The Benefit of Conserving and Gaining Resources after Trauma: A Systematic Review

COVID-19 Symptoms and Mental Health Outcomes among Italian Healthcare Workers: A Latent Class Analysis

The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a "psychological pandemic". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal-Wallis (KW) test with Dunn's multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs.

University students' psychological distress during the COVID-19 pandemic: A structural equation model of the role of resource loss and gain

Using the Conservation of Resources (COR) theory, we aimed to determine whether university students' loss and gain in resources during the pandemic mediated the relationships between COVID-19 exposure/concern and depression and anxiety. In 2021, 7013 Israeli university students completed online questionnaires. We assessed the data using structural equation modeling. We found that resource loss was directly related to concern (β = 0.32, p < 0.001). Depression and anxiety were both directly related to loss of resources (depression: β = 0.75, p < 0.001; anxiety: β = 0.69, p < 0.001) and concern (depression: β = 0.06, p < 0.001; anxiety: β = 0.12, p < 0.001). Resource loss had an indirect effect on the relationships between concern and depression (β = 0.24, p < 0.001) and concern and anxiety (β = 0.22, p < 0.001). COR theory may help explain the mechanisms behind university students' mental health during the pandemic and provides a framework to better understand preparedness for future pandemics, epidemics, and major disasters. Governments and universities should help prevent the loss of resources during future emergencies.

Cultural determinants and resilience and recovery factors associated with trauma among Aboriginal help-seeking clients from an Aboriginal community-controlled counselling service

In addition to resilience and resistance, collective and personal experiences of trauma are commonly cited within the context of Aboriginal and Torres Strait Islander and other Indigenous First People's experiences of colonisation. This study investigated whether a range of risk and protective factors, including cultural determinants of social and emotional wellbeing, were associated with posttraumatic stress outcomes among 81 Aboriginal help-seeking clients from an Aboriginal community-controlled counselling service in Melbourne, Australia. The study explored potential relationships between trauma exposure, child removal from natural family, experiences of racism, gender, and trauma symptom severity. The study also investigated whether personal, relationship, community and cultural strengths and determinants of wellbeing, as detailed in the Aboriginal Resilience and Recovery Questionnaire, moderated the relationship between trauma exposure and posttraumatic stress symptom severity. Participants commonly endorsed symptoms of distress consistent with Posttraumatic Stress Disorder and cultural idioms of distress as documented in the Aboriginal Australian Version of the Harvard Trauma Questionnaire. Two generations of child removal from one's natural family, experiences of racism, stressful life events experienced during the past 12 months, being male, and not having access to funds for basic living expenses were all associated with greater trauma symptom severity. Conversely, participants self-reported access to personal, relationship, community and cultural strengths was associated with lower trauma symptom severity. Regression analysis revealed that trauma exposure, stressful life events, access to basic living expenses, and personal, relationship, community, and cultural strengths were all important predictors of posttraumatic stress symptom severity. Participant access to strength and resources that included connections to community and culture, moderated the relationship between trauma exposure and trauma symptom severity.

PTSD as a Moderator of the Relationship Between the Distribution of Personal Resources and Spiritual Change Among Participants of Hostilities in Ukraine

The theory of conservation of resources (COR) can be used to search for mechanisms that explain spiritual changes caused by trauma. The present study aimed to verify whether PTSD could be a potential moderator between the distribution of personal resources and spiritual changes. The study included a total of 324 adults (75 women and 243 men) aged 18-74. The mean age was 34.3 (SD = 9.9). The Polish adaptation of Hobfoll's Conservation of Resources-Evaluation (COR-E), the posttraumatic stress disorder (PTSD) Checklist-Civilian Version and the Posttraumatic Growth Inventory were employed in the research. This study analyzed the spiritual change, which is one of the five domains of posttraumatic growth. The outcomes indicated the significant role of PTSD as a moderator of the relationships between 1) personal resources gain and spiritual change and 2) personal resources loss and spiritual change. PTSD is not a moderator in the relationship between assigning value to personal resources and spiritual change.

The Mediating Role of Dispositional Optimism in the Relationship between Health Locus of Control and Self-Efficacy in Pregnant Women at Risk of Preterm Delivery

Difficult situations during pregnancy, such as threatened preterm labor, trigger negative experiences in women. The levels of stress experienced and the way individuals cope with it depend on their personal resources, such as optimism, internal health locus of control, and self-efficacy, among other factors. The purpose of this paper was to determine the role of dispositional optimism in the relationship between health locus of control and self-efficacy in pregnant women with threatened preterm labor. Dispositional optimism plays the role of mediator in relationships between: (1) internal health control and self-efficacy; and (2) impact of random events on one's health and self-efficacy. Dispositional optimism does not mediate the relationship between the perceived impact of others on one's health and self-efficacy. For women with a high-risk pregnancy, dispositional optimism is a significant resource for coping with the problems they encounter. It changes the direction (from negative to positive) of the association between experiencing the impact of external factors (random events) on one's health and perceived self-efficacy. It prevents the cycle of loss caused by the interpretation of random events as having an impact on one's health, and acts as a mediator to initiate a cycle of gains that leads to greater perceived self-efficacy. Optimistic pregnant women maintain a positive outlook, even when confronted with difficult, negative experiences such as threatened preterm labor.

The Relationship Between Perceived Social Support and PTSD Symptoms After Exposure to Physical Assault: An 8 Years Longitudinal Study

Consequences of nondomestic violence are known to be multifaceted with high rates of emotional and psychological problems in addition to physical injuries, and victims report many trauma related symptoms. This study explore if perceived social support (PSS) (Social Provisions Scale [SPS]) and post-traumatic stress disorder (PTSD) symptoms (Impact of Event Scale [IES-22]) are interrelated among adult victims at four assessment points up until eight years after the exposure to physical assault; soon after the event (T1), three months after T1 (T2), one year after T1 (T3), and eight years after T1 (T4). One hundred and forty-three subjects participated at T1, 94 at T2, 73 at T3, and 47 accepted a follow-up at T4. At T1, 138 of 143 completed the questionnaires within 16 weeks after the incident. PTSD symptoms were highly correlated across time (p < .001); PSS were significantly correlated only between T1 and T2 (p < .001), T1 and T3 (p < .05), and between T2 and T3 (p < .05). Cross-lagged analyses showed an inverse relationship between prior PSS and later PTSD symptoms across all time points (ps < .05); not proved between prior PTSD symptoms and later PSS (ps > .1). PSS at T1 was an independent predictor of PSS one year and eight years after the incident. We conclude that higher perception of social support protects against the development of PTSD symptoms; diminished perception of social support increases the risk of developing PTSD symptoms. These findings suggest that PSS after experiencing a violent assault should be considered as an important factor in natural recovery in the long run, as well as essential alongside psychiatric treatment. Establishing psychosocial interventions for victims of physical violence in the acute phase may prevent prolonged trauma reactions.

Can the Concepts of Energy and Psychological Energy Enrich Our Understanding of Psychosocial Adaptation to Traumatic Experiences, Chronic Illnesses and Disabilities?

The aim of this paper is to familiarize the reader with the concept of psychological energy (PE), and the role it plays in deepening our understanding of psychosocial adaptation to traumatic life events and, more pointedly, the onset of chronic illness and disability (CID). In order to implement this aim, the following steps were undertaken: First, a brief historical review of the nature of energy, force and action, as traditionally conceived in the field of physics, is provided. Second, an overview of PE is presented, with a shared emphasis on both its historical underpinnings and its present conceptualizations in the fields of social, health and rehabilitation psychology. Particular emphasis is placed upon applications of PE in the domains of adaptation to stress, trauma and CID onset. Third, reviewed are measuring instruments that have been traditionally applied to the assessment of the nature, content and magnitude of PE and its dynamics. Finally, new perspectives are offered on the dimensional structure, processes and dynamics, assumed to undergird PE, its underlying conceptual similarities to physical energy, and its potential and deeper link to the process of psychosocial adaptation in the aftermath of experiencing trauma and CID.

Family support and posttraumatic growth among tourism workers during the COVID-19 shutdown: The role of positive stress mindset

The COVID-19 pandemic has taken a severe hit on the health of workers in the tourism industry. It is crucial to understand how to help the workforce in this service industry become resilient and adaptive through this crisis. The primary objective of this research is to examine how family support nurtures tourism workers' posttraumatic growth (PTG), an adaptation form in the resilience process. The valid data were collected from 384 tourism workers who were on unpaid leave or layoff during the COVID-19 crisis. The results demonstrated the positive relationship between family support and tourism workers' PTG, for which positive stress mindset was identified as a mediation mechanism. Deliberate and intrusive ruminative thinking styles moderated the effect of family support on positive stress mindset. Theoretical and practical implications of the mechanisms through which family support promotes tourism workers' PTG are discussed.

Iranian and Iraqi torture survivors in Finland and Sweden: findings from two population-based studies

Background

Most refugees and other forced migrants have experienced potentially traumatic events (PTEs). Torture and other traumatic experiences, as well as various daily stressors, impact the mental health and psychosocial well-being of war-affected populations.

Methods

The study includes two population-based samples of Iranian and Iraqi men living in Finland and Sweden. The Finnish Migrant Health and Well-being Study (Maamu) was conducted in 2010–2012. The Linköping study was conducted in Sweden in 2005. In both samples, health and well-being measures, social and economic outcomes as well as health service utilization were reported.

Results

The final sample for analysis consisted of two groups of males of Iranian or Iraqi origin: 278 residents in Finland and 267 residents in Sweden. Both groups were subdivided according to the reported PTEs: Torture survivors; Other PTEs; No PTEs. Migrants that reported PTEs, torture survivors in particular, had significantly poorer social and health outcomes. Torture survivors also reported lower trust and confidence in authorities and public service providers, as well as more loneliness, social isolation and experiences of discrimination.

Conclusions

Torture and other PTEs prevalent in refugee and migrant populations create a wide-ranging and long-term impact in terms of increased risk of various types of adverse social and health conditions. Early identification through systematic and effective screening should be the first step in guiding migrants and refugees suffering from experiences of torture and other PTEs to flexible, multidisciplinary services.

Personal Resources and Spiritual Change among Participants’ Hostilities in Ukraine: The Mediating Role of Posttraumatic Stress Disorder and Turn to Religion

The theory of conservation of resources (COR) can be used for searching mechanisms which explain spiritual changes caused by trauma. The aim of this paper was to analyze the relationship between distribution of personal resources and spiritual change, as well as the mediating role of posttraumatic stress disorder (PTSD) and turn to religion (stress coping strategy) in this relationship among participants’ hostilities in Ukraine. A total of 314 adults—74 women and 235 men—participated in the study. The mean age was 72.59. Polish adaptation of Hobfoll’s Conservation of Resources-Evaluation (COR-E), the Posttraumatic Stress Disorder (PTSD) Checklist—Civilian Version (PCL-C), the Inventory for Measuring Coping with Stress (MINI-COPE), and The Posttraumatic Growth Inventory (PTGI) were employed in the research. The mediating role of posttraumatic stress disorder and turn to religion in relationship between personal resources loss and spiritual change was confirmed. The turn to religion plays the role of mediator in relationship between personal resources gain/assigning value to personal resources and spiritual change. The results justify the postulate of conducting further research in the field of testing models which take into account the relationship between posttraumatic stress disorder, religious coping stress, and posttraumatic spiritual change. The conducted analyses should include the assumptions of the COR theory as well as psychological, social, and situational factors that could generate spiritual change.

Distress and Resilience in Resettled Refugees of War: Implications for Screening

There is little work published about predictors of specific trajectory types of distress in refugees of war during early resettlement in a host country. Data about distress (Refugee Health Screener—15 (RHS-15)) and possible predictors of distress were collected at the domestic medical examination (T1) within 90 days of arrival and the civil surgeon examination (T2) 11–16 months after T1 for refugee groups from three countries (COU). Descriptive, correlative, analyses of variance, and regression techniques were used to determine trajectory type and their predictors. A higher percentage (7.3%) were distressed at T2 than at T1. By group, the Bhutanese became more distressed, the Burmese became less distressed, and Iraqi’s continued to have high distress. A regression model showed gender, loss, post-migration stress, and self-efficacy to be significant predictors of trajectory type (R² = 0.46). When the T1 RHS-15 score was added to the model, observed variance increased (R² = 0.53) and T1 RHS score accounted for the majority of variance (r = 0.64, p < 0.001), with post-migration stress accounting for markedly less (β = 0.19, p = 0.03). Loss and self-efficacy became less significant. Loss was, however, a strong predictor of delayed and chronic distress trajectory type. These data suggest that screening for distress should occur at least twice during resettlement to detect those with initial distress and those with delayed distress. Screening should be coupled with identifying other social determinants of health and a comprehensive assessment to determine the need for intervention for secondary prevention (i.e., reducing delayed distress) and treatment (reducing chronic distress).

The Relationship between Women's Resources and Health-Related Quality of Life in a Sample of Female Victims of Intimate Partner Violence

While it is known that resource inadequacy increases the risk of exposure to intimate partner violence (IPV) and that women's health is significantly impacted by IPV, scant research has documented diminished resources as a primary determinant of women's health. Fifty female victims of moderate to severe IPV completed assessments of their physical, sexual and psychological experiences of IPV, resource profile, symptoms of posttraumatic stress disorder (PTSD) and depression and mental and physical health-related quality of life (HRQoL). Women's resources, controlling for age, income, psychological abuse and sexual coercion, were unique predictors of symptoms of PTSD, symptoms of depression; and mental HRQoL. The public health implications of the adequacy of women's resources are discussed in the context of IPV prevention and intervention. Future studies should evaluate the efficacy of economic empowerment programs regarding the impact on IPV survivors' mental and physical health and safety.

Improved social services and the burden of post-traumatic stress disorder among economically vulnerable people after a natural disaster: a modelling study

BACKGROUND

Hurricanes and other natural disasters produce public health and economic consequences that last well beyond their immediate aftermath. Resource loss is a core driver of post-traumatic stress disorder (PTSD) after large-scale traumatic events. We examined the effect of restoration of residential and housing-related financial resources on recovery from PTSD in post-disaster contexts.

METHODS

We built an agent-based model, empiricised with observational and experimental data, to test the effects of differing health service approaches on PTSD recovery, measured by prevalence and persistence. We tested a social services case management (SSCM) approach similar to Psychological First Aid, featuring shelter-based social service provision and linkage to mental health treatment for people who were displaced and had income loss, by comparing the treatment effectiveness of usual care alone, usual care with SSCM, stepped care alone, and stepped care with SSCM.

FINDINGS

An SSCM approach to restore housing and provide linkage to mental health services among people who were displaced and had income loss after a large-scale natural disaster resulted in between 1·56 (95% CI 1·55-1·57) and 5·73 (5·04-6·91) times as many remitted PTSD cases as non-SSCM conditions at the end of the first year, and between 1·16 (1·16-1·17) and 2·28 (2·25-2·32) times as many remitted cases at the end of the second year.

INTERPRETATION

Restoring economic and housing resources to populations affected by a natural disaster would significantly reduce the mental health burden in populations, particularly those with resource loss, after a disaster.

FUNDING

US Department of Health and Human Services.

Social support and post-traumatic growth among a sample of arthritis patients: Analysis in light of conservation of resources theory

The study examined the association between social support dimensions and post-traumatic growth (PTG) among a sample of arthritis patients. In particular, we wanted to verify the mediating role of resources, as described by the Conservation of Resources (COR) theory, on the aforementioned relationship. A total of 207 patients with a clinical diagnosis of arthritis were recruited to participate in the study, including 149 females and 58 males. This was a cross-sectional study, with PTG evaluated by the Post-Traumatic Growth Inventory (PTGI) and social support assessed via the Berlin Social Support Scales (BSSS). To assess the level of subjectively possessed resources among participants, we used the COR evaluation questionnaire (COR-E). Provided support, but not received support, was positively related to the level of PTG among participants. In addition, the level of spiritual resources mediated the aforementioned relationship. The results of this contribute to the literature on the psychological aspects of arthritis. It seems that providing support may be related to positive consequences among arthritis patients, in the form of PTG, with spiritual resources being of significant value in this process.

Narrating hope and resistance: A critical analysis of sources of agency among Palestinian children living under military violence

BACKGROUND

In light of critical and socioconstructionist theories, the aim of our research was to analyze source of agency, psychological adjustment to trauma as protective factors against political violence in children living in three different refugee camps in Palestine, as well as exploring the risks to which these children are exposed.

METHODS

Thematic content analysis was applied to children's written and drawn productions in order to extract the main categories and themes.

RESULTS

Four main domains of agency emerged from the analysis: personal growth, political well-being, social relationships, and geographical context. For each domain, specific dimensions are discussed.

CONCLUSIONS

The results of this preliminary exploration of children's agency suggest that the children's living environment plays a key role in shaping their suffering and reactions to war and ongoing violence. Furthermore, the social nature of the children affected by war-related suffering forces practitioners and policymakers to question the effectiveness of intervention programs that are predominantly focused on symptoms.

Clinical Outcome and Management for Geriatric Traumatic Injury: Analysis of 2688 Cases in the Emergency Department of a Teaching Hospital in Taiwan

Geriatric traumatic injuries in emergency departments are frequent and associated with higher mortality rates and catastrophic functional outcomes. Several prediction scores have been established to manage traumatic patients, including the shock index (SI), revised trauma score (RTS), injury severity score (ISS), trauma injury severity score (TRISS), and new injury severity score (NISS). However, it was necessary to investigate the effectiveness and efficiency of care for the geriatric traumatic population. In addition, image studies such as computed tomography and magnetic resonance imaging play an important role in early diagnosis and timely intervention. However, few studies focus on this aspect. The association between the benefit of carrying out more image studies and clinical outcomes remains unclear. In this study, we included a total of 2688 traumatic patients and analyzed the clinical outcomes and predicting factors in terms of geriatric trauma via pre-hospital and in-hospital analysis. Our evaluation revealed that a shock index ≥1 may be not a strong predictor of geriatric trauma due to the poor physical response in the aging population. This should be modified in geriatric patients. Other systems, like RTS, ISS, TRISS, and NISS, were significant in terms of predicting the clinical outcome.