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Vacation, Collective Restoration, and Mental Health in a Population
Abstract
Vacations enable people to help one another, spend time together in pleasant contexts, and renew relational resources. Reasoning that these shared activities spread social and psychological benefits through social networks, we hypothesized that increase in the number of vacationing workers engenders nonlinear decline in psychological distress at the population level. We applied time-series methods to aggregate data on monthly dispensation of antidepressants to the Swedish population for the 147 months starting January 1993. We obtained the data from the pharmacy corporation allied with the national health care system and from governmental sources. Dispensation of antidepressants declined logarithmically with increase in the number of vacationing workers, for men and women alike. The associations held among people beyond retirement age as well as people of working age, further evidence that vacation benefits spread beyond vacationing workers. The results bear on the social regulation of time for restoration as a general determinant of population health.
... Second, collective restoration theory (CRT), suggests that restorative experiences can spread from individuals to their wider communities by, for example, positive emotional contagion (Hartig, 2021). This might occur, for instance, in situations where people unknown to each other have pleasant encounters in public places such as parks, or merely witness others engaging in similar activities at similar times, both leading to a collective sense of trust through positive informal interactions and/or shared normative behaviours (de Vries et al., 2013;Hartig et al., 2013;Kaźmierczak, 2013;Weinstein et al., 2015). ...
... We would, therefore, encourage future studies to investigate and use items deliberatively developed to measure these constructs. For example, according to the theory, collective restoration is more likely to occur when whole communities are restoring from usual demands (Hartig et al., 2013) and ideally it would be measured at a community level (Hartig, 2021). More sophisticated testing of the theories in future will require further scale development and testing. ...
... Collective restoration could also be promoted with different types of interventions (beyond the synchronisation of holiday periods; Hartig et al., 2013). These interventions could be (a) design-based, such as the inclusion of facilities that foster direct social interaction, including circular seating and infrastructure for organising events/gatherings (Hunter et al., 2019), providing opportunities for positive emotional contagion; and/or (b) behavioural, such as providing the context for normative nature-based behaviours (e.g. ...
Rates of living alone, especially in more urbanised areas, are increasing across many industrialised countries, with associated increases in feelings of loneliness and poorer mental health. Recent studies have suggested that access to nature (e.g. parks and green spaces) can reduce the stressors associated with loneliness, partly through providing opportunities to nurture personal relationships (relational restoration) and engage in normative community activities (collective restoration). Such associations might vary across different household compositions and socio-demographic or geographical characteristics, but these have not been thoroughly tested. Using data collected across 18 countries/territories in 2017-2018, we grouped urban respondents into those living alone (n = 2062) and those living with a partner (n = 6218). Using multigroup path modelling, we tested whether the associations between neighbourhood greenspace coverage (1-km-buffer from home) and mental health are sequentially mediated by: (a) visits to greenspace; and subsequently (b) relationship and/or community satisfaction, as operationalisations of relational and collective restoration, respectively. We also tested whether any indirect associations varied among subgroups of respondents living alone. Analyses showed that visiting green space was associated with greater mental well-being and marginally lower odds of using anxiety/depression medication use indirectly, mediated via both relationship and community satisfaction. These indirect associations were equally strong among respondents living alone and those living with a partner. Neighbourhood green space was, additionally, associated with more visits among respondents living with a partner, whereas among those living alone, this was sensitive to the green space metric. Within subgroups of people living alone, few overall differences were found. Some indirect pathways were, nevertheless, stronger in males, under 60-year-olds, those with no financial strain, and residents in warmer climates. In conclusion, supporting those living alone, as well as those living with a partner, to more frequently access their local greenspaces could help improve mental health via promoting relational and collective restoration.
... The regular and persistent demands of life and work can take a toll on our well-being by depleting our physical resources and cognitive capacity, resulting in emotional distress, poor performance and other adverse outcomes for both individuals and societies (Hartig, Catalano, Ong, & Syme, 2013). Technological advances have exacerbated this problem as they not only increase the pace and intensity of work, but also allow the boundaries of the working week to expandfor many people, work is now accessible anywhere and anytime (Härmä, 2006;Siltaloppi, Kinnunen, & Feldt, 2009). ...
... The provision of vacation time is one way that society has responded to this problem, however many workers fail to use their annual leave entitlements (Birchall, 2011;Hilbrecht & Smale, 2016), and those who do may not fully disengage from work while on vacation. Although it is a commonly-held belief that short breaks and vacations help people recover from the stresses and strains of everyday life and work, very little academic research has been undertaken to systematically examine the restorative benefits that taking a break can provide (de Bloom et al., 2010;Hartig et al., 2013;Hazel, 2005). ...
... This study has demonstrated that taking a short break (3-4 days away from home) or longer vacation (1-5 weeks away from home) is able to achieve measurable restorative benefits, using both objective (performance on cognitive tests) and subjective (self-report) measures. The effect on cognitive performance is particularly important, as the capacity to focus attention on a task is a central tenet of Attention Restoration Theory (Kaplan, 1995;Kaplan & Kaplan, 1989;Kaplan & Talbot, 1983), and is an important factor affecting job performance and emotional well-being (Hartig et al., 2013). These objective and subjective benefits remained, albeit at a reduced level, one week after the break or vacation. ...
This paper applies Attention Restoration Theory to explore the restorative benefits of short breaks and vacations among Australian university staff (N = 156). Three groups (Vacation, Short Break and No Break) were compared using both objective (physiological and cognitive) and subjective (self-report) measures. Cognitive and self-report measures demonstrated that taking a break increases the ability to focus attention and improves restorative well-being. No consistent effects were found using physiological measures. Short breaks have an advantage over longer vacations on some measures, and this may be explained by attributes of the environment and activities in which vacationers engaged. Detachment from work is particularly important in achieving restorative benefits. Suggestions are offered for optimising the restorative effectiveness of taking a break.
... All of the work reviewed earlier emphasizes the restoration of individual resources. One recent contribution has however considered the environmental circumstances that contribute to renewal of shared resources in a collective process (Hartig, Catalano, Ong, & Syme, 2013). With inputs from environmental psychology, time geography, and social epidemiology, this theory considers how the social regulation of time affects population health by affecting the ability of different people to converge in desired social constellations in settings that in other ways also promote restoration. ...
... In the initial test of this theory, Hartig et al. (2013) focused on vacation as an example of the social regulation of time for restoration. In contrast to the documentation of health benefits for individuals, research has otherwise not considered the extent to which benefits of vacationing spread among individuals, an ecological effect that could show in population health. ...
... As another indicator that benefits spread among people, Hartig et al. (2013) found that the association held for dispensation to men and women of retirement age as well as to men and women of working age. In line with other work in social epidemiology, including the work in the salutogenic tradition initiated by Antonovsky (1979), the results call for attention to the social conditions that determine the access that individuals have to significant resources, such as social resources, which affect multiple disease outcomes through multiple mechanisms (see also Link & Phelan, 1995;Syme, 1967). ...
This in-depth survey of salutogenesis shows the breadth and strengths of this innovative perspective on health promotion, health care, and wellness. Background and historical chapters trace the development of the salutogenic model of health, and flesh out the central concepts, most notably generalized resistance resources and the sense of coherence, that differentiate it from pathogenesis. From there, experts describe a range of real-world applications within and outside health contexts, from positive psychology to geriatrics, from small towns to corrections facilities, and from school and workplace to professional training. Perspectives from scholars publishing in languages other than English show the global relevance of the field.Among the topics in the Handbook:· Emerging ideas relevant to the salutogenic model of healthSpecific resistance resources in the salutogenic model of health The sense of coherence and its measurementThe application of salutogenesis in communities and neighborhoodsThe application of salutogenesis to health development in youth with chronic conditionsThe application of salutogenesis in mental health care settingsThe Handbook of Salutogenesis summarizes an increasingly salient field for graduate and professional students of public health, nursing, psychology, and medicine, and for their instructors. It will also appeal to health-related academicians and professionals who wish to have a thorough grounding in the topic.
... All of the work reviewed earlier emphasizes the restoration of individual resources. One recent contribution has however considered the environmental circumstances that contribute to renewal of shared resources in a collective process (Hartig, Catalano, Ong, & Syme, 2013). With inputs from environmental psychology, time geography, and social epidemiology, this theory considers how the social regulation of time affects population health by affecting the ability of different people to converge in desired social constellations in settings that in other ways also promote restoration. ...
... In the initial test of this theory, Hartig et al. (2013) focused on vacation as an example of the social regulation of time for restoration. In contrast to the documentation of health benefits for individuals, research has otherwise not considered the extent to which benefits of vacationing spread among individuals, an ecological effect that could show in population health. ...
... As another indicator that benefits spread among people, Hartig et al. (2013) found that the association held for dispensation to men and women of retirement age as well as to men and women of working age. In line with other work in social epidemiology, including the work in the salutogenic tradition initiated by Antonovsky (1979), the results call for attention to the social conditions that determine the access that individuals have to significant resources, such as social resources, which affect multiple disease outcomes through multiple mechanisms (see also Link & Phelan, 1995;Syme, 1967). ...
Restorative environments support the renewal of adaptive resources that people have depleted while trying to meet everyday demands. In this overview of theory and research on restorative environments, we illustrate the complementarity and potential for integration of a restoration perspective with the salutogenic perspective in health promotion. We show how research on restorative environments can augment understanding of salutogenesis, calling attention to the dynamics of the depletion and renewal of resources needed for maintaining and promoting health and explaining how sociophysical environments can play a positive role in people’s ongoing efforts to manage diverse adaptive resources. We also show how research on salutogenesis can augment research on restorative environments, opening for a broader view of the kinds of resources that can become depleted and the different levels on which they are organized and become available. We close by elaborating on implications of our observations for salutogenesis research and practice, with a view to advancing the integration of the two research fields.
... For example, it encourages consideration of other forms of capacity building aside from social contacts and physical activity (e.g. improving the functioning of the immune system through increased exposure to microbial biodiversity; Kuo, 2015) and other forms of restoration aside from stress recovery and attention restoration (e.g., collective forms of restoration of social resources; Hartig et al., 2013). ...
... For example, each of the three domains of pathways that we have discussed here (mitigation, restoration and instoration) comprise more specific mechanisms, either known, hypothesized or as yet unrecognized; these warrant more attention (cf. Hartig et al., 2013;Kuo, 2015). ...
Background:
In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear.
Objectives:
During an Expert Workshop held in September 2016, the evidence linking greenspace and health was reviewed from a transdisciplinary standpoint, with a particular focus on potential underlying biopsychosocial pathways and how these can be explored and organized to support policy-relevant population health research.
Discussions:
Potential pathways linking greenspace to health are here presented in three domains, which emphasize three general functions of greenspace: reducing harm (e.g. reducing exposure to air pollution, noise and heat), restoring capacities (e.g. attention restoration and physiological stress recovery) and building capacities (e.g. encouraging physical activity and facilitating social cohesion). Interrelations between among the three domains are also noted. Among several recommendations, future studies should: use greenspace and behavioural measures that are relevant to hypothesized pathways; include assessment of presence, access and use of greenspace; use longitudinal, interventional and (quasi)experimental study designs to assess causation; and include low and middle income countries given their absence in the existing literature. Cultural, climatic, geographic and other contextual factors also need further consideration.
Conclusions:
While the existing evidence affirms beneficial impacts of greenspace on health, much remains to be learned about the specific pathways and functional form of such relationships, and how these may vary by context, population groups and health outcomes. This Report provides guidance for further epidemiological research with the goal of creating new evidence upon which to develop policy recommendations.
... Even if the other has the ability to provide support, the exchange is typically predicated on the existence of a relationship between the giver and the recipient. This relational resource exists between people, not in one or the other person alone, and it also can become depleted, for example through a lack of reciprocity in the giving of support ( Hartig et al. 2013). As people use physical, psychological and social resources on an everyday basis, and so pay the cost of adapting to demanding circumstances, the need for restoration arises regularly. ...
... Encouraging doctors and other health care facilitators to recommend regular contact with nature is one often-discussed option, but such recommendations may have little effect on people who are caught in circumstances that allow little time for restoration. To date, the literature on restorative environments has hardly considered the implications of time limitations (though see Hartig et al. 2013). ...
The vast majority of people live in urbanized areas. These offer numerous advantages, such as access to a great variety of entertainment and cultural events, services such as educational and medical centers, and opportunities for mixing with different kinds of people in lively public places. Urbanized areas also challenge residents, however, with pollution, crowding and information overload. The effort to deal with the various demands of everyday urban life taxes the physical, psychological and social resources of residents and, over time, this may impair their health. During the past few decades, environmental psychologists have initiated research into the role that the sociophysical environment plays in restoring people’s diminished capabilities. This chapter focuses on restorative environments, which promote people’s health and well-being by supporting their recovery from efforts to meet the demands of everyday life. We first discuss some basic concepts, including health, restoration and the theories that have guided research to date. Then, we move on to describe some key findings in the research area, with particular regard to the restorative potential of different settings in and around cities and their implications for urban residents’ health and well-being. The research evidence concerning environmental supports for restoration is organized into four sections: the residential context, work and school settings, care settings, and other settings. Overall, the results obtained show that restoration is more likely to occur in environments that offer contact with nature, from wilderness to a window view of trees. Most of the empirical studies we review refer to environments with natural elements and features; however, not all restorative environments offer contact with nature, and we also discuss the restorative qualities found in other settings, such as monasteries, museums and urban plazas. In covering the research on these different environments, we consider a variety of short-term psychological benefits that reflect restorative processes, such as improvements in emotional states, the ability to concentrate, and the capacity to inhibit impulsive behavior. We also consider how achieving long-term health goals, such as weight control, might be facilitated by repeated restorative experiences. The empirical evidence obtained over the past few decades offers some guidance for environmental design and planning that can boost the restorative quality of residential areas, workplaces, schools, hospitals and other settings of everyday life. We close by discussing these practical implications and by making recommendations for future research.
... Likewise, greenspace in the school surroundings may benefit academic performance (Browning and Rigolon, 2019), but the evidence remains limited (Singh et al., 2022) and of suboptimal quality (van den Bogerd et al., 2020). However, as suggested by studies in adults, restoration may proceed in natural environments lacking vegetation (Li et al., 2022a), or in environments lacking natural features altogether, such as a company canteen (Bellini et al., 2019) or an artistic/historical setting (Scopelliti et al., 2019), as well as during various experiences unrelated to nature, such as being on vacation (Hartig et al., 2013) or listening to pleasant music (Baldwin and Lewis, 2017). Other people can also facilitate and speed up the process of restoration by providing social support, sense of safety, and sharing our experiences (Staats and Hartig, 2004;Staats et al., 2010). ...
Background
The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity.
Methods
Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature.
Results
Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature.
Conclusions
It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.
... A few exceptional studies emphasize a limited number of variables from either individual or vacation context (e.g., Lehto, 2012;Vada et al., 2020). In addition, the societal context's influence has been largely ignored (Hartig et al., 2013). Without considering contextual factors, interactions between the individual and the environment, as well as the entire dynamic system may result in biased interpretations and applications in both research and practice. ...
... Collective restoration theory (CRT) refers to the attenuation of demands and promotion of positive shared experiences within local communities, cities and societies that may result from policies that enable widespread and simultaneous green space visitation and so the potential spread of benefits among those who come together in them, whether known or unknown to one another (e.g. public park provisions, public holidays, national vacation legislation (Hartig et al., 2013); see also (Jim et al., 2018)). ...
Persistent loneliness troubles people across the life span, with prevalence as high as 61 % in some groups. Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and further research. We conducted a systematic review of quantitative studies testing associations between green space and loneliness, searching seven databases. Twenty two studies were identified by 25/01/2022. Most of the studies were conducted in high-income countries and fifteen (68 %) had cross-sectional designs. Green space was measured inconsistently using either objective or subjective indicators. Few studies examined specific green space types or qualities. The majority of studies measured general loneliness (e.g. using the UCLA loneliness scale). Different types of loneliness (social, emotional, existential) were not analysed. Of 132 associations, 88 (66.6 %) indicated potential protection from green space against loneliness, with 44 (33.3 %) reaching statistical significance (p < 0.05). We integrated these findings with evidence from qualitative studies to elaborate and extend the existing pathway domain model linking green space and health. These elaborations and extensions acknowledge the following: (a) different types of green space have implications for different types of loneliness; (b) multilevel circumstances influence the likelihood a person will benefit or suffer harm from green space; (c) personal, relational, and collective processes operate within different domains of pathways linking green space with loneliness and its concomitants; (d) loneliness and its concomitants are explicitly positioned as mediators within the broader causal system that links green space with health and wellbeing. This review and model provide guidance for decision making and further epidemiological research on green space and loneliness.
... Collective restoration theory (CRT) refers to the attenuation of demands and promotion of positive shared experiences within local communities, cities and societies that may result from policies that enable widespread and simultaneous green space visitation and so the potential spread of benefits among those who come together in them, whether known or unknown to one another (e.g. public park provisions, public holidays, national vacation legislation (Hartig et al., 2013); see also (Jim et al., 2018)). ...
Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and further research. We conducted a systematic review of quantitative studies testing associations between green space and loneliness, searching seven databases. Twenty two studies were identified by 25/01/2022. Most of the studies were conducted in high-income countries and fifteen (68%) had cross-sectional designs. Green space was measured inconsistently using either objective or subjective indicators. Few studies examined specific green space types or qualities. The majority of studies measured general loneliness (e.g. using the UCLA loneliness scale). Different types of loneliness (social, emotional, existential) were not analysed. Of 132 associations, 88 (66.6%) indicated potential protection from green space against loneliness, with 44 (33.3%) reaching statistical significance (p<0.05). We integrated these findings with evidence from qualitative studies to elaborate and extend the existing pathway domain model linking green space and health. These elaborations and extensions acknowledge the following: (a) different types of green space have implications for different types of loneliness; (b) multilevel circumstances influence the likelihood a person will benefit or suffer harm from green space; (c) personal, relational, and collective processes operate within different domains of pathways linking green space with loneliness and its concomitants; (d) loneliness and its concomitants are explicitly positioned as mediators within the broader causal system that links green space with health and wellbeing. This review and model provide guidance for decision making and further epidemiological research on green space and loneliness.
... He illustrates the role of such higher order processes with reference to government policies, such as those concerning "national vacation legislation" that create opportunities for restorative activities within a population. And yet, when discussing a study of the positive psychological effects of such policies (Hartig, Catalano, Ong, & Syme, 2013), he laments that where people choose to vacation was not considered. Adopting a dyadic or a collective unit of analysis should not preclude consideration of the properties of the environments where restorative activities occur. ...
The way that psychologists conceptualize the nature of visual perception directly influences the way they conceptualize the environment from a psychological standpoint. For that reason, commentary on the contributions to this symposium volume addressing the relationship between the natural environment and psychological functioning is organized with regard to the implicit approach to visual perception each chapter adopts. Such theoretical commitments shape how we think about the environment from a psychological perspective, the kind of research questions we ask, the particular methodologies that are employed and, in some cases, the practical applications that stem from them. This examination of the volume’s chapters is preceded by a discussion of the complexities attending a definition of the natural environment, and a proposal that psychologists might base that definition on those environmental properties that perceivers attend to when designating an environment as natural. Having specified those perceivable properties, we can proceed to inquire on what basis perceivers express greater preference for natural environments. In the course of these reflections, other pertinent issues are discussed, including environmental preference in relation to evolutionary theory; affordances and environmental preference; and psychological restoration as a process of re-establishing functional stability. Particular attention is paid to the place of perception-action in relation to the environment.
... I refer to these interpersonal aspects of relationships as relational resources; they do not exist in one person alone, independent of the other(s) (cf., Cordelli, 2015;Hartig, Catalano, Ong, & Syme, 2013). As a constituent of any closer relationship, they provide a basis for action by those involved, enabling and motivating the exchange of individual resources, including material as well as personal functional resources. ...
The restoration perspective on human adaptation offers a broad view of relations between environment and health; however, it remains underutilized as a source of insight for nature-and-health studies. In this chapter, I start from the restoration perspective in showing ways to extend theory and research concerned with the benefits of nature experience. I first set out the basic premises of the restoration perspective and consider how it has come to have particular relevance for understanding the salutary values now commonly assigned to nature experience. I then discuss the currently conventional theoretical narrative about restorative effects of nature experience and organize some of its components in a general framework for restorative environments theory. Extending the framework, I put forward two additional theories. These call attention to the restoration of resources as held within closer relationships and as held collectively by members of a population. In closing, I consider ways to work with the general framework and further develop the narrative about nature, restoration, and health. The extensions made here raise important considerations for nature preservation efforts, urban planning, health promotion strategies, and ways of thinking about human–nature relations.
... However, it was clear that participants in our study also saw these places in nature as venues for developing stronger bonds with others through spending time together in pleasant settings. Strong social bonds are important for wellbeing (Helliwell & Putnam 2004), and the idea that certain environments can support collective restoration among multiple individuals is becoming of increasing interest to environmental psychologists (Hartig, Catalano, Ong, & Syme, 2013). Through this study we suggest that shared experience of important places in nature can strengthen social bonds between individuals, with concomitant impacts on wellbeing. ...
In this study we examined links between specific, known places in nature and perceived psychological benefits. The qualitative data (N = 8) were gathered during an experiment where participants viewed a slideshow of ten place photos of their own selection and spoke aloud about a positive memory associated with the place in the relevant experimental condition (high attachment, low attachment, or favourite place). The majority of the places were in Finland, and were summer cottages, lakes, and forests. Some participants discussed urban or non-Finnish nature. We found themes in the participant reflections that related to mental health and wellbeing. Of these, social company and the passage of time support recent interest in concepts of relational, social, and/or collective restoration. Reducing states of negative affect and arousal but also enhancing positive affect, and facilitating cognitive recovery and reflection emphasise the value of natural settings for general wellbeing. Attachment to place was perceived to enhance certain outcomes achieved in natural settings, but also made participants aware of the sometimes negative consequences arising from place loss or nostalgia. Attachment to specific places in nature and its temporal development may therefore be an important consideration for future studies and practitioners working with nature-based interventions for mental health.
... 2018), as well as fewer depressive symptoms (Verma et al., 2017) and a decreased use of antidepressants (Hartig et al., 2013). However, the question remains as to how vacations affect psychological and physical health. ...
Background:
Vacationing provides potential recovery from work stress and is associated with cardiovascular disease morbidity and mortality. This study considered psychological variables that might change as a vacation is approaching (fade-in) or after a vacation ends (fade-out) and how these associations might vary as a function of ongoing work stress. Methods: Sixty workers eligible for paid time off were recruited from the community. Multiple assessments occurred during an 8- to 10-week period spanning the period before and after a vacation. A piecewise random coefficient model compared changes over time (slopes) for pre- and post-vacation periods. Outcomes included affect, aggression, social support, and work stress. Results: Hostile affect, negative affect, stress, and physical aggression all declined significantly during the post-vacation period (relative to no change during the pre-vacation period). In addition, these changes in pre- versus post-vacation periods differed as a function of work stress, with some vacation benefits observed specifically among workers with low work stress. Conclusions: Findings indicate that vacations produced psychological benefits that persist beyond the vacation period. Vacation-associated benefits may serve as mechanisms underlying associations between vacations and slow developing disease. However, work stress appears to spillover and can thereby undermine a vacation's fade-in and fade-out benefits.
... Existing studies indicate that vacations promote employees' recovery, well-being, and job performance (Chen & Petrick, 2013;de Bloom et al., 2009;de Bloom, Ritter, Kühnel, Reinders, & Geurts, 2014;Hartig, Catalano, Ong, & Syme, 2013;Kühnel & Sonnentag, 2011). Vacationing is, for example, associated with higher life satisfaction and subjective well-being, fewer health complaints, better self-rated health, and lower levels of exhaustion after the vacation (see Chen & Petrick, 2013, for a review). ...
The aim of this study was to investigate whether beneficial vacation effects can be strengthened and prolonged with a smartphone-based intervention. In a four-week longitudinal study among 79 Finnish teachers, we investigated the development of recovery, well-being, and job performance before, during, and after a one-week vacation in three groups: non-users (n = 51), passive (n = 18) and active (n = 10) users. Participants were instructed to actively use a recovery app (called Holidaily) and complete five digital questionnaires. Most recovery experiences and well-being indicators increased during the vacation. Job performance and concentration capacity showed no significant time effects. Among active app users, creativity at work increased from baseline to after the vacation, whereas among non-users it decreased and among passive users it decreased a few days after the vacation but increased again one and a half weeks after the vacation. The fading of beneficial vacation effects on negative affect seems to have been slower among active app users. Only few participants used the app actively. Still, results suggest that a smartphone-based recovery intervention may support beneficial vacation effects.
... After vacation, compared to before vacation, vacationers reported, for instance, fewer health complaints (Fritz & Sonnentag, 2006;Strauss-Blasche et al., 2000), lower levels of exhaustion (Etzion, 2003;Westman & Eden, 1997;Westman & Etzion, 2001) and higher life satisfaction (Gilbert & Abdullah, 2004;Lounsbury & Hoopes, 1986;Strauss-Blasche, Ekmekcioglu & Marktl, 2000). More recent studies could replicate and broaden these findings and showed significant associations between vacationing, positive hedonic affect balance (Nawijn, 2011;Nawijn, Mitas, Lin & Kerstetter, 2013), increases in life satisfaction (Chen, Huang & Petrick, 2016) and work engagement, as well as decreases in burnout (Kühnel & Sonnentag, 2011) and population-level dispensation of antidepressants during vacation periods (Hartig, Catalano, Ong & Syme, 2013). ...
This study investigates the relationship between organizational career management and career satisfaction, as well as three mediating resources based on the social cognitive career theory. Using an employee survey, 165 employees of a municipal utility company were questioned. In line with the theory, bootstrap confidence interval results show that the positive relationship between organizational career management and career satisfaction is mediated by individual career planning and perceived organizational support. Occupational self-efficacy was partly confirmed as a mediator. Findings illustrate the importance of organizational career management and provide practical implications regarding its implementation.
... After vacation, compared to before vacation, vacationers reported, for instance, fewer health complaints (Fritz & Sonnentag, 2006;Strauss-Blasche et al., 2000), lower levels of exhaustion (Etzion, 2003;Westman & Eden, 1997;Westman & Etzion, 2001) and higher life satisfaction (Gilbert & Abdullah, 2004;Lounsbury & Hoopes, 1986;Strauss-Blasche, Ekmekcioglu & Marktl, 2000). More recent studies could replicate and broaden these findings and showed significant associations between vacationing, positive hedonic affect balance (Nawijn, 2011;Nawijn, Mitas, Lin & Kerstetter, 2013), increases in life satisfaction (Chen, Huang & Petrick, 2016) and work engagement, as well as decreases in burnout (Kühnel & Sonnentag, 2011) and population-level dispensation of antidepressants during vacation periods (Hartig, Catalano, Ong & Syme, 2013). ...
Background. Research shows that vacationing can increase well-being. However, these effects do not seem to last long. Research on written reminiscing suggests that positive holiday memories may temporarily raise well-being, thereby buffering or undoing job stress and prolonging positive vacation effects. Satisfaction of six psychological needs is expected to explain the relationship between vacation (memories) and well-being: Detachment, Relaxation, Autonomy, Mastery, Meaning and Affiliation (= DRAMMA).
Method. An experimental study with a student population (N = 85) was conducted in the laboratory. DRAMMA aspects were measured with a self-report questionnaire, based on existing, validated scales. Fatigue was monitored with digital self-reports before, during and after demanding tasks and a subsequent written reminiscence assignment. After the demanding tasks, the experimental group recalled and wrote down memories of a nice holiday whereas the control group recalled a nice evening. Written texts were analyzed for satisfaction of the six needs.
Results. Qualitative analyses of the written holiday memories showed that all six assumed DRAMMA mechanisms could be found in the texts. Six additional mechanisms were found that may not be fully covered in the DRAMMA model. Moreover, repeated measures ANOVAs showed that reminiscing was beneficial for recovery from stress: Fatigue decreased after written reminiscence. Particularly autonomy and affiliation contributed to a decrease in fatigue. Despite the fact that vacation memories produced significantly higher levels of meaning, there was no difference between the two experimental groups concerning fatigue after the reminiscence task.
Discussion and Conclusion. Written reminiscence on positive past events seems to help people to recover from stress after cognitively draining tasks. Vacation memories seem to assist people to find purpose in life. The DRAMMA model provides a useful framework for research on recovery from job stress based on the idea that leisure time offers employees the opportunity to fulfill psychological needs. It broadens the well-known recovery experiences perspective by including the important factors of meaning and affiliation. More research in larger samples using varied research designs is needed to arrive at a better understanding of the role of psychological need satisfaction during work and leisure time.
... Apart from spatial interdependency, children's restorative experiences are likely to be constrained by several, quite unknown, factors (Collado et al., 2016c). From studies with adults we know that individual time constraints (Hartig et al., 2013a), cold weather conditions that may keep people inside (Hartig et al., 2013b), perceived danger (Staats and Hartig, 2004;Herzog and Rector, 2009), and heavy traffic disturbances (Von Lindern et al., 2016) are factors on which the restorative potential of a certain environment depends. Little attention has been paid, however, to the inherently relational nature of restorative environments when assessing children's restorative experiences. ...
This article offers an overview of what has been done until now on restorative research with children and opens up new inquires for future research. Most of the work has studied children's exposure to nature and the restorative benefits this contact provides, focusing on the renewal of children's psychological resources. The paper begins with an introduction to children's current tendency toward an alienation from the natural world and sets out the objectives of the article. It is followed by four main sections. The first two sections report on what we already know in this research area, distinguishing between children with normal mental capabilities and those suffering from attention-deficit hyperactivity disorder (ADHD). The findings gathered in these sections suggest that children's contact with nature improves their mood and their cognitive functioning, increases their social interactions and reduces ADHD symptoms. The next section describes five suggestions for future research: (1) the need for considering the relational dynamics between the child and the environment in restoration research, and the concept of constrained restoration; (2) the possibility of restorative needs arising from understimulation; (3) the importance of considering children's social context for restoration; (4) the relationship between restoration and pro-social and pro-environmental behaviors; and (5) children's restorative environments other than nature. We close by making some final remarks about the importance of restoring daily depleted resources for children's healthy functioning.
... However, the kind of restoration has to correspond with the source of stress and mental fatigue. Hartig, Catalano, and Ong (2007) pointed out that sleep, for example, might not help people to recover from depleted social resources; an active, shared behavior would be more likely to support restoration in this case (Hartig, Catalano, Ong, & Syme, 2013). This notion as well as the definitions of fascination, extent, compatibility, and being away suggest that restorative characteristics are not per se attributes of any given environment, but that the amount of actually experienced restoration also depends on human-environment and human-human transactions. ...
Being away is considered a key requirement for restoring depleted cognitive resources. However, it is unclear which personenvironment transactions promote or constrain the sense of being away. This study examines whether perceived interdependencies between cognitively demanding and leisure-time settings can reduce the perceived sense of being away. The results from an online survey of German adults indicated that self-reported health-related outcomes after leisure time were related to the perceived sense of being away during leisure time. Both the perceived sense of being away and self-reported health-related outcomes were impaired when people perceived more interdependencies between cognitively demanding and leisure-time settings. The findings suggest that people report a stronger sense of being away and increased health and wellbeing when perceived setting interdependencies are reduced. This application of behavior setting theory in the restorative environments framework provides a more sophisticated understanding of human-environment transactions that may constrain or promote health and wellbeing.
... Additionally, the specific kind of restorative experience has to correspond with the type of depleted resource. Sleep might for example not be appropriate to recover from depleted social resources for which restoration could require pleasant activities with those persons with whom relational bonds have been weakened (Hartig, Catalano, & Ong, 2007;Hartig, Catalano, Ong, & Syme, 2013). Theorizing in restorative environments research still requires further understanding of the possible impact of social, cognitive or behavioral processes on restorative outcomes. ...
Contact with nature can promote health and well-being through providing opportunities for restoring diminished psychological resources. Among those factors relevant for experiencing restoration are having a sense of being away from stress and daily demands. However, only little is known about how perceived interdependencies (in terms of social, behavioral and cognitive aspects) between settings usually relied on for restoration and those settings where stress and demands are encountered may impact having a sense of being away, and thus influence perceived restoration. In a visitor survey (N = 115) conducted at the Wilderness Park Zürich those perceived setting interdependencies that might influence having a sense of being away were assessed. The relationship between perceived setting interdependencies, having a sense of being away and restorative outcomes was analyzed by employing a structural equation model. The perceived setting interdependencies accounted for 26% of the explained variance for experiencing being away and had a negative indirect and total effect on perceived restorative outcomes. The more setting interdependencies a park visitor reported, the lower were the ratings for having a sense of being away and restorative outcomes. Researchers and practitioners who work with restorative environments and related domains are encouraged to further elaborate on setting-related aspects that may promote or hinder experiencing being away while spending time in an environment that is usually used for restorative purposes. These insights may be used to improve restoration of depleted psychological resources, to promote health and well-being, and thus to increase the overall visiting experience.
Unlabelled:
Vacation is an essential feature of modern life for many people, and there is a fundamental assumption that short-term leave contributes to physical improvement and, thus, it is an improving the quality of life factor.
Objective:
To study physiological and a number of psychophysiological body characteristics of the Magadan region residents when moving from northern latitudes to the conditions of the southern band in the summer period for vacation.
Material and methods:
Through year-round psychophysiological monitoring of a group, consisting of 19 male northern residents volunteers (mean age 33.2±1.5 years), a sample (15 men) was formed. These participants left the territory of the Magadan region for summer vacation during the research period. The mean vacation length was 47±6 days. The subjects were analyzed by the main indicators of physical development, cardiovascular system, heart rate variability, as well as individual psychophysiological characteristics.
Results:
Short-term departure from the Magadan region did not cause significant changes in the main indicators of physical development, which was manifested in the absence of statistically significant differences in the indicators of body mass, total fat in the body and body mass index. A similar tendency was noted about the main cardiovascular indicators, except the significantly lower value of myocardial index on the post-vacation period, the reduction of which demonstrates a decrease in the total amount of dispersive abnormalities and, in general, an optimization of the cardiovascular system. At the same time, the conducted analysis of heart rate variability indicators shows a change in sympathetic-parasympathetic balance towards higher parasympathetic activity, which demonstrates the positive effect of summer vacation. Negative tendencies of the vacation effect manifested in a slight speed increase of a comprehensive visual-motor reaction, as well as in an increase of the harmful habits number.
Conclusion:
The obtained results of the study expand knowledge about the positive contribution of summer vacation to the health and well-being of working population of the Northern region, and also show that the vacation activities positive results can be assessed on the basis of the indicators of the heart rate variability, the myocardial index, as well as on the basis of the objective and subjective assessment of the psychophysiological condition analysis. These findings fully provide the basis for further research in the sphere of summer vacation activities organization as a public health resource.
In this chapter, the authors consider how research on restorative environments can augment research on salutogenesis by calling attention to the dynamics of depletion and renewal of resources needed for the maintenance and promotion of health and well-being and by showing how the sociophysical environment comes into play in people’s ongoing efforts to manage diverse resources. The authors also consider how research on salutogenesis can augment research on restorative environments by encouraging a broader view of the kinds of resources that can be depleted and the different levels on which they are organised and become available. The authors thus indicate areas for more systematic, reciprocal exchange between the fields.
Spending time in nature is beneficial for stress reduction and recovery. Using the properties of biophilic design, this study examined the influence of a nature-based indoor environment on physiological stress systems. An experimental study was designed to assess the influence of indoor natural elements on autonomic activity (heart rate variability or HRV), self-reported environmental assessments. No differences in heart rate variability were found between participants assigned to either condition. The room with natural elements was rated more positively than the room without natural elements. Participant preference had more impact on changes in HRV for participants without exposure to natural elements. The results suggest that natural elements in indoor environments may influence the regulation of stress response via environmental preference.
Abbreviations: ANCOVA: Analysis of Covariance; ANS: Autonomic Nervous System; AVNN: Average of NN; DST: Digit Span Test; EAS: Environmental Assessment Scale; ECG: Electrocardiograph; fMRI: Functional magnetic resonance imaging; HF: High Frequency; HRV: Heart Rate Variability; INE: Indoor Nature Exposure; NR: Nature-Relatedness Scale; PANAS: Positive and Negative Affect Schedule; SAM: Search and Memory Test; SLSI: Student Life Stress Inventory; SMT: Sentence Making Test
This article employs institutional ethnography (IE) inclusive of its distinctive epistemological stance to elucidate the institutional organization of the everyday work experience of the employee living with self-reported depression. The study was conducted within a large industrial manufacturing plant in Ontario, Canada. We discuss three institutionally organized processes that play a dominant role in coordinating the experiences of employees with self-reported depression: (1) employees’ work of managing and negotiating episodes of depression, (2) managers’ administrative work of maintaining privacy and confidentiality, and (3) the administrative work of authorizing illness. We shed light on how confidential medicalized disability management programs render managers ill prepared and inadequately trained to provide mental health support to their employees. Our findings inform advocacy efforts and facilitate both organizational and policy change to enhance services and supports for employees.
‘How long should a man’s vacation be?’ was the title of an article in the New York Times in 1910, in which businessmen, academics and politicians discussed whether vacations for the working classes were necessary and why. Today, European workers enjoy a minimum of 20 days paid annual leave (plus statutory days) and the tourism industry employs more than 260 million people worldwide. Does that mean we have the answers to the intriguing questions raised in a newspaper more than 100 years ago? Not quite.
Our journey will pass major theories and milestones of research on recovery from work, and get an overview of findings on vacation effects. As a souvenir of your trip, you’ll be given some practical tips to make the most of your next holiday.
Researchers often invoke a mortality displacement or 'harvesting' mechanism to explain mortality patterns, such that those with underlying health vulnerabilities die sooner than expected in response to environmental phenomena, such as heat waves, cold spells and air pollution. It is unclear if this displacement mechanism might also explain observed increases in suicide following economic contraction, or if suicides are induced in persons otherwise unlikely to engage in self-destructive behaviour. Here, we test two competing hypotheses explaining an observed increase in suicides following unemployment-induction or displacement.
We apply time series methods to monthly suicide and unemployment data from Sweden for the years 2000-2011. Tests are conducted separately for working age (20-64 years old) men and women as well as older (aged 65 years and older) men and women.
Displacement appeared among older men and women; an unexpected rise in unemployment predicted an increase in suicides 6 months later, followed by a significant decrease 8 months later. Induction appeared among working age men, but not among working age women; an unexpected rise in unemployment predicted an increase in suicides 4-6 months later.
Displacement and induction both appear to have operated following unexpected labour market contractions in Sweden, though with different population segments.
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The overall test for lack of fit in autoregressive-moving average models proposed by Box & Pierce (1970) is considered. It is shown that a substantially improved approximation results from a simple modification of this test. Some consideration is given to the power of such tests and their robustness when the innovations are nonnormal. Similar modifications in the overall tests used for transfer function-noise models are proposed
Let n observations Y 1, Y 2, ···, Y n be generated by the model Y t = pY t−1 + e t , where Y 0 is a fixed constant and {e t } t-1 n is a sequence of independent normal random variables with mean 0 and variance σ2. Properties of the regression estimator of p are obtained under the assumption that p = ±1. Representations for the limit distributions of the estimator of p and of the regression t test are derived. The estimator of p and the regression t test furnish methods of testing the hypothesis that p = 1.
Outliers in time series can be regarded as being generated by dynamic intervention models at unknown time points. Two special cases, innovational outlier (IO) and additive outlier (AO), are studied in this article. The likelihood ratio criteria for testing the existence of outliers of both types, and the criteria for distinguishing between them are derived. An iterative procedure is proposed for detecting IO and AO in practice and for estimating the time series parameters in autoregressive-integrated-moving-average models in the presence of outliers. The powers of the procedure in detecting outliers are investigated by simulation experiments. The performance of the proposed procedure for estimating the autoregressive coefficient of a simple AR(l) model compares favorably with robust estimation procedures proposed in the literature. Two real examples are presented.
Women's entrance into the labor market in large numbers has exacerbated incom-patibilities between employer and family interests. Research reveals that conflict between paid work and family responsibilities has been linked to decreased em-ployee productivity as well as decreased family functioning. In this review, we explore the nature of job/family incompatibility, organizational interests in family responsive policies, and the current prevalence of various policies within work organizations. We then review what is known about the effectiveness of particular family-responsive policies on organizational and family functioning. Finally, we consider barriers to further institutionalization of family responsive policy and suggest future research and policy directions.
This study extends research on psychological restoration by encompassing a broad set of restorative situations available to urban residents. Preferences are assessed for mundane restorative situations comprising leisure activity, setting, and social context, given different levels of attentional fatigue. Attentional fatigue, activity-setting, and social context were experimentally manipulated. The settings for activities were home, park, city center, and transit. Participants (N = 70) read scenarios describing an attentional state and rated their preference for the situations. Results show interactive effects of attentional state with activity-setting and with social context. The park was most preferred given attentional fatigue. Results confirm that while residents may particularly value urban nature for restoration, their urban context also provides other mundane but attractive restorative situations.
Considerable policy action has focused on the social patterning of health, especially the health risks associated with low income. More recent attention has turned to transport, food systems, workplaces, and location, and the way their intersections with social position and income create health inequalities. Time is another dimension that structures what people do; yet the way in which time contours health has been neglected. This paper explores (a) how time might influence health, and (b) the way in which time scarcity complicates current understandings of health inequalities. Alongside other meanings, time can be thought of as a health resource. People need time to access health services, build close relationships, exercise, work, play, care, and consume—all activities that are fundamental to health. There is evidence that the experience of time pressure is directly related to poorer mental health. Lack of time is also the main reason people give for not taking exercise or eating healthy food. Thus, another impact of time scarcity may be its prevention of activities and behaviours critical for good health. We investigate whether time scarcity, like financial pressure, is socially patterned, and thus likely to generate health inequality. The experience of time scarcity appears to be linked to variations in time devoted to employment or caring—activities closely bound to gender, status, and life course. One reason that time scarcity is socially patterned is because of the way in which caring is valued, allocated, and negotiated in households and the market. Adding paid employment to caring workloads is now normative, transforming the allocation of time within families. But caring requires a close interlocking with others’ needs, which are often urgent and unpredictable, creating conflict with the linear, scheduled, and commodified approach to time required in the workplace. We review the evidence for the possibility that these time pressures are indeed contributing to socially patterned health inequalities among people caring for others. We also explore the potential for time scarcity to compound other sources of health inequality through interplays with income and space (urban form, transportation networks and place of residence). People who are both time and income poor, such as lone mothers, may face compounding barriers to good health, and the urban geography of time-scarce families represents the embedding of time – money – space trade-offs linked to physical location. In Australia and the US, poorer families are more likely to live in mid to outer suburbs, necessitating longer commutes to work. These suburbs have inferior public transport access, and can lack goods and services essential to health such as shops selling fresh foods. We conclude with a tentative framework for considering time and health in the context of policy actions. For example, social policy efforts to increase workforce participation may be economically necessary, but could have time-related consequences that alter health. Similarly, if cities are to be made livable, health promoting, and more equitable, urban designers need to understand time and time – income – space trade-offs. Indeed, many social policies and planning and health interventions involve time dimensions which, if they remain unacknowledged, could further compound time pressures and time-related health inequality.
The growing frequency of vacation travel in the developed world has ensured that tourism is seen as an essential element of the quality of life. A cross-comparative analysis of tourism consumption indicates substantial differences in tourism consumption and the structural position of vacations as a social right between nations. Higher levels of vacation entitlement and consumption in Europe can be linked to corporatist or social democratic welfare regimes that recognize tourism consumption as a social right. In the United States and Japan, however, more liberal welfare regimes are linked to lower vacation entitlements and greater inequalities in distribution of income and/or leisure time. The resulting differences in vacation time availability are reflected in time-intensive tourism consumption patterns in Europe, and money-intensive consumption patterns in the United States and Japan. With increasing liberalization, however, there are signs that these international differences are beginning to narrow.
Link and Phelan (1995) developed the theory of fundamental causes to explain why the association between socioeconomic status (SES) and mortality has persisted despite radical changes in the diseases and risk factors that are presumed to explain it. They proposed that the enduring association results because SES embodies an array of resources, such as money, knowledge, prestige, power, and beneficial social connections that protect health no matter what mechanisms are relevant at any given time. In this article, we explicate the theory, review key findings, discuss refinements and limits to the theory, and discuss implications for health policies that might reduce health inequalities. We advocate policies that encourage medical and other health-promoting advances while at the same time breaking or weakening the link between these advances and socioeconomic resources. This can be accomplished either by reducing disparities in socioeconomic resources themselves or by developing interventions that, by their nature, are more equally distributed across SES groups.
Objectives:
The aim of this meta-analysis is to investigate to what extent vacation has positive effects on health and well-being, how long such effects endure after work resumption, and how specific vacation activities and experiences affect these relationships.
Methods:
Based on a systematic literature search (PsycInfo, Medline) and methodological exclusion criteria, in a stepwise approach, 7 studies were selected and reviewed. Effect sizes (Cohen's d) were calculated i) for every outcome variable within every study, ii) for every study by averaging the effect sizes per study, and iii) for homogeneous categories of outcome variables (exhaustion, health complaints, life satisfaction).
Results:
The results suggest that vacation has positive effects on health and well-being (small effect, d=+0.43), but that these effects soon fade out after work resumption (small effect, d=-0.38). Our research further demonstrated that vacation activities and experiences have hardly been studied. Therefore, their contribution to vacation effect and fade out remains unclear.
Discussion:
Progress in future vacation research will depend on strong research designs that incorporate repeated measurements pre-, inter- and post-vacation.
This study examined the association between long working hours and cognitive function in middle age. Data were collected in
1997–1999 (baseline) and 2002–2004 (follow-up) from a prospective study of 2,214 British civil servants who were in full-time
employment at baseline and had data on cognitive tests and covariates. A battery of cognitive tests (short-term memory, Alice
Heim 4-I, Mill Hill vocabulary, phonemic fluency, and semantic fluency) were measured at baseline and at follow-up. Compared
with working 40 hours per week at most, working more than 55 hours per week was associated with lower scores in the vocabulary
test at both baseline and follow-up. Long working hours also predicted decline in performance on the reasoning test (Alice
Heim 4-I). Similar results were obtained by using working hours as a continuous variable; the associations between working
hours and cognitive function were robust to adjustments for several potential confounding factors including age, sex, marital
status, education, occupation, income, physical diseases, psychosocial factors, sleep disturbances, and health risk behaviors.
This study shows that long working hours may have a negative effect on cognitive performance in middle age.
Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social
relationships on health. Prospective studies, which control for baseline health status, consistently show increased risk of
death among persons with a low quantity, and sometimes low quality, of social relationships. Experimental and quasi-experimental
studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying
causes. The mechanisms through which social relationships affect health and the factors that promote or inhibit the development
and maintenance of social relationships remain to be explored.
A hypothesized need to form and maintain strong, stable interpersonal relationships is evaluated in light of the empirical literature. The need is for frequent, nonaversive interactions within an ongoing relational bond. Consistent with the belongingness hypothesis, people form social attachments readily under most conditions and resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes. Lack of attachments is linked to a variety of ill effects on health, adjustment, and well-being. Other evidence, such as that concerning satiation, substitution, and behavioral consequences, is likewise consistent with the hypothesized motivation. Several seeming counterexamples turned out not to disconfirm the hypothesis. Existing evidence supports the hypothesis that the need to belong is a powerful, fundamental, and extremely pervasive motivation.
Ecological studies have been evaluated in epidemiological contexts in terms of the "ecological fallacy." Although the empirical evidence for a lack of comparability between correlations derived from ecological- and individual-level analyses is compelling, the conceptual meaning of the ecological fallacy remains problematic. This paper argues that issues in cross-level inference can be usefully conceptualized as validity problems, problems not peculiar to ecological-level analyses. Such an approach increases the recognition of both potential inference problems in individual-level studies and the unique contributions of ecological variables. This, in turn, expands the terrain for the location of causes for disease and interventions to improve the public's health.
This article examines gender differences in psychological distress by assessing men's and women's experience of daily stressors and psychological distress in a sample of 166 married couples. Respondents completed a structured daily diary each day over the course of 42 days. Results showed that women reported a higher prevalence of high distress days and a lower prevalence of distress-free days than men. Gender differences in daily distress were attributable largely to women experiencing more onsets of distress episodes rather than being more likely to continue in a distress state from one day to subsequent days. Results from hierarchical linear models (HLM) indicated that the significant gender differences diminished after respondents' daily stressors were taken into account. Implications of these findings for gender role and rumination theories are discussed.
The objective of this study was to determine the risk for various causes of posttrial death associated with vacation frequency during the Multiple Risk Factor Intervention Trial (MRFIT).
Middle-aged men at high risk for coronary heart disease (CHD) were recruited for the MRFIT. As part of the questionnaires administered during the first five annual visits, men were asked whether they had had a vacation during the past year. For trial survivors (N = 12,338), the frequency of these annual vacations during the trial were used in a prospective analysis of posttrial all-cause and cause-specific mortality during the 9-year follow-up period.
The relative risk (RR) associated with more annual vacations during the trial was 0.83 (95% confidence interval [CI], 0.71-0.97) for all-cause mortality during the 9-year follow-up period. For cause of death, the RRs were 0.71 (95% CI, 0.58-0.89) and 0.98 (95% CI, 0.78-1.23) for cardiovascular and noncardiovascular causes, respectively. The RR was 0.68 (95% CI, 0.53-0.88) for CHD (including acute myocardial infarction). These associations remained when statistical adjustments were made for possible confounding variables, including baseline characteristics (eg, income), MRFIT group assignment, and occurrence of a nonfatal cardiovascular event during the trial.
The frequency of annual vacations by middle-aged men at high risk for CHD is associated with a reduced risk of all-cause mortality and, more specifically, mortality attributed to CHD. Vacationing may be good for your health.
Data from prescribing physicians were used to assess whether serotonergic antidepressants were used for appropriate indications and at appropriate initial dosages.
Data were derived from the confidential logs of psychiatrists and primary care physicians who provided prescription information from January 1, 1997, through June 30, 1999, as part of the National Disease and Therapeutic Index physician survey. The survey is not affiliated with a reimbursement system and therefore minimizes bias related to reimbursement. Data on the primary reason for use and the dosage at the time of first use were obtained for prescriptions of citalopram, fluoxetine, paroxetine, sertraline, venlafaxine, and extended-release venlafaxine.
Depressive disorders accounted for the majority of the 3,206 prescriptions for the six antidepressants (74 percent to 86.2 percent). The next most common indications for use were anxiety (4.1 percent to 12.6 percent) and obsessive-compulsive disorder (1.3 percent to 3.3 percent). For patients with depressive disorders, psychiatrists prescribed slightly higher antidepressant dosages than primary care physicians.
Serotonergic antidepressants are used primarily for the treatment of depression and depression-related disorders and are prescribed at the recommended starting dosages.
Survey data from 95 women with Stage 1 (n = 36), Stage 2 (n = 49), or Stage 3 (n = 10) breast cancer both confirm and extend prior research indicating that restriction of normal activities is an important factor in depressed affect. Illness severity was directly related to more restricted routine activities, and more activity restriction was associated with higher public self-consciousness and less social support. Beyond the effects of age, self-consciousness, illness severity, and social support, activity restriction explained significant additional variance in symptoms of depression. Moreover, activity restriction mediated the impact of pain, public self-consciousness, and social support on depressed affect, which implies that these factors foster symptoms of depression by disrupting normal activities.
This article examines gender differences in psychological distress by assessing men's and women's experience of daily stressors and psychological distress in a sample of 166 married couples. Respondents completed a structured daily diary each day over the course of 42 days. Results showed that women reported a higher prevalence of high distress days and a lower prevalence of distress-free days than men. Gender differences in daily distress were attributable largely to women experiencing more onsets of distress episodes rather than being more likely to continue in a distress state from one day to subsequent days. Results from hierarchical linear models (HLM) indicated that the significant gender differences diminished after respondents' daily stressors were taken into account. Implications of these findings for gender role and rumination theories are discussed.
Social interaction is among the most frequently reported reasons for participation in leisure. However, little is known about the nature of social interaction processes in leisure settings and whether these are different than those occurring in non-leisure contexts (or if they vary in different leisure contexts). This paper examines the potential contributions of social exchange theory to the study of leisure behaviour, and presents the results of an exploratory investigation which utilized social exchange theory to examine resource exchange occurring in both leisure and non-leisure settings. Overall differences in perceptions about resource exchange in leisure and non-leisure contexts existed among respondents, and males and females had different perceptions of the resource exchange occurring in a leisure setting. The results suggest that social exchange theory provides a promising means to develop further understanding of the social aspects of leisure behaviour and, in turn, assist the continuing formulation of leisure theory through integration with other theoretical approaches.
A quantitative and qualitative review of existing literature on working hours and health was carried out. Meta-analyses were performed on 21 study samples. Results indicated small, but significant positive mean correlations between overall health symptoms, physiological and psychological health symptoms, and hours of work. Qualitative analysis of 12 other studies supported these findings of a positive relationship between hours of work and ill-health. Different factors which may obscure the relationship between health and hours of work are discussed, together with other moderating influences. Taking these into account it is proposed that the results of the meta-analyses together with the qualitative analysis offer support for a link between hours of work and ill-health.
This study explores the unique interplay of family vacation travel, family cohesion, and family communication through a sample of 265 family travelers. The results reveal that family vacation contributes positively to family bonding, communication and solidarity. Family interaction styles differ during the family leisure travel process. Two types of families are identified differing on the dimension of cohesion, corresponding to separated and connected families. Three types of families are identified differing on the dimension of adaptation, corresponding to flexible, confused and structured families. This research represents an attempt to use a unique theoretical framework to empirically assess family functioning in the leisure travel setting.
Many children live in families where one or both parents work evenings, nights, or weekends. Do these work schedules affect family relationships or well-being? Using cross-sectional survey data from dual-earner Canadian families (N= 4,306) with children aged 2 – 11 years (N= 6,156), we compared families where parents worked standard weekday times with those where parents worked nonstandard schedules. Parents working nonstandard schedules reported worse family functioning, more depressive symptoms, and less effective parenting. Their children were also more likely to have social and emotional difficulties, and these associations were partially mediated through family relationships and parent well-being. For some families, work in the 24-hour economy may strain the well-being of parents and children.
Given that holidays both reflect a society's attributes and serve to modify these attributes, they are a valuable tool for a macro-sociological analysis. This paper proceeds by examining Durkheim's well-known contributions on rituals and advancing theoretical ideas on how these might be modified, seeking to develop a theory of holidays. The article concerns the role of holidays in managing tensions and recommitment to values; their role in relating communities to the society at large; their effect on gender roles, and the theoretical issues concerning holiday cycles and holiday-engineering efforts by religious authorities and states that have endeavored to adapt holidays for their own purpose. The article relies on public accounts, personal observations, and findings culled from a few studies by contemporary social scientists.
Behavioral activation (BA), as a stand-alone treatment for depression, began as a behavior therapy treatment condition in a component analysis study of the Beck, Rush, Shaw, and Emery version of cognitive therapy. BA attempts to help depressed people reengage in their lives through focused activation strategies. These strategies counter patterns of avoidance, withdrawal, and inactivity that may exacerbate depressive episodes by generating additional secondary problems in individuals' lives. BA is designed to help individuals approach and access sources of positive reinforcement in their lives, which can serve a natural antidepressant function. Our purpose in this article is to describe BA and the history of its development.
Constraint of restorative activities prolongs chronic stress and may exacerbate depressive symptoms. Treating unseasonable weather as an ecological constraint on restorative activities in outdoor settings, we investigated the relationship between cold summer temperatures and the dispensation of selective serotonin reuptake inhibitors (SSRIs) in Sweden. We obtained nationally aggregated data on defined daily doses of SSRIs dispensed monthly from 1991 through 1998. We analyzed the data using autoregressive, integrated, moving average time-series modeling methods. Dispensation of SSRIs correlated negatively with monthly mean temperature for July, the peak vacation period. The association held for both men and women, net of trends, seasonality, and other statistical controls. The constrained restoration hypothesis augments response style, restricted activity and seasonality explanations for depression. The study provides a novel perspective on green spaces and other outdoor settings as mental health resources.
A group of individuals behaves as a population system when patterns of connections among individuals influence population health outcomes. Epidemiology usually treats populations as collections of independent individuals rather than as systems of interacting individuals. An appropriate theoretical structure, which includes the determinants of connections among individuals, is needed to develop a "population system epidemiology." Infection transmission models and sufficient-component cause models provide contrasting templates for the needed theoretical structure. Sufficient-component cause models focus on joint effects of multiple exposures in individuals. They handle time and interactions between individuals in the definition of variables and assume that populations are the sum of their individuals. Transmission models, in contrast, model interactions among individuals over time. Their nonlinear structure means that population risks are not simply the sum of individual risks. The theoretical base for "population system epidemiology" should integrate both approaches. It should model joint effects of multiple exposures in individuals as time related processes while incorporating the determinants and effects of interactions among individuals. Recent advances in G-estimation and discrete individual transmission model formulation provide opportunities for such integration.
Most organisms (including humans) developed daily rhythms in almost every aspect of their body. It is not surprising that rhythms are also related to affect in health and disease. In the present review we present data that demonstrate the evidence for significant interactions between circadian rhythms and affect from both human studies and animal models research. A number of lines of evidence obtained from human and from animal models research clearly demonstrate relationships between depression and circadian rhythms including (1) daily patterns of depression; (2) seasonal affective disorder; (3) connections between circadian clock genes and depression; (4) relationship between sleep disorders and depression; (5) the antidepressant effect of sleep deprivation; (6) the antidepressant effect of bright light exposure; and (7) the effects of antidepressant drugs on sleep and circadian rhythms. The integration of data suggests that the relationships between the circadian system and depression are well established but the underlying biology of the interactions is far from being understood. We suggest that an important factor hindering research into the underlying mechanisms is the lack of good animal models and we propose that additional efforts in that area should be made. One step in that direction could be the attempt to develop models utilizing diurnal animals which might have a better homology to humans with regard to their circadian rhythms. This article is part of a Special Issue entitled 'Anxiety and Depression'.
Aetiology confronts two distinct issues: the determinants of individual cases, and the determinants of incidence rate. If exposure to a necessary agent is homogeneous within a population, then case/ control and cohort methods will fail to detect it: they will only identify markers of susceptibility. The corresponding strategies in control are the 'high-risk' approach, which seeks to protect susceptible individuals, and the population approach, wich seeks to control the causes of incidence. The two approaches are not usually in competition, but the prior concern should always be to discover and conttrol the causes of incidence.
Description:
The American College of Physicians developed this guideline to present the available evidence on the pharmacologic management of the acute, continuation, and maintenance phases of major depressive disorder; dysthymia; subsyndromal depression; and accompanying symptoms, such as anxiety, insomnia, or neurovegetative symptoms, by using second-generation antidepressants.
Methods:
Published literature on this topic was identified by using MEDLINE, EMBASE, PsychLit, the Cochrane Central Register of Controlled Trials, and International Pharmaceutical Abstracts from 1980 to April 2007. Searches were limited to English-language studies in adults older than 19 years of age. Keywords for search included terms for depressive disorders and 12 specific second-generation antidepressants-bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine-and their specific trade names. This guideline grades the evidence and recommendations by using the American College of Physicians clinical practice guidelines grading system. RECOMMENDATION 1: The American College of Physicians recommends that when clinicians choose pharmacologic therapy to treat patients with acute major depression, they select second-generation antidepressants on the basis of adverse effect profiles, cost, and patient preferences (Grade: strong recommendation; moderate-quality evidence). RECOMMENDATION 2: The American College of Physicians recommends that clinicians assess patient status, therapeutic response, and adverse effects of antidepressant therapy on a regular basis beginning within 1 to 2 weeks of initiation of therapy (Grade: strong recommendation; moderate-quality evidence). RECOMMENDATION 3: The American College of Physicians recommends that clinicians modify treatment if the patient does not have an adequate response to pharmacotherapy within 6 to 8 weeks of the initiation of therapy for major depressive disorder (Grade: strong recommendation; moderate-quality evidence). RECOMMENDATION 4: The American College of Physicians recommends that clinicians continue treatment for 4 to 9 months after a satisfactory response in patients with a first episode of major depressive disorder. For patients who have had 2 or more episodes of depression, an even longer duration of therapy may be beneficial (Grade: strong recommendation; moderate-quality evidence).
This article reports on interrelationships between the medical and emotional health of 95 men who were prospectively followed from age 18 to 53. Fifty of these originally healthy men developed illness patterns sometimes called psychosomatic (ulcer, colitis, allergy, hypertension, musculo-skeletal disorders). These men were compared with the other 45 similarly studied men who never developed such illnesses. Although men who developed "psychosomatic" illnesses were more likely to seek medical or psychiatric attention, they exhibited only slightly more psychopathology. Both as children and as adults they had more physical illness of all kinds. They were less likely to indulge in vacations and athletics and more likely to use tranquilizers and excessive alcohol. Men with "psychosomatic" illnesses experienced a greater variety of somatic symptoms under stress, but the loci of these somatic symptoms shifted over time and were not significantly associated with the sites of psychosomatic illness. Premorbidly, the 20 men who were eventually to develop serious irreversible physical illness of any kind reflected far more psychopathology than the 45 men who developed psychosomatic illness.
This study investigates the relation of psychosocial variables to the 20-year incidence of myocardial infarction or coronary death among women in the Framingham Study. In 1965-1967, a psychosocial interview was given along with the collection of other coronary risk factor data. This study includes 749 women aged 45-64 years who were free of coronary disease at this baseline examination. Demographic variables, psychosocial scales (such as tension and reactions of anger), and individual interview items (such as attitudes toward children, money, and religion) were measured. When age, systolic blood pressure, the ratio of serum total cholesterol to high-density lipoprotein cholesterol, diabetes, cigarette smoking, and body mass index were controlled for in multivariate proportional hazards models, the predictors of the 20-year incidence of myocardial infarction or coronary death were as follows: among employed women, perceived financial status only; among homemakers, symptoms of tension and anxiety, being lonely during the day, difficulty falling asleep, infrequent vacations, housework affecting health, and believing one is prone to heart disease (p less than 0.05 for all variables); and among both groups of women combined, low educational level, tension, and lack of vacations. These results are discussed in relation to previous findings from the Framingham Study.
Catalano, R. (Public Policy Research Organization, U. of California, Irvine, CA 92717) and S. Serxner. Time-series designs of potential interest to epidemiologists. Am J Epidemiol 1987; 126:724–31.
Recent developments in time-series designs that may be useful in epidemiology are described. The hypothesis that increased employment affects the rate of accidental injuries per worker month among manufacturing workers is tested to demonstrate the methods. Results suggest that increased employment increased the monthly rate of accidental injuries in San Diego and Los Angeles Counties in the 11-year period 1974 through 1984.
Over the last several decades, epidemiological studies have been enormously successful in identifying risk factors for major diseases. However, most of this research has focused attention on risk factors that are relatively proximal causes of disease such as diet, cholesterol level, exercise and the like. We question the emphasis on such individually-based risk factors and argue that greater attention must be paid to basic social conditions if health reform is to have its maximum effect in the time ahead. There are two reasons for this claim. First we argue that individually-based risk factors must be contextualized, by examining what puts people at risk of risks, if we are to craft effective interventions and improve the nation's health. Second, we argue that social factors such as socioeconomic status and social support are likely "fundamental causes" of disease that, because they embody access to important resources, affect multiple disease outcomes through multiple mechanisms, and consequently maintain an association with disease even when intervening mechanisms change. Without careful attention to these possibilities, we run the risk of imposing individually-based intervention strategies that are ineffective and of missing opportunities to adopt broad-based societal interventions that could produce substantial health benefits for our citizens.
The utility of ecological studies is considered in terms of the salience of their designs and is exemplified in four levels: obligate and apt; optional and apt; optional, not apt but convenient; and maladroit (neither obligate, apt, nor justifiable by convenience). Ecological studies are obligate when they are the only choice available, either because of the question asked (as in testing differences between groups and discovering group effects), or where there are "dependent happenings" (as in transactions involving more than one individual), or because individual data are lacking. Apt studies are logically appropriate; analysis and results are not extrapolated beyond necessity or without precautions. Obligate studies enforced by lack of individual data may be apt or less than apt. Optional ecological studies may be apt or, if less than apt, they may yet be convenient. Maladroit studies are neither obligate, apt, nor convenient. Each class of study is illustrated by examples ordered according to a standard design hierarchy.
As employment of different dose standards would be impractical and confusing, the aim of this article is to compare the define daily dose (DDD) with some more recently proposed standards, namely, the minimum marketed dose (MMD), the equipotential dose (ED), the average daily dose (ADD), and the non-standard prescribed daily dose (PDD).
Literature review, critical comparative analysis.
The DDD, defined by an independent scientific committee assisting the WHO Collaborating Centre for Drugs Statistics Methodology, has been employed in a large number of national and international comparative studies at the population level, usually as number of DDDs per 1000 inhabitants per day. However, the DDD can also be used at the individual level. The PDD, not being a standard unit, can be appropriately used in a second step to explain differences detected by the DDD methodology.
A globally accepted dose standard unit is important in drug utilisation studies, particularly if different investigations are to be compared. None of the alternatives seemed to offer any advantage over the DDD. Hence there is reason to advocate use of the DDD as the sole standard dose unit in all pharmacoepidemiologic studies.
Physical disease is commonly considered a risk factor for depression among older adults. However, this pattern is not consistently supported, and a theoretical framework for understanding such a relationship has not been articulated. P.M. Lewinsohn, H. Hoberman, L. Teri, and M. Hautzinger's (1985) integrative model of depression predicts that disease will be a risk factor for depression only when disease results in functional impairment, and that impairment in the absence of disease is also a risk factor for depression. The authors tested these predictions in a community-based sample of older adults followed longitudinally and found that functional impairment was a significant risk factor for depression, regardless of disease status. Disease was not a significant predictor of major depression, nor did it interact with impairment to predict depression.
Female labor force participation has increased considerably, but women's traditional responsibility for home and family has not changed accordingly. Although women's employment per se does not seem to have negative health consequences, studies show that stress from role conflicts and work overload is reflected in women's elevated psychophysiological arousal not only at work but also off work, which may induce psychosomatic symptoms (e.g., cardiovascular and musculoskeletal disorders). In addition, multiple role demands reduce women's possibilities to make a professional career on the same terms as men. Data emphasize the need for a new allocation of work functions between the sexes and the need for organizational changes leading to more influence and control over work to make it possible for both men and women to combine a qualified job with a meaningful family life.
Survey data from 95 women with Stage 1 (n = 36), Stage 2 (n = 49), or Stage 3 (n = 10) breast cancer both confirm and extend prior research indicating that restriction of normal activities is an important factor in depressed affect. Illness severity was directly related to more restricted routine activities, and more activity restriction was associated with higher public self-consciousness and less social support. Beyond the effects of age, self-consciousness, illness severity, and social support, activity restriction explained significant additional variance in symptoms of depression. Moreover, activity restriction mediated the impact of pain, public self-consciousness, and social support on depressed affect, which implies that these factors foster symptoms of depression by disrupting normal activities.
It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.
Aetiology confronts two distinct issues: the determinants of individual cases, and the determinants of incidence rate. If exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it: they will only identify markers of susceptibility. The corresponding strategies in control are the 'high-risk' approach, which seeks to protect susceptible individuals, and the population approach, which seeks to control the causes of incidence. The two approaches are not usually in competition, but the prior concern should always be to discover and control the causes of incidence.