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Jones R, Jackson D, Ranse J, Arena A, Clegg L, Sutton C, Gayed A, Rice K, Usher K. A Scoping Review of Trauma, Mental Health and First Responders in Australia. Int J Ment Health Nurs 2024. [PMID: 39090821 DOI: 10.1111/inm.13397] [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] [Received: 04/02/2024] [Revised: 05/20/2024] [Accepted: 07/11/2024] [Indexed: 08/04/2024]
Abstract
Exposure to traumatic and/or violent events is an inherent part of the first responder role, which increases the risk of developing acute and chronic mental health symptoms and conditions. Suicidality for Australian first responders have recently increased with prevalence considered much higher compared with the general population. To inform specific recommendations for Australian first responders, there is a need to establish what evidence is available regarding these issues within the Australian context. The aim of this scoping review was to explore the impacts of trauma on the mental health of Australian first responders, the strategies recommended to address these issues and any unique needs in rural contexts. A scoping review was undertaken following PRISMA guidelines for scoping reviews. Peer-reviewed articles on Australian first responder mental health from seven databases were screened for inclusion. This review highlights that despite available evidence on the types of traumas and adverse mental health outcomes experienced, less evidence exists pertaining to intervention effectiveness. There are major gaps in evidence within rural and remote contexts which hinders effective planning and delivery of support for rural and regional first responders. Clinicians such as mental health nurses, particularly in rural areas, need to be aware of these gaps which impact planning and delivery of support and are in prime position to ensure screening, interventions and strategies are used and evaluated to determine their suitability for rural first responders.
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Affiliation(s)
- Rikki Jones
- University of New England, Armidale, Australia
- Manna Institute, University of New England, Armidale, Australia
| | | | | | - Andrew Arena
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Lisa Clegg
- Charles Sturt University, Bathurst, Australia
| | | | - Aimee Gayed
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Kylie Rice
- University of New England, Armidale, Australia
| | - Kim Usher
- University of New England, Armidale, Australia
- Manna Institute, University of New England, Armidale, Australia
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Counson I, Sanatkar S, Knight A, Lawrence D, Harvey SB. Comparing post-traumatic stress severity in professional and volunteer Australian firefighters. Occup Med (Lond) 2023; 73:410-418. [PMID: 37713597 DOI: 10.1093/occmed/kqad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND While extensive research has highlighted increased risk for post-traumatic stress disorder (PTSD) in firefighters, previous research has yielded mixed results regarding the role of work status (professional versus volunteer) in the development of psychopathological symptoms. AIMS To explore the predictive strength of work status on PTSD or post-traumatic stress symptom severity in a large sample of professional (PFFs) and volunteer (VFFs) Australian firefighters exposed to operational work-related trauma. METHODS The stratified random sample comprised 1317 PFFs (n = 1148 (87%) males and 13%, n = 169 (13%) females) and 898 VFFs (n = 744 (83%) males and n = 154 (17%) females) who reported having experienced trauma while working or volunteering. Participants completed demographic, health and work-related questions and mental health measures of stress, trauma, PTSD, social support and use of mental health prevention programmes. RESULTS The results revealed a significant relationship between work status and PTSD, with PFFs reporting higher levels of PTSD symptom severity compared to VFFs. This association persisted after controlling for demographics, health, stress away from work, social support and use of organizational mental health support programmes (debriefing and face-to-face training for mental and physical self-care). CONCLUSIONS This study suggests the importance of work status in PTSD amongst Australian firefighters exposed to operational trauma. Future research is needed to substantiate our findings and examine why PFFs may be more prone to developing PTSD. Implications for the provision of mental health programmes offered by fire organizations to their members are discussed.
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Affiliation(s)
- I Counson
- Black Dog Institute, School of Psychiatry, UNSW Sydney, Randwick, NSW 2031, Australia
| | - S Sanatkar
- Black Dog Institute, School of Psychiatry, UNSW Sydney, Randwick, NSW 2031, Australia
| | - A Knight
- School of Life Course & Population Sciences, King's College London, London, SE1 1UL, UK
| | - D Lawrence
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - S B Harvey
- Black Dog Institute, School of Psychiatry, UNSW Sydney, Randwick, NSW 2031, Australia
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Petrie K, Spittal M, Zeritis S, Phillips M, Deady M, Forbes D, Bryant R, Shand F, Harvey SB. Suicide among emergency service workers: a retrospective mortality study of national coronial data, 2001-2017. Psychol Med 2023; 53:5470-5477. [PMID: 36073166 DOI: 10.1017/s0033291722002653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Emergency service workers (ESW) are known to be at increased risk of mental disorders but population-level and longitudinal data regarding their risk of suicide are lacking. METHOD Suicide data for 2001-2017 were extracted from the Australian National Coronial Information Service (NCIS) for two occupational groups: ESW (ambulance personnel, fire-fighters and emergency workers, police officers) and individuals employed in all other occupations. Age-standardised suicide rates were calculated and risk of suicide compared using negative binomial regression modelling. RESULTS 13 800 suicide cases were identified among employed adults (20-69 years) over the study period. The age-standardised suicide rate across all ESW was 14.3 per 100 000 (95% CI 11.0-17.7) compared to 9.8 per 100 000 (95% CI 9.6-9.9) for other occupations. Significant occupational differences in the method of suicide were identified (p < 0.001). There was no evidence for increased risk of suicide among ESW compared to other occupations once age, gender and year of death were accounted for (RR = 0.99, 95% CI 0.84-1.17; p = 0.95). In contrast, there was a trend for ambulance personnel to be at elevated risk of suicide (RR = 1.41, 95% CI 1.00-2.00, p = 0.053). CONCLUSION Whilst age-standardised suicide rates among ESW are higher than other occupations, emergency service work was not independently associated with an increased risk of suicide, with the exception of an observed trend in ambulance personnel. Despite an increased focus on ESW mental health and wellbeing over the last two decades, there was no evidence that rates of suicide among ESW are changing over time.
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Affiliation(s)
- Katherine Petrie
- Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, 2000, Australia
| | - Matthew Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Stephanie Zeritis
- Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
| | - Matthew Phillips
- Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
| | - Mark Deady
- Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
| | - David Forbes
- Department of Psychiatry, Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, 2000, Australia
| | - Fiona Shand
- Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
| | - Samuel B Harvey
- Black Dog Institute, School of Medicine, University of New South Wales, Randwick, NSW, 2031, Australia
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Reffi AN, Cheng P. Healthy sleep may bolster resilience to depression and posttraumatic stress disorder in new paramedics. Sleep 2023; 46:zsad064. [PMID: 36883766 DOI: 10.1093/sleep/zsad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Indexed: 03/09/2023] Open
Affiliation(s)
- Anthony N Reffi
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health, Detroit, MI, USA
| | - Philip Cheng
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health, Detroit, MI, USA
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Sharma V, Singh TG, Kaur A, Mannan A, Dhiman S. Brain-Derived Neurotrophic Factor: A Novel Dynamically Regulated Therapeutic Modulator in Neurological Disorders. Neurochem Res 2023; 48:317-339. [PMID: 36308619 DOI: 10.1007/s11064-022-03755-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 02/04/2023]
Abstract
The growth factor brain-derived neurotrophic factor (BDNF), and its receptor tropomyosin-related kinase receptor type B (TrkB) play an active role in numerous areas of the adult brain, where they regulate the neuronal activity, function, and survival. Upregulation and downregulation of BDNF expression are critical for the physiology of neuronal circuits and functioning in the brain. Loss of BDNF function has been reported in the brains of patients with neurodegenerative or psychiatric disorders. This article reviews the BDNF gene structure, transport, secretion, expression and functions in the brain. This article also implicates BDNF in several brain-related disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, major depressive disorder, schizophrenia, epilepsy and bipolar disorder.
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Affiliation(s)
- Veerta Sharma
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India.
| | - Amarjot Kaur
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
| | - Ashi Mannan
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
| | - Sonia Dhiman
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
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Tang J, Li XC, Zhang X. The Eudemonic Wellbeing of Volunteers in a Public Health Emergency: COVID-19 in China. Front Psychol 2022; 13:903147. [PMID: 35719588 PMCID: PMC9200989 DOI: 10.3389/fpsyg.2022.903147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
With improvements in the public awareness regarding volunteer opportunities, more people are participating in social work, particularly during emergency events. The mental health of volunteers has been attracting more academic attention due to its increasing social significance. Drawing on the Theory of Planned Behavior, a qualitative interview was conducted to identify important attitudes, subjective norms, and perceived control factors guiding people's volunteering behaviors in an emergency context. Then, a sequential quantitative survey was implemented based on the results of the qualitative study to explore the impact of the aforementioned factors and job involvement on eudemonic well-being. The moderating role of empathy in these relationships was also investigated in this nested design. The results indicate that behavioral attitudes, perceived control, and job involvement have significant positive effects on volunteers' eudemonic well-being. A high perspective taking (cognitive empathy) of volunteers positively moderates the relationship between job involvement and eudemonic well-being, while high personal distress (affective empathy) buffers this relationship. The theoretical and practical implications of these findings are discussed in relation to emergency volunteer activities.
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Affiliation(s)
- Juan Tang
- Faculty of Hospitality and Tourism Management, Macau University of Science and Technology, Macau, Macau SAR, China
| | - Xiao-Chen Li
- Faculty of Hospitality and Tourism Management, Macau University of Science and Technology, Macau, Macau SAR, China
| | - Xi Zhang
- School of Innovation and Entrepreneurship, Guangdong Polytechnic Normal University, Guangzhou, China
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Alexithymia and Emotional Deficits Related to Posttraumatic Stress Disorder: An Investigation of Content and Process Disturbances. Case Rep Psychiatry 2022; 2022:7760988. [PMID: 35103107 PMCID: PMC8800611 DOI: 10.1155/2022/7760988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/08/2022] [Indexed: 01/31/2023] Open
Abstract
Background Posttraumatic stress disorder (PTSD) is a debilitating mental disorder that develops in the aftermath of traumatic life experiences, especially those that occurred in childhood. PTSD is associated with intrusive memories, distressing dreams, dissociative reactions, avoidance of trauma-related stimuli, negative mood and sense of well-being, increased arousal and irritability, and clinically significant distress and impaired functioning. Case Presentation. The following case report presents a 42-year-old male displaying symptoms of PTSD, alexithymia, and depression. Conclusion Untreated alexithymia may aggravate the trauma and cause the development of PTSD and depression.
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Tan L, Petrie K, Deady M, Bryant RA, Harvey SB. Systematic review of first responder post-deployment or post-incident psychosocial interventions. Occup Med (Lond) 2022; 72:160-169. [PMID: 35020931 DOI: 10.1093/occmed/kqab182] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND First responder populations, such as emergency services and the military, report elevated levels of mental health problems. Although post-deployment or post-incident psychosocial support interventions are widely implemented within these services, its effectiveness in preventing the development of mental disorders is unclear. AIMS To systematically assess which, if any, post-deployment or post-incident psychosocial interventions are effective at preventing the development of post-traumatic stress disorder (PTSD) and common mental disorders (CMD) amongst military and emergency service worker (ESW) settings. METHODS A systematic review was conducted by searching four databases for any randomized controlled trials (RCTs) or controlled trials of post-deployment or post-incident interventions. The primary outcomes assessed were differences in symptoms of PTSD and CMD. Study quality was examined using the Downs and Black checklist. Pooled effect sizes and 95% CI were calculated using random-effects modelling for main meta-analyses, planned subgroup and sensitivity analyses. RESULTS From 317 articles, seven RCTs were included in the final meta-analysis. Interventions identified included psychological debriefing, screening, stress education, team-based skills training and a peer-delivered risk assessment. A very small but significant effect was found for team-based skills training in reducing CMD symptoms. Some evidence was also found for team cohesion training in reducing both PTSD and CMD. CONCLUSIONS Limited evidence was found for post-deployment or post-incident psychosocial interventions within military and ESW populations. More high-quality studies, particularly among ESW settings, are urgently needed to determine how to better prevent the development of trauma related disorders after exposure.
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Affiliation(s)
- Leona Tan
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, UNSW Sydney, Kensington, NSW, Australia
| | - Katherine Petrie
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, UNSW Sydney, Kensington, NSW, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, UNSW Sydney, Kensington, NSW, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
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Mikutta C, Schmid JJ, Ehlert U. Resilience and Post-traumatic Stress Disorder in the Swiss Alpine Rescue Association. Front Psychiatry 2022; 13:780498. [PMID: 35401258 PMCID: PMC8985199 DOI: 10.3389/fpsyt.2022.780498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The present study aimed to assess the frequency of trauma exposure, the prevalence of possible post-traumatic stress disorder (PTSD), the extent of resilience, and sense of coherence among personnel of the Swiss alpine rescue association (ARS). METHODS Using a trilingual online survey approach, 465 mountain rescuers of the ARS were surveyed using the Posttraumatic Diagnostic Scale (PDS), the PTSD Checklist 5 (PCL-5), the Resilience Scale 13 and 14 (RS-13/-14), the Perceived Stress Scale 10 (PSS-10), the General Health Questionnaire 12 (GHQ-12), the Pittsburg Sleep Quality Index (PSQI), the Sense of Coherence Scale 13 (SOC-13), and the Berlin Social Support Scales (BSSS). RESULTS Although the rate of mountain rescuers having witnessed or experienced a traumatic event was high (71%), the prevalence of possible PTSD was low (0.9%). The sample showed high resilience and high sense of coherence. Resilience was positively correlated with work experience. Low perceived stress and high sense of coherence predicted resilience. The severity of PTSD symptoms was mainly predicted by low sense of coherence. Sense of coherence mediated the interaction between resilience and severity of PTSD symptoms. CONCLUSION The findings suggest that resilience and sense of coherence are indicative for the low prevalence of possible PTSD among mountain rescuers, and may therefore represent valuable screening and training parameters for mountain rescue personnel.
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Affiliation(s)
- Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Privatklinik Meiringen, Meiringen, Switzerland
| | - Julia J Schmid
- Department of Clinical Psychology, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology, University of Zurich, Zurich, Switzerland
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Zhang Y, Workman A, Russell MA, Williamson M, Pan H, Reifels L. The long-term impact of bushfires on the mental health of Australians: a systematic review and meta-analysis. Eur J Psychotraumatol 2022; 13:2087980. [PMID: 35957633 PMCID: PMC9359172 DOI: 10.1080/20008198.2022.2087980] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The long-term health effects of bushfires include the potential to trigger new and exacerbate existing mental health problems. OBJECTIVE This review aimed to determine the prevalence of long-term mental health issues in Australian populations exposed to bushfires. METHOD A systematic search was conducted in five databases (Embase, Medline, PsycINFO, Scopus, and Web of Science) to identify studies focusing on Australian populations impacted by bushfires with the prevalence of mental health issues reported at 2+ years after bushfire. The Joanna Briggs Institute prevalence critical appraisal tool was utilised. We conducted meta-analyses to determine the prevalence of general psychological distress in the general population, and a narrative synthesis. RESULTS We included 21 articles based on 5 studies and conducted on 3 bushfire events. Meta-analyses showed a pooled prevalence of 14% (95% CI 12%-16%) for psychological distress in the general population at 2-4 years post bushfire. The overall prevalence of long-term psychological problems in firefighters at 2-7 years ranged from 28% to 47.6%. The prevalence of some psychological issues decreased with time and was directly proportional to the level of bushfire impact. CONCLUSIONS As the magnitude of long-term bushfire-related mental health impacts in Australia is severe, it is important to monitor psychological problems and assist communities in future. Future research needs include: (a) more studies on the full range of long-term psychological impacts of bushfires, and (b) consensus on instruments and diagnostic criteria to define mental health issues. HIGHLIGHTS First systematic review of long-term bushfire mental health issues in Australia.Indicating substantial mental health problems among affected populations.Long-term issues were linked to bushfire impact and elevated among firefighters.Highlighting need for further rigorous research on long-term disaster sequalae.
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Affiliation(s)
- Yanqin Zhang
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Annabelle Workman
- Melbourne Climate Futures, Melbourne Law School, The University of Melbourne, Parkville, Australia
| | - Melissa A Russell
- Centre of Epidemiology and Biostatics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Michelle Williamson
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Haotai Pan
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
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Mueller AK, Singh A, Webber MP, Hall CB, Prezant DJ, Zeig‐Owens R. PTSD symptoms, depressive symptoms, and subjective cognitive concerns in WTC-exposed and non-WTC-exposed firefighters. Am J Ind Med 2021; 64:803-814. [PMID: 34415073 DOI: 10.1002/ajim.23285] [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: 05/14/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Firefighting has been associated with posttraumatic stress disorder (PTSD) and other mental health conditions. We previously found that among Fire Department of the City of New York (FDNY) responders to the World Trade Center (WTC) disaster, higher-intensity WTC-exposure predicted PTSD symptoms, depressive symptoms, and subjective cognitive concerns. The present study aims to compare these symptoms in the FDNY WTC-exposed cohort versus a comparison cohort of non-FDNY, non-WTC-exposed firefighters. METHODS The study population included WTC-exposed male firefighters from FDNY (N = 8466) and non-WTC-exposed male firefighters from Chicago (N = 1195), Philadelphia (N = 770), and San Francisco (N = 650) fire departments who were employed on 9/11/2001 and completed a health questionnaire between 3/1/2018 and 12/31/2020. Current PTSD symptoms, depressive symptoms, and subjective cognitive concerns were assessed via validated screening instruments. Multivariable linear regression analyses stratified by fire department estimated the impact of covariates on each outcome. RESULTS Adjusted mean PTSD symptom scores ranged from 23.5 ± 0.6 in Chicago firefighters to 25.8 ± 0.2 in FDNY, and adjusted mean depressive symptom scores ranged from 7.3 ± 0.5 in Chicago to 9.4 ± 0.6 in Philadelphia. WTC-exposure was associated with fewer subjective cognitive concerns (β = -0.69 ± 0.05, p < .001) after controlling for covariates. Across cohorts, older age was associated with more cognitive concerns, but fewer PTSD and depressive symptoms. CONCLUSIONS WTC-exposed firefighters had fewer cognitive concerns compared with non-WTC-exposed firefighters. We were unable to estimate associations between WTC exposure and PTSD symptoms or depressive symptoms due to variability between non-WTC-exposed cohorts. Longitudinal follow-up is needed to assess PTSD, depressive, and cognitive symptom trajectories in firefighter populations as they age.
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Affiliation(s)
- Alexandra K. Mueller
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
| | - Ankura Singh
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
| | - Mayris P. Webber
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
| | - Charles B. Hall
- Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
| | - David J. Prezant
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
| | - Rachel Zeig‐Owens
- Fire Department of the City of New York Bureau of Health Services Brooklyn New York USA
- Department of Medicine, Pulmonology Division Montefiore Medical Center Bronx New York USA
- Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
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Roncone R, Giusti L, Mammarella S, Salza A, Bianchini V, Lombardi A, Prosperocco M, Ursini E, Scaletta V, Casacchia M. "Hang in There!": Mental Health in a Sample of the Italian Civil Protection Volunteers during the COVID-19 Health Emergency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8587. [PMID: 34444336 PMCID: PMC8394470 DOI: 10.3390/ijerph18168587] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 01/23/2023]
Abstract
Few studies have been conducted on civil volunteers and their emotional conditions concerning the current COVID-19 pandemic. The present study aimed to evaluate the impact of the COVID-19 emergency on the mental health (general well-being, depression level, and post-traumatic distress), coping strategies, and training needs in an Italian sample of 331 Civil Protection volunteers of the L'Aquila province, during the first nationwide "lockdown" (8 March-3 June 2020). The rate of respondents to the online survey was limited (11.5%), presumably because displaying distress would be considered a sign of "weakness", making volunteers unable to do their jobs. More than 90% of the volunteers showed good mental health conditions and a wide utilization of positive coping strategies, with the less experienced displaying better emotional conditions compared to colleagues with 10 or more years of experience. The type of emergency, the relatively few cases of contagion and mortality in the territory compared to the rest of Italy, and the sense of helping the community, together with the awareness of their group identity, could have contributed to the reported well-being. These results may help to identify the needs of volunteers related to this new "urban" emergency to improve both their technical and emotional skills.
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Affiliation(s)
- Rita Roncone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
- University Unit Rehabilitation Treatment, Early Interventions in Mental Health, Hospital S. Salvatore, 67100 L’Aquila, Italy
| | - Laura Giusti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Silvia Mammarella
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Anna Salza
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Valeria Bianchini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
| | - Annalina Lombardi
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Massimo Prosperocco
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Elio Ursini
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Valentina Scaletta
- LARES Italia—Unione Nazionale Laureati Esperti in Protezione Civile, 67100 L’Aquila, Italy; (A.L.); (M.P.); (E.U.); (V.S.)
| | - Massimo Casacchia
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Spennati 1, Edificio Delta 6, Studio 110-Coppito, 67100 L’Aquila, Italy; (L.G.); (S.M.); (A.S.); (V.B.); (M.C.)
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Brief Mental Health Disorder Screening Questionnaires and Use with Public Safety Personnel: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073743. [PMID: 33916659 PMCID: PMC8038412 DOI: 10.3390/ijerph18073743] [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: 03/11/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
Brief mental health disorder screening questionnaires (SQs) are used by psychiatrists, physicians, researchers, psychologists, and other mental health professionals and may provide an efficient method to guide clinicians to query symptom areas requiring further assessment. For example, annual screening has been used to help identify military personnel who may need help. Nearly half (44.5%) of Canadian public safety personnel (PSP) screen positive for one or more mental health disorder(s); as such, regular mental health screenings for PSP may be a valuable way to support mental health. The following review was conducted to (1) identify existing brief mental health disorder SQs; (2) review empirical evidence of the validity of identified SQs; (3) identify SQs validated within PSP populations; and (4) recommend appropriately validated brief screening questionnaires for five common mental health disorders (i.e., generalized anxiety disorder (GAD), major depressive depression (MDD), panic disorder, posttraumatic stress disorder, alcohol use disorder). After reviewing the psychometric properties of the identified brief screening questionnaires, we recommend the following four brief screening tools for use with PSP: the Patient Health Questionnaire-4 (screening for MDD and GAD), the Brief Panic Disorder Symptom Screen—Self-Report, the Short-Form Posttraumatic Checklist-5, and the Alcohol Use Disorders Identification Test-Consumption.
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Sahebi A, Yousefi K, Moayedi S, Golitaleb N, Esmaeili Vardanjani A, Golitaleb M. Prevalence of Posttraumatic Stress Disorder among Firefighters in Iran: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:358-365. [PMID: 33240386 PMCID: PMC7610073 DOI: 10.18502/ijps.v15i4.4301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Firefighters are exposed to many different chemicals and physical hazards and experience a significant number of accidents and injuries. They are exposed to high-risk of posttraumatic stress disorder (PTSD). The purpose of this study was to determine the prevalence of PTSD among Iranian firefighters. Method: This was a systematic review and meta-analysis. Valid Persian and English keywords were searched in data resources, including SID, Magiran, Irandoc, Google Scholar, PubMed, Scopus, and Web of Science to retrieve articles on the prevalence of PTSD among Iranian firefighters. The STROBE checklist was used to assess the quality of the articles. Heterogeneity among the studies was assessed by I2 index. The data were analyzed using Stata14 software. Results: Of the 316 articles selected in the initial search, 3 articles the inclusion criteria and were used for the meta-analysis. A total of 274 firefighters were studied. The prevalence of PTSD was 23.17% among Iranian firefighters (I2 = 92.4%, 95% CI = 6.71-39.62, p < 0.001). Conclusion: The prevalence of PTSD is among Iranian firefighters relatively high and has been on the rise over the recent years.
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Affiliation(s)
- Ali Sahebi
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Kosar Yousefi
- Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Siamak Moayedi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, United States
| | - Najaf Golitaleb
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Esmaeili Vardanjani
- Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohamad Golitaleb
- Department of Critical Care Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
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Reid BO, Haugland H, Abrahamsen HB, Bjørnsen LP, Uleberg O, Krüger AJ. Prehospital Stressors: A Cross-sectional Study of Norwegian Helicopter Emergency Medical Physicians. Air Med J 2020; 39:383-388. [PMID: 33012477 DOI: 10.1016/j.amj.2020.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/14/2020] [Accepted: 05/25/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Personnel working in helicopter emergency medical services (HEMS) and search and rescue (SAR) are exposed to environmental stressors, which may impair performance. The aim of this survey was to study the extent HEMS and SAR physicians report the influence of specific danger-based and non-danger-based stressors. METHODS The study was performed as a cross-sectional, anonymous, Web-based (Questback AS, Bogstadveien 54, 0366 Oslo, Norway) survey of Norwegian HEMS and SAR physicians between December 2, 2019, and February 25, 2020. RESULTS Of the recipients, 119 (79.3%) responded. In helicopter operations, 33.6% (n = 40) reported involvement in a minor accident and 44.5% (n = 53) a near accident. In the rapid response car, 26.1% (n = 31) reported near accidents, whereas 26.9% (32) reported this in an ambulance. Of physicians, 20.2% (n = 24) received verbal abuse or threats during the last 12 months. When on call, 50.4% (n = 60) of physicians reported sometimes or often being influenced by fatigue. CONCLUSION This study shows that Norwegian HEMS and SAR physicians are exposed to several stressors of both a danger-based and non-danger-based nature, especially regarding accidents, threatening patient behavior, and fatigue. Very serious incidents appear to be seldom, and job satisfaction is high.
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Affiliation(s)
- Bjørn Ole Reid
- Department of Emergency Medicine and Prehospital Services, St Olavs Hospital, Trondheim, Norway; Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.
| | - Helge Haugland
- Department of Emergency Medicine and Prehospital Services, St Olavs Hospital, Trondheim, Norway; Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway
| | - Håkon Bjorheim Abrahamsen
- Institute for Safety, Economics and Planning, University of Stavanger, Norway; Department of Anesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
| | - Lars Petter Bjørnsen
- Department of Emergency Medicine and Prehospital Services, St Olavs Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Prehospital Services, St Olavs Hospital, Trondheim, Norway; Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway
| | - Andreas J Krüger
- Department of Emergency Medicine and Prehospital Services, St Olavs Hospital, Trondheim, Norway; Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway
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Schnell T, Suhr F, Weierstall-Pust R. Post-traumatic stress disorder in volunteer firefighters: influence of specific risk and protective factors. Eur J Psychotraumatol 2020; 11:1764722. [PMID: 33029308 PMCID: PMC7473037 DOI: 10.1080/20008198.2020.1764722] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Volunteer firefighters belong to a risk population regarding the development of posttraumatic stress disorder (PTSD). However, given the frequency of work-related trauma, PTSD prevalences seem relatively low. Protective factors appear to be effective and are the focus of this study. OBJECTIVE We investigated the PTSD-prevalence as well as the influence of trauma exposure and the impact of protective factors resilience and Sense of Coherence (SoC) on symptoms of PTSD in volunteer firefighters. METHOD Data from 232 participants of an online questionnaire study were analysed using a path model approach. RESULTS 'The results suggest a possible prevalence of PTSD of 12.5% and 2.2% for partial PTSD based on self-report measures. SoC and trauma event load proved to be independent of each other, as no intercorrelations were found. But both directly predicted PTSD severity. Higher resilience scores predicted the participants' Sense of Coherence, but PTSD severity was only indirectly affected by resilience, which was entirely mediated by SoC. Further, although SoC and trauma load increase with age and years of job experience, it is only SoC that affects PTSD severity, not age or years of experience. CONCLUSIONS The results emphasize that not only exposure to potentially traumatic events predicts the later probability of developing symptoms of PTSD, but that the integration of stressful experiences into the self-concept (associated with SoC) is essential for the development of PTSD. Future research should address the question of causality between SoC and PTSD, and consider which factors moderate the SoC.
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Affiliation(s)
- Thomas Schnell
- Department of Clinical Psychology and Psychotherapy, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Frederike Suhr
- Department of Clinical Psychology and Psychotherapy, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Roland Weierstall-Pust
- Department of Clinical Psychology and Psychotherapy, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
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Taylor J, McLean L, Richards B, Glozier N. Personalised yoga for burnout and traumatic stress in junior doctors. Postgrad Med J 2020; 96:349-357. [DOI: 10.1136/postgradmedj-2019-137413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 01/09/2023]
Abstract
ObjectivesJunior doctors are frequently exposed to occupational and traumatic stress, sometimes with tragic consequences. Mindfulness-based and fitness interventions are increasingly used to mitigate this, but have not been compared.We conducted a randomised, controlled pilot trial to assess the feasibility, acceptability and effectiveness of these interventions in junior doctors.MethodsWe randomised participants (n=21) to weekly 1-hour sessions of personalised, trauma-informed yoga (n=10), with a 4-hour workshop, and eHealth homework; or group-format fitness (n=8) in an existing wellness programme, MDOK. Burnout, traumatic stress and suicidality were measured at baseline and 8 weeks.ResultsBoth interventions reduced burnout, and yoga increased compassion satisfaction within group on the Professional Quality of Life scale, without difference between groups on this measure.Personalised yoga significantly reduced depersonalisation (z=−1.99, p=0.05) compared with group fitness on the Maslach Burnout Inventory (MBI-HSS (MP)) and showed greater flexibility changes. Both interventions increased MBI Personal Accomplishment, with no changes in other self-report psychological or physiological metrics, including breath-counting.Participants doing one-to-one yoga rated it more highly overall (p=0.02) than group fitness, and reported it comparatively more beneficial for mental (p=0.01) and physical health (p=0.05). Face-to-face weekly sessions were 100% attended in yoga, but only 45% in fitness.ConclusionIn this pilot trial, both yoga and fitness improved burnout, but trauma-informed yoga reduced depersonalisation in junior doctors more than group-format fitness. One-to-one yoga was better adhered than fitness, but was more resource intensive. Junior doctors need larger-scale comparative research of the effectiveness and implementation of individual, organisational and systemic mental health interventions.Trial registration numberANZCTR 12618001467224.
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