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Gellisch M, Olk B, Schäfer T, Brand-Saberi B. Unraveling psychological burden: the interplay of socio-economic status, anxiety sensitivity, intolerance of uncertainty, and stress in first-year medical students. BMC MEDICAL EDUCATION 2024; 24:945. [PMID: 39210353 PMCID: PMC11363420 DOI: 10.1186/s12909-024-05924-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The escalating prevalence of mental health issues among young adults, set against the backdrop of a global healthcare system under pressure, underscores the necessity for cultivating a resilient medical workforce. This study investigates the influence of socio-economic status (SES) on psychological well-being, with a particular focus on Anxiety Sensitivity (AS) and Intolerance of Uncertainty (IU) among first-year medical students. Understanding the psychological dimensions affecting medical students is crucial for fostering a future medical workforce that is both capable and mentally healthy. METHODS This research involved 321 first-year medical students, evaluated using the Perceived Stress Questionnaire (PSQ), Anxiety Sensitivity Index (ASI), the Intolerance of Uncertainty Scale (UI-18), and the Student Self-Efficacy Scale (SSE), alongside socio-economic categorization. Employing descriptive statistics, ANOVA, and correlation analyses, the study aimed at elucidating the SES impact on AS and IU, among other psychological constructs. RESULTS The analysis revealed significant SES-related differences, especially in the realms of Anxiety Sensitivity and Intolerance of Uncertainty. Notably, ASI_C (cognitive concerns) exhibited strong positive correlations with both UI_A (reduced ability to act due to IU) (Pearson's r = 0.562, p < 0.001) and UI_B (burden due to IU) (Pearson's r = 0.605, p < 0.001), highlighting the link between cognitive aspects of anxiety and uncertainty intolerance. Furthermore, UI_C (vigilance due to IU) was significantly associated with SES (F(4, 316) = 2.719, p = 0.030, η² = 0.033), pointing to the complex ways in which socio-economic factors modulate responses to uncertainty. Self-efficacy emerged as a significant counterbalance, showing protective associations against the adverse effects of heightened Anxiety Sensitivity and Intolerance of Uncertainty. CONCLUSION Our findings indicate that lower socio-economic status is associated with higher levels of Anxiety Sensitivity and Intolerance of Uncertainty, which contribute to increased stress among first-year medical students. Additionally, Self-Efficacy emerged as a significant protective factor, mitigating the expressions of AS and IU. Although medical faculties cannot change SES characteristics within their student body, recognizing its impact allows for the development of tailored support systems to address the unique challenges faced by students from diverse socio-economic backgrounds. This study underscores the necessity of considering social diversity, particularly regarding AS and IU characteristics, to foster a supportive and effective medical education environment with an outlook on sustainable mental health in a demanding work context.
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Affiliation(s)
- Morris Gellisch
- Center for Medical Education, Ruhr-University Bochum, 44801, Bochum, Germany.
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany.
- Faculty of Health, Department of Operative Dentistry and Preventive Dentistry, Witten/Herdecke University, Witten, Germany.
| | - Bettina Olk
- HSD Hochschule Döpfer, University of Applied Sciences, Waidmarkt 3 and 9, 50676, Cologne, Germany
| | - Thorsten Schäfer
- Center for Medical Education, Ruhr-University Bochum, 44801, Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
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Korpela S, Nordquist H. Supporting emergency service workers to cope with critical incidents that can lead to psychological burden at work - developing skills in the Post Critical Incident Seminar: a qualitative interview study. BMC Psychol 2024; 12:44. [PMID: 38254237 PMCID: PMC10804621 DOI: 10.1186/s40359-024-01534-x] [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: 08/04/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Emergency service workers face critical incidents causing psychological burden. This qualitative study investigates how attending a Post Critical Incident Seminar could affect the skills of emergency service workers to overcome incidents that can cause psychological burden at work and their consequences with the following research questions: (1) How did attending the Post Critical Incident Seminar impact the skills to overcome work incidents that can lead to psychological burden? and (2) How have these skills been manifested since attending the Post Critical Incident Seminar? METHODS The data consists of individual interviews with fifteen emergency services workers who attended a Post Critical Incident Seminar in April 2021 in Finland. The interviews were conducted six months after the Post Critical Incident Seminar and analysed using inductive content analysis. RESULTS The results of the first research question formed two main categories: improved performance abilities and improved self-regulation abilities. From the results of the second research question two main categories were created: new kind(s) of well-being and readiness to help. Several upper categories and sub-categories were discovered. CONCLUSIONS Based on the results, attending a Post Critical Incident Seminar may be effective in developing skills to overcome critical incidents that can lead to psychological burden. Further follow-up studies should investigate how acquired skills from the Post Critical Incident Seminar practically affect emergency service workers and their well-being in the longer term.
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Affiliation(s)
- Sanna Korpela
- South-Eastern Finland University of Applied Sciences, Pääskysentie 1, Kotka, 48220, Finland
| | - Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Pääskysentie 1, Kotka, 48220, Finland.
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Phelps AJ, Madden K, Carleton RN, Johnson L, Carey LB, Mercier JM, Mellor A, Baills J, Forbes D, Devenish-Meares P, Hosseiny F, Dell L. Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members following exposure to Moral Transgression. JOURNAL OF RELIGION AND HEALTH 2023; 62:3995-4015. [PMID: 37697218 PMCID: PMC10682271 DOI: 10.1007/s10943-023-01908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/13/2023]
Abstract
Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study explores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence-based treatment in collaboration with mental health practitioners.
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Affiliation(s)
- Andrea J Phelps
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia.
| | - Kelsey Madden
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
| | | | - Lucinda Johnson
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
| | - Lindsay B Carey
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | | | - Andrew Mellor
- National Police Chaplaincy Group, Brisbane, Queensland, Australia
| | - Jeffrey Baills
- National Police Chaplaincy Group, Brisbane, Queensland, Australia
| | - David Forbes
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
| | | | | | - Lisa Dell
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
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Hörberg A, Wälivaara BM, Wihlborg J. Taking or creating control: A qualitative study of uncertainty among novice nurses in ambulance care. Int Emerg Nurs 2023; 69:101308. [PMID: 37348240 DOI: 10.1016/j.ienj.2023.101308] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/27/2023] [Accepted: 05/13/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION In emergency nursing situations, uncertainty may lead to delays, or block a decision which can have devastating consequences for a patient. The ambulance service is a complex clinical environment that often challenges the decision-making capabilities of the professionals, especially novice nurses. Novice nurses' uncertainty may also lead to unhealthy transitions and turnover. To increase the understanding of how uncertainty affects novice nurses, this study explores novice nurses' uncertainty during the first year of professional practice in the ambulance service. METHOD A qualitative descriptive design was applied using qualitative content analysis of thirteen individual face-to-face semi-structured deep interviews. RESULT From nine subcategories, three generic categories were derived: Reflections on contextual understanding, Strategies to create control, and Actions to take control. These were combined to form the main category Understanding what and dealing with how, while becoming a confident professional. CONCLUSION Uncertainty is exacerbated by situations that demand rapid decisions or actions. This is especially true of newcomers to a profession. Preparing novices through study programs and encouraging continuous reflection in professional practice may increase resilience and tolerance of uncertainty, as well as benefiting professional development.
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Affiliation(s)
- Anna Hörberg
- Dalarna University, School of Health and Welfare, SE-791 88 Falun, Sweden.
| | - Britt-Marie Wälivaara
- Luleå University of Technology, Division of Nursing and Medical Technology, Department of Health, Education and Technology, SE-971 87 Luleå, Sweden
| | - Jonas Wihlborg
- Dalarna University, School of Health and Welfare, SE-791 88 Falun, Sweden
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Khoury JMB, Jamshidi L, Shields RE, Nisbet J, Afifi TO, Fletcher AJ, Stewart SH, Asmundson GJG, Sauer-Zavala S, Krätzig GP, Carleton RN. Putative risk and resiliency factors among Royal Canadian Mounted Police cadets. Front Psychol 2023; 14:1048573. [PMID: 37008880 PMCID: PMC10053504 DOI: 10.3389/fpsyg.2023.1048573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
ObjectiveMental health disorders are prevalent among active-duty Royal Canadian Mounted Police (RCMP) officers. The current study was designed to assess whether RCMP cadets commencing the Cadet Training Program are inherently at greater risk of developing mental health challenges by statistically comparing cadet putative risk and resiliency scores to scores from young adult populations. The study was also designed to assess for sociodemographic differences in putative risk and resiliency variables among RCMP cadets in order to facilitate future comparisons.MethodsCadets (n = 772; 72.2% men) completed self-report measures of several putative risk variables (i.e., anxiety sensitivity, fear of negative evaluation, pain anxiety, illness and injury sensitivity, intolerance of uncertainty, and state anger) and resiliency. Scores were statistically compared to samples from Canadian, American, Australian, and European young adult populations.ResultsCadets had statistically significantly lower scores on all putative risk variables and statistically significantly higher resiliency scores compared to the young adult populations. In the cadet sample, there were statistically significant differences in putative risk and resiliency variables across gender and sex.ConclusionCadets’ significantly lower scores on putative risk variables and higher scores on resiliency suggest that they may be psychologically strong; as such, it may be that the nature of police work, as opposed to inherent individual differences in risk and resiliency, accounts for active-duty RCMP officers’ comparatively higher prevalence of mental health disorders over time.Clinical Trial Registration: ClinicalTrials.gov, Identifier NCT05527509.
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Affiliation(s)
- Juliana M. B. Khoury
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Sociology and Social Studies, University of Regina, Regina, SK, Canada
| | - Amber J. Fletcher
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sherry H. Stewart
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY, United States
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: R. Nicholas Carleton,
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Shiloh S, Peleg S, Nudelman G. Core self-evaluations as resilience and risk factors of psychological distress during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:95-109. [PMID: 35073806 DOI: 10.1080/13548506.2022.2030480] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In view of the grave consequences of distress reactions to the COVID-19 pandemic, this study investigated CSE (Core Self-evaluations) - internal/external health locus of control, generalized self-efficacy and trait optimism - and intolerance of uncertainty as potential correlates of distress reactions. We conducted an online questionnaire-based cross-sectional study with 422 Israeli respondents. Pandemic-related distress was defined by perceived stress, negative and positive affect, and worries. Predictors were: health locus of control, generalized self-efficacy, trait optimism, and intolerance of uncertainty. The findings show that CSEs and intolerance of uncertainty added between 11% (to perceived stress) and 22% (to negative affect) of explained variance beyond the background variables. Specifically, higher trait optimism and generalized self-efficacy were associated with less distress, and greater intolerance of uncertainty was correlated with higher distress. In conclusion, the CSE framework is useful for explaining psychological distress during the COVID-19 pandemic. Beyond their theoretical contribution, the findings may have practical implications for increasing resilience and ameliorating distress during a pandemic.
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Affiliation(s)
- Shoshana Shiloh
- School of Psychological Sciences, Gordon Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shira Peleg
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Gabriel Nudelman
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
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Carleton RN, McCarron M, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Camp RD, Shields RE, Jamshidi L, Nisbet J, Maguire KQ, MacPhee RS, Afifi TO, Jones NA, Martin RR, Sareen J, Brunet A, Beshai S, Anderson GS, Cramm H, MacDermid JC, Ricciardelli R, Rabbani R, Teckchandani TA, Asmundson GJG. Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel. BMC Psychol 2022; 10:295. [PMID: 36494748 PMCID: PMC9733219 DOI: 10.1186/s40359-022-00989-0] [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: 09/13/2022] [Accepted: 11/13/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder. METHODS The current protocol paper describes the PSP PTSI Study (i.e., design, measures, materials, hypotheses, planned analyses, expected implications, and limitations), which was originally designed to evaluate an evidence-informed, proactive system of mental health assessment and training among Royal Canadian Mounted Police for delivery among diverse PSP (i.e., firefighters, municipal police, paramedics, public safety communicators). Specifically, the PSP PTSI Study will: (1) adapt, implement, and assess the impact of a system for ongoing (i.e., annual, monthly, daily) evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; and, (4) assess the impact of providing diverse PSP with a tailored version of the Emotional Resilience Skills Training originally developed for the Royal Canadian Mounted Police in mitigating PTSIs based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. Participants are assessed pre- and post-training, and then at a follow-up 1-year after training. The assessments include clinical interviews, self-report surveys including brief daily and monthly assessments, and daily biometric data. The current protocol paper also describes participant recruitment and developments to date. DISCUSSION The PSP PTSI Study is an opportunity to implement, test, and improve a set of evidence-based tools and training as part of an evidence-informed solution to protect PSP mental health. The current protocol paper provides details to inform and support translation of the PSP PTSI Study results as well as informing and supporting replication efforts by other researchers. TRIAL REGISTRATION Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered. TRIAL REGISTRATION ClinicalTrials.gov, NCT05530642. Registered 1 September 2022-Retrospectively registered. The subsequent PSP PTSI Study results are expected to benefit the mental health of all participants and, ultimately, all PSP.
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Affiliation(s)
- R. Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Michelle McCarron
- Research Department, Saskatchewan Health Authority, Regina, SK S4S 0A5 Canada
| | - Gregory P. Krätzig
- Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY 40506 USA
| | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3 Canada
| | - Amber J. Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald D. Camp
- Faculty of Business and Economics, University of Northern British Columbia, Prince George, BC V2N 4Z9 Canada
| | | | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Renée S. MacPhee
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5 Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Nicholas A. Jones
- Department of Justice Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald R. Martin
- Faculty of Education, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jitender Sareen
- Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Alain Brunet
- McGill’s Psychiatry Department and Douglas Institute Research Center, 6875 Lasalle Boulevard, Verdun, QC H4H 1R3 Canada
| | - Shadi Beshai
- Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | | | - Heidi Cramm
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Joy C. MacDermid
- School of Physiotherapy, Western University, London, ON N6A 3K7 Canada
| | - Rosemary Ricciardelli
- School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3 Canada
| | - Rasheda Rabbani
- George & Fay Yee Centre for Healthcare Innovation, Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
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The role of intolerance of uncertainty and anxiety sensitivity on nursing students’ depression, anxiety, and stress levels. Nurse Educ Pract 2022; 65:103487. [DOI: 10.1016/j.nepr.2022.103487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
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Ricciardelli R, Carleton RN, Anschuetz B, Gravel S, McKay B. Testifying after an Investigation: Shaping the Mental Health of Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13643. [PMID: 36294223 PMCID: PMC9602447 DOI: 10.3390/ijerph192013643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/01/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
In this editorial, we draw on two Canadian cases to interrogate how mass causality events and investigations consume many responders before (e.g., public safety communicators, detachment service assistants), during (e.g., police, fire, paramedics), and after the incident (e.g., coroners, correctional workers, media coverage). Their well-being may suffer from the associated processes and outcomes. In the current article, we focus on the mass causality incident of 2020 in Nova Scotia, Canada, and the investigation following a prisoner death in 2019 in Newfoundland, Canada, to explore how testifying post-incident can be made more palatable for participating public safety personnel (PSP). Specifically, we study how testifying after an adverse event can affect PSP (e.g., recalling, vicarious trauma, triggers) and how best to mitigate the impact of testimony on PSP well-being, with a lens to psychological "recovery" or wellness. We focus here on how to support those who may have to testify in a judicial proceeding or official inquiry, given being investigated for best-intended actions can result in moral injury or a posttraumatic stress injury, both exacerbated by judicial review, charge, accusation, or inquiry.
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Affiliation(s)
- Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | | | | | | | - Brad McKay
- Badge of Life Canada, Orillia, ON L3V 5X6, Canada
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Carleton RN, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Afifi TO, Brunet A, Martin R, Hamelin KS, Teckchandani TA, Jamshidi L, Maguire KQ, Gerhard D, McCarron M, Hoeber O, Jones NA, Stewart SH, Keane TM, Sareen J, Dobson K, Asmundson GJG. The Royal Canadian Mounted Police (RCMP) Study: protocol for a prospective investigation of mental health risk and resilience factors. Health Promot Chronic Dis Prev Can 2022; 42:319-333. [PMID: 35993603 PMCID: PMC9514212 DOI: 10.24095/hpcdp.42.8.02] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Royal Canadian Mounted Police (RCMP), like all public safety personnel (PSP), are frequently exposed to potentially psychologically traumatic events that contribute to posttraumatic stress injuries (PTSI). Addressing PTSI is impeded by the limited available research. In this protocol paper, we describe the RCMP Study, part of the concerted efforts by the RCMP to reduce PTSI by improving access to evidence-based assessments, treatments and training as well as participant recruitment and RCMP Study developments to date. The RCMP Study has been designed to (1) develop, deploy and assess the impact of a system for ongoing annual, monthly and daily evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; (4) augment the RCMP Cadet Training Program with skills to proactively mitigate PTSI; and (5) assess the impact of the augmented training condition (ATC) versus the standard training condition (STC). Participants in the STC (n = 480) and ATC (n = 480) are assessed before and after training and annually for 5 years on their deployment date; they also complete brief monthly and daily surveys. The RCMP Study results are expected to benefit the mental health of all participants, RCMP and PSP by reducing PTSI among all who serve.
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Affiliation(s)
- R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Gregory P Krätzig
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Shannon Sauer-Zavala
- Department of Psychology, University of Kentucky, Lexington, Kentucky, United States of America
| | - J Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amber J Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alain Brunet
- Department of Psychiatry and Douglas Institute Research Centre, McGill University, Verdun, Quebec, Canada
| | - Ron Martin
- Faculty of Education, University of Regina, Regina, Saskatchewan, Canada
| | | | - Taylor A Teckchandani
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, Saskatchewan, Canada
| | - Kirby Q Maguire
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, Saskatchewan, Canada
| | - David Gerhard
- Department of Computer Science, University of Regina, Regina, Saskatchewan, Canada
| | | | - Orland Hoeber
- Department of Computer Science, University of Regina, Regina, Saskatchewan, Canada
| | - Nicholas A Jones
- Department of Justice Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Sherry H Stewart
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Terence M Keane
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System & Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Jitender Sareen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Keith Dobson
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Gordon J G Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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de Sousa AR, Teixeira JRB, Palma EMS, Moreira WC, Santos MB, de Carvalho HEF, Almeida ÉS, Florencio RMS, de Queiroz AM, Merces MCD, Mota TN, Araújo IFM, da Silva JC, dos Santos SD, Camargo ELS, Lourenção LG, da Silva RAR, Carvalho ESDS, Lua I, Barros S, de Araújo TM, de Oliveira MAF, Pereira Á, Abreu W, da Cruz Sequeira CA. Psychological Distress in Men during the COVID-19 Pandemic in Brazil: The Role of the Sociodemographic Variables, Uncertainty, and Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010350. [PMID: 35010610 PMCID: PMC8744977 DOI: 10.3390/ijerph19010350] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 12/28/2022]
Abstract
Objective: To analyze the relationships between sociodemographic variables, intolerance to uncertainty (INT), social support, and psychological distress (i.e., indicators of Common Mental Disorders (CMDs) and perceived stress (PS)) in Brazilian men during the COVID-19 pandemic. Methods: A cross-sectional study with national coverage, of the web survey type, and conducted with 1006 Brazilian men during the period of social circulation restriction imposed by the health authorities in Brazil for suppression of the coronavirus and control of the pandemic. Structural equation modeling analysis was performed. Results: Statistically significant direct effects of race/skin color (λ = 0.268; p-value < 0.001), socioeconomic status (SES) (λ = 0.306; p-value < 0.001), household composition (λ = 0.281; p-value < 0.001), PS (λ = 0.513; p-value < 0.001), and INT (λ = 0.421; p-value < 0.001) were evidenced in the occurrence of CMDs. Black-skinned men with higher SES, living alone, and with higher PS and INT levels presented higher prevalence values of CMDs. Conclusions: High levels of PS and INT were the factors that presented the strongest associations with the occurrence of CMDs among the men. It is necessary to implement actions to reduce the stress-generating sources as well as to promote an increase in resilience and the development of intrinsic reinforcements to deal with uncertain threats.
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Affiliation(s)
- Anderson Reis de Sousa
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador 40231-300, BA, Brazil; (A.R.d.S.); (M.B.S.); (É.S.A.); (I.F.M.A.); (J.C.d.S.); (Á.P.)
| | - Jules Ramon Brito Teixeira
- Departamento de Saúde, Universidade Estadual de Feira de Santana, Feira de Santana 44001-970, BA, Brazil; (J.R.B.T.); (S.D.d.S.); (E.S.d.S.C.); (T.M.d.A.)
| | | | - Wanderson Carneiro Moreira
- Escola de Enfermagem, Universidade de São Paulo, Sao Paulo 05403-000, SP, Brazil; (W.C.M.); (S.B.); (M.A.F.d.O.)
- Coordenação de Saúde do Adolescente, Jovem e Homem, Diretoria Técnica, Secretaria de Saúde, Prefeitura Municipal de Ananindeua, Ananindeua 67130-600, PA, Brazil
| | - Milena Bitencourt Santos
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador 40231-300, BA, Brazil; (A.R.d.S.); (M.B.S.); (É.S.A.); (I.F.M.A.); (J.C.d.S.); (Á.P.)
| | | | - Éric Santos Almeida
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador 40231-300, BA, Brazil; (A.R.d.S.); (M.B.S.); (É.S.A.); (I.F.M.A.); (J.C.d.S.); (Á.P.)
| | | | | | | | - Tilson Nunes Mota
- Secretaria de Ciência, Tecnologia e Inovação, Salvador 41745-004, BA, Brazil;
| | - Isabella Félix Meira Araújo
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador 40231-300, BA, Brazil; (A.R.d.S.); (M.B.S.); (É.S.A.); (I.F.M.A.); (J.C.d.S.); (Á.P.)
| | - Josielson Costa da Silva
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador 40231-300, BA, Brazil; (A.R.d.S.); (M.B.S.); (É.S.A.); (I.F.M.A.); (J.C.d.S.); (Á.P.)
| | - Sélton Diniz dos Santos
- Departamento de Saúde, Universidade Estadual de Feira de Santana, Feira de Santana 44001-970, BA, Brazil; (J.R.B.T.); (S.D.d.S.); (E.S.d.S.C.); (T.M.d.A.)
| | | | | | | | - Evanilda Souza de Santana Carvalho
- Departamento de Saúde, Universidade Estadual de Feira de Santana, Feira de Santana 44001-970, BA, Brazil; (J.R.B.T.); (S.D.d.S.); (E.S.d.S.C.); (T.M.d.A.)
| | - Iracema Lua
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, BA, Brazil;
| | - Sônia Barros
- Escola de Enfermagem, Universidade de São Paulo, Sao Paulo 05403-000, SP, Brazil; (W.C.M.); (S.B.); (M.A.F.d.O.)
| | - Tânia Maria de Araújo
- Departamento de Saúde, Universidade Estadual de Feira de Santana, Feira de Santana 44001-970, BA, Brazil; (J.R.B.T.); (S.D.d.S.); (E.S.d.S.C.); (T.M.d.A.)
| | - Márcia Aparecida Ferreira de Oliveira
- Escola de Enfermagem, Universidade de São Paulo, Sao Paulo 05403-000, SP, Brazil; (W.C.M.); (S.B.); (M.A.F.d.O.)
- Programa de Pós-Graduação em Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria 97105-900, RS, Brazil
| | - Álvaro Pereira
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador 40231-300, BA, Brazil; (A.R.d.S.); (M.B.S.); (É.S.A.); (I.F.M.A.); (J.C.d.S.); (Á.P.)
| | - Wilson Abreu
- Centro de Investigação em Tecnologias e Serviços de Saúde, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal;
| | - Carlos Alberto da Cruz Sequeira
- Centro de Investigação em Tecnologias e Serviços de Saúde, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal;
- Correspondence:
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Meat in a Seat: A Grounded Theory Study Exploring Moral Injury in Canadian Public Safety Communicators, Firefighters, and Paramedics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212145. [PMID: 34831899 PMCID: PMC8618733 DOI: 10.3390/ijerph182212145] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022]
Abstract
The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of "frustrating moral expectations" emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.
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Di Nota PM, Kasurak E, Bahji A, Groll D, Anderson GS. Coping among public safety personnel: A systematic review and meta–analysis. Stress Health 2021; 37:613-630. [PMID: 34597464 PMCID: PMC8013542 DOI: 10.1002/smi.3039] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 12/02/2022]
Abstract
Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as various strategies (i.e., behaviours, skills, thought and emotion regulation) for dealing with stressors, which are broadly categorized as either approach (adaptive, positive, social support) or avoidant coping strategies (maladaptive withdrawal, avoidance, substance use). This systematic review and meta-analysis aims to evaluate longitudinal coping outcomes among PSP. Thirteen eligible repeated-measures studies explicitly evaluated coping in 1854 police officers, firefighters, and rescue and recovery workers. Study designs included randomized-control trials, within-subject interventions and observational studies. Effect sizes (Cohen's d) at follow-up were described in 11 studies. Separate meta-analyses reveal small (d < 0.2) but non-significant improvements in approach and avoidant coping. Studies were of moderate quality and low risk of publication bias. Heterogeneity in outcome measures, follow-up durations, and study types precluded subgroup analyses. The current findings can inform the development and evaluation of organizational training programs that effectively promote sustained adaptive coping for PSP and mitigate PTSIs.
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Affiliation(s)
- Paula M. Di Nota
- Office of Applied Research and Graduate StudiesJustice Institute of British ColumbiaNew Westminster, BCCanada,Department of PsychologyUniversity of TorontoTorontoCanada
| | - Emily Kasurak
- Department of PsychiatryQueen's UniversityKingston, OntarioCanada
| | - Anees Bahji
- Department of PsychiatryUniversity of CalgaryCalgaryCanada
| | - Dianne Groll
- Department of PsychiatryQueen's UniversityKingston, OntarioCanada
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Badawi A, Steel Z, Harb M, Mahoney C, Berle D. Changes in intolerance of uncertainty over the course of treatment predict posttraumatic stress disorder symptoms in an inpatient sample. Clin Psychol Psychother 2021; 29:230-239. [PMID: 34110076 PMCID: PMC9292517 DOI: 10.1002/cpp.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022]
Abstract
Intolerance of uncertainty (IU) is the inability to tolerate distress that arises in response to the absence of important information. The level of IU has been investigated across various psychological disorders; however, few studies have examined IU in trauma‐affected samples. We aimed to investigate the relationship between IU and posttraumatic stress disorder (PTSD) across the course of treatment. Participants (n = 106) had a diagnosis of PTSD and were from first responder, military, and occupational injury backgrounds. Participants completed self‐report questionnaires pre‐ and post‐engagement in an inpatient group trauma‐informed psychoeducation and skills (TIPS) intervention. Regression analyses indicated that decreases in overall and inhibitory IU were associated with decreases in PTSD severity overall and at the symptom cluster level. However, prospective IU was only associated with changes in the re‐experiencing, avoidance, and arousal PTSD symptom clusters. Our findings are congruent with the nascent literature indicating that IU may be a maintaining factor for PTSD, suggesting clinical relevance for attendance to IU within the course of treatment.
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Affiliation(s)
- Amalia Badawi
- Discipline of Clinical Psychology, University of Technology, Sydney, Australia
| | - Zachary Steel
- School of Psychiatry, University of New South Wales, Sydney, Australia.,St John of God Healthcare, Richmond Hospital, Sydney, Australia.,Black Dog Institute, Randwick, Australia
| | | | | | - David Berle
- Discipline of Clinical Psychology, University of Technology, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
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15
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Lentz LM, Smith-MacDonald L, Malloy D, Carleton RN, Brémault-Phillips S. Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers. Front Psychol 2021; 12:639781. [PMID: 33868111 PMCID: PMC8044342 DOI: 10.3389/fpsyg.2021.639781] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Public Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger. OBJECTIVE This scoping review was designed to identify the extant empirical research regarding the construct of moral injury, its associated constructs, and how it relates to moral distress in firefighters, paramedics, and police officers. METHODS A systematic literature search of peer-reviewed research was conducted using databases MEDLINE, EMBASE, APA PsychInfo, CINHAL PLUS, Web of Science, SCOPUS, and Google Scholar. Included studies were selected based on the inclusion criteria before being manually extracted and independently screened by two reviewers. RESULTS The initial database search returned 777 articles, 506 of which remained after removal of duplicates. Following review of titles, abstracts, and full texts, 32 studies were included in the current review. Participants in the articles were primarily police officers, with fewer articles focusing on paramedics and firefighters. There were two studies that included mixed populations (i.e., one study with police officers, firefighters, and other emergency service workers; one study with paramedic and firefighter incident commanders). Most studies were qualitative and focused on four topics: values, ethical decision-making, organizational betrayal, and spirituality. CONCLUSION Public safety organizations appear to recognize the experience of moral distress or moral injury among public safety personnel that results from disconnects between personal core values, formal and informal organizational values, vocational duties, and expectations. Further research is needed to better understand moral distress or moral injury specific to public safety personnel and inform training and treatment in support of public safety personnel mental health.
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Affiliation(s)
- Liana M. Lentz
- Faculty of Health Science, Western University, London, ON, Canada
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada
| | - Lorraine Smith-MacDonald
- Faculty of Health Science, Western University, London, ON, Canada
- Heroes in Mind Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - David Malloy
- King’s University College, University of Western Ontario, London, ON, Canada
| | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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16
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Zhuo L, Wu Q, Le H, Li H, Zheng L, Ma G, Tao H. COVID-19-Related Intolerance of Uncertainty and Mental Health among Back-To-School Students in Wuhan: The Moderation Effect of Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030981. [PMID: 33499409 PMCID: PMC7908243 DOI: 10.3390/ijerph18030981] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 01/08/2023]
Abstract
The current wave and future trend of the novel coronavirus disease 2019 (COVID-19) has triggered public uncertainty, causing unbearable psychological pressure on people. A cross-sectional online questionnaire was conducted among back-to-school students in Wuhan from 31 August 2020, to 14 September 2020, by using convenience sampling. A total of 1017 participants voluntarily provided sociodemographic characteristics and accomplished the following scales: the Intolerance of Uncertainty Scale (IUS-12), the Social Support Scale (SSQ), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index-7 (ISI-7). Results revealed that the levels of anxiety, depression, and insomnia were moderate, moderate and subthreshold, respectively. A one-way multivariate analysis of variance indicated that those with different attitudes toward the trajectory of the COVID-19 epidemic in China showed significantly different results in anxiety and depression (p < 0.001). Moderation modeling implicated that social support significantly moderated the predictive relationship between intolerance of uncertainty and mental health variables including anxiety and depression, but failed on insomnia. Findings indicate that back-to-school students in Wuhan experience mental health problems and improving social support measures could buffer the effect of intolerance of uncertainty with respect to COVID-19 on mental health.
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Suhas S, Nayok SB, Chaturvedi SK. Parasocial Interactions, Intolerance to Uncertainty and Mental Health Rehabilitation During Pandemics. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2021; 8:1-4. [PMID: 33777661 PMCID: PMC7978456 DOI: 10.1007/s40737-021-00213-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Satish Suhas
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Swarna Buddha Nayok
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Santosh Kumar Chaturvedi
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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18
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Ferrer-Torres A, Giménez-Llort L. Confinement and the Hatred of Sound in Times of COVID-19: A Molotov Cocktail for People With Misophonia. Front Psychiatry 2021; 12:627044. [PMID: 34040551 PMCID: PMC8141632 DOI: 10.3389/fpsyt.2021.627044] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
Forced strict confinement to hamper the COVID-19 pandemic seriously affected people suffering from misophonia (M+) and those living with them. Misophonia is a complex neurophysiological and behavioral disorder of multifactorial origin, characterized by an intense physiological and emotional response produced by intolerance to auditory stimuli of the same pattern, regardless of physical properties. The present work studied the secondary impact that strict confinement caused in 342 adults (224 women: 118 men) regularly attending a medical psychological center in Barcelona. Misophonia, usually underdiagnosed, showed a prevalence of 35%, the same for women (37%) than men (31%). A retrospective analysis using a physical-psychological-social inventory of 10 variables evaluated the number of individuals that during confinement and self-confinement (March 11 - June 29, 2020) canceled (mostly M-) and/or requested a therapeutic intervention, the reasons for their request, and the strategies they used to self-manage the situation. Ten main variables indicated that the confinement exponentially increased the effects of misophonia compared with results from the same individuals during the last quarter of 2019. Most people diagnosed with misophonia continued with tele-assistance during the confinement because of this impact's self-concern. Besides the impacts as part of the general population, M+ also developed different symptoms causing significant personal, social, and job/occupational imbalance, as compared to M-. Health, fears, conflicts with neighbors, study-related difficulties were outstanding reasons for consultations. The LSB-50 test for 'Psychological and Psychosomatic Symptoms' applied to M+ revealed the increase of 8 of 9 items of this psychopathological test. Sleep disorders (coronasomnia), hostility, depression, and somatization were more severe than in previous assessments. Women presented the worst psychological and psychosomatic states (eight out of nine, as compared to one out of nine in males). The study unveiled the complex physical-psychological-social burden, the need for dissemination and a gender perspective to understand the secondary impact of COVID-19 pandemic on the mental health of the population with misophonia. The results also show that in this new COVID era people suffering from misophonia need to develop coping strategies addressing modifiable risk and protective factors. They deserve familial/social comprehension, stronger clinical support and a gender medicine perspective.
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Affiliation(s)
- Antonia Ferrer-Torres
- L'Alfatier - Centro Médico Psicológico, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
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19
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Burns C, Buchanan M. Factors that Influence the Decision to Seek Help in a Police Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6891. [PMID: 32967171 PMCID: PMC7559930 DOI: 10.3390/ijerph17186891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking for or receiving assistance. The stigma of being perceived as weak or incompetent, concerns about being labelled unfit for duty, and worry that accessing psychological support will impact future career advancement can affect the decision to seek help. The Enhanced Critical Incident Technique was utilized to investigate the following research question: What helps or hinders the decision to access psychological services in a police population? Qualitative interviews were conducted with 20 serving Royal Canadian Mounted Police officers in the lower mainland of British Columbia, Canada. The findings encompass five main themes: the importance of systemic factors, access to information and education, quality and influence of relationships, individual characteristics, and organizational processes that will increase the likelihood of accessing mental health services. The results contribute to the empirical literature by enhancing what is known about elements that influence an officers' decision to seek psychological services, and factors that can enable officers to overcome barriers.
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Affiliation(s)
- Carolyn Burns
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Burns Psychological Services, Langley, BC V2Y 0E2, Canada
| | - Marla Buchanan
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
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