Job Satisfaction & Work Stress in the IT Industry

Work stress and low job satisfaction are the primary drivers for help-seeking in IT professionals. PR a 34-yr old software engineer employed in an IT company came to us for guidance while considering a career change. He felt stressed, and experienced his work as meaningless. He felt alienated from his colleagues and his job dissatisfaction was high.

PR’s is not a one-off case. A PPC Worldwide study reported that 62% of all employees experience work stress. Responses to a poll specifically studying IT related work stress are as depicted in the chart above.

Work stress contributes to job dissatisfaction and increased attrition in the workforce. Most burnout prevention methods focus on personal responsibility for wellness. They require sacrifice of personal time with the perverse goal of being more effective at work. We have already seen what the individual needs to do to manage stress with a health promoting lifestyle,  Even 15 minutes of exercise is effective. We now need to look at the organisational factors resulting in committed employees.

Job satisfaction involves certain obligations that exist in an employment relationship. Pay is largely considered to be the single-most contributor to job satisfaction, and perceptions of fairness in compensation have a direct influence on commitment to the organisation. However, intrinsic motivators contribute greatly to resistance to work stress. These include

Nature of work

Nature of work is an intrinsic motivator measured by an individual’s feeling that their job is meaningful. They feel engagement, and a sense of pride in the job. Humiliation at work does not foster this sense of engagement. For many of our clients humiliation is a prime driver to distress and burnout.

RK came to us when he was thinking of quitting his job. He had been 'de-promoted' into his own team when they were unable to meet a target. His self-esteem was low and he was depressed. He recovered with treatment and counselling. He could then decide his next career move from a position of strength.

Relationship with co-workers

Work plays an important part in fulfilling an individual’s social needs. Co-worker acceptance and a sense of belonging to a group and culture affect job satisfaction. Unfortunately the culture in many IT organisations continues to reflect the ‘in’ and ‘out’ groupings of the college hostels through which their managers have emerged. This only adds to the job dissatisfaction of IT professionals who may be contributing at their jobs but do not feel a part of the organisation.

The motivated and stress tolerant employee shows commitment to the organisation in two ways

1. Emotional
 Job dissatisfaction is inversely associated with emotional commitment. IT professionals who are satisfied feel more emotionally attached to and involved with their organisations.
2. Obligational
Job satisfaction is associated with feeling more obliged to remain with the organisation.
3. Continuance
Continuance commitment (cost associated with leaving the company) is not related to job satisfaction; pay does not matter disproportionately to the IT professional.

Work stress and work pressure are correlated with job dissatisfaction and poor employee engagement. The IT professional’s decision to stay with the company due to feelings of attachment and obligation results from job satisfaction rather than the costs associated with leaving the company. A working atmosphere that validates the individual and their differences will enhance that attachment and commitment to the organisation.

References

1. E.J. Lumley, M. Coetzee, R. Tladinyane, N. Ferreira. Exploring the job satisfaction and organisational commitment of employees in the information technology environment. Southern African Business Review Volume 15 Number 1 2011.
2. Kaluzniacky, Eugene. Stress Management. In: Managing psychological factors in information systems work : an orientation to emotional intelligence. Idea Group. London, 2004. Pg238-245.
3. Psychol Rep. 2009 Dec;105(3 Pt 1):759-70. Employee engagement and job satisfaction in the information technology industry. Kamalanabhan TJ, Sai LP, Mayuri D.
4. Saradha.H. Employee engagement in relation to organizational citizenship behaviour in information technology organizations. Submitted in partial fulfillment of the requirements for the degree of Master of Philosophy. Institute of Management, Christ University, Bangalore. 2010.

Conduct Disorder and Behaviour Problems in Children



 

Conduct disorder and behaviour problems in children make the news when a 5-year old or a grandmother is killed while extorting money. Aggression in children  is just one of the offenses associated with conduct disorders . The seemingly lesser offenses of stealing in thousands from the home, or smoking 'weed' with their friends, pale in contrast. At the lowest end of the spectrum are those children who repeatedly confront authority in school or at home. Dubbed as 'monster kids' these children are viewed indulgently as being mischievous, naughty, 'bad', or 'delinquent'. Very seldom are they seen as having a mental health problem - a conduct disorder.

What is Conduct Disorder?

Behaviour problems that are persistent, violate the rights of others, go against societal norms, and disrupt family life, indicate a conduct disorder and merit psychiatric assessment. Conduct disorder is amongst the commonest childhood disorders seen in our clinic. Every one of us knows or has heard of a child with conduct disorders . Conduct disorder is characterised by the following behaviour problems .

Aggression

This child (maybe a 2 year old preschool cherub) picks fights, bullies, or physically hurts younger siblings at home. He is frequently taken to the principal's office for fighting in school. When this child enters the park the other children get ready to leave. He has often used a weapon (stick, cricket bat, stone or brick) to deliberately assault a person or hurt an animal.

Destruction of property

These children are wilfully destructive. They are the ones who scratch the paint off your new car, slash the seats of parked 2 wheelers, deface the lift, cut up a mothers dress, and tear the library book. More seriously they set fire to clothes and in extreme cases to vehicles.

Lying and deceit

These are children who steal from parents, grandparents, and classmates. They forge their parent's signature on school reports, cheques, and credit cards.They lie,  cheat and pilfer from shops.

Violation of rules

They stay out until late at night against home rules and curfews. They 'bunk' school to hang out with other antisocial friends, and run away from home overnight.

What happens to children with conduct disorder behaviours ?

Most parents feel a child will outgrow behaviour problems and conduct disorders .  However studies show this is not so. If not addressed and treated, children with conduct disorders are suspended from school, and have brushes with the law. Half of these children also have ADHD (Attention Deficit Hyperactivity Disorder) which further impacts their schooling. Broken relationships and marriages, and substance abuse including alcohol and cannabis abuse are common. As adults children with behaviour problems develop antisocial personalities and lead a criminal lifestyle. In the extreme a child with conduct disorder will murder his grandmother or a hapless neighbour's toddler.

Alzheimer's caregiver techniques

Caregivers living with persons having Alzheimer's Disease face specific problem behaviours. These behavioural problems result from memory loss that is the hallmark symptom of Alzheimer's. We have previously discussed resources giving hope for dementia caregivers. Caregiver do's and dont's for mental illnesses in general have also been highlighted. Living with Alzheimer's Disease is the theme for World Alzheimer's Day 2012. In this post we specify methods to help caregivers living with persons having Alzheimer's handle problems related to memory loss and reduce the burden of  care at home.

Caregiver techniques for Alzheimer's

1. Regular routine enables basic activities of daily living for a longer period of time. Make a visual time-table and regularly remind the person with Alzheimers to consult it so it becomes a habit.
2. Keep large clocks in each room and remind them of the time at every opportunity.
3. A personalised calendar with large figures helps plan and anticipate potentially confusing events such as a festival or travel.
4. A room with a window is great for orientation. Natural daylight and dark phases maintain the sleep-wake cycle.
5. Greet at every new meeting with date and time. The date is particularly difficult for a person with Alzheimer's to learn - it changes every day -  hence the disorientation. Repetition will keep the person with Alzheimers disease current with the month and year for longer.
6. Keep familiar objects like photos, phone, books, and decorative pieces in the same place. People with Alzheimer's often have to move from one set of caregivers to another. Placing these objects in the same general positions helps them to avoid confusion and  anxiety.
7. Photographs are important visual memory pegs. Two or three frames with photographs of the caregiver families and old friends reassures the person with Alzheimer's disease and facilitates their smooth transition between caregivers.
8. An identity card is essential for every person with  Alzheimer's. It must contain an address and an emergency contact number. It should be worn at all times, even inside the  house. Your loved one can wander out of an open door and not  be able to find her way back. Reinforce and rehearse showing or consulting the identity card on being asked for address or phone number.
9. Encourage and let them do the  things they can. Don't take over every activity or your caregiver burden will increase. Prompt them when they hesitate or take time. Help them in those activities they are unable to do.

Anti-dementia drugs delay nursing home admissions for upto a year. To make home this stay meaningful and to reduce the burden of care these methods need to be used by caregivers living with Alzheimer's Disease patients.

Alzheimers disease - mild cognitive impairment countdown

Alzheimers dementia is usually diagnosed when memory loss and behavioural symptoms are readily apparent to their caregivers. At this stage the primary concern is to slow further deterioration. Caregivers at the clinic have often wished they could have looked into the future. Many have a history of Alzheimers disease in their elderly and wondered whether there was an earlier way of knowing. New knowledge gives us hope in this direction.

Alzheimers disease before memory loss

We now have the beginnings of a time line in the countdown to dementia. It is now possible to trace the beginnings of Alzheimers Dementia up to 20 years before its manifestation with memory loss and impaired function.

20

Beta-amyloid levels in the cerebrospinal fluid (CSF)  begin to drop 20 years before the onset of dementia. Alzheimer's Disease is characterized by toxic deposition of specific beta-amyloid (Aβ1-42) plaques around the brain cells. In normal aging beta-amyloid continues to increase in the brain fluid. However, in Alzheimers Dementia brain fluid beta-amyloid is markedly reduced.This is due to reduce clearance of beta-amyloid from the brain to the blood and CSF, as well as increased beta-amyloid plaque deposition in the brain.

15

15 years before dementia onset, beta-amyloid deposits can be detected by amyloid imaging PET scans. The best known amyloid PET tracer is Pittsburgh Compound-B (PIB). PIB retention is found in over 90% clinically diagnosed AD patients.
Tau protein accumulation inside the brain cells (neurons) is the second hallmark of Alzheimer's disease.  Microtuble associated protein tau (MAPT) in the brain fluid (CSF) increases with age. In Alzheimer's disease tau levels are markedly increased and reflects damage to the neurons and axons (brain cells). High CSF tau level differentiates mild cognitive impairment (MCI) from that which progresses to Alzheimer's disease.
Shrinkage or atrophy of the brain becomes detectable by MRI. This atrophy is visible in brain structures that are essential for the conscious memory of facts and events. These areas are located in the brain’s medial temporal lobe. This shrinkage is apparent on using a visual rating system which also measures its severity. The more extensive the brain atrophy, the more advanced the clinical stage of Alzheimer’s disease.

10

PET Scan (FDG-PET) changes in the way the brain uses glucose are apparent 10 years before dementia. These PET scan changes correlate with progression of Alzheimers disease.
Episodic memory loss begins at this stage. Episodic memory loss is the inability to learn new information or to recall previously learned information. It manifests as forgetting of recent events and conversations, repetitive questions, repetitive retelling of stories, forgetting the date, forgetting appointments, misplacing objects, losing valuables, and forgetting that food is cooking on the stove. The formation of new episodic memories requires intact medial temporal lobes of the brain; these are progressively destroyed in Alzheimers disease.

5

Mild cognitive impairment (MCI) deveelops 5 years before dementia. People with mild cognitive impairment have problems with thinking and memory loss. Mild cognitive impairment does not interfere with everyday activities. Persons with mild cognitive impairment are often aware of their forgetfulness.
Preventive therapies for Alzheimers disease (AD) require the development of biomarkers that are sensitive to subtle brain changes occurring in the preclinical stage of the disease. Early diagnostics is necessary to identify and treat at risk individuals before irreversible neuronal loss occurs.
Sources

1. Bateman R. The dominantly inherited Alzheimer's network trials: an opportunity to prevent Alzheimer's disease. Program and abstracts of the Alzheimer's Association International Conference 2012; July 14-19, 2012; Vancouver, British Columbia, Canada. Featured research session F3-04
2. Christian Humpel. Identifying and validating biomarkers for Alzheimer's disease. Trends Biotechnol. 2011 January; 29(1): 26–32. doi: 10.1016/j.tibtech.2010.09.007
3. Duara R, Loewenstein DA, Potter E, Appel J, Greig MT, Urs R, Shen Q, Raj A, Small B, Barker W, Schofield E, Wu Y, Potter H. Medial temporal lobe atrophy on MRI scans and the diagnosis of Alzheimer disease. Neurology. 2008 Dec 9;71(24):1986-92.
4. Mosconi L, Berti V, Glodzik L, Pupi A, De Santi S, de Leon MJ. Pre-clinical detection of Alzheimers disease using FDG-PET, with or without amyloid imaging. J Alzheimers Dis. 2010;20(3):843-54.

ADHD treatment improves academic performance

ADHD treatment improves academic performance

ADHD medication enhances academic performance when started early. ADHD drug treatment improves reading ability in children with Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia. New research shows that drug treatment of ADHD also improves maths ability especially when started early - at least by the 4th standard. Children starting treatment a year or two later show progressively greater declines in academic performance.

ADHD is characterised by inattention and hyperactive-impulsive behaviour. Parents who bring their children to the clinic are focused only on issues arising from the child's hyperactivity. Impairments due to inattention are not immediately apparent in the pre-school years. Depending on the severity of ADHD, inattention is unmasked when the child enters academic life in primary school or during the transitions to middle school, high school, and college. At each  of these stages an increasing demand is placed on the cognitive faculty of attention which the child's brain is not capable of meeting.

Children with ADHD fail to absorb formative academic concepts in primary school. However, rote learning or tutoring by the parents helps the child clear these initial stages. It is only later when the cognitive load exceeds the child's capacity to concentrate that academic problems become manifest. By this time the child's academic progress has already taken a downward trajectory. Reversing this trend and repairing the negative impact on the child's self-esteem entails considerably more effort, time and sustenance at these later stages. The earlier treatment for ADHD is initiated, the better.

Inattention in ADHD is due  to altered brain proteins. These are involved in modulation of the neurochemical - dopamine. This results in reduced dopamine in the synapse (fluid filled space that transmits information from one brain cell to another).  Altered dopamine modulation in the frontal lobe of the brain makes the child impulsive and distractible. ADHD medications act on dopamine and noradrenaline receptors to keep each dopamine molecule longer in the synaptic cleft. Dopamine is then available to stimulate the receptors for longer.

Parental concerns regarding side-effects of ADHD drug treatment on the developing child are largely unfounded. There is now evidence that shows long-term treatment with therapeutic doses of ADHD medication does not affect the developing brain or other standard measures of growth. ADHD drug treatment also does not increase the risk for addiction. As with any other medication side effects can arise at the start of treatment. Adherence to the review schedule will help monitor and mitigate these. All medication is prescribed after carefully weighing the risks and benefits. In the case of ADHD the risks are poor academic functioning and subsequent narrowing of career options at best, to dropping out or expulsion from school and subsequent delinquency at the worst. The benefits of treatment are highlighted in the  report card shown above.

Drug treatment of ADHD enhances academic performance and learning by reducing the inattention and hyperactivity of ADHD. The child with ADHD has attentional and impulse control issues. Inattention and hyperactivity interfere with classroom learning. The earlier ADHD treatment is started the better the outcome in terms of academic achievement. Many children have experienced these benefits.

References

1. Kathryn E Gill, Peter J Pierre, James Daunais, Allyson J Bennett, Susan Martelle, H Donald Gage, James M Swanson, Michael A Nader and Linda J Porrino. Chronic Treatment with Extended Release Methylphenidate Does Not Alter Dopamine Systems or Increase Vulnerability for Cocaine Self-Administration: A Study in Nonhuman Primates. Neuropsychopharmacology , (18 July 2012) | doi:10.1038/npp.2012.117
2. Penny Corkum, Melissa McGonnell and Russell Schachar. Factors affecting academic achievement in children with ADHD. Journal of Applied Research on Learning. Vol. 3, Article 9, 2010.
3. Zoëga, et al. A Population-Based Study of Stimulant Drug Treatment of ADHD and Academic Progress in Children. Pediatrics 2012;130:2011-3493