General self-efficacy and posttraumatic stress after a natural disaster: a longitudinal study

Validity and reliability of the Chinese version of human-robot interaction self-efficacy scale in Chinese adults

BACKGROUND

With the fast-paced advancements of robot technology, human-robot interaction (HRI) has become increasingly popular and complex, and self-efficacy in HRI has received extensive attention. Despite its popularity, this topic remains understudied in China.

OBJECTIVE

In order to provide a psychometrically sound instrument in China, this study aimed to translate and validate the Self-Efficacy in Human-Robot Interaction Scale (SE-HRI) in two Chinese adult samples (N1 = 300, N2 = 500).

METHODS

The data was analyzed by SPSS 26.0 and Amos 24.0. Item analysis and exploratory factor analysis were conducted using Sample 1 data. Confirmatory factor analysis, criterion-related validity analysis, and reliability analysis were then performed using Sample 2 data.

RESULTS

The results revealed that the Chinese SE-HRI scale consisted of 13 items in a two-factor model, suggesting a good model fit. Moreover, general self-efficacy and willingness to accept the use of artificial intelligence (AI) were both positively correlated with self-efficacy in HRI, while negative attitudes toward robots showed an inverse correlation, proving the Chinese SE-HRI scale exhibited excellent criterion-related validity.

CONCLUSION

The Chinese SE-HRI scale is a reliable assessment tool for evaluating self-efficacy in HRI in China. The study discussed implications and limitations, and suggested future directions.

Mental health burden following extreme weather events in South-east Asia: A systematic review and meta-analysis

Background

Exposure to extreme weatherly events potentially develops mental disorders among affected individuals.

Aim

To synthesize the burden of mental disorders following impact of extreme weather events in South-east Asian (SEA) countries.

Methods

Proposal was registered in PROSPERO register [CRD42023469788] and reported as per PRISMA-2020 guidelines. Studies reporting prevalence of mental health disorders following extreme weather events from SEA countries during 1990 and 2023 were searched on Embase, PubMed, and Scopus databases. Study quality was assessed using Appraisal tool for Cross-Sectional Studies. Overall pooled prevalence was computed using DerSimonian-Laird method for random-effects model and reported as 95% confidence intervals.

Results

On screening 12,046 records, we included 155 studies (2,04,474 participants) for analysis. Overall burden of mental disorders was 35.31% (95%CI: 30.42%-40.21%). In subgroup analysis, studies on cyclones, India, local residents, children and adolescents, rural settings, and community settings reported higher burden of mental disorders. Depression (28.58%; 95%CI: 24.05%-33.1%) and PTSD (29.36%; 95%CI: 26.26%-32.46%) had similar prevalence. Visiting tourists to SEA region experienced fear, fear of recurrence of tsunami, nightmares, and sense of helplessness. Mental health outcomes were relatively higher in studies conducted within 1 year of events. Heterogeneity and possibility of publication bias exists among the reported studies.

Conclusion

With the significant rise in episodes of extreme weather events in SEA region over the last three decades, mental disorders are documented in different proportions. We suggest prioritizing well-informed policies to formulate inclusive and resilient strategies on effectively identifying and treating mental health concerns among victims of extreme weather events.

A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards

BACKGROUND

Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members.

METHODS

An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson's correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman's Rank was used for violations of normality.

RESULTS

A total of 57 surf lifesavers/lifeguards aged 13-59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed.

CONCLUSION

This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.

Self-Efficacy and Mental Health Help-Seeking Behavior of World Trade Center Health Registry Enrollees, 2015-2016

The September 11th World Trade Center (WTC) disaster resulted in an elevated prevalence of Post-Traumatic Stress Disorder (PTSD) among those directly exposed, yet lower than expected rates of mental health treatment seeking and high levels of reported perceived unmet mental healthcare need were observed in this population in the years following. Self-efficacy, an individual's self-perception of their ability to succeed in specific situations or accomplish a task or goal, may in part explain this discrepancy; however, little is known about its interplay with the help-seeking behaviors of disaster-exposed populations. We used WTC Health Registry data (n = 11,851) to describe the relationship between self-efficacy and three outcomes related to help-seeking behavior: (1) seeking mental health treatment, (2) perceived unmet mental health care needs, and (3) satisfaction with mental health treatment. Multinomial logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CI). We found a dose-response relationship between self-efficacy score and mental health help-seeking: for every one unit increase in self-efficacy score, we observed a 6% increase in the odds of having treatment 4 to 12 months ago (OR = 1.06, CI: 1.03-1.09), a 7% increase in the odds of having had treatment 1 to 2 years ago (OR = 1.07, CI: 1.04, 1.09), and a 10% increase in the odds of having sought treatment 2 or more years ago (OR = 1.10, CI: 1.08, 1.12) compared to those who had sought treatment more recently. An understanding of individual self-efficacy may help improve post-disaster mental health treatment in order to provide more tailored and helpful care.

Psychological Network Analysis of General Self-Efficacy in High vs. Low Resilient Functioning Healthy Adults

Resilience to stress has gained increasing interest by researchers from the field of mental health and illness and some recent studies have investigated resilience from a network perspective. General self-efficacy constitutes an important resilience factor. High levels of self-efficacy have shown to promote resilience by serving as a stress buffer. However, little is known about the role of network connectivity of self-efficacy in the context of stress resilience. The present study aims at filling this gap by using psychological network analysis to study self-efficacy and resilience. Based on individual resilient functioning scores, we divided a sample of 875 mentally healthy adults into a high and low resilient functioning group. To compute these scores, we applied a novel approach based on Partial Least Squares Regression on self-reported stress and mental health measures. Separately for both groups, we then estimated regularized partial correlation networks of a ten-item self-efficacy questionnaire. We compared three different global connectivity measures-strength, expected influence, and shortest path length-as well as absolute levels of self-efficacy between the groups. Our results supported our hypothesis that stronger network connectivity of self-efficacy would be present in the highly resilient functioning group compared to the low resilient functioning group. In addition, the former showed higher absolute levels of general self-efficacy. Future research could consider using partial least squares regression to quantify resilient functioning to stress and to study the association between network connectivity and resilient functioning in other resilience factors.

Assessing the effects of disasters and their aftermath on pregnancy and infant outcomes: A conceptual model

Although many studies have examined broad patterns of effects on pregnancy and infant outcomes after disasters, the causes of adverse outcomes are not always clear. Disasters cause interrelated exposure to environmental pollutants, psychological stressors, and lack of health care, and interacts with other social determinants of health. This topical review examines the short- and long-term effects of disasters on pregnancy and how they are mediated by social, behavioral, and environmental effects. In the short term, disasters are associated with physical trauma, adverse environmental exposures, and unstable housing. In the longer term, disasters may lead to relocation, changes in family functioning, and negative economic effects. These aspects of disaster exposure, in turn, lead to lack of access to health care, increased stress and negative mental health outcomes, and negative behavioral changes, including smoking and substance use, poor nutrition, physical overexertion and limited activity, and reduction in breastfeeding. All of these factors interact with social determinants of health to worsen effects on the most vulnerable women, infants, and communities. Few interventions after disasters have been tested. With the increase in disasters due to climate change and the ongoing coronavirus pandemic, the models of effects of disasters and their human health consequences need increasing refinement, and, more importantly, should be applied to interventions that improve disaster prevention, mitigation, and response.

Latent Profiles and Influencing Factors of Posttraumatic Stress Symptoms Among Adults During the COVID-19 Pandemic

The COVID-19 pandemic severely affected public health and the prevalence of posttraumatic stress symptoms among adults in Hubei Province, China. In this study, a total of 2,930 (662 males and 2,268 females) adults answered a questionnaire obtaining information on their demographics, posttraumatic stress symptoms (i.e., intrusion and avoidance), social media exposure, social media involvement, and self-efficacy. Results of the latent profile analysis identified four latent profiles of posttraumatic stress symptoms, which are, no symptoms, high intrusion–low avoidance, moderate symptoms, and high symptoms. The multinomial logistic regression analyses revealed the contributors to the posttraumatic stress symptoms subgroups. Adults with high social media involvement were classified into the high intrusion–low avoidance group, whereas adults with low self-efficacy were included in the moderate symptoms group. Meanwhile, adults with high social media involvement and low self-efficacy were included in the high symptoms group. Interventions may focus on decreasing social media involvement for the adults in the high Intrusion–low avoidance group, improving self-efficacy for the adults in the moderate symptoms group, and reducing social media involvement and improving self-efficacy for the adults in the high symptoms group.

Machine learning to reveal hidden risk combinations for the trajectory of posttraumatic stress disorder symptoms

The nature of the recovery process of posttraumatic stress disorder (PTSD) symptoms is multifactorial. The Massive Parallel Limitless-Arity Multiple-testing Procedure (MP-LAMP), which was developed to detect significant combinational risk factors comprehensively, was utilized to reveal hidden combinational risk factors to explain the long-term trajectory of the PTSD symptoms. In 624 population-based subjects severely affected by the Great East Japan Earthquake, 61 potential risk factors encompassing sociodemographics, lifestyle, and traumatic experiences were analyzed by MP-LAMP regarding combinational associations with the trajectory of PTSD symptoms, as evaluated by the Impact of Event Scale-Revised score after eight years adjusted by the baseline score. The comprehensive combinational analysis detected 56 significant combinational risk factors, including 15 independent variables, although the conventional bivariate analysis between single risk factors and the trajectory detected no significant risk factors. The strongest association was observed with the combination of short resting time, short walking time, unemployment, and evacuation without preparation (adjusted P value = 2.2 × 10⁻⁴, and raw P value = 3.1 × 10⁻⁹). Although short resting time had no association with the poor trajectory, it had a significant interaction with short walking time (P value = 1.2 × 10⁻³), which was further strengthened by the other two components (P value = 9.7 × 10⁻⁵). Likewise, components that were not associated with a poor trajectory in bivariate analysis were included in every observed significant risk combination due to their interactions with other components. Comprehensive combination detection by MP-LAMP is essential for explaining multifactorial psychiatric symptoms by revealing the hidden combinations of risk factors.

Anxiety and resilience in the face of natural disasters associated with climate change: A review and methodological critique

In the past two decades, climate change-related natural disasters, such as hurricanes, floods, and droughts have become increasingly frequent and severe, impacting the emotional and psychological well-being of those who are directly or indirectly exposed to them. Despite great interest in understanding differences in anxiety and resilience in response to natural disasters, enthusiasm appears to outstrip empirical clarity, as there remains considerable ambiguity as to determinants of resilient or pathological outcomes following exposure to natural disasters. In addition, there are several major methodological limitations in climate change and related natural disaster research, including the use of univariate analyses, cross-sectional design, and retrospective measures. Keeping these limitations in mind, we first review literature examining the mental health outcomes of natural disasters. Findings suggest that, overall, resilience is more common than pathological outcomes. Second, we use a multi-dimensional framework of resilience to selectively review factors at the event, individual, as well as family and community levels that could help inform resilient or pathological outcomes. Finally, we consider key limitations and future directions for research and practice in the field of anxiety and resilience in response to climate disasters.

Assessment of Factors Associated With Long-term Posttraumatic Stress Symptoms Among 56 388 First Responders After the 2011 Great East Japan Earthquake

IMPORTANCE

First responders are at risk for developing symptoms of posttraumatic stress disorder (PTSD). Little is known about the risk factors for developing PTSD during a years-long period after complex mass disasters.

OBJECTIVE

To explore the long-term course of PTSD symptoms and to identify risk factors and their relative association with PTSD among first responders dispatched to the 2011 Japanese earthquake, tsunami, and nuclear disaster.

DESIGN, SETTING, AND PARTICIPANTS

This 6-year, large, prospective cohort study was part of a continuous longitudinal study of Japan Ground Self-Defense Force first responders. The data were collected at 1, 6, 12, 24, 36, 48, 60, and 72 months after mission completion from 2011 to 2017. Of approximately 70 000 eligible participants, 56 388 were enrolled in this study. Data were analyzed from 2017 to 2020.

EXPOSURES

Stress exposures owing to personal or professional disaster experience (eg, duties with body recovery or radiation exposure risk) and working conditions (eg, deployment length, postdeployment overtime work).

MAIN OUTCOMES AND MEASURES

The Impact of Event Scale-Revised score assessed PTSD symptoms; scores of at least 25 were defined as probable PTSD. Cox proportional hazards regression models assessed the risk factors for incidence of probable PTSD.

RESULTS

Among the 56 388 participants, 97.1% were men, and the median age at enrollment was 34 (range, 18-63) years. A probable PTSD rate was 2.7% at 1 month and showed a downward trend in the first year and a subsequent plateau. The cumulative incidence of probable PTSD was 6.75%. The severity of PTSD symptoms demonstrated a high degree of rank-order stability over time. Rather than professional disaster experience, sociodemographic factors and working conditions were independently associated with the incidence of probable PTSD: personal experience of the disaster (hazard ratio [HR], 1.96; 95% CI, 1.72-2.24), deployment length of at least 3 months (HR vs <1 month, 1.75; 95% CI, 1.52-2.02), increased age (HR for ≥46 vs ≤25 years, 2.28; 95% CI, 1.79-2.92), and postdeployment overtime work of at least 3 months (HR vs little to none, 1.61; 95% CI, 1.39-1.87).

CONCLUSIONS AND RELEVANCE

Given these findings, in the future, first responders' PTSD symptoms might be mitigated by shortening deployment length, avoiding postdeployment overtime work, and paying special attention to the needs of personnel with personal experience of the disaster or older age. Efforts to alleviate responders' initial symptoms will be required.

Impact of Stressful Events on Motivations, Self-Efficacy, and Development of Post-Traumatic Symptoms among Youth Volunteers in Emergency Medical Services

During the last decades, Israeli emergency medical services (EMS) personnel has been exposed to different potentially traumatic events, including mass terror attacks. The aims of the present study were to identify how potentially traumatic events affect young volunteers in their motivation to volunteer and their perceived self-efficacy while being at risk of developing post-traumatic symptoms. The final sample included 236 Magen David Adom (MDA, the "Israeli Red Cross") youth volunteers. The study evaluated their motivational factors for volunteering, perceived self-efficacy, participation in potentially traumatic events, and post-traumatic symptoms. Over two-thirds of the volunteers participated in a traumatic event on duty. Volunteers who were involved in potentially stressful events scored higher levels of post-traumatic symptoms, though still very low and subclinical. Nonetheless, participating in stressful events contributed to an increased sense of self-efficacy. No difference in post-traumatic symptom levels was observed between volunteers who partook in mass casualty incidents and those who did not. The results demonstrate that MDA youth volunteers may mostly benefit from participating in situations requiring the administration of emergency medicine, even stressful ones. They may help to find ways to empower the volunteers and increase their resilience.

Longitudinal Relationship between Self-efficacy and Posttraumatic Stress Symptoms 8 Years after a Violent Assault: An Autoregressive Cross-Lagged Model

Self-efficacy is assumed to promote posttraumatic adaption, and several cross-sectional studies support this notion. However, there is a lack of prospective longitudinal studies to further illuminate the temporal relationship between self-efficacy and posttraumatic stress symptoms. Thus, an important unresolved research question is whether posttraumatic stress disorder (PTSD) symptoms affect the level of self-efficacy or vice versa or whether they mutually influence each other. The present prospective longitudinal study investigated the reciprocal relationship between general self-efficacy (GSE) and posttraumatic stress symptoms in 143 physical assault victims. We used an autoregressive cross-lagged model across four assessment waves: within 4 months after the assault (T1) and then 3 months (T2), 12 months (T3) and 8 years (T4) after the first assessment. Stress symptoms at T1 and T2 predicted subsequent self-efficacy, while self-efficacy at T1 and T2 was not related to subsequent stress symptoms. These relationships were reversed after T3; higher levels of self-efficacy at T3 predicted lower levels of posttraumatic stress symptoms at T4, while posttraumatic tress symptoms at T3 did not predict self-efficacy at T4. In conclusion, posttraumatic stress symptoms may have a deteriorating effect on self-efficacy in the early phase after physical assault, whereas self-efficacy may promote recovery from posttraumatic stress symptoms over the long term.

Lenticular nucleus correlates of general self-efficacy in young adults

General self-efficacy (GSE) is an important factor in education, social participation, and medical treatment. However, the only study that has investigated the direct association between GSE and a neural correlate did not identify specific brain regions, rather only assessed brain structures, and included older adult subjects. GSE is related to motivation, physical activity, learning, the willingness to initiate behaviour and expend effort, and adjustment. Thus, it was hypothesized in the present study that the neural correlates of GSE might be related to changes in the basal ganglia, which is a region related to the abovementioned self-efficacy factors. This study aimed to identify the brain structures associated with GSE in healthy young adults (n = 1204, 691 males and 513 females, age 20.7 ± 1.8 years) using regional grey matter density and volume (rGMD and rGMV), fractional anisotropy (FA) and mean diffusivity (MD) analyses of magnetic resonance imaging (MRI) data. The findings showed that scores on the GSE Scale (GSES) were associated with a lower MD value in regions from the right putamen to the globus pallidum; however, there were no significant association between GSES scores and regional brain structures using the other analyses (rGMD, rGMV, and FA). Thus, the present findings indicated that the lenticular nucleus is a neural correlate of GSE.