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Seidman AJ, Born W, Corriveau E. First Responders During COVID-19: Career Calling, PTSD, and Work Self-Efficacy. Am J Prev Med 2024; 66:1017-1023. [PMID: 38211731 DOI: 10.1016/j.amepre.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION During the COVID-19 pandemic, first responders were identified as a high-risk group for developing symptoms of post-traumatic stress disorder (PTSD) and depression, which are commonly associated with negative thoughts about oneself. This may pose risk to perceptions of work self-efficacy, an integral component of employee well-being and occupational functioning. In line with the Job Demands-Resources Model (Demerouti et al., 2001), the present study examined whether the degree to which first responders' perceived career calling (i.e., a "summons" to work) served as a protective factor in the relationship between PTSD symptoms associated with the COVID-19 pandemic and perceptions of self-efficacy in the workplace. METHODS Participants were 138 first responders from local county police and fire departments who completed online screening measures for probable PTSD and depression, as well as self-reports of work self-efficacy and career calling, between May and June 2020. Statistical analysis occurred between 2020 and 2021. RESULTS Moderation analysis, controlling for depression and relevant covariates, revealed an interaction between PTSD symptoms and career calling, ΔR2=0.04, p=0.017. At low levels of career calling, there was a significant and negative relationship between PTSD symptoms and work self-efficacy (b=‒0.14, p=0.023), but not among first responders with average or high calling (p's>0.58). Positive screening rates were 22% for probable PTSD and 19% for depression. CONCLUSIONS Perceiving a career calling may help protect first responders during COVID-19 from the deleterious effects of PTSD symptomatology on work self-efficacy. Prevention efforts targeting first responders with low calling strength may be warranted.
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Affiliation(s)
| | - Wendi Born
- Department of Psychiatry, University of Kansas School of Medicine, Kansas City, Kansas
| | - Erin Corriveau
- Department of Family Medicine & Community Health, University of Kansas School of Medicine, Kansas City, Kansas
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2
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Wagner SL, White N, White M, Fyfe T, Matthews LR, Randall C, Regehr C, Alden LE, Buys N, Carey MG, Corneil W, Krutop E, Fraess-Phillips A. Work outcomes in public safety personnel after potentially traumatic events: A systematic review. Am J Ind Med 2024; 67:387-441. [PMID: 38458612 DOI: 10.1002/ajim.23577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/29/2024] [Accepted: 02/18/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety. METHODS The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis. RESULTS Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization. CONCLUSIONS Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.
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Affiliation(s)
- Shannon L Wagner
- Office of the Vice President Research, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Nicole White
- Department of Health Sciences, School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Lynda R Matthews
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Christine Randall
- School of Health Sciences & Social Work, Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Cheryl Regehr
- Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- School of Health Sciences & Social Work, Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences & Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Elyssa Krutop
- Aligned Counselling, Kamloops, British Columbia, Canada
| | - Alex Fraess-Phillips
- Department of Health Sciences, School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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3
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Günak MM, Ebrahimi OV, Pietrzak RH, Fried EI. Using network models to explore the associations between posttraumatic stress disorder symptoms and subjective cognitive functioning. J Anxiety Disord 2023; 99:102768. [PMID: 37716026 DOI: 10.1016/j.janxdis.2023.102768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 06/24/2023] [Accepted: 09/03/2023] [Indexed: 09/18/2023]
Abstract
Several studies have identified relationships between posttraumatic stress disorder (PTSD) and cognitive functioning. Here, we aimed to elucidate the nature of this relationship by investigating cross-sectional associations between subjective cognitive functioning (SCF) and 1) the PTSD sum score, 2) symptom domains, and 3) individual symptoms. We also investigated temporal stability by testing whether results replicated over a 3-year period. We estimated partial correlation networks of DSM-5 PTSD symptoms (at baseline) and SCF (at baseline and follow-up, respectively), using data from the National Health and Resilience in Veterans Study (NHRVS; N = 1484; Mdn = 65 years). The PTSD sum score was negatively associated with SCF. SCF was consistently negatively associated with the PTSD symptom domains 'marked alterations in arousal and reactivity' and 'negative alterations in cognitions and mood', and showed robust relations with the specific symptoms 'having difficulty concentrating' and 'trouble experiencing positive feelings'. Results largely replicated at the 3-year follow-up, suggesting that some PTSD symptoms both temporally precede and are statistically associated with the development or maintenance of reduced SCF. We discuss the importance of examining links between specific PTSD domains and symptoms with SCF-relations obfuscated by focusing on PTSD diagnoses or sum scores-as well as investigating mechanisms underlying these relations. Registration Number: 37069 (https://aspredicted.org/n5sw7.pdf).
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Affiliation(s)
- Mia Maria Günak
- Department of Clinical Psychology, Leiden University, Pieter de la Court Building, Wassernaarseweg 52, 2333 AK Leiden, the Netherlands; Department of Psychology, LMU Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Omid V Ebrahimi
- Department of Clinical Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway; Department of Psychology, University of Amsterdam, Roeterseiland Campus, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, the Netherlands
| | - Robert H Pietrzak
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, P.O. Box 208034, 60 College Street, New Haven, CT 06520-0834, USA
| | - Eiko I Fried
- Department of Clinical Psychology, Leiden University, Pieter de la Court Building, Wassernaarseweg 52, 2333 AK Leiden, the Netherlands.
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4
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Seligowski AV, Fonkoue IT, Noble NC, Dixon D, Gluck R, Kim YJ, Powers A, Pace TW, Jovanovic T, Umpierrez G, Ressler KJ, Quyyumi AA, Michopoulos V, Gillespie CF. Vagal control moderates the association between endothelial function and PTSD symptoms in women with T2DM. Brain Behav Immun Health 2022; 26:100527. [PMID: 36247837 PMCID: PMC9557816 DOI: 10.1016/j.bbih.2022.100527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Individuals with posttraumatic stress disorder (PTSD) are more likely to present with metabolic diseases such as type-2 diabetes mellitus (T2DM), and cardiovascular dysfunction has been implicated in this link. These diseases disproportionately affect women and individuals exposed to chronic environmental stressors (e.g., community violence, poverty). We examined associations among PTSD, cardiovascular indices, and metabolic function in highly trauma-exposed Black women with T2DM. Methods Participants (N = 80) were recruited for a follow-up study of stress and T2DM as part of the Grady Trauma Project. PTSD symptoms were assessed with the Clinician Administered PTSD Scale (CAPS-IV). Cardiovascular indices included heart rate (HR), blood pressure (BP), respiratory sinus arrhythmia (RSA), and endothelial function (assessed via flow-mediated dilation; FMD). An oral glucose tolerance test was used as an indicator of metabolic function. Results Of the cardiovascular indices, only FMD was significantly associated with PTSD symptoms (CAPS Avoidance symptoms; β = -0.37, p = .042), and glucose tolerance (β = -0.44, p = .019), controlling for age and body mass index. The association between FMD and PTSD Avoidance was moderated by RSA such that the effect of FMD was only significant at low levels of RSA (simple slopes β = -0.87, p = .004). Conclusions Our results indicate that endothelial function is significantly related to PTSD and glucose tolerance, over and above other cardiovascular measures (HR, BP, RSA). Further, our results suggest that low RSA may be a risk factor for the link between poor endothelial function and PTSD in women with T2DM.
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Affiliation(s)
- Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Ida T. Fonkoue
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Drew Dixon
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Rachel Gluck
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ye Ji Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Thaddeus W.W. Pace
- College of Nursing and College of Medicine (Psychiatry), University of Arizona, Tucson, AZ, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Guillermo Umpierrez
- Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Arshed A. Quyyumi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Charles F. Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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5
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Bardeen JR, Gorday JY, Weathers FW. Executive functioning deficits exacerbate posttraumatic stress symptoms: A longitudinal mediation model. J Anxiety Disord 2022; 87:102556. [PMID: 35276509 PMCID: PMC8996315 DOI: 10.1016/j.janxdis.2022.102556] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/16/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
Executive functioning (EF) consists of a set of related, but distinct, higher-level cognitive abilities that are used to organize and integrate lower-level processes in the service of engaging in goal-direct behavior. Evidence suggests that deficits in EF are a vulnerability factor for the development of posttraumatic stress (PTS) symptoms. Less understood, however, is the role that EF plays in symptom maintenance and exacerbation following trauma exposure. As such, the primary purpose of the present study was to determine whether EF deficits exacerbate PTS symptoms over the course of one year. A secondary aim of this study was to use a cross-lagged design to determine the directional relations among EF deficits and PTS. Trauma-exposed adults (N = 98) completed a clinical interview and self-report measures at an initial assessment session (Time 1 [T1]). Participants also completed self-report measures at 6- (Time 2 [T2]; n = 92) and 12-month (Time 3 [T3]; n = 91) follow-up sessions. As predicted, EF deficits at T2 mediated the relationship between PTS symptoms from T1 to T3, thus suggesting that EF deficits exacerbate PTS symptoms following trauma exposure. Results from a cross-lagged path analysis from T2 to T3 suggest that deficits in EF exert a stronger influence on the maintenance of PTS symptoms than vice versa. These results have implications for (a) identifying individuals that are at elevated risk for developing PTS symptoms, (b) developing precision medicine-based approaches for alleviating PTS symptoms, and (c) improving well-established PTSD treatments for those with relative deficits in EF.
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6
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Baker LD, Stroman JC, Kalantar EA, Bock RC, Berghoff CR. Indirect Associations Between Posttraumatic Stress Symptoms and Other Psychiatric Symptoms, Alcohol Use, and Well-being via Psychological Flexibility Among Police Officers. J Trauma Stress 2022; 35:55-65. [PMID: 33821526 DOI: 10.1002/jts.22677] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 11/08/2022]
Abstract
Police officers experience a high number of potentially traumatic events (PTEs) often associated with elevated posttraumatic stress symptoms (PTSS). In addition, PTSS are related to co-occurring psychiatric symptoms (e.g., anxiety, depression), alcohol misuse, and low perceived well-being. Yet, behavioral processes that may account for the associations between PTSS and unfavorable outcomes remain unspecified. Psychological flexibility, or one's response to private experiences (e.g., PTE-related memories) with an open, aware, and active approach, may be one such process. The present study aimed to evaluate psychological flexibility as both a mediator and moderator of PTSS and commonly co-occurring psychiatric symptoms, alcohol use, and general well-being, using cross-sectional data provided by a sample of police officers (N = 459) recruited from three regionally distributed U.S. police agencies. Structural equation modeling indicated a well-fitting model wherein psychological flexibility indirectly accounted for associations among PTSS and endogenous outcomes, χ2 (107, N = 457) = 225.33, p < .001, CFI = .99, TLI = .98, RMSEA = .05, 90% CI [.04, .06], SRMR = .03. Psychological flexibility also moderated associations between PTSS and psychiatric symptoms, B = 1.58 (SE = 0.22), p < .001; and well-being, B = -3.84 (SE = 0.46), p < .001. Although additional research is needed, these preliminary results suggest psychological flexibility may be a behavioral process that accounts for negative outcomes associated with PTSS and a productive intervention target in the context of PTSS and generalized distress. Further research regarding the role of psychological flexibility in PTSS-related outcomes for police officers appears warranted.
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Affiliation(s)
- Lucas D Baker
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Joel C Stroman
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Emily A Kalantar
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Rachel C Bock
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
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7
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Rodriguez-Arrastia M, García-Martín M, Villegas-Aguilar E, Ropero-Padilla C, Martin-Ibañez L, Roman P. Emotional and psychological implications for healthcare professionals in disasters or mass casualties: A systematic review. J Nurs Manag 2021; 30:298-309. [PMID: 34590385 DOI: 10.1111/jonm.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/18/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022]
Abstract
AIM To synthesize and describe the emotional and psychological implications for healthcare professionals who provided care in a mass casualty incident or disaster. BACKGROUND The experience of healthcare providers immersed in the actual uncertainty of an ongoing disaster is real, challenging, complex and strongly connected with emotions. Identifying these implications for healthcare professionals is essential for developing strategies to help these professionals deliver high-quality care. EVALUATION A systematic review was conducted in PubMed, CINAHL, Scopus, Nursing & Allied Health Database and PsycINFO using published data until February 2021 and following the PRISMA guidelines. KEY ISSUES Nineteen articles were included. Factors associated with negative psychological implications were identified and different strategies have been synthesized to prevent or reduce them when caring for the victims of a disaster. CONCLUSIONS Feelings of sadness, helplessness, fear and blockage, among others, were identified as common reactions among nurses and other healthcare professionals dealing in mass casualties or disasters. These reactions may lead to post-traumatic disorder, turning professionals into hidden victims. IMPLICATIONS FOR NURSING MANAGEMENT Organizations, senior charge nurses and other health service managers need to foster resilience and flexibility among their workforce to improve self-care during a disaster, as well as ensure policies to address a lack of emotional preparedness among their personnel. Some strategies to consider include cognitive behavioural therapy, psychoeducation or meditation.
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Affiliation(s)
- Miguel Rodriguez-Arrastia
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Manuel García-Martín
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,IMA S0082 Group, Hospital de Poniente, Almeria, Spain
| | | | - Carmen Ropero-Padilla
- Faculty of Health Sciences, Pre-Department of Nursing, Jaume I University, Castellon de la Plana, Spain.,Research Group CYS, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Luis Martin-Ibañez
- Field Artillery Group, Light Infantry Brigade "King Alfonso XIII" II of the Legion, Almeria, Spain
| | - Pablo Roman
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Research Group CTS-451 Health Sciences, University of Almeria, Almeria, Spain.,Health Research Centre, University of Almeria, Almeria, Spain
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8
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Mordeno IG, Gallemit IMJS, Ferolino MAL, Sinday JV. DSM-5-Based ASD Models: Assessing the Latent Structural Relations with Functionality in War-Exposed Individuals. Psychiatr Q 2021; 92:347-362. [PMID: 32748123 DOI: 10.1007/s11126-020-09804-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is a dearth of studies investigating the latent structure of Acute Stress Disorder (ASD) following the changes in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). To date, there is no consensus on the best representation of ASD. This study addressed this gap by examining four latent ASD models in a sample of war-exposed individuals (N = 424). Investigation on the relationship of the best-fitting model to functionality in the latent level was also conducted. The five-factor model, composed of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal factors, yielded the best-fitting model. Latent associations between the factors of the model and functionality suggest that symptoms of functionality do not significantly affect the factor structure of ASD. These findings have implications for understanding the underlying mechanism of ASD and can inform the development of more nuanced trauma-related interventions, particularly addressing ASD symptoms and functionality separately.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, Mindanao State University - Iligan Institute of Technology, Andres Bonifacio Ave., Tibanga, 9200, Iligan City, Philippines.
| | - I Marie Joy S Gallemit
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Michelle Anne L Ferolino
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Jonahliza V Sinday
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
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Abstract
Individuals who witness team members exhibiting symptoms of an acute stress reaction (ASR) in the middle of a high-stress operational event may be negatively affected; ASR-related training may moderate this impact. In the present study, 560 Israeli soldiers were surveyed about ASR exposure, posttraumatic stress disorder (PTSD) symptoms, public stigma, and whether they had received ASR-related training. This training, called YaHaLOM, is a Hebrew acronym that outlines steps for managing ASR in team members. Controlling for combat exposure, greater exposure to ASR symptoms was associated with more overall PTSD symptoms, PTSD cluster symptoms, and public stigma. YaHaLOM training buffered these relationships for PTSD, intrusion and avoidance symptoms, and public stigma. The findings suggest that such training may help teams in high-risk occupations better manage ASR exposure.
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10
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Carmassi C, Porta I, Bertelloni CA, Impagnatiello P, Capone C, Doria A, Corsi M, Dell'Osso L. PTSD and post-traumatic stress spectrum in the Italian Navy Operational Divers Group and corps of Coast Guard Divers employed in search and rescue activities in the Mediterranean refugees emergences and Costa Concordia shipwreck. J Psychiatr Res 2020; 129:141-146. [PMID: 32912594 DOI: 10.1016/j.jpsychires.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/06/2020] [Accepted: 07/06/2020] [Indexed: 11/28/2022]
Abstract
Rescue personnel is at high risk for Post-traumatic Stress Disorder (PTSD) because of the possible repetitive exposition to "cruel details of traumatic events" (DSM-5). Literature reported PTSD rates in combat exposed veterans, although the Italian Navy military personnel has been frequently involved in no-war activities in most recent years, such as Search and Rescue (SAR) activities of civilians involved in catastrophic events. The study aimed at exploring the prevalence of PTSD and its impact on social and work functioning among divers of the Italian Navy employed in the SAR activities for the Costa Concordia shipwreck (2012), the collapsed control tower of the Genoa harbour (2013), and the "Mare Nostrum" and "Triton" immigrant emergency Operations in the Mediterranean Sea. The 85 Italian Navy and Coast Guard Divers on duty for these activities were involved in the study and forty fulfilled the assessments, including the: Impact Event Scale (IES-r), Trauma and Loss Spectrum Self-Report (TALS-SR) and Work and Social Adjustment Scale (WSAS). In the three years before enrollment 77.5% of the sample (n = 31) performed at least one rescue operation, with full and partial DSM-5 PTSD rates being 7.5% and 22.5%, respectively. A correlation emerged between WSAS domains or total scores and TALS-SR score domains for PTSD. Rescue Navy personnel resulted to be at risk for post-traumatic stress symptoms, and these subthreshold PTSD manifestations appear to impact on functioning. Further studies are needed to better investigate PTSD risk and resilience factors in this particular group of workers.
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Affiliation(s)
- Claudia Carmassi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
| | | | - Carlo Antonio Bertelloni
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
| | | | | | | | - Martina Corsi
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
| | - Liliana Dell'Osso
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
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11
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North CS, Van Enkevort E, Hong BA, Surís AM. Association of PTSD symptom groups with functional impairment and distress in trauma-exposed disaster survivors. Psychol Med 2020; 50:1556-1562. [PMID: 31258106 DOI: 10.1017/s0033291719001569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND In the nearly a quarter of a century since the addition of the clinically significant distress/impairment criterion to the definition of PTSD in DSM-IV, little research has been done to examine the association of this criterion with symptom group criteria and with the numbing subgroup specifically. This study was conducted to examine these relationships in a large database of disaster survivors consistently studied across 12 different incidents of the full range of disaster typology. METHODS Analysis was conducted on a merged database representing 1187 trauma-exposed survivors of 12 different disasters studied systematically. DSM-IV-TR criteria for disaster-related PTSD were assessed with the Diagnostic Interview Schedule. RESULTS PTSD Group C (avoidance/numbing) and numbing specifically were less common and more associated than other symptom groups with criterion F (distress/impairment). Consistently in multivariable models, group C and numbing were independently associated with criterion F. Group D (hyperarousal) was less strongly associated with criterion F. Neither group B (intrusion) nor avoidance were associated with criterion F. CONCLUSIONS In this and other studies, group C and numbing specifically have been shown to be associated with criterion F, which is consistent with the demonstration that group C and the numbing component specifically are central to the psychopathology of PTSD. The addition of the distress/impairment requirement broadly across the psychiatric diagnoses in DSM-IV added little value to PTSD symptom criteria. Future revisions of diagnostic criteria may benefit by carefully considering these findings to possibly re-include a prominent numbing symptom section.
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Affiliation(s)
- Carol S North
- The Altshuler Center for Education & Research at Metrocare Services and Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Erin Van Enkevort
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Barry A Hong
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Alina M Surís
- VA North Texas Health Care System and The University of Texas Southwestern Medical Center, Dallas, TX, USA
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12
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Lee W, Lee YR, Yoon JH, Lee HJ, Kang MY. Occupational post-traumatic stress disorder: an updated systematic review. BMC Public Health 2020; 20:768. [PMID: 32448255 PMCID: PMC7245752 DOI: 10.1186/s12889-020-08903-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/12/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although numerous studies on occupational post-traumatic stress disorder (PTSD) have been conducted prior to the 1950-2010 seminal systematic review by Skogstad et al., the prevalence, risk factors, and impact of this disorder following traumatic events in occupational settings remain unclear. This study aims to address this knowledge gap by reviewing the literature published after 2010. METHODS We reviewed literature from databases such as PubMed and Google Scholar using PRISMA guidelines to identify studies that address occupational PTSD and examined the status (prevalence or incidence), the risk factors, and the health effects of PTSD among workers. RESULTS In total, 123 articles were identified, and finally, 31 (25.2%) articles were selected after excluding duplicates. Various occupational traumatic physical events were reported such as natural or manmade disaster, explosion, accident, handling refugee corpses, or bullying at work. Risk of PTSD was closely associated with working conditions, severity of injury, history of mental disorder, occurrence of psychiatric symptoms at the time of the event, personality, interpersonal relationships, etc. Workers with PTSD were likely to experience a deterioration of physical and psychological health and impairment of social and occupational functioning. CONCLUSIONS Our review suggests that many workers remain highly vulnerable to occupational PTSD and its consequences.
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Affiliation(s)
- Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yi-Ryoung Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye-Ji Lee
- Occupational Safety and Health Research Institute, Ulsan, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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