Psychosocial considerations for mass decontamination

Citizens’ Communication Needs and Attitudes to Risk in a Nuclear Accident Scenario: A Mixed Methods Study

The potential devastation that a nuclear accident can cause to public health and the surrounding environment demands robust emergency preparedness. This includes gaining a greater knowledge of citizens’ needs in situations involving radiation risk. The present study examines citizens’ attitudes to a remediation scenario and their information and communication needs, using focus group data (n = 39) and survey data (n = 2291) from Sweden. The focus groups uniquely showed that adults of all ages express health concerns regarding young children, and many also do so regarding domestic animals. Said protective sentiments stem from a worry that even low-dose radiation is a transboundary, lingering health risk. It leads to doubts about living in a decontaminated area, and high demands on fast, continuous communication that in key phases of decontamination affords dialogue. Additionally, the survey results show that less favorable attitudes to the remediation scenario—worry over risk, doubt about decontamination effectiveness, and preferences to move away from a remediation area—are associated with the need for in-person meetings and dialogue. Risk managers should thus prepare for the need for both in-person meetings and frequent information provision tasks, but also that in-person, citizen meetings are likely to feature an over-representation of critical voices, forming very challenging communication tasks.

The psychological impact of the COVID-19 pandemic in Portugal: The role of personality traits and emotion regulation strategies

Recent evidence suggests that both personality traits (PT) and emotion regulation (ER) strategies play an important role in the way people cope with the COVID-19 pandemic. The aim of this study was two folded. First, to longitudinally investigate the psychological distress (depression, anxiety, and stress levels) taking in consideration PT and ER strategies in 3 different moments: during the first lockdown period (April/20), at the first deconfinement (May/20) and 1-month after the first deconfinement (Jun/20)-Experiment I. Second, to cross-sectionally evaluate the impact of the pandemic in psychological distress and the correlates with PT and ER 6-months after the first deconfinement November/20 to February/21 -Experiment II. A total of 722 volunteers (Experiment I = 180; Experiment II = 542) aged 18 years or older participated in this online survey. The findings from Experiment I show that psychological distress decreased after the lockdown period, however, neuroticism traits predicted higher levels of depression, anxiety and stress symptoms, while difficulties in ER strategies were identified as a risk factor for depression and stress. For experiment II, neuroticism traits and being infected with COVID-19 were associated to higher levels of symptomatology, while unemployment and the use of emotional suppression strategies to cope with emotional situations were associated to depressive and anxiety symptoms. Although the psychological impact of the COVID-19 outbreak decreased over time in our sample, the current findings suggest that difficulties in emotional regulation and high levels of neuroticism traits might be potential risk factors for psychiatric symptomatology during the COVID-19 pandemic. Thus, people with difficulties in ER and neuroticism traits would benefit from psychological interventions that provide personality-appropriate support and promote emotion regulation skills during stressful events, such as the case of the global pandemic.

How Long Does Adaption Last for? An Update on the Psychological Impact of the Confinement in Portugal

During the first COVID-19 related confinement in Portugal, there was a decrease in the levels of psychological symptoms measured by the Depression, Anxiety and Stress Scale 21 (March to April 2020). Upon experiencing a new period of restraints in 2021, the psychological impact of this sample was assessed again (N = 322, two more time points). It was expected that the psychological symptoms evidenced in February 2021 would be at similar levels to those found in April 2020, leading to a transfer of adaptation. Contrary to our hypothesis, in the second confinement in Portugal there were higher levels of depression and stress symptoms than at the beginning of the pandemic. On the other hand, the maximum level of anxiety was observed in March 2020. It seems that our perception of the threats in 2021 was not the same as at the onset of COVID-19, or that knowledge was not disseminated to the general population to increase their mental health literacy and help them cope with the imposed challenges.

The associations between media use, peritraumatic distress, anxiety and resilience during the COVID-19 pandemic

This study examined the relationship between media use, experiences of media use as having a negative and/or positive impact on coping, peritraumatic distress, anxiety symptoms and resilience during the COVID-19 pandemic. A convenience sample of 902 Israeli adults (mean age = 46.21) completed measures of peritraumatic distress, anxiety symptoms and resilience, and reported on their media use experiences one month following the initial outbreak of the disease in Israel (April 2020). After controlling for COVID-19 related events and demographic covariates, experiencing media use as having a negative impact on coping was related to higher levels of peritraumatic distress and anxiety symptoms and lower levels of resilience. In contrast, experiencing media as having a positive impact was not related to peritraumatic distress, anxiety symptoms or resilience. The findings suggest that those reporting that media use had a negative impact on coping are at greater risk of experiencing higher levels of peritraumatic distress and anxiety symptoms as well as lower resilience. In addition, traditional media use was related to higher resiliency. Developing understanding of how media could be used to optimally support emergency responses is crucial in order to minimize psychopathology. Unified, clear, trustworthy and informative messaging has a special importance during a mass public health crisis. Further research will contribute to guidance of potential risk and resilience aspects of media use during emergencies.

Media exposure predicts acute stress and probable acute stress disorder during the early COVID-19 outbreak in China

Background

The COVID-19 has led to unprecedented psychological stress on the general public. However, the associations between media exposure to COVID-19 and acute stress responses have not been explored during the early COVID-19 outbreak in China.

Methods

An online survey was conducted to investigate the relationships between media exposure to COVID-19 and acute stress responses, and to recognize associated predictors of acute stress responses on a sample of 1,450 Chinese citizens from February 3 to February 10, 2020. Media exposure questionnaire related to COVID-19 was developed to assess media exposure time, media exposure forms and media exposure content. The Stanford Acute Stress Reaction Questionnaire (SASRQ) was used to measure acute stress responses, including continuous acute stress symptom scores and the risk of probable acute stress disorder (ASD). A series of regression analyses were conducted.

Results

Longer media exposure time and social media use were associated with higher acute stress and probable ASD. Viewing the situation of infected patients was associated with higher acute stress, whereas viewing the latest news about pandemic data was associated with lower odds of probable ASD. Being females, living in Hubei Province, someone close to them diagnosed with COVID-19, history of mental illness, recent adverse life events and previous collective trauma exposure were risk factors for acute stress responses.

Conclusions

These findings confirmed the associations between indirect media exposure to pandemic events and acute stress responses. The governments should be aware of the negative impacts of disaster-related media exposure and implement appropriate interventions to promote psychological well-being following pandemic events.

The association between disaster exposure and media use on post-traumatic stress disorder following Typhoon Hato in Macao, China

Background: Direct exposure to natural disasters and related losses are associated with post-traumatic stress disorder (PTSD). It is less clear whether indirect media exposure is associated with PTSD. Objective: This study investigated key exposure-related risk factors for PTSD and examined the effect of media exposure on the prevalence of disaster-related PTSD. Method: Typhoon Hato directly hit Macao on 23 August 2017. It was one of the most serious natural disasters ever to strike southern China. One month after the event, 1876 Chinese university students in Macao were recruited into a cross-sectional study (mean age 20.01 years, SD = 2.63; 66.2% female). Self-reported typhoon exposure, media use and exposure to disaster-related content, and PTSD symptoms were collected using an electronic survey. Univariable analyses assessed associations between risk factors and PTSD, which were then included in a series of multivariable logistic regressions. Results: The prevalence of PTSD was 5.1%. Adjusted models demonstrated that being male (vs female) [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) 1.07-2.63], home damage (aOR = 2.86, 95% CI 1.71-4.78), witnessing people injured (aOR = 2.33, 95% CI 1.36-4.00), and almost drowning during the storm (aOR = 8.99, 95% CI 1.92-41.99) were associated with PTSD. After adjusting for direct exposure, indirect exposure to disaster-related social media content, including information related to drowning victims (aOR = 1.29, 95% CI 1.00-1.67) and residents' emotional reactions (aOR = 1.98, 95% CI 1.44-2.72), was associated with PTSD. Viewing more information about the storm itself (aOR = 0.37, 95% CI 0.28-0.49) and images of heroic acts (aOR = 0.72, 95% CI 0.55-0.94) were significantly associated with lower odds of PTSD. Conclusion: These findings add to the literature demonstrating that some types of media use and certain media content following a natural disaster are associated with PTSD.

Media use and insomnia after terror attacks in France

Direct exposure to traumatic events often precipitates sleep disorders. Sleep disturbance has also been observed amongst those indirectly exposed to trauma, via mass media. However, previous work has focused on traditional media use, rather than contemporary social media. We tested associations between both traditional and social media consumption and insomnia symptoms following 2015 terror attacks in Paris France, controlling for location and post-traumatic symptomology. 1878 respondents, selected to represent the national French population, completed an internet survey a month after the Bataclan attacks (response rate 72%). Respondents indicated different media use, post-traumatic stress and insomnia. Controlling for demographics, location and PTSD, insomnia was associated with both traditional (β 0.10, P = .001) and social media use (β 0.12, P = .001). Associations between social media and insomnia were independent of traditional media use. Interventions targeted at social media may be particularly important following mass trauma.

Communicating public health advice after a chemical spill: results from national surveys in the United Kingdom and Poland

OBJECTIVE

The aim of this study was to enhance public health preparedness for incidents that involve the large-scale release of a hazardous substance by examining factors likely to influence public responses to official guidance on how to limit their exposure.

METHODS

An online demographically representative survey was conducted in the United Kingdom (n = 601) and Poland (n = 602) to test the strength of association of trust in authorities, anxiety, threat, and coping appraisals with the intention to comply with advice to shelter in place following a hypothetical chemical spill. The impact of ease of compliance and style of message presentation were also examined.

RESULTS

Participants were more likely to comply if at home when the incident happened, but message presentation had little impact. Coping appraisals and trust were key predictors of compliance, but threat appraisals were associated with noncompliance. Anxiety was seen to promote behavioral change. UK participants were more likely to comply than Polish participants.

CONCLUSIONS

Successful crisis communications during an emergency should aim to influence perceptions regarding the efficacy of recommended behaviors, the difficulties people may have in following advice, and perceptions about the cost of following recommended behaviors. Generic principles of crisis communication may need adaptation for national contexts.

Psychosocial care to affected citizens and communities in case of CBRN incidents: a systematic review

Disasters are associated with a substantial psychosocial burden for affected individuals (including first responders) and communities. Knowledge about how to address these risks and problems is valuable for societies worldwide. Decades of research into post-disaster psychosocial care has resulted in various recommendations and general guidelines. However, as CBRN (chemical, biological, radiological, nuclear) events form a distinctive theme in emergency planning and disaster preparedness, it is important to systematically explore their implications for psychosocial care. The aim of this study is to answer two questions: 1). To what extent does psychosocial care in the case of CBRN events differ from other types of events? 2). How strong is the scientific evidence for the effectiveness of psychosocial care interventions in the context of a CBRN event? A systematic literature review was conducted. Searches were performed in Medline, PsychINFO, Embase and PILOTS. Studies since January 2000 were included and evaluated by independent reviewers. The 39 included studies contain recommendations, primarily based on unsystematic literature reviews, qualitative research and expert opinions. Recommendations address: 1) public risk- and crisis communication, 2) training, education and exercise of responders, 3) support, and 4) psychosocial counselling and care to citizens and responders. Although none of the studies meet the design criteria for effectiveness research, a substantial amount of consensus exists on aspects relevant to CBRN related psychosocial care. Recommendations are similar or complementary to general post-disaster psychosocial care guidelines. Notable differences are the emphasis on risk communication and specific preparation needs. Relevant recurring topics are uncertainty about contamination and health effects, how people will overwhelm health care systems, and the possibility that professionals are less likely to respond. However, the lack of evidence on effectiveness makes it necessary to be careful with recommendations. More evaluation research is absolutely needed.

Predicting response to reassurances and uncertainties in bioterrorism communications for urban populations in New York and California

Recent national plans for recovery from bioterrorism acts perpetrated in densely populated urban areas acknowledge the formidable technical and social challenges of consequence management. Effective risk and crisis communication is one priority to strengthen the U.S.'s response and resilience. However, several notable risk events since September 11, 2001, have revealed vulnerabilities in risk/crisis communication strategies and infrastructure of agencies responsible for protecting civilian populations. During recovery from a significant biocontamination event, 2 goals are essential: (1) effective communication of changing risk circumstances and uncertainties related to cleanup, restoration, and reoccupancy; and (2) adequate responsiveness to emerging information needs and priorities of diverse populations in high-threat, vulnerable locations. This telephone survey study explored predictors of public reactions to uncertainty communications and reassurances from leaders related to the remediation stage of an urban-based bioterrorism incident. African American and Hispanic adults (N=320) were randomly sampled from 2 ethnically and socioeconomically diverse geographic areas in New York and California assessed as high threat, high vulnerability for terrorism and other public health emergencies. Results suggest that considerable heterogeneity exists in risk perspectives and information needs within certain sociodemographic groups; that success of risk/crisis communication during recovery is likely to be uneven; that common assumptions about public responsiveness to particular risk communications need further consideration; and that communication effectiveness depends partly on preexisting values and risk perceptions and prior trust in leaders. Needed improvements in communication strategies are possible with recognition of where individuals start as a reference point for reasoning about risk information, and comprehension of how this influences subsequent interpretation of agencies' actions and communications.

Comparison of fluence-to-dose conversion coefficients for deuterons, tritons and helions

Secondary radiation in aircraft and spacecraft includes deuterons, tritons and helions. Two sets of fluence-to-effective dose conversion coefficients for isotropic exposure to these particles were compared: one used the particle and heavy ion transport code system (PHITS) radiation transport code coupled with the International Commission on Radiological Protection (ICRP) reference phantoms (PHITS-ICRP) and the other the Monte Carlo N-Particle eXtended (MCNPX) radiation transport code coupled with modified BodyBuilder™ phantoms (MCNPX-BB). Also, two sets of fluence-to-effective dose equivalent conversion coefficients calculated using the PHITS-ICRP combination were compared: one used quality factors based on linear energy transfer; the other used quality factors based on lineal energy (y). Finally, PHITS-ICRP effective dose coefficients were compared with PHITS-ICRP effective dose equivalent coefficients. The PHITS-ICRP and MCNPX-BB effective dose coefficients were similar, except at high energies, where MCNPX-BB coefficients were higher. For helions, at most energies effective dose coefficients were much greater than effective dose equivalent coefficients. For deuterons and tritons, coefficients were similar when their radiation weighting factor was set to 2.