Psychiatry and Psychology
Research is focused in two areas: (1) studies to identify risk and protective factors (e.g., stressors, traumatic events, coping, social support) that are predictive of psychological symptoms, substance abuse, intimate partner violence, and other behavioral and health outcomes; and (2) studies to examine the effectiveness of interventions implemented in the workplace and other community-based settings at modifying key risk and protective factors and preventing psychiatric disorders, substance abuse, and other negative behavioral and health outcomes.
Extensive Research Description
There is increasing interest in the development of workplace preventive interventions as a means of reaching large segments of the adult population to address the potentially adverse effects of work, family, work-family, and other stressors. The spectrum of documented stress-related problems among workers is extensive, ranging from psychological symptoms, including depression, anxiety, and somatic complaints to substance abuse to physical health problems such as heart disease, hypertension, and obesity. These problems are costly to employers, employees and their families as well as to society at large. It is estimated that in the workplace, billions of dollars are lost each year in diminished productivity, high rates of absenteeism, and reduced performance resulting from these types of stress-related problems.
The Yale Work and Family Stress Program was initially established through two grants funded by NIDA and NIAAA (David L. Snow, PI). Based on a risk and protective factor model, these investigations assessed whether an intervention, Coping with Work and Family Stress, aimed at increasing individuals’ use of active coping strategies and social support, reducing stressors and avoidance coping, and enhancing effective stress management approaches led to the prevention or reduction of alcohol and drug use and psychological symptoms. Essential components of the research included: 1) identifying risk and protective factors that are predictive of substance use and psychological symptoms and that can be targeted in subsequent interventions; and 2) assessing the effectiveness of randomized controlled interventions implemented in the workplace. Significant effects of these efficacy trials have been shown in reducing work, family, and work-family stressors, increasing social support from supervisors and coworkers, enhancing the use active coping and decreasing the use of avoidance coping strategies, and in reducing alcohol consumption, smoking and other substance use, and psychological symptoms of anxiety, depression, and somatic complaints. Based on these research findings, Coping with Work and Family Stress was designated by SAMHSA in 2003 as a Model Prevention Program and, more recently (2007), was listed as an evidence-based program by the National Registry of Effective Programs and Practices (NREPP). Building on this phase of research, effectiveness trials are currently underway with new populations and settings, most notably with medical residents in training at university medical schools. In addition to this ongoing research, the program is now in a stage of active dissemination nationally and internationally. Future intervention research will involve: (1) efforts to change risk and protective factors at multiple levels of the organization (individual employee, work group or department, overall organization) in order to achieve even greater effect sizes, (2) to test the efficacy of modified, but related, interventions designed specifically for family caregivers in the workplace, in one instance, and, in another, for women in community settings at risk for HIV/AIDS and substance abuse disorders, (3) to disseminate science-based workplace interventions to military personnel and their families; and 4) to collaborate on a study of the effects of changes in Time and Place Management (TPM) policies (i.e. workplace flexibility) on employee health, well being, and productivity in a large U.S. corporation
- Further testing of the efficacy of the Coping with Work and Family Stress intervention on behavioral and physical health outcomes with new populations and within a broader spectrum of settings (e.g., medical students in university settings).
- Testing modifications of the Coping with Work and Family Stress intervention with selected, high-risk populations (e.g., family caregivers in the workplace or women in community settings at risk for AIDS and substance abuse).
- Conducting longitudinal, risk and protective factor research to identify individual and organizational factors predictive of behavioral and physical health outcomes in the general population as well as among an aging workforce.
- Continued collaboration in examining the precursors, correlates, and outcomes of intimate partner violence (both victimization and perpetration) for women and men.
- McClowry, S.G., Snow, D.L., Tamis-LeMonda, C.S., & Rodriquez, E.T. (2010). Testing the efficacy of INSIGHTS on student disruptive behavior, classroom management, and student competence in inner city primary grades. School Mental Health, 2, 23-35.
- Snow, D.L. (2009). Coping with Work and Family Stress. Interview by J. Casey and K. Corday, Sloan Work and Family Research Network, Boston College, Chestnut Hill, MA. Retrieved from http://wfnetwork.bc.edu/The_Network_News/65/experts.htm
- Sullivan, T.P., Holt, L.J., Titus, J.A., Swan, S.C., & Snow, D.L. (2010). Does the inclusion criterion of women’s aggression as opposed to their victimization result in samples that differ on key dimensions of intimate partner violence? Violence Against
- Tamis-LeMonda, C.S., Briggs, R.D., McClowry, S.G., & Snow, D.L. (2009). Maternal control and sensitivity, child gender, and maternal education in relation to children’s behavioral outcomes in African American families. Journal of Applied Developmental Ps
- Caldwell, J., Swan, S.C., Sullivan, T.P., & Snow, D.L. (2009). Why I hit him: Women’s reasons for intimate partner violence. Journal of Aggression, Maltreatment & Trauma, 18, 672-697.
- Tamis-LeMonda, C. Briggs, R.D., McClowry, S.G., & Snow, D.L. (2008). Challenges to the study of African American parenting: Conceptualization, sampling, research approaches, measurement, and design. Parenting: Science and Practice, 8, 319-358.
- Sullivan, T. P., Cavanaugh, C. E., Ufner, M. J., Swan, S. C., & Snow, D. L. Relationships among women's use of aggression, their victimization and substance use problems: A test of the moderating effects of race/ethnicity. Journal of Aggression, Maltreatm
- Swan, S.C., Gambone, L., Caldwell, J.E., Sullivan, T., & Snow, D.L. A review of research on women’s use of violence with male intimate partners. Violence and Victims, 23, 301-314, 2008.
- Snow, D.L., Sullivan, T., Swan, S.C., Tate, D.C., & Klein, I. The role of coping and problem drinking in men’s abuse of female partners: Test of a path model. Violence and Victims, 21, 267-285, 2006.
- Swan, S.C., & Snow, D.L. The development of a theory for women’s use of violence in intimate relationships. Violence Against Women, 12, 1026-1045, 2006.
- Sullivan, T., Meese, K., Swan, S., Mazure, C., & Snow, D.L. Precursors and correlates of women’s violence: Child abuse, traumatization, victimization of women, avoidance coping, and psychological symptoms. Psychology of Women Quarterly, 29, 290-301, 2005
- Snow, D. L., Swan, S. C., Raghavan, C., Connell, C., & Klein, I. The relationship of work stressors, coping, and social support to psychological symptoms among female secretarial employees. Work and Stress, 17, 241-263, 2003.
- Snow, D. L., Swan, S. C., & Wilton, L. A workplace coping skills intervention to prevent alcohol abuse. In J. Bennett & W.E.K. Lehman (Eds.), Preventing workplace substance abuse: Beyond drug testing to wellness. Washington, DC: American Psychological
- Swan, S.C., & Snow, D.L. A typology of women’s use of violence in intimate relationships. Violence Against Women, 8, 286-319, 2002.
- Swan, S.C., & Snow, D.L. Behavioral and psychological differences among abused women who use violence in intimate relationships. Violence Against Women, 9, 75-109, 2003.
- Snow, D. L., & Kline, M. L. Preventive interventions in the workplace to reduce negative psychiatric consequences of work and family stress. In C. M. Mazure (Ed.), Does stress cause psychiatric illness? Washington, DC: American Psychiatric Press, pp. 2
- Snow, D. L., Tebes, J. K., & Ayers, T. S. Impact of two social-cognitive interventions to prevent adolescent substance use: Test of an amenability to treatment model. Journal of Drug Education, 27, 1-17, 1997.
- Kline, M. L., & Snow, D. L. Effects of a worksite coping skills intervention on the stress, social support, and health outcomes of working mothers. Journal of Primary Prevention, 15, 105-121, 1994.
- Snow, D. L., Tebes, J. K., & Arthur, M. Panel attrition and external validity in adolescent substance use research. Journal of Consulting and Clinical Psychology, 60, 804-807, 1992.
- Snow, D. L., Tebes, J. K., Arthur, M. W., & Tapasak, R. C. Two-year follow-up of a social-cognitive intervention to prevent substance use. Journal of Drug Education, 22, 103-116, 1992.
- Snow, D. L., & Kline, M. L. A worksite coping skills intervention: Effects on women’s psychological symptomatology and substance use. The Community Psychologist, 24, 14-17, 1991.
- Snow, D. L., Gersick, K. E., Leslie, L., Lyons, M., Russell, D., Adkins, E., & Kazak, A. A key informant needs assessment of an adult population: Application to consultation and prevention programs. Journal of Community Psychology, 15, 161 175, 1987.
- Snow, D. L., & Newton, P. M. Task, social structure and social process in the community mental health center movement. American Psychologist, 31, 582 594, 1976.