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 - THES A1 - Muschalla, Beate T1 - Workplace-related anxieties and workplace phobia : a concept of domain-specific mental disorders T1 - Arbeitsplatzbezogene Ängste und Arbeitsplatzphobie : Konzeptualisierung einer lebensbereichsspezifischen psychischen Erkrankung N2 - Background: Anxiety in the workplace is a special problem as workplaces are especially prone to provoke anxiety: There are social hierarchies, rivalries between colleagues, sanctioning through superiors, danger of accidents, failure, and worries of job security. Workplace phobia is a phobic anxiety reaction with symptoms of panic occurring when thinking of or approaching the workplace, and with clear tendency of avoidance. Objectives: What characterizes workplace-related anxieties and workplace phobia as domain-specific mental disorders in contrast to conventional anxiety disorders? Method: 230 patients from an inpatient psychosomatic rehabilitation center were interviewed with the (semi-)structured Mini-Work-Anxiety-Interview and the Mini International Neuropsychiatric Interview, concerning workplace-related anxieties and conventional mental disorders. Additionally, the patients filled in the self-rating questionnaires Job-Anxiety-Scale (JAS) and the Symptom Checklist (SCL-90-R)measuring job-related and general psychosomatic symptom load. Results: Workplace-related anxieties occurred together with conventional anxiety disorders in 35% of the patients, but also alone in others (23%). Workplace phobia could be found in 17% of the interviewed, any diagnosis of workplace-related anxiety was stated in 58%. Workplace phobic patients had significantly higher scores in job-anxiety than patients without workplace phobia. Patients with workplace phobia were significantly longer on sick leave in the past 12 months (23,5 weeks) than patients without workplace phobia (13,4 weeks). Different qualities of workplace-related anxieties lead with different frequencies to work participation disorders. Conclusion: Workplace phobia cannot be described by only assessing the general level of psychosomatic symptom load and conventional mental disorders. Workplace-related anxieties and workplace phobia have an own clinical value which is mainly defined by specific workplace-related symptom load and work-participation disorders. They require special therapeutic attention and treatment instead of a “sick leave” certification by the general health physician. Workplace phobia should be named with a proper diagnosis according to ICD-10 chapter V, F 40.8: “workplace phobia”. N2 - Hintergrund: Angst am Arbeitsplatz ist ein spezielles Phänomen, da Arbeitsplätze ihrer Natur nach angstauslösende Charakteristika aufweisen: Vorgesetzte die sanktionieren, Rangkämpfe mit Kollegen, reale Unfallgefahren, Scheitern und Leistungsversagen, Unklarheit um plötzliche Veränderungen, Arbeitsplatzunsicherheit. Arbeitsplatzphobie ist eine phobische Angstreaktion mit Panikerleben beim Gedanken an oder bei Annäherung an den Arbeitsplatz. Fragestellung: Was charakterisiert arbeitsplatzbezogene Ängste und Arbeitsplatzphobie als lebensbereichsspezifische Angsterkrankungen in Abgrenzung zu klassischen Angsterkrankungen? Methode: 230 Patienten einer stationären psychosomatischen Rehabilitation wurden im halbstrukturierten Interview (Mini-Arbeits-Angst-Interview, Mini International Neuropsychiatric Interview) hinsichtlich arbeitsplatzbezogener Ängste und klassischer psychischer Erkrankungen befragt. Selbsteinschätzungsurteile wurden hinsichtlich des Schweregrads der arbeitsbezogenen (Job-Angst-Skala, JAS) und allgemeinen psychosomatischen (Symptom-Checkliste, SCL-90-R) Symptombelastung erhoben. Ergebnisse: 58% der befragten Patienten litten an mindestens einer arbeitsplatzbezogenen Angstvariante. Arbeitsplatzbezogene Ängste kamen bei 35% der Befragten zusammen mit einer klassischen Angsterkrankung vor, bei 23% jedoch als allein stehende Angsterkrankung. 17% der Befragten erfüllten die Kriterien einer Arbeitsplatzphobie. Arbeitsplatzphobie-Patienten hatten signifikant höhere Job-Angst-Werte als Patienten ohne Arbeitsplatzphobie, und sie waren signifikant länger arbeitsunfähig in den letzten 12 Monaten (23,5 Wochen versus 13,4 Wochen). Schlussfolgerung: Arbeitsplatzbezogene Ängste und Arbeitsplatzphobie haben eine spezielle klinische Wertigkeit, die sich anhand arbeitsbezogener Partizipationsstörungen und spezifischer arbeitsbezogener Symptombelastung beschreiben lässt. Arbeitsplatzphobie erfordert besondere therapeutische Herangehensweisen anstelle von angsterhaltender da Vermeidungsverhalten fördernder „Krankschreibung“. Arbeitsplatzphobie sollte als Diagnose benannt werden entsprechend ICD-10 Kapitel V, F 40.8: “Arbeitsplatzphobie”. KW - Arbeitsplatzphobie KW - Angsterkrankung KW - Arbeitsplatz KW - Arbeitsunfähigkeit KW - Partizipationsstörung KW - workplace phobia KW - anxiety disorder KW - workplace KW - sick leave KW - participation disorder Y1 - 2008 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus-20048 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 - 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 - 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 T1 - Work-anxiety-coping intervention improves work-coping perception while a recreational intervention leads to deterioration BT - results from a randomized controlled trial JF - European journal of work and organizational psychology : the official journal of The European Association of Work and Organizational Psychology N2 - Work-anxieties are costly and need early intervention. The perception of being able to cope with work is a basic requirement for work ability. This randomized controlled trial investigates whether a cognitive behavioural, work-anxiety-coping group (WAG) intervention leads to better work-coping perception than an unspecific recreational group (RG). Heterogeneous people in medical rehabilitation, who were due to return to work, were interviewed concerning their work-anxieties, and either randomly assigned to a WAG (n=85) or a RG (n=95). The participants (with an average of 50years old [range 23-64]; 51% women; 70% workers or employees, 25% academics, 5% unskilled) followed the group intervention for four or six sessions. The perceived work-coping was assessed by self-rating (Inventory for Job-Coping and Return Intention JoCoRi) after each group session. Although participants had a slight temporary decrease in work-coping after group session two (from M-1=2.47 to M-2=2.28, d(Cohen)=-.22), the WAG led to the improvement of perceived work-coping over the intervention course (from M-1=2.47 to M-6=2.65, d(Cohen)=.18). In contrast, participants from the RG reported lower work-coping after six group sessions (from M-1=2.26 to M-6=2.02, d(Cohen)=-.18). It is considered that people with work-anxieties need training in work-coping. By focusing on recreation only, this may lead to deterioration of work-coping. Indeed, intervention designers should be aware of temporary deterioration (side effects) when confronting participants with work-coping. KW - Work-anxiety KW - work-coping KW - return to work KW - intervention KW - mental health Y1 - 2017 U6 - https://doi.org/10.1080/1359432X.2017.1384378 SN - 1359-432X SN - 1464-0643 VL - 26 IS - 6 SP - 858 EP - 869 PB - Taylor & Francis CY - Abingdon ER - TY - JOUR A1 - Muschalla, Beate A1 - Heldmann, Madleen A1 - Fay, Doris T1 - The significance of job-anxiety in a working population JF - Occupational medicine N2 - Background Job-anxiety, as distinguished from trait-anxiety, is associated with long-term sickness absence. The prevalence of job-anxiety within a working population is not known. Identifying individuals who would benefit from intervention might be useful. Aims To investigate job-anxiety in employees not undergoing treatment for mental health illness, firstly by assessing the level of job-anxiety and work-related avoidance tendencies in a working sample, and secondly by testing whether job-anxiety is distinguishable from trait-anxiety. Methods Cross-sectional survey of a convenience sample obtained through personal contact distribution. Employees from different professional settings completed an anonymous questionnaire and provided information on their employment status. The State-Trait-Anxiety Inventory (STAI-T) was used to measure trait-anxiety and the Job-Anxiety-Scale (JAS) was used to assess job (state) anxiety. Results There was a 69% response rate (240 responses); 188 responses were available for analysis of whom 62% were women. There were no employees with high trait-anxiety. Ten employees (5%) reported increased job-anxiety and of these nine employees reported high 'tendencies of avoidance and workplace absence'. Avoidance was most often accompanied by the comorbid job-anxieties 'job-related social anxiety', 'fear of changes at work' and 'fears of existence', 'anticipatory' and 'conditioned' job-anxiety and 'panic symptoms'. Conclusions In this sample, self-reported job-anxiety appeared as a specific type of anxiety as opposed to trait-anxiety. In the workplace job-anxiety can present as job-avoidance and sickness absence and should be distinguished from trait-anxiety. In practice, employers and occupational health practitioners should be aware of those employees prone to sickness absence. KW - Job-anxiety KW - occupational health KW - sickness absence KW - trait-anxiety KW - workplace Y1 - 2013 U6 - https://doi.org/10.1093/occmed/kqt072 SN - 0962-7480 VL - 63 IS - 6 SP - 415 EP - 421 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Muschalla, Beate A1 - Kessler, U. A1 - Schwantes, U. A1 - Linden, M. T1 - Rehabilitationsbedarf bei Hausarztpatienten mit psychischen Störungen JF - Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation N2 - Hintergrund: Rehabilitationsmedizin ist nach § 2 und § 26 SGB IX die medizinische Spezialdisziplin zur Vorbeugung, Diagnostik und Behandlung chronischer Erkrankungen. Dies betrifft in besonderem Maße psychische Erkrankungen. Die Behandlung chronischer Erkrankungen erfordert in der Regel eine komplexe und multimodale Langzeitbetreuung, bei der niedergelassenen Ärzten eine zentrale Rolle zukommt. Allerdings gibt es bislang nur wenig ausgearbeitete Konzepte zu den rehabilitationsmedizinischen Aufgaben niedergelassener Ärzte und den ihnen zur Verfügung stehenden diesbezüglichen Behandlungsoptionen. Methoden: Zur Klärung der Frage, welche Rolle rehamedizinische Aspekte in der Hausarztpraxis haben, wurden im ersten Schritt 40 niedergelassene Ärzte zum geschätzten Anteil chronisch psychisch kranker Patienten in ihrer Praxis befragt. Im zweiten Schritt wurden 1 451 Patienten im Alter von 18 bis 60 Jahren mittels des WHO-5-Screenings zum psychischen Wohlbefinden, dem IMET-Fragebogen zu Teilhabestörungen, der Burvillskala zur Multimorbidität und Fragen zum psychischen Erkrankungsstatus und Arbeitsstatus untersucht. Ergebnisse:Im Durchschnitt schätzten die Hausärzte den Anteil ihrer Patienten mit psychischen Erkrankungen auf 41,9% (SD=18,2; Range 15-90%).Von den Patienten gaben 46,5% an, unter psychischen Beschwerden zu leiden. 38,3% der Patienten sagten, dass die Probleme bereits seit 6 Monaten oder länger bestehen (chronisch), und 26,9% erklärten, dass sie die Beschwerden in den letzten 6 Monaten durchgängig erlebt haben (persistierend). Insgesamt litten 29,7% der 18- bis 60-jährigen Hausarztpatienten unter chronischen psychischen Beschwerden mit zusätzlich relevanten Teilhabestörungen. Schlussfolgerungen: Patienten mit chronischen psychischen Problemen und Teilhabestörungen sind in Praxen niedergelassener Ärzte häufig anzutreffen. Niedergelassene Ärzte und insbesondere Hausärzte sind demnach zu einem wesentlichen Teil ihrer Tätigkeit als Rehabilitationsmediziner anzusehen. In ihren Händen liegt die Diagnostik, Behandlung, Koordinierung und Langzeitführung der chronisch Kranken, wie auch die sozialmedizinische Betreuung, von der Feststellung einer Arbeitsunfähigkeit bis hin zur Einleitung stationärer Rehamaßnahmen. Die Bedeutung der niedergelassenen Ärzte im Rehaprozess verdient organisatorisch wie wissenschaftlich mehr Aufmerksamkeit. KW - chronic illness KW - rehabilitation episodes KW - primary care KW - participation disorders Y1 - 2013 U6 - https://doi.org/10.1055/s-0032-1327587 SN - 0034-3536 SN - 1439-1309 VL - 52 IS - 4 SP - 252 EP - 257 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Linden, Michael A1 - Muschalla, Beate A1 - Hansmeier, Thomas A1 - Sandner, Gabriele T1 - Reduction of sickness absence by an occupational health care management program focusing on self-efficacy and self-management JF - Work : a journal of prevention, assessment & rehabilitation N2 - BACKGROUND: The aim of occupational health care management programs (OHMP) is to improve the health status of employees, increase work ability and reduce absence time. This includes better coping abilities, work-related self-efficacy and self-management which are important abilities that should be trained within OHMPs. OBJECTIVES: To study the effectiveness of an OHMP including special interventions to enhance self-efficacy and self-management. PARTICIPANTS: Employees from the German Federal Pension Agency. METHODS: Effects of an OHMP on sickness absence was studied by comparing an intervention group (N = 159) and two control groups (N = 450). A core feature of the OHMP were group sessions with all members of working teams, focussing on self-efficacy and self management of the individual participant as well as the team as a group (focus groups). Participants in the OHMP were asked for their subjective evaluation of the focus groups. Rates of sickness absence were taken from the routine data of the employer. RESULTS: Participants of the OHMP indicated that they had learned better ways of coping and communication and that they had generated intentions to make changes in their working situation. The rate of sickness absence in the intervention group decreased from 9.26% in the year before the OHMP to 7.93% in the year after the program, while there was in the same time an increase of 7.9% and 10.7% in the two control groups. CONCLUSIONS: The data suggest that OHMP with focus on self-efficacy and self management of individuals and teams are helpful in reducing work absenteeism. KW - Focus group KW - team training KW - prevention KW - health status KW - sickness absence Y1 - 2014 U6 - https://doi.org/10.3233/WOR-131616 SN - 1051-9815 SN - 1875-9270 VL - 47 IS - 4 SP - 485 EP - 489 PB - IOS Press CY - Amsterdam 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 - Work-related anxieties in research and practice JF - Zeitschrift für Arbeits- und Organisationspsychologie : german journal of work and organizational psychology N2 - Workplaces contain by their very nature different anxiety-provoking characteristics. When workplace-related anxieties manifest, absenteeism, long-term-sick leave, and even disability pension can be the consequences. In medical-vocational rehabilitation about 30-60 % of the patients suffer from workplace-related anxieties that are often a barrier for return to work. Even in mentally healthy employees, 5 % said that they were prone to ask for a sick leave certificate due to workplace-related anxieties. Future research should focus on workplace-related anxieties not only in rehabilitation, but more earlier, i. e. in the workplace. The concept of workplace-related anxieties offers ideas which can be useful in mental-health-oriented work analysis, employee-workplace-fit, and job design. KW - workplace KW - anxiety KW - sick leave KW - mental health-oriented work analysis Y1 - 2014 U6 - https://doi.org/10.1026/0932-4089/a000166 SN - 0932-4089 SN - 2190-6270 VL - 58 IS - 4 SP - 206 EP - 214 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Muschalla, Beate A1 - Linden, Michael T1 - Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders JF - Journal of the American Board of Family Medicine N2 - Purpose: Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia. Methods: A convenience sample of 288 primary care patients with chronic mental disorders (70% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed. Results: Workplace phobia was found in 10% of patients with chronic mental disorders, that is, approximately about 3% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life. Conclusions: Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints. KW - Anxiety KW - Mental Health KW - Sick Leave KW - Workplace Y1 - 2014 U6 - https://doi.org/10.3122/jabfm.2014.04.130308 SN - 1557-2625 SN - 1558-7118 VL - 27 IS - 4 SP - 486 EP - 494 PB - American Board of Family Medicine CY - Lexington 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 - 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 - Flöge, B. A1 - Fay, Doris A1 - Jöbges, M. A1 - Linden, M. A1 - Muschalla, Beate T1 - Side Effects of Occupational Group Therapy JF - Fortschritte der Neurologie, Psychiatrie N2 - Background: Occupational therapy is an important co-therapy in psychiatric therapy. It is a common belief that no risks are associated with occupational therapy. Negative effects caused by group therapy, especially occupational therapy, have not been in the focus of research yet. In this study we want to illustrate possible types and intensities of group side effects through occupational therapy. Patients and Methods: Patients of an inpatient rehabilitation facility filled out the Adverse Treatment Reaction Group Checklist. The checklist contains 47 items divided in six dimensions: group size, content, group participants, group outcome and global. The self-rating used a 5-point likert scale (0 = not at all; 4 = verymuch, extremely stressful) and gives information about types and intensities of the side effects. Results: 88.9 % of 45 patients reported negative effects of occupational group therapy. 28.9 % of the patients rated the side effect as at least severe. Discussion: Occupational therapy is associated with side effects as every other group therapy. Possible side effects caused by group therapy should be considered while planning and implementing occupational therapy. KW - side effects KW - occupational therapy KW - group therapy Y1 - 2016 U6 - https://doi.org/10.1055/s-0042-119026 SN - 0720-4299 SN - 1439-3522 VL - 84 SP - 729 EP - 732 PB - Thieme CY - Stuttgart 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 A1 - Linden, Michael A1 - Joebges, Michael T1 - Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting JF - Journal of occupational and environmental medicine N2 - Objective: The aim of this study was to study the effects of a short-term cognitive behavior therapy on work-anxiety and sickness-absence in patients with work-anxiety. Methods: Three-hundred forty-five inpatients who suffered from cardiologic, neurological, or orthopedic problems and additionally work-anxiety were randomly assigned into two different group interventions. Patients got four sessions of a group intervention, which either focused on cognitive behavior-therapy anxiety-management (work-anxiety coping group, WAG) or unspecific recreational activities (RG). Results: No differences were found between WAG and RG for work-anxiety and subjective work ability. When looking at patients who were suffering only from work-anxiety, and no additional mental disorder, the duration of sickness absence until 6 months follow-up was shorter in the WAG (WAG: 11 weeks, RG: 16 weeks, P = 0.050). Conclusion: A shortterm WAG may help return to work in patients with work-anxieties, as long as there is no comorbid mental disorder. Y1 - 2016 U6 - https://doi.org/10.1097/JOM.0000000000000678 SN - 1076-2752 SN - 1536-5948 VL - 58 SP - 398 EP - 406 PB - American Institute of Physics CY - Philadelphia ER - TY - JOUR A1 - Muschalla, Beate A1 - Fay, Doris A1 - Linden, M. T1 - Self-reported workplace perception as indicators of work anxieties JF - Occupational medicine N2 - Work anxiety is a potentially disabling mental health problem, which can cause (long-term) sickness absence. In many cases patients do not openly report their anxieties and tend to give externalizing explanations of inner problems. Therefore people with work anxiety may perceive their workplace more negatively than those without such anxiety. To investigate the relation between subjective work description and work anxiety. There were 148 inpatient participants and 8015 general population controls. Patients with work anxiety described their workplace significantly more negatively than patients without work anxiety and employees in the general population, with no differences in workplace descriptions between psychosomatic patients without work anxiety and the general population sample. The type of complaint about work conditions was related to the specific type of work anxiety. Reports about workplace burdens can be indicative of work anxiety and should prompt further in-depth assessments. The content of complaints about work conditions may point to the type of underlying work anxiety. KW - Anxiety KW - diagnostic KW - sickness absence KW - work anxiety KW - workplace Y1 - 2016 U6 - https://doi.org/10.1093/occmed/kqv160 SN - 0962-7480 SN - 1471-8405 VL - 66 SP - 168 EP - 170 PB - Oxford Univ. Press CY - Oxford 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 - 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 -