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             (also see published version)

About Psychology:

•   Psychology Primer: What is a Psychologist
•   Psychology Primer: The Romanow Commission
•   Psychology Primer: A New Role in the Health of Nova Scotians
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Recent Releases:

•   APA'S Stress in America Survey Indicates Financial Concerns Top Stressors
• H1N1: Waiting and Wathing
•   APA Survey shows holiday stress putting women's     health at risk
• 2009 - Organizations Receive Psychologically Health Workplace Awards
•   High Stress Looms across the Border
  Stress a Major Health Problem in the U.S., Warns APA
•   Virginia Tech tragedy may touch close to home
  

APA'S STRESS IN AMERICA SURVEY INDICATES

FINANCIAL CONCERNS TOP STRESSORS

As the Holidays near and national unemployment levels push higher, the American Psychological Association’s (APA) newest Stress in America survey finds that Americans continue to cite financial concerns as leading sources of stress.

Approximately seven in ten Americans report that money is a significant source of stress (71 percent), according to APA’s 2009 Stress in America survey, with similarly high percentages reporting stress resulting from work (69 percent) and the economy (63 percent). More than half of adults (55 percent) also cited family responsibilities as a significant source of stress in their lives.

“According to our survey three quarters of adults in this country already report moderate to high levels of stress,” says psychologist Katherine Nordal, PhD, APA’s executive director for professional practice. “The holiday season can bring with it additional emotional and financial stressors that can negatively impact both physical and mental health.”

Psychologists urge parents to pay particular attention to the stress their children may experience during the holidays. APA’s Stress in America survey found that children are nearly two times more likely to worry about financial concerns than their parents realize. Specifically, 30 percent of youth say they worry about their family having enough money, while only 18 percent of parents report that this is a source of stress for their child.

“While the holidays are stressful for many people, there are some things we can all do to manage that stress and enjoy the season,” says Dr. Nordal. “Given the concerns our young people are reporting about stress and money, parents need to be good models for managing stress in healthy ways.”


APA suggests the following strategies to manage holiday stress and enjoy the season:

Take time for yourself. Taking care of yourself helps you to take better care of others in your life. Go for a long walk or take time out to read or listen to your favorite music. By slowing down you will actually have more energy to accomplish your goals.

Volunteer. Many charitable organizations face new challenges as a result of the ongoing economic downturn. Find a local charity, such as a soup kitchen or a shelter, where you and your family can volunteer together. Helping others who are less fortunate can put hardships in perspective and can build stronger family relationships.

Set realistic expectations. No holiday celebration is perfect; view inevitable missteps as opportunities to demonstrate flexibility and resilience. Create a realistic budget and remind your children that the holidays aren’t about expensive gifts.

Remember what’s important. Commercialism can overshadow the true sentiment of the holiday season. When your holiday expense list is running longer than your monthly budget, scale back. Remind yourself that family, friends and the relationships in our lives are what matter most.

Seek support. Talk about stress related to the holidays with your friends and family. Getting things out in the open can help you navigate your feelings and work toward a solution. If you continue to feel overwhelmed, consider talking with a professional such as a psychologist to help you develop coping strategies and better manage your stress. A psychologist has the skills and professional training to help people learn to manage stress and cope more effectively with life problems, using techniques based on best available research and their clinical skills and experience, and taking into account an individual’s unique values, goals and circumstances. Psychologists have doctoral degrees and are licensed by the state in which they practice. They receive one of the highest levels of education of all health care professionals, spending an average of seven years in education and training after they receive their undergraduate degrees.

Stress in America is part of APA’s Mind/Body Health public education campaign. For additional information on stress and lifestyle and behavior, visit www.apahelpcenter.org, read the campaign blog www.yourmindyourbody.org, and follow @apahelpcenter on Twitter.

Methodology
The 2009 Stress in America Survey was conducted online within the United States by Harris Interactive on behalf of the American Psychological Association, between July 21, 2009 and August 4, 2009 among 1,568 adults aged 18+ who reside in the U.S. This report also includes the results of a YouthQuery survey conducted between August 19 and 27, 2009 among 1,206 young people aged 8-17 years old. Results were weighted as needed for age, sex, race/ethnicity, education, region, and household income. Propensity score weighting was also used to adjust for respondents’ propensity to be online. No estimates of theoretical sampling error can be calculated; a full methodology is available.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 150,000 researchers, educators, clinicians, consultants, and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession, and as a means of promoting health, education, and human welfare.

Harris Interactive is a global leader in custom market research. With a long and rich history in multimodal research that is powered by our science and technology, Harris Interactive assists clients in achieving business results. Harris Interactive serves clients globally through its North American, European, and Asian offices and a network of independent market research firms. For more information, please visit www.harrisinteractive.com.

H1N1: Watching and Waiting

by Charles Hayes, Ph.D.

News media around the world are tracking the numbers of people who have contracted swine flu and those unfortunate enough to succumbed to it. Signs are everywhere that health officials are taking the outbreak of this flu much more seriously than the typical seasonal flu.

This article is written to serve two purposes. The first is to acquaint the Community of Psychologists with current information about the swine flu pandemic. The second is to prepare for a role that psychologists may play should the pandemic become more incapacitating.

The World Health Organization (WHO) determined that the current outbreak of Swine flu has become a pandemic. Their decision is based solely on the spread of the disease and not on its severity. The US Centers for Disease Control and Prevention (CDC) state the current swine flu is a novel H1N1 flu variant.

It seems that this swine flu is particularly virulent. It is not known how it began. The CDC confirmed two cases in the USA on April 21, 2009. Both cases were children living in California, but not in contact with one another or with swine. Mexican authorities had informed WHO that they had 18 patients demonstrating influenza-like illnesses in March. The numbers of people with such symptoms increased steadily through April. By May 1, 2009 the novel H1N1 influenza had been confirmed in the UK, US, Canada, Spain, Germany and Mexico with these countries also confirming secondary transmission. By June 26, 2009 swine flu had been confirmed in 75 countries around the world with related deaths reported in 13 of these countries. (For a dramatic graph outlining the spread of swine flu see:

http://news.bbc.co.uk/2/hi/uk_news/8083179.stm .

The symptoms of novel H1N1 are reported to be similar to seasonal flu and include fever, cough, sore throat, stuffed or runny nose, body ache, headache, chills, and fatigue. Some people who are infected also report vomiting and diarrhoea.

The CDC in Atlanta, Georgia reports that with seasonal flu certain people are at higher risk of serious flu-related complications. The list typically includes people 65 years of age and older, children younger than five years of age, pregnant women, and people of any age who may be medically compromised. The early indications are that pregnancy and certain diseases commonly associated with increased risk of complications from flu such as asthma and diabetes, also appear to be associated with increased risk in novel H1N1 as well.

There is an expected rate of mortality associated with seasonal influenzas. For example, the CDC reports that every year in the United States on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years of age. Over 90 percent of deaths and 60 percent of hospitalizations occur in people older than 65.

As of June 26, 2009 the US has confirmed 21,449 cases of swine flu with 87 deaths associated with it. The number of people in the US suspected of having the swine flu currently is one million people.

CDC reports that few children and adults younger than 60 years of age have existing antibody to novel H1N1 flu virus. Approximately 1/3 of people over 60 years of age may have antibodies against this virus. There appear to be some differences in susceptibility with novel H1N1 in that people older than 64 years do not yet appear to be at increased risk.

So far with novel H1N1 the largest numbers of confirmed and probable cases have occurred in people between the ages of 5 and 24 years of age. This statistic is reminiscent of the reported findings with the 1918 Spanish flu: also an H1N1 influenza. Another similarity is the susceptibility of our aboriginal peoples. For example, consider that Nunavut reported more laboratory-confirmed cases of H1N1 influenza virus on June 24, 2009 than did British Columbia, or the Atlantic provinces. For Canadian information see the Public Health Agency of Canada (PHAC) website at:

http://www.phac-aspc.gc.ca/alert-alerte/swine_200904-eng.php

It is likely that novel H1N1 is spread by the same mechanisms as is seasonal flu. Studies with seasonal flu indicate that people may be contagious from one day before developing symptoms and up to 7 days afterwards. Children, especially younger children, may be potentially contagious for longer periods.

The spread of novel H1N1 virus is thought to occur in the same way that seasonal flu spreads, thus the precautions are the same. Most jurisdictions, including that of Nova Scotia, have focused on containment. In Nova Scotia the responsibility for monitoring and practice protocols lies with the N.S. Department of Health (DoH). Spread is primarily from airborne contagion from sneezing and coughing from those infected. People are advised to ensure they cough into a tissue or even their arm. Contagion may also come from touching something that has flu viruses on it and then from touching one's eye, mouth or nose. Thus people are being asked to try not to touch their noses, mouths or eyes. Hand alcohol based lotions are also being used in an attempt to contain the outbreak of novel H1N1.

The first line of defence has been voluntary. Those people who believe that they have the flu are encouraged to stay at home until they are symptom free. Such advice is sensible and practical. However, there is no way of enforcing it. In fact, a recent newspaper article featured a couple with swine flu at their wedding ceremony. They were advised to wear a face mask and to stay 10 feet away from the wedding guests. Thus, it is not hard to imagine others believing that it is not all that important to stay home.

Any voluntary stay-at-home condition will be in jeopardy if wages will be cut because the individual stays at home. One of the reasons Severe Acute Respiratory Syndrome (SARS) became so difficult to control in Canada was thought to be because some ill people refused to stay home when it affected their wages, thereby continuing the human to human chain of infection.

People with flu-like symptoms should wear facial masks and attempt to keep separated from others until asymptomatic. The ill person should be encouraged to wash hands frequently and follow respiratory hygiene practices. Hand washing should be thorough and it is recommended that hand washing continue for as long as it takes to sing Happy Birthday twice. Hands should be dried thoroughly. See the WHO site for techniques of hand washing. It is recommended that any one suspected of having swine influenza should be administered empiric antiviral treatment.

Federal Health officials are warning should the Swine flu outbreak continue to grow then expect that there could be widespread closures of public services like grocery and other stores, schools, and businesses. Presumably they envision something similar to what happened recently in Mexico City. Thus, people are being advised to stock pile foodstuffs, medications, etc. that may be needed but difficult to obtain if there is a widespread shut down of services.

The Spanish flu became alarmingly deadly when it returned in September. The second was a killer. Consider, in all, nearly 50,000 Canadians died in the 1918 outbreak. The effect was worldwide. The 1918 H1N1 influenza returned in a third wave, which was not as deadly as the second, but the death toll was still in the millions. All told the 1918 estimates suggest that as many as 100 million people died as a result of influenza related illness worldwide. Then the population was estimated to be 1.8 billion. In other words, the death toll was roughly 5 percent of the world's population in less than one calendar year.

The 1918 influenza seemed to aggressively target healthy young adults, between the ages of eighteen and forty, mainly because their strong immune systems vigorously overreacted – a so-called cytokine storm – and killed them, often within a day. This occurs when cytokine cells activate immune cells at the site of infection causing more and more immune cells to come to the infection site. If this occurs in the lungs it may cause damage sufficient to impair the lungs resulting in death.

Given that the world's current population is much larger now, it is conceivable that the novel H1N1 influenza could result in as many as 350 million deaths worldwide should it mimic the 1918 pandemic with more deadly subsequent waves. See: http://www.walrusmagazine.com/articles/2006.02-health-pandemic-fear/ .

The Government of Canada has been preparing large amounts of H1N1 specific antiviral medications such as Oseltamivir (Tamiflu) for use. Fortunately novel H1N1 is susceptible to it and to Zanamivir (Relenza). The Canadian and the US governments are also preparing influenza vaccines, which should be available in the fall. The antivirals are to be used only for those with influenza-like illness. All Canadians, even those that were previously infected with the novel H1N1 influenza but are now healthy, should be vaccinated in the fall. The vaccination is recommended since influenza viruses rapidly mutate.

The organizers of the DoH response feel that there is no role required for psychologists not employed in the Health system. However, it should be pointed out, vigorously, that the current novel H1N1 pandemic is continuing to infect people during summer, at the time when UV light helps destroys flu viruses. There is a possibility that the containment response could fail since it has already failed in the midlands city of Birmingham in Britain. Health officials there are moving to a mitigation phase.

The Canadian Psychological Association (CPA) has been active along with other interested groups in trying to offset the possible surge effect often seen when people are faced with overwhelming trauma such as was seen in Hurricane Katrina or even in the Swiss Air 111 recovery. You may wish to access the CPA website for current information on precautions to use in this pandemic.

The Post-Trauma Services Committee of the Association of Psychologists of Nova Scotia (APNS) believes that psychologists could be of help in a pandemic. It seems plausible that civic authorities and services will quickly be overrun and overwhelmed.

From a psychological point of view it is well-known that many more people are affected psychologically than are affected physically whenever large scale traumatic events occur. There is a recognized need to deal with these victims as well as those with physical injuries since surges of people can occur at treatment sites causing disruption and chaos. It is conceivable that the same may occur should a large number of deaths associated with novel H1N1 should occur as happened in the 1918 Spanish influenza.

It is known from trauma research that some people are more vulnerable for psychological reactivity to the threat of novel H1N1 than others. Those who may have an increased likelihood of developing an adverse reaction to the threat are those people who tend to worry excessively about their health, or who have experienced a previous or recent traumatic event, who live alone, or who have few social supports.

Psychological victims will need attention. Psychologists may be amongst those who are best prepared in terms of training and experience to assist. We should be ready to help out even if the eventuality is that we are not needed.
If centres can be developed where the psychological victims are triaged and contained then the provision of good, accurate, communication about the dangers, information about the use of proper mask (for those ill) and hand-washing hygiene (for everyone) becomes truly important. Then it would make sense for psychologists and others to provide psychological first aid and related techniques to help curtail hysteria and psychological hyper-reactivity.

APA SURVEY SHOWS HOLIDAY STRESS PUTTING WOMEN’S HEALTH AT RISK

Added Holiday Stress Increases Women’s Reliance on Unhealthy Behaviors More Often than Men

Nearly half of all women in the United States experience heightened stress during the holidays at great risk to the health of their minds and bodies, according to a recent national survey released by the American Psychological Association (APA). Compared to previous surveys on stress, APA found that women are actually doing less to address the increased stress of the holiday season. Despite repeated warnings about the effects of stress on both psychological and physical health, women are relying more on unhealthy behaviors to manage stress during the holidays and the rest of the year.

Juggling work and added family responsibilities, such as planning for holiday gatherings, shopping for gifts and cooking leave most women feeling like they can’t take time to relax during the crunch to get everything done for the holidays. Survey findings show that added holiday stress, on top of already disproportionately high stress levels in women year round, makes it hard for women to relax. This increases the likelihood that they will turn to unhealthy behaviors like using food to deal with stress (41 percent) or drinking alcohol (28 percent).

“People who cope with stress by engaging in unhealthy behaviors and lifestyle, regardless of the time of year, may alleviate symptoms of stress in the short term, but end up creating significant health problems in the long run, and, ironically, more stress,” says Dean Perry, M.Sc., R.Psych, Public Education Co-ordinator, Association of Psychologists of Nova Scotia (APNS).

“Research shows that stress, and the unhealthy behaviors people use to manage it, contribute to some of our country’s biggest health problems such as obesity, heart disease and diabetes. So it’s imperative that people take steps to address issues like holiday stress in healthier ways.”

A national stress survey conducted by APA in January 2006 found that, during the year, 31 percent of women turn to food to manage stress compared to 19 percent of men. The holiday stress survey, conducted by APA in October 2006, showed that comfort eating rises by ten percent at the holidays as a source of stress relief for women (versus a six percent increase for men), indicating that holiday pressures are having an impact on women’s behaviors.


“The effectiveness with which people manage stress — especially women during the holidays, given their increased stress levels — is critical to long-term mind and body health,” says Perry. “It seems that women, in particular, view holiday stress and their ways of coping with it as a normal part of the season.” Results from the January 2006 survey show that women report stress affects them more than men do (51 percent versus 43 percent) and that women are more likely than men to report multiple stressors. The same is true during the holidays. Women (44 percent) are more likely than men (31 percent) to report an increase of stress during the holiday season, citing lack of time (69 percent versus 63 percent), lack of money (69 percent versus 55 percent), and pressure to give or get gifts (51 percent versus 42 percent) as primary stressors. While stress is an important health issue for everyone to take note of, survey findings indicate that identifying healthy strategies for managing stress is critical to the mind/body health of women.

The January 2006 survey shows that stress does have an effect on overall mind/body health. Adults who experience a great deal of stress rate their psychological and physical health lower than adults who are not experiencing stress. Women under stress are more likely than men to report that they are in fair or poor health. People very concerned with the level of stress in their lives are more likely to report a number of specific ailments and symptoms.

§   59 percent report feeling nervous or sad
§   51 percent report symptoms of fatigue
§   56 percent report inability to sleep or sleeping too much
§   55 percent report lack of interest, motivation or energy
§   46 percent report headaches
§   48 percent report muscular tension
§   32 percent report frequent upset stomach or indigestion
§   37 percent report change in appetite
§   29 percent report feeling faint or dizzy
§   26 percent report tightness in chest
§   23 percent report change in sex drive

“My advice to both men and women is to pay attention to what causes their stress and to find healthy ways of managing it. Everyone responds to their stress in some way. The key is handling stress in a manner that doesn't make things worse,” says Perry.
.
The holiday stress survey was conducted October 2-5, 2006 by Greenberg, Quinlan Rosner Research for the APA, with the objectives of exploring stress during the holidays, the causes of stress and how holiday stress differs from other times of the year, as well as what people do differently during the holiday season to manage their stress. The telephone poll reached 786 adults, 369 men and 417 women, 18 years or older and was weighted by gender, age, race and education. For tips on managing holiday stress or to learn more about stress and mind/body health, visit the American Psychological Association at www.APAhelpcenter.org.



The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

2009 - ORGANIZATIONS RECEIVE PSYCHOLOGICALLY HEALTHY WORKPLACE AWARDS

Program Rewards Employers for Creating Workplaces
That Foster Employee Health and Well-being While Enhancing Organizational Performance

Halifax, Feb. 5, 2009 – Three organizations will receive recognition from the Psychologically Healthy Workplace Award Program in Nova Scotia.

The award winners are the College of Physicians and Surgeons of Nova Scotia, Staples Contact Centre and NB Power.

The psychologically healthy workplace program honours organizations across Canada and the U.S. that show a commitment to the psychological health and well-being of their employees, create a positive work environment, and demonstrate high organizational performance.

“It always makes sense -- both common sense and business sense -- to treat employees well. In times of economic uncertainty, this type of treatment becomes increasingly important,” says Arla Day, chair of the Psychologically Healthy Workplace Committee in Nova Scotia. “We are recognizing
these organizations for their outstanding accomplishments, and sharing their best practices to inspire other companies to create healthy practices.”

When you give to your employees, they give back to the organization. And what does this “giving” to employees entail? These best practices involve basic, cost-free activities (for example, treating employees with respect, encouraging communication and feedback) to novel practices and programs, such as sponsoring corporate sports events, offering flextime, health funds, and tuition reimbursement, and providing lunch and learn series.

“Employers who understand the benefits of a workplace that is sensitive to their employees' psychological well-being will have a competitive advantage,” says Kevin Kelloway, director of the CN Centre of Occupational Health & Safety. “They can serve as models for other employers.”

The health and safety of Nova Scotia workers are critical issues, and organizations should be acknowledged for their efforts in promoting employee safety and health. The benefits of a healthy workplace include increased productivity, employee retention, recruiting advantages, enhanced company image and a better workplace atmosphere, as well as workers who are less stressed and happier.

The organizations were judged on: whether they are “family friendly” and the steps they take to reduce work stress; how they encourage employee growth and development; the extent to which theyinvolve employees in decision-making; how they recognize and support employee accomplishments
and initiatives; and the extent to which they promote physical and psychological health, safety, and wellness.

The Award Recipients:
• The College of Physicians and Surgeons of Nova Scotia is being recognized for Excellence in Developing a Psychologically Healthy Workplace. One of the site reviewers, Dr. David Mensink, noted how impressed he was by their many healthy practices, such as a health fund, flextime, and tuition reimbursement. “The atmosphere during the site visit was warm, engaging, and yet the employees were very busy and active in their work responsibilities. The overall impression is that this workplace displays a culture of excellence.”

• Staples Contact Centre (Lower Sackville) is being recognized for Excellence in Employee Involvement and Recognition. They have worked to improve communication, develop member surveys, and provide individual, group, and organization recognition awards. Debby Vincent, Senior Contact Center Manager is thrilled with the award. “To be recognized for our
Excellence in Employee Involvement & Recognition is a wonderful way to end the year. Over the 10 years that we have been open, so many of our initiatives have been a result of the great ideas contributed by employees. We are proud of the commitment of our entire team to make Staples a Great Place to Work.”

• NB Power will receive a Special Consideration Award, and is being recognized for Excellence in Employee Health & Safety. NB Power's dedication to the physical and psychological wellbeing of their employees is evident from the array of health and safety programs they offer, such as a fresh fruit program, integrated wellness services, a Healthy Workplace Plan, the HEAL program, and personal health profiles.

The awards will be handed out at a reception at The Westin Nova Scotian on Thursday, Feb. 5 from 4:30 p.m. 6:30 p.m.
For more information about the Psychologically Healthy Workplace Award, please contact:

Dr. Arla Day
(902) 420-5854
arla.day@smu.ca.