TY - JOUR A1 - Muschalla, Beate T1 - A concept of psychological work capacity demands BT - first evaluation in rehabilitation patients with and without mental disorders JF - Work : a journal of prevention, assessment & rehabilitation N2 - BACKGROUND: Work capacity demands are a concept to describe which psychological capacities are required in a job. Assessing psychological work capacity demands is of specific importance when mental health problems at work endanger work ability. Exploring psychological work capacity demands is the basis for mental hazard analysis or rehabilitative action, e.g. in terms of work adjustment. OBJECTIVE: This is the first study investigating psychological work capacity demands in rehabilitation patients with and without mental disorders. METHODS: A structured interview on psychological work capacity demands (Mini-ICF-Work; Muschalla, 2015; Linden et al., 2015) was done with 166 rehabilitation patients of working age. All interviews were done by a state-licensed socio-medically trained psychotherapist. Inter-rater-reliability was assessed by determining agreement in independent co-rating in 65 interviews. For discriminant validity purposes, participants filled in the Short Questionnaire for Work Analysis (KFZA, Prumper et al., 1994). RESULTS: In different professional fields, different psychological work capacity demands were of importance. The Mini-ICF-Work capacity dimensions reflect different aspects than the KFZA. Patients with mental disorders were longer on sick leave and had worse work ability prognosis than patients without mental disorders, although both groups reported similar work capacity demands. CONCLUSIONS: Psychological work demands - which are highly relevant for work ability prognosis and work adjustment processes - can be explored and differentiated in terms of psychological capacity demands. KW - Mental disorders KW - mental health KW - sick leave KW - work ability KW - work demands Y1 - 2018 U6 - https://doi.org/10.3233/WOR-182691 SN - 1051-9815 SN - 1875-9270 VL - 59 IS - 3 SP - 375 EP - 386 PB - IOS Press CY - Amsterdam ER - TY - JOUR A1 - Muschalla, Beate A1 - Fay, Doris A1 - Seemann, Anne T1 - Asking for work adjustments or initiating behavioural changes - what study on the reactions towards colleagues with a personality disorder JF - Fundamenta informaticae N2 - People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues’ reactions towards a problematic worker dependent on the returning person’s reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes. KW - Workplace KW - personality disorders KW - mental health KW - sick leave KW - acceptance KW - social distance Y1 - 2016 U6 - https://doi.org/10.1080/13548506.2015.1109671 SN - 1354-8506 SN - 1465-3966 VL - 21 SP - 856 EP - 862 PB - IOS Press CY - Abingdon ER - TY - JOUR A1 - Muschalla, Beate A1 - Poguntke, Kim Joy A1 - Linden, Michael T1 - Assessment of Capacity Impairment in Patients with Mental Disorders by Routine Clinical Assessment and by Structured Assessment with the Mini-ICF-APP JF - Psychopathology N2 - Background: Physicians and therapists are also consulted to give judgments on working ability. Ability to work cannot simply be derived from the patient’s symptom status but from the illness-related capacity impairments in relation to the work demands. A structured assessment of capacity impairments has been evaluated and applied internationally: the Mini-ICF-APP Social Functioning Scale. It is currently unclear whether a free-text clinical report (i.e., usual clinical practice: clinical exploration according to clinical standards, but without a standardized documentation form, instead a text is written) and a structured capacity assessment correspond to the overall work ability judgment, i.e., the decision whether a patient is “fit for work” or “unfit for work.” Objectives: This investigation assessed, for the first time, whether usual clinical judgment and the additional structured capacity rating support the work ability decision. Methods: A total of 100 medical reports from patients in a psychotherapy hospital were excerpted for psychopathological symptoms and capacity disorders using a checklist. Additionally, a structured assessment of capacity disorders was documented on the Mini-ICF-APP rating for all patients. Results: In the free-text clinical medical report, endurance, flexibility, and contacts to others were the things mainly reported as impaired. This was similar to the structured Mini-ICF-APP rating. However, other capacity impairments were also reported in the Mini-ICF-APP, i.e., adherence to rules and regulations, planning and structuring, assertiveness, and group integration. When the free-text clinical report and the structured Mini-ICF-APP rating were compared, there was a higher rate of stated impairments covering all capacity dimensions in the Mini-ICF-APP rating. Conclusions: The free-text report in the medical report shows the differences between patients who are fit for work and those who are not, and thus speak for the validity of work ability decisions. However, optimization is possible in terms of depth and differentiation of capacity impairment description by adhering to the standard set by the Mini-ICF-APP. KW - Mini-ICF-APP KW - Capacity KW - Disability KW - General practice KW - Mental disorder KW - Clinical judgment KW - Work ability Y1 - 2019 U6 - https://doi.org/10.1159/000502123 SN - 0254-4962 SN - 1423-033X VL - 52 IS - 4 SP - 248 EP - 255 PB - Karger CY - Basel ER - TY - JOUR A1 - Muschalla, Beate T1 - Capacity-oriented behavior therapy in mental disorders JF - Verhaltenstherapie N2 - Capacity-Oriented Behavior Therapy in Mental Disorders Mental disorders come along with the impairment of activities and capacities of daily live. Behavior therapy often uses capacity trainings for improving compensatory behavior, beside symptom reduction as such. This article gives an overview on how behavior therapy techniques can be used to improve compensatory behavior in different capacity domains that were conceptually derived from the International Classification of Functioning, Disability and Health (ICF) and which are often impaired in mental disorders. KW - Capacities KW - Capacity disorders KW - Mental disorders KW - ICF KW - Behavior therapy Y1 - 2014 U6 - https://doi.org/10.1159/000358737 SN - 1016-6262 SN - 1423-0402 VL - 24 IS - 1 SP - 48 EP - 55 PB - Karger CY - Basel ER - TY - JOUR A1 - Muschalla, Beate T1 - Different work capacity impairments in patients with different work-anxieties JF - International archives of occupational and environmental health N2 - Purpose Persons with work-anxieties are especially endangered for work capacity impairment and sick leave. Work capacity impairment is not directly due to symptoms but due to illness-related capacity disorders. Work capacity impairments can be described on different dimensions (e.g., social interaction, decision making and judgment, endurance, mobility). Understanding the type of work capacity impairment is important for reintegration interventions. This is the first study to investigate work capacity impairment in risk patients with different work-anxieties. Results Patients with different work-anxieties were impaired in different capacity dimensions: Work-related social anxiety went along with clinically relevant impairment in capacity of assertiveness (M = 2.40), anxiety of insufficiency went along with impaired capacity of endurance (M = 2.20), and work-related generalized worrying was accompanied by impairment in the capacity for decision making (M = 1.82). Specific capacity impairment dimensions were related to sick leave duration, while a global work ability prognosis was not. Conclusions The capacity approach is useful to describe work impairment more precisely and beyond symptoms. On this basis, reintegration-focusing interventions such as capacity training (e.g., social interaction training) or work adjustment (e.g., reducing exposure with interactional work tasks) can be initiated. KW - Work ability KW - Work-anxiety KW - Sick leave KW - Impairment KW - Mental disorders KW - ICF Y1 - 2016 U6 - https://doi.org/10.1007/s00420-015-1099-x SN - 0340-0131 SN - 1432-1246 VL - 89 SP - 609 EP - 619 PB - Springer CY - New York ER - TY - JOUR A1 - Muschalla, Beate A1 - Fay, Doris A1 - Hoffmann, Karin T1 - Inventory for Job Coping and Return Intention (JoCoRi) JF - Diagnostica N2 - Ein großer Anteil der Erwerbstätigen ist aufgrund gesundheitlicher Einschränkungen einmalig oder mehrfach in seiner Berufsbiografie längere Zeit arbeitsunfähig. Auf Grundlage etablierter psychologischer Konstrukte und empirischer Befunde wurde ein spezifisch arbeitsbezogenes Inventar für Job-Coping und Rückkehrintention (JoCoRi) entwickelt. Der Selbsteinschätzungsfragebogen wurde an drei unabhängigen Stichproben (N = 243, N = 337, N = 111) von Rehabilitationspatienten aus Psychosomatik, Orthopädie, Kardiologie und Neurologie geprüft. Faktorenanalytische Ergebnisse der ersten Stichprobe bestätigen eine mehrfaktorielle Struktur. Das Inventar enthält 30 Items in 7 Skalen: 1. Arbeitsbezogene Rückkehrintention und -planung, 2. Arbeitsbezogene Selbstwirksamkeitserwartung, 3. Arbeitsbezogene Selbstberuhigung und Selbstinstruktion, 4. Arbeitsbezogene externale Kontrollüberzeugung, 5. Aktives Coping am Arbeitsplatz, 6. Bedeutung der Arbeit, 7. Kontrollüberzeugung bzgl. der Arbeitsaufnahme. Die Varianzaufklärung liegt bei 68 %. 25 Items haben Hauptladungen > .60. Interne Konsistenzen und Trennschärfen sind überwiegend zufriedenstellend. Die Modellgüte der konfirmatorischen Faktorenanalyse ist überzeugend. Das Modell ist in einer unabhängigen Stichprobe stabil (N = 337). Die Skalen wurden mit inhaltlich analogen Globalkonstrukten validiert. Die mehrfaktorielle Struktur kann in der zweiten Stichprobe repliziert werden. Eine längsschnittliche Analyse der dritten Stichprobe prüft die prädiktive Validität der Rückkehrintentionsskala; sie wird hinsichtlich Arbeitsunfähigkeitsdauer und Arbeitsfähigkeitsstatus bestätigt. KW - return-to-work intention KW - work-related coping KW - scale development KW - work anxieties Y1 - 2016 U6 - https://doi.org/10.1026/0012-1924/a000146 SN - 0012-1924 SN - 2190-622X VL - 62 SP - 143 EP - 156 PB - Frontiers Research Foundation CY - Göttingen ER - TY - JOUR A1 - Muschalla, Beate T1 - Is it a Case of "Work-Anxiety" When Patients Report Bad Workplace Characteristics and Low Work Ability? JF - Journal of Occupational Rehabilitation N2 - Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients’ work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians’ judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments. KW - Work anxiety KW - Work ability KW - Workplace KW - Sick leave KW - Work characteristics Y1 - 2016 U6 - https://doi.org/10.1007/s10926-016-9637-2 SN - 1053-0487 SN - 1573-3688 VL - 27 SP - 106 EP - 114 PB - Springer CY - New York ER - TY - JOUR A1 - Muschalla, Beate A1 - Henning, Anne A1 - Haake, Tim Woody A1 - Cornetz, Kathrin A1 - Olbrich, Dieter T1 - Mental health problem or workplace problem or something else BT - what contributes to work perception? JF - Disability and rehabilitation : an international, multidisciplinary journal N2 - Purpose: Work perception is an important predictor for work ability and, therefore, of interest for rehabilitation. Until now it is unclear to which extent different psychological aspects explain work perception. This study investigates in which way workplace problems on the one hand, and mental health and coping on the other hand, contribute to work perception. Methods: A heterogeneous sample of 384 persons in working age with and without mental health problems was recruited. Participants gave self-reports on workplace problems, mental health problems, work-coping, work-anxiety, and work perception. Results: Persons with mental health problems and workplace problems (M + W) perceive the highest degree of work demands, followed by persons with workplace problems but without mental health problems (NM + W). Work-anxiety appeared as the strongest factor explaining perception of high work demands, whereas general mental health problems did not contribute significantly to variance explanation. Conclusions: Persons with specific mental health problems in terms of work-anxiety may be expected to perceive higher work demands. They may be detected when asking for work perception, e.g., within the frame of return-to-work interventions in rehabilitation, or in occupational health settings by mental hazard analysis. KW - work ability KW - work anxiety KW - workplace KW - mental disorders KW - rehabilitation KW - work perception Y1 - 2018 U6 - https://doi.org/10.1080/09638288.2018.1501099 SN - 0963-8288 SN - 1464-5165 VL - 42 IS - 4 SP - 502 EP - 509 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - JOUR A1 - Muschalla, Beate T1 - Negative work perception not changed in a short work-anxiety-coping group therapy intervention JF - International journal of occupational and environmental health N2 - Background: Work anxiety is often associated with long-term sick leave and requires early intervention. Work anxieties are associated with negative work perception. Therefore, one aim in early intervention is a cognitive reframing of dysfunctional perceptions of workplace characteristics. Methods: A psychotherapeutic specialist conducted two group programs of four sessions each. One hundred twenty-three rehabilitation in-patients with work anxieties were randomly assigned either to a work anxiety-coping group or to a recreational group. The Short Questionnaire for Work Analysis (KFZA) was administered before and after the group treatment to measure perceptions of working conditions. Results: Participants from the work anxiety-coping group did not see their work in a significantly more positive light at the end of the intervention compared to participants from the recreational group. Conclusions: A short work anxiety-coping group did not initiate a consistent positive re-appraisal of work. Employers and occupational physicians should not expect positive changes of work perception when an employee returns from short medical rehabilitation including work-directed treatment. Additional support from the workplace must be considered, e.g. employer-physician-employee conversation preceding return to work, or (temporary) work adjustment. KW - Workplace KW - Mental health KW - Anxiety KW - Sick leave KW - Work-oriented interventions KW - Work perception KW - Return to work KW - Mental disorders Y1 - 2016 U6 - https://doi.org/10.1080/10773525.2016.1238663 SN - 1077-3525 SN - 2049-3967 VL - 22 SP - 321 EP - 324 PB - Frontiers Research Foundation CY - Abingdon ER - TY - JOUR A1 - Muschalla, Beate A1 - Jöbges, Michael T1 - Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients BT - a cross-sectional observation study JF - Archives of Physical Medicine and Rehabilitation N2 - Objective: To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. Design: Cross-sectional observation study. Setting: Neurology, orthopedic, and cardiology rehabilitation clinics. Participants: Patients (N=4610; age, 18-65y) with work anxieties. Interventions: Not applicable. Main Outcome Measures: Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. Results: Approximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. Conclusions: About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave. (c) 2017 by the American Congress of Rehabilitation Medicine KW - Anxiety KW - Mental health KW - Rehabilitation KW - Sick leave KW - Workplace Y1 - 2017 U6 - https://doi.org/10.1016/j.apmr.2017.06.017 SN - 0003-9993 SN - 1532-821X VL - 99 IS - 1 SP - 57 EP - 64 PB - Elsevier CY - Philadelphia ER -