Effects of medical crisis intervention on anxiety, depression, and posttraumatic stress symptoms: a meta-analysis

Psychological first aid to support healthcare professionals

Psychological first aid (PFA) may be considered a form of acute psychological crisis intervention designed to foster human resilience. PFA has been universally endorsed as an important addition to the corpus of mental health-related support services in the wake of disasters. As support grows for its utilization beyond disasters alone, consideration should be given to the application of PFA to high-risk occupational setting. While PFA has begun to be used in the emergency services, it would also seem to be well suited for fostering resilience in healthcare settings where burnout and vicarious traumatization may approach the prevalence of silent epidemics. This paper describes PFA and argues for its utilization as a non-stigmatizing approach to foster the resilience of healthcare professionals and in doing so avoiding the “second victim” phenomenon.

Psychological consequences and associated risk factors among adult survivors of the 2008 Wenchuan earthquake

BACKGROUND

In 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan, China. Following this disaster, several studies were conducted which assessed the degree of mental disorders in the affected population, but very few considered that several disorders may occur at the same time. This paper aims to investigate the psychological effects and risk factors among adult survivors one-year after the earthquake event.

METHODS

2080 adult earthquake survivors from 19 counties in the affected areas were interviewed. A stratified sampling strategy was used to collect the information. Earthquake survivors completed self-report questionnaires, which included a post-traumatic stress disorder (PTSD) checklist, a self-rating depression scale and a self-rating anxiety scale.

RESULTS

Fifty nine percent of the participants were male. The prevalence of probable PTSD in the sample was 40.1% (based on the DSM-IV criteria). Significant differences in the demographic variables were found in the levels of anxiety, depression, and PTSD. Anxiety levels were found to be positively correlated with depression (r = 0.438, p < 0.01) and PTSD (r = 0.322, p < 0.01). Risk factors for each symptom were also identified. Being female, having a low income level and having a low perceived level of social support were found to be the risk factors associated with anxiety, depression, and PTSD. There appeared to be no obvious relationship between the distance from the epicenter of the earthquake event and the severity of the psychological problems.

CONCLUSIONS

PTSD, anxiety, and depression were prevalent among the survivors. Most findings on the predictors were found to be consistent with current research. Positive adjustment and social support were found to be needed for the highest-risk population.

Characteristics of staff victims of pschiatric patient assaults: 15-year analysis of the Assaulted Staff Action Program (ASAP)

Psychiatric patient assaults on staff victims are a worldwide occupational hazard. This paper reports on a 15-year study of the characteristics of staff victims of patient assaults and a crisis intervention procedure to ameliorate the aftermath of theses incidents. The debate on the efficacy of early interventions is outlined and the present 15-year findings are presented, findings demonstrating remarkable consistency in victim characteristics over time. The crisis intervention procedures were associated with sharp declines in disrupted victim functioning. The validity of the study's findings are noted and the implications for enhanced risk management training and staff victim crisis intervention procedures are discussed.