Posttraumatic stress disorder in co-workers following exposure to a fatal construction accident in China

A Review on the Prevalence of Poor Mental Health in the Construction Industry

A plethora of studies on the prevalence of poor mental health have been undertaken in the general population. Nevertheless, an understanding of the prevalence of poor mental health in the context of high-risk settings, such as construction, is missing. This is noteworthy as poor mental health is widespread in this context. Given that over 100 million people work in construction on a global scale, a better understanding of the burden of poor mental health in construction is needed. To this end, a review on the prevalence of key mental health-related conditions in construction was undertaken. Through this review, over 1000 papers were identified through PubMed and Google Scholar. After applying inclusion and exclusion criteria, a final set of 19 documents were included. Results showed that anxiety and depressive disorders, as well as psychological distress, have a high burden in construction. Vulnerable population subgroups (e.g., women, minority ethnic groups) were identified. Construction is a high-risk setting and despite this, the burden of poor mental health in this context is not given the importance it deserves. This review sheds light on the prevalence of key conditions, which are linked to high humanistic and economic burden. This review provides a foundation and useful starting point for further investigations, and results from this review may be used to inform future research, workplace interventions, and policy.

Psychological distress and quality of community life among migratory construction workers in India

Objectives

The objectives of this study are to elicit sociodemographic details, assess the level of psychological distress, and measure the quality of community life (QoCL) of migratory construction workers.

Materials and Methods

A cross-sectional research design and survey method of sampling was followed. The semi-structured interview schedule, self-reporting questionnaire, and QoCL scale were used as measures for the study.

Results

Out of 75 respondents, 37 (49.3%) did not have formal education, 38 (50.7%) have migrated for less than a month duration, 33 (44.0%) respondents migrated with their families. The mean age of respondents was 32.03 ± 9.82 years. About 48 (64.0%) were identified as potential respondents for psychosocial care and female respondents (M = 12.90 ± 4.03, t = -3.03, P < 0.003) have higher distress than males (M = 9.50 ± 4.56, t = -3.03, P < 0.003) ones. Overall, QoCL indicated a below moderate (59.08 ± 8.31) level.

Conclusion

The distress was high and QoCL indicated a below moderate level. Intersectoral and community mental health services were required to enhance QoCL and reduce distress among migratory construction workers.

Influence of Prefabricated Construction on the Mental Health of Workers: Systematic Review

Despite the significant contribution of the construction industry to national and global economies, the risk it poses to the health and safety of its workers is concerning. With substantial improvement in physical health and safety performance, especially in industrialised and developed economies, attention has shifted to the mental health of construction workers. The construction industry has implemented several worker-focused and management-oriented intervention programs, but problems related to poor mental health persist, and the industry ranks high in suicide figures. Entering the Construction 4.0 era, the use of technologies and new construction methods have been touted to have the potential to improve mental wellbeing. Therefore, this research addresses this lingering problem by: (1) identifying and classifying stressors of mental health and (2) assessing the relevance of adopting prefabricated construction to improving mental health. A two-phased PRISMA-guided systematic review was conducted due to the nonavailability of past studies that combine the concepts of prefabrication and mental health. Mental health stressors were grouped into three categories, with industry-related identified as having an influence on management/organisational and personal stressors. Prefabricated construction, on the other hand, by virtue of its benefits over traditional construction, is found to be capable of eliminating, or at least reducing, the impact of industry-related stressors and, by extension, promoting good mental health.

The relationship of trauma-related guilt with PTSD symptoms in adult trauma survivors: a meta-analysis

Posttraumatic stress disorder (PTSD) is a severe condition that is associated with trauma-related guilt. We aimed at providing a comprehensive quantitative systematic review on the relationship between trauma-related guilt and adult PTSD. Database searches in Medline, PsycINFO, PTSDpubs and Web of Knowledge resulted in the inclusion of 163 eligible studies with a total of 35 020 trauma survivors. The studies reported on 157 cross-sectional and 19 longitudinal data points. Overall, we included 135 studies not included in previous meta-analyses. Random-effect models yielded a moderate cross-sectional correlation (r = 0.38, 95% CI 0.35-0.42, p < 0.001, I² = 90.3%) and a small to moderate predictive correlation (r = 0.21, 95% CI 0.13-0.29, p < 0.001, I² = 66.7%). The association appeared to be stable over time and was robust to sensitivity analyses. All symptom clusters significantly correlated with guilt. No effects were found for military v. civilian populations or clinical v. non-clinical samples. Effects were smaller for high-quality studies and larger for instruments based on DSM-5. Further significant moderators were type of guilt measure and trauma type. The largest association was found among participants reporting war-related trauma (r = 0.44, 95% CI 0.36-0.51) and the smallest among survivors of motor-vehicle accidents (r = 0.18, 95% CI 0.02-0.33). The results underpin the role of trauma-related guilt in the onset and maintenance of PTSD symptoms, which have important clinical implications. Future studies should further explore the change interactions of guilt and PTSD symptoms.

Domains of Psychosocial Risk Factors Affecting Young Construction Workers: A Systematic Review

Despite being a key provider of employment, construction work significantly contributes to poor mental health among young construction workers worldwide. Although there are studies on the psychosocial risk factors (PRFs) that make young construction workers susceptible to poor mental health, the literature is fragmented. This has obscured a deeper understanding of PRFs and the direction for future research, thus making it challenging to develop appropriate interventions. To address this challenge, we systematically reviewed the literature on young construction workers’ PRFs using meta-aggregation, guided by the PICo, PEO, and PRISMA frameworks. We sought to synthesize the domains of PRFs that affect young construction workers’ mental health, and to determine the relationships between the PRF domains, psychological distress, and poor mental health. A total of 235 studies were retrieved and 31 studies published between 1993 and 2020 met the inclusion criteria. We identified 30 PRFs and categorized them into ten domains, which were further classified into personal, socio-economic, and organizational/industrial factors. The findings of this review contribute to achieving an in-depth understanding of young construction workers’ PRF domains and their patterns of interaction. The findings are also useful to researchers and policymakers for identifying PRFs that are in critical need of attention.

Mental Ill-Health Risk Factors in the Construction Industry: Systematic Review

Mental ill health is a significant cause of suicide and disability worldwide. It has particularly affected the construction industry. The construction labor sectors in Australia and the United Kingdom have suicide rates 2 and 3.7 times higher, respectively, than their overall national averages, which has attracted the attention of researchers and the industry. However, few studies have examined the state of construction workers' mental health. This paper systematically reviews the existing body of knowledge on mental health in the construction industry. In total, 16 journal articles met inclusion criteria, and 32 risk factors (RFs) were deduced. The foremost RFs were related to job demand and job control. A conceptual framework and checklist to aid in better understanding these RFs were developed. In assessing mental health, the primary tool used was the Depression Anxiety Stress Scale. The findings of this study help to deepen the understanding of professional mental health assessment scales and relevant RFs and protective factors as used in the construction industry. The study concludes that stronger methodologies are needed for studies into RFs and protective factors in the construction industry.

Impact of individual resilience and safety climate on safety performance and psychological stress of construction workers: A case study of the Ontario construction industry

INTRODUCTION

The construction industry has hit a plateau in terms of safety performance. Safety climate is regarded as a leading indicator of safety performance; however, relatively little safety climate research has been done in the Canadian construction industry. Safety climate may be geographically sensitive, thus it is necessary to examine how the construct of safety climate is defined and used to improve safety performance in different regions. On the other hand, more and more attention has been paid to job related stress in the construction industry. Previous research proposed that individual resilience may be associated with a better safety performance and may help employees manage stress. Unfortunately, few empirical research studies have examined this hypothesis. This paper aims to examine the role of safety climate and individual resilience in safety performance and job stress in the Canadian construction industry.

METHOD

The research was based on 837 surveys collected in Ontario between June 2015 and June 2016. Structural equation modeling (SEM) techniques were used to explore the impact of individual resilience and safety climate on physical safety outcomes and on psychological stress among construction workers.

RESULTS

The results show that safety climate not only affected construction workers' safety performance but also indirectly affected their psychological stress. In addition, it was found that individual resilience had a direct negative impact on psychological stress but had no impact on physical safety outcomes.

CONCLUSIONS

These findings highlight the roles of both organizational and individual factors in individual safety performance and in psychological well-being.

PRACTICAL APPLICATIONS

Construction organizations need to not only monitor employees' safety performance, but also to assess their employees' psychological well-being. Promoting a positive safety climate together with developing training programs focusing on improving employees' psychological health - especially post-trauma psychological health - can improve the safety performance of an organization.

Psychosocial work environment and mental health among construction workers

We assessed psychosocial work environment, the prevalence of mental health complaints and the association between these two among bricklayers and construction supervisors. For this cross-sectional study a total of 1500 bricklayers and supervisors were selected. Psychosocial work characteristics were measured using the Dutch Questionnaire on the Experience and Evaluation of Work and compared to the general Dutch working population. Mental health effects were measured with scales to assess fatigue during work, need for recovery after work, symptoms of distress, depression and post-traumatic stress disorder. The prevalence of self-reported mental health complaints was determined using the cut-off values. Associations between psychosocial work characteristics and self-reported mental health complaints were analysed using logistic regression. Total response rate was 43%. Compared to the general working population, bricklayers experienced statistically significant worse job control, learning opportunities and future perspectives; supervisors experienced statistically significant higher psychological demands and need for recovery. Prevalence of self-reported mental health effects among bricklayers and supervisors, respectively, were as follows: high need for recovery after work (14%; 25%), distress (5%, 7%), depression (18%, 20%) and post-traumatic stress disorder (11%, 7%). Among both occupations, high work speed and quantity were associated with symptoms of depression. Further, among construction supervisors, low participation in decision making and low social support of the direct supervisor was associated with symptoms of depression. The findings in the present study indicate psychosocial risk factors for bricklayers and supervisors. In each occupation a considerable proportion of workers was positively screened for symptoms of common mental disorders.

Disclosure attitudes and social acknowledgement as predictors of posttraumatic stress disorder symptom severity in Chinese and German crime victims

OBJECTIVE

Only rare data exist comparing cross-cultural aspects of civilian traumatization. We compared prevalence rates of posttraumatic stress disorder (PTSD) in German and Chinese crime victims, and investigated the cross-cultural effect of 2 interpersonal predictors.

METHOD

German (n = 151) and Chinese (n = 144) adult crime victims were assessed several months postcrime. The parallel questionnaire set assessed PTSD symptom severity, disclosure attitudes, social acknowledgement, and demographic and crime characteristics.

RESULTS

German and Chinese participants differed significantly in their PTSD symptom severity. However, in both samples, disclosure attitudes and social acknowledgement predicted PTSD symptom severity with a similar strength, in addition to the effects of other PTSD predictors.

CONCLUSIONS

The results suggest that interpersonal variables are predictors of PTSD symptom severity in both cultures and should be included in etiologic models of PTSD.

Validating the General Sleep Disturbance Scale among Chinese American parents with hospitalized infants

The purpose of this cross-sectional descriptive study was to assess the reliability and validity of the English and Chinese versions of the General Sleep Disturbance Scale (GSDS) among Chinese American parents with hospitalized infants. A convenience sample of 22 mothers and 22 fathers in the San Francisco area participated in this study. Cronbach alpha coefficients were .85 and .81 for the English and Chinese versions, respectively. Concurrent validity was demonstrated through correlations with wrist actigraphy readings. Although results of the study indicate that the GSDS is an acceptable instrument to measure parents' sleep disturbance among the Chinese American population, a need for further work was identified.

A review of studies of the Hamilton depression rating scale in healthy controls: implications for the definition of remission in treatment studies of depression

The Hamilton Rating Scale for Depression (HRSD) is the most commonly used symptom severity scale to evaluate the efficacy of antidepressant treatment. On the basis of an expert consensus panel, an HRSD score of < or = 7 was recommended as a cutoff to define remission. Since that recommendation, little empirical work has been conducted to confirm the validity of this threshold. One approach toward determining a cutoff score for defining remission is to establish the range of values for healthy controls. We therefore conducted a literature review of studies of the HRSD in healthy controls to determine the normal range of values. Studies of the HRSD in healthy control groups were identified in two ways. First, a MEDLINE search for the years 1966 to 2002 was conducted using the key words Hamilton, depression, and controls, and articles were reviewed. Second, the 69 studies included in two review articles written by the authors were examined. We identified 27 studies that included data on the HRSD for 1014 healthy controls. Across all studies, the weighted mean (SD) HRSD score, adjusting for sample size, was 3.2 (3.2; 95% CI, 3.0 to 3.4). HRSD scores were similar in geriatric and nongeriatric samples, and in men and women. Because HRSD scores in healthy controls are more likely to follow a skewed than a normal distribution, based on a mean of 3.2 and a SD of 3.2, at least 84% of healthy controls scored 7 or less on the HRSD, and 97.5% scored 10 or less. Thus, these results can be taken as support for the recommended cutoff of 7 on the HRSD to define remission. The results can also be used for normative comparisons in which posttreatment group mean scores are compared with mean scores from normative samples.