables, linkages to established work stress models, and improvements of these interventions to increase their effectiveness for employees.
Recent meta-analyses have shown that posttraumatic stress disorder (PTSD) in adolescents and young adults can be effectively treated; however, there is a lack of studies that investigated the ...efficacy of psychotherapy in the clinically important group of adolescents with PTSD related to childhood sexual and/or physical abuse and co-occurring symptoms of borderline personality disorder (BPD).
The aim of this study was a first evaluation of the efficacy of a specifically developed trauma-focused treatment (DBT-PTSD-EA) for adolescent patients with PTSD and BPD symptoms after interpersonal violence in childhood and adolescence.
Validated questionnaires including the Davidson trauma scale (DTS), the borderline symptom list (BSL-23) and the Beck depression inventory (BDI-II) were used to assess treatment-related changes in psychopathology in 39 treatment-seeking adolescents with a diagnosis of PTSD and symptoms of BPD after childhood sexual and/or physical abuse. The diagnoses were established from standardized clinical interviews. The analyses were primarily based on pre-to-post comparisons of all patients who were included (intent to treat analyses, ITT).
Significant improvements were observed in all questionnaires including PTSD severity, intrusive re-experiencing, hyperarousal, PTSD-related avoidance, severity of BPD and depressive symptoms. The pre-post effect sizes were large for the DTS total score (Cohen's d = 1.24) and medium to large for both the BSL-23 (d = 0.69) and the BDI-II (d = 0.72). While these results are very promising, the validity is limited by the lack of a control group.
Objective: About half of individuals seeking treatment for borderline personality disorder (BPD) present with co-occurring posttraumatic stress disorder (PTSD). However, therapies that have been ...proven efficacious for simultaneously treating the full spectrum of core symptoms in patients with a dual diagnosis of BPD + PTSD are lacking. Method: This is a subgroup analysis from a randomized controlled trial (registration number DRKS00005578) which compared the efficacy of two treatment programs, dialectical behavior therapy for PTSD (DBT-PTSD) versus cognitive processing therapy (CPT). Specifically, the present analysis was carried out in 93 women with a dual diagnosis of BPD + PTSD (Diagnostic and Statistical Manual for Mental Disorders; DSM-5). Outcome evaluations included the Clinician-Administered PTSD Scale, the Borderline Symptom List, and validated scales assessing dissociation, depression, and global functioning. The primary analysis was based on the intent-to-treat population, using mixed models. Results: Both PTSD and BPD symptoms significantly decreased in both treatment groups. For PTSD symptoms, pre-post effect sizes were d = 1.20, 95% confidence interval (CI): 0.80-1.58 in the DBT-PTSD group and d = 0.90, 95% CI: 0.57-1.22 in the CPT group; for BPD symptoms, they were d = 1.17, 95% CI: 0.77-1.55, and d = 0.50, 95% CI: 0.20-0.79, respectively. Between-group comparisons significantly favored DBT-PTSD for improvement in symptoms of PTSD, BPD, and dissociation. Between-group differences regarding depression and global functioning were not significant. Conclusion: Both DBT-PTSD and CPT emerged as promising treatment options for simultaneously addressing the full spectrum of core symptoms in patients diagnosed with BPD + PTSD. Differential efficacy was in favor of DBT-PTSD as participants randomized to the DBT-PTSD arm improved more with respect to both their BPD and PTSD symptoms.
What is the public health significance of this article?
The results of this randomized clinical trial will have an immediate impact for adults with a dual diagnosis of BPD and PTSD as defined in the DSM-5, as they show that the full symptomatic spectrum of both conditions can be efficaciously treated through a psychotherapeutic treatment.
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