Personal resources, coping self-efficacy, and quake exposure as predictors of psychological distress following the 1999 earthquake in Turkey

The mediating role of self-efficacy, social support, and hope in the relation between mental health and resilience among 2023 Türkiye earthquake survivors

This research aims to investigate the mediating role of self-efficacy, social support, and hope in the relationship between depression, anxiety, stress, and resilience in 2023 Türkiye earthquake survivors (N = 491). The findings from a multi-mediation analysis showed the indirect effect of depression, anxiety, and stress on resilience through self-efficacy, social support, and hope. Thus, self-efficacy, social support, and hope may be protective factors for resilience in earthquake survivors. Strategies to improve self-efficacy and hope in earthquake survivors and social support may be necessary in reducing the stress factors caused by earthquakes.

Disaster response self-efficacy of nursing students: Perceived level and associated factors

OBJECTIVES

The study aimed to assess the level of disaster response self-efficacy (DRSE) among nursing students in Bangladesh and examine the factors influencing their level of DRSE.

METHODS

A cross-sectional study design was used for this research. A self-administered descriptive structured questionnaire was used to collect survey data from 573 students of nursing colleges in four districts: Chattogram, Dhaka, Khulna, and Rajshahi. The Bengali version of the DRSE Scale was adopted and used to measure the outcome variable.

RESULTS

The nursing students exhibited a moderate level of disaster response self-efficacy (Mean = 3.63; SD = 0.73), as well as moderate levels of knowledge (Mean = 3.87; SD = 0.71), skills (Mean = 4.24; SD = 0.91), and preparedness (Mean = 4.31; SD = 0.76) in disaster management. Significant positive correlations were found between respondents' disaster knowledge (r = 0.447, p < 0.01), skills (r = 0.516, p < 0.01), and preparedness (r = 0.701, p < 0.01) with disaster response self-efficacy. Gender, age, having children in the household, post-basic BSc in nursing students, and disaster knowledge were significantly associated with nursing students' DRSE. Female respondents had a 0.27-unit lower DRSE (β = -0.270 (95 % CI: -0.389, -0.115), p < 0.001) than male respondents. Besides, the respondents per unit increase in disaster knowledge occurred a 0.438-unit increase in DRSE (β = 0.438 (95 % CI: 0.367, 0.510), p < 0.001). However, no statistically significant associations were found between the respondents' disaster experience and disaster-related training with their DRSE scores.

CONCLUSION

Improving disaster management knowledge by including disaster management-related courses and organizing more training, drills, seminars, and workshops may improve their DRSE.

The development and initial validation of the Earthquake Fear Scale: Its links to personality traits, psychological distress, harmony in life, and mental wellbeing

Unexpected and unpredictable earthquakes may have a negative impact on people's mental health. The earthquake fear experienced by individuals causes psychological problems. This article is made up of three different studies that look at earthquake fear. The seven item Earthquake Fear Scale (EFS) was confirmed in Study I (N = 407) utilising confirmatory factor analysis. In addition, Item Response Analysis was done, and it was found that all of the items showed a good degree of discrimination. The reliability of the EFS has been proven with different reliability coefficients. In Study II (N = 505), both correlation and network analysis were carried out, and earthquake fear was found to be significantly associated with depression, anxiety, stress, and mental wellbeing. Moreover, neuroticism and conscientiousness, two of the big five personality traits, are significantly associated with earthquake fear. In Study III (N = 382), it was revealed that psychological distress and harmony in life play a serial and fully mediating role in the link between earthquake fear and mental wellbeing. The psychological influence of earthquake fear is emphasised in this pioneering and comprehensive study on earthquake fear.

School-based psychosocial and educational interventions for children and adolescents after the 1999 Marmara earthquakes in Turkey: A review on lessons learned

The massive earthquakes experienced in August and November 1999 affected thousands of people in the Marmara region, the most densely populated and industrialized part of Turkey. The humanitarian and economic cost was so enormous, and these earthquakes have changed the Turkish disaster management system and the Turkish people's approach to disasters. Marmara earthquakes are also considered as a milestone in the provision of psychosocial services for disaster victims. This paper aims to review the psychosocial interventions targeting children, adolescents, and their families after the 1999 earthquakes in Turkey. The progression from initial responses to more organized psychosocial interventions is outlined. Conducting the interventions at schools has ensured that thousands of children, teachers, and parents are reached in the most efficient and effective way possible. The significance of the school context in designing psychosocial interventions is highlighted and implications of the lessons learned for traumatic experiences of children and parents are also explored. It is evaluated that these inferences obtained from the Marmara earthquake in Turkey can be used in disasters around the world.

Emotion Regulation Use Varies Across Socioecological Levels of Pandemic Stress in Older Adults

OBJECTIVES

COVID-19 escalated stress within family/neighborhood (local) and national/cultural (global) levels. However, the impact of socioecological levels of stress on pandemic emotion regulation remains largely unexplored.

METHODS

Thirty older adults from the Northeast US (63-92 years) reported on pandemic stress and emotion regulation in semi-structured interviews. Responses were coded into socioecological sources of local and global stress, and associated use of cognitive emotion regulation strategies from the Cognitive Emotion Regulation Questionnaire was explored.

RESULTS

Older adults experienced significant distress at global levels, and perception of lacking top-down safety governance may have exacerbated local distress of engaging in daily activities during the COVID-19 pandemic. Participants endorsed coping with local stressors via perspective-taking, acceptance, and other adaptive strategies, while global sources of stress were associated with greater use of maladaptive strategies, including other-blame and rumination.

CONCLUSION

Quantitative assessments may underestimate significant older adult distress and maladaptive coping toward global stressors. Findings should be replicated with more diverse populations beyond the COVID-19 context.

The development of the fear of earthquake scale: validity and reliability study in Türkiye after the 2023 earthquake

BACKGROUND

In 2023, Türkiye experienced a significant earthquake disaster that profoundly impacted 11 provinces. The enduring consequences of these earthquakes on daily life triggered widespread fears and anxieties in society, leading to scholarly investigations in this field.

OBJECTIVE

The primary objective of this study was to create and evaluate the psychometric properties of the Fear of Earthquake Scale (FES), a modified adaptation of the Fear of COVID-19 Scale (FCV-19 S), tailored to measure earthquake-related experiences in Türkiye.

METHODS

A total of 315 Turkish adult participants (106 men, 209 women), with a mean age of 37.71 years, completed the FES, along with the Brief Psychological Resilience Scale (BPRS). Psychometric analyses included confirmatory factor analysis as well as the evaluation of alternative factor structures, internal consistency, convergent validity, and criterion validity with respect to resilience.

RESULTS

The findings indicate that the Turkish version of the Fear of Earthquake Scale has strong psychometric properties in terms of validity and reliability. After assessing various factor structures, it was observed that the two-factor model which represents the emotional and somatic response to fear, exhibited the best-fit values The Cronbach's alpha coefficients were calculated as 0.89 for the overall FES, 0.84 for the emotional subscale and 0.86 for the somatic subscale, indicating high internal consistency. Additionally, the negative correlation between resilience and the FES supports the criterion validity of the scale, and multi-group confirmatory factor analyses proved that measurement invariance held across genders and whether they experienced an earthquake or not for all groups. Furthermore, the results of the study revealed that women and individuals with prior earthquake experience reported higher levels of fear of earthquakes.

CONCLUSIONS

The FES emerged as a reliable and valid tool for assessing earthquake-related fears among the Turkish population.

Fear of COVID-19 and Fear of Earthquake: Multiple Distressing Events and Well-Being in Croatia

People in Croatia have recently experienced two major earthquakes in the midst of COVID-19 pandemic, which are possible sources of increased fear. In order to capture and understand the effects of the simultaneously occurring threatening events, the aims of this study were threefold. First, we aimed to examine the psychometric properties and factor structure of the Croatian version of the Fear of COVID-19 scale (FCV-19S). Second, bearing in mind that there is a lack of instruments for measuring fear of earthquakes, the study aimed to develop and examine the psychometric properties the Fear of Earthquake Scale (FES), as a version of FCV-19S, modified for the earthquake experience. Finally, the study aimed to examine differences in well-being indicators (life satisfaction, positive and negative affect) between four groups of participants who either had/did not have COVID-19 disease or had experienced/did not have experienced earthquake. The study was conducted among 1136 participants adults who took part in the fourth year of the Croatian longitudinal study on well-being. Among them, N = 665 participants experienced earthquake and responded to additional questions regarding that experience. The analyses demonstrated valid psychometric properties and one-factorial structure of FCV-19S and FES scales. The findings showed that people who went through earthquake experience (vs. those without earthquake experience and COVID-19 infection) reported higher negative affect and lower positive affect, indicating that people in Croatia seem to have been more fearful of earthquakes than COVID-19 pandemic. Findings suggest the long-term negative effects of earthquake on fear and well-being in comparison to COVID-19 pandemic.

Effect of caregiver burden on anticipatory grief among caregivers of elderly cancer patients: Chain mediation role of family functioning and resilience

This study aimed to explore the relationship between caregiver burden and anticipatory grief among caregivers of elderly cancer patients, and to examine the chain mediation effects of family functioning and resilience. A total of 624 valid questionnaires were collected. The Structural Equation Model was established to test the mediating effects of family functioning and resilience. Results showed that caregiver burden has a direct positive effect on anticipatory grief, both family functioning and resilience have negative effects on caregiver burden and anticipatory grief, and that resilience moderates the mediating effect of family functioning. Our findings suggest that reducing the caregiver burden among caregivers of elderly cancer patients, improving family functioning, and enhancing resilience have important effects in alleviating the anticipatory grief of caregivers. Our findings provide some references for further research. Medical staff should better understand the grief experience of caregivers and implement interventions to enable caregivers to better cope with anticipatory grief and psychological stress, so as to promote the quality of care for elderly cancer patients.

The Disaster Adaptation and Resilience Scale: development and validation of an individual-level protection measure

Given the increasing threat of disasters in the United States and elsewhere around the world, well-tested assessment tools that operationalise specific protective factors associated with adaptation and resilience to such events are needed. Consequently, the authors proposed, developed, and validated the Disaster Adaptation and Resilience Scale (DARS) to measure five domains found to support adaptive responses in individuals exposed to disasters: physical resources; social resources; problem-solving; distress regulation; and optimism. The development and validation processes of DARS occurred across two studies: the first comprised construct development, item generation, and expert review, whereas the second involved a full validation evaluation of the psychometric properties of the scale in a sample of adults exposed to a disaster in the US (N=625). The results revealed that DARS had psychometric properties that support its use among adults experiencing a disaster. A discussion is presented on how the scale can be employed in both research and practice.

Promoting Mental Health of Nurses During the Coronavirus Pandemic: Will the Rapid Deployment of Nurses' Training Programs During COVID-19 Improve Self-Efficacy and Reduce Anxiety?

Introduction The nursing profession is extremely demanding and stressful. Nurses have been facing a tremendous amount of fear and anxiety during the ongoing coronavirus disease 2019 (COVID-19) pandemic. General self-efficacy is considered one of the most influential factors that can modify the impact of anxiety on nurses' mental health. In this study, we aimed to determine the predictors of self-efficacy and anxiety among nurses during the current COVID-19 pandemic. Methods We conducted a cross-sectional survey involving 368 nurses working in a tertiary care hospital. The General Self-Efficacy scale (GSE) and Generalized Anxiety Disorder Scale-7 (GAD-7) were used for assessing self-efficacy and anxiety. The chi-square test followed by bivariate and multivariable regression analyses was performed to identify the determinants of self-efficacy and anxiety. Results The mean age of the nurses was 28.91 years (SD=3.68), with a mean working experience in the nursing field of 5.32 years (SD=2.48). The mean self-efficacy and anxiety scores were 32.19 (SD=4.53) and 3.82 (SD=2.87), respectively. Multivariable analysis showed that higher age (>30 years, p=.003), professional education acquired through a diploma course instead of a graduate degree (p<.001), and lack of training on handling COVID-19 patients (p=.003) were significant determinants of higher anxiety among nurses. Similarly, higher economic status (p=.001), sufficient COVID-19 training (p=.049), having family members tested positive for COVID-19 (p=.012), professional experience (≤5 years, p<0.001), and quarantine period (≤14 days, p=.002) were revealed to be independent determinants of a higher sense of self-efficacy among nurses during the COVID-19 pandemic. Conclusion Receiving adequate levels of training on COVID-19 plays a vital role in improving self-efficacy and reducing anxiety among nurses during the ongoing pandemic. Managing anxiety, increasing self-efficacy, and ensuring more exposure to COVID-19-related training may improve nurses' mental health and prepare them for fighting pandemics in a much better and more efficient manner.

A Balancing Act During Covid-19: Teachers' Self-Efficacy, Perception of Stress in the Distance Learning Experience

One of the many drastic changes caused by Covid-19 was the quick implementation of distance learning which represented a great technological challenge to many teachers and students. In fact, Italy ranks 24th amongst the 27-EU member countries in digital competitiveness which testifies to the significant delays and gaps in basic digital skills amongst the population. Based on the difficulties encountered in organizing distance learning, we assumed that teachers' perceived stress increased. Given that transversal skills can be associated with this relationship, we hypothesized that among these skills, self-efficacy mediated the relationship between the difficulties in organizing distance learning and perceived stress. Since we targeted teachers from Italy and other European countries, we also hypothesized that this mediator effect would be different for both samples. Our sample was composed of a total of 366 primary/middle school teachers of which 86% female. After doing a mediation analyses with Process, Hayes' Model 4, we confirmed H1 but not H2: resulting in a partial mediation effect of self-efficacy for each individual group of teachers. Since difficulties of distance learning can affect the perception of stress, we believe that the promotion of transversal skills, such as self-efficacy, can better equip teachers when facing stressful situations.

Self-Rated Mental and Physical Health of U.S. Gulf Coast Residents

Repeated exposure to hurricanes and tropical storms likely impacts the mental and physical health of populations living along the U.S. Gulf Coast. In this study, the self-rated physical and mental health of residents in the U.S. Gulf Coast was estimated and factors associated with differences in self-rated health were identified. The 12-item Short Form Health Survey (SF-12) was administered online to a sample of 3030 residents of the U.S. Gulf Coast in December 2017. Responses were scored to calculate mental component summary scores and physical component summary scores. Multiple linear regression models were fitted to identify predictors of self-rated health among the residents. Residents of U.S. Gulf Coast States have poorer self-rated physical and mental health compared to the U.S. population. Women and respondents reporting higher perception of flood risk had worse self-rated mental health, while hurricane evacuees, adults of at least 25 years of age, those with self-reported hurricane damage, and respondents reporting higher perception of surge risk had worse self-rated physical health. Residents of U.S. Gulf Coast States have poorer self-rated health compared to national standards. These findings may have practical implications for hurricane-associated physical and mental health services planning and delivery.

Self-Leadership and Psychological Capital as Key Cognitive Resources for Shaping Health-Protective Behaviors during the COVID-19 Pandemic

As COVID-19 has become a global pandemic, health researchers and practitioners have focused attention on identifying the factors that may help to shape health-protective behaviors, protecting individual health and well-being, and helping to mitigate the spread of COVID-19. This study explores the potential role of self-leadership and psychological capital (PsyCap) as key cognitive resources for shaping health-protective behaviors. Using multiple theoretical frameworks (social cognitive theory, psychological resources theory, and the health belief model), this paper develops and tests a hypothesized serial mediation model in which PsyCap and coping self-efficacy mediate the relationship between self-leadership and health-protective behaviors including hand washing, wearing face masks, and social distancing. Results suggest that PsyCap and coping self-efficacy mediate the positive relationship between self-leadership and health-protective behaviors. These results yield valuable insights regarding the usefulness of self-leadership and PsyCap as cognitive resources for shaping health-protective behaviors and for possible self-leadership and PsyCap interventions, potentially tailored to at-risk populations, which should have practical benefits for both the current and future pandemics and health crises.

Evolution and impact of self-efficacy during French COVID-19 confinement: a longitudinal study

Based on social cognitive theory, we propose that self-efficacy is a personal resource that protects people from the impact of confinement in the context of the COVID-19 pandemic. In a longitudinal study where 197 French citizens were surveyed over 8 weeks of confinement (though only 25 participants responded each of these 8 weeks), we examined the relationships between general self-efficacy and positive affect, negative affect and adaptive performance at work. Consistent with theoretical expectations, self-efficacy was relatively stable during confinement and was positively related to positive affect and negatively related to negative affect. Self-efficacy was also positively correlated with all dimensions of adaptive performance at work during confinement. The role of self-efficacy as a protective factor against depressive risks induced by the stressful COVID-19 pandemic is discussed.

Dispositional Optimism and Disaster Resilience: A natural experiment from the 2011 Great East Japan Earthquake and Tsunami

OBJECTIVE

Dispositional optimism - the general belief that good things will happen - is considered a key asset for the preservation of mental health after a traumatic life event. However, it has been hypothesized that in extreme situations such as major disasters where positive expectations cannot overcome the grim reality on the ground, being optimistic might be a disadvantage. To test this mismatch hypothesis, this study explores whether higher pre-disaster dispositional optimism is associated with higher posttraumatic stress (PTS) and depressive symptoms among individuals who experienced the 2011 Great East Japan Earthquake and Tsunami.

METHODS

Information on optimism was collected from community-dwelling residents aged ≥65 years seven months before the 2011 Earthquake/Tsunami in Iwanuma, a Japanese city located 80-km from the epicenter. Data on disaster-related personal experiences (e.g., loss of relatives or friends/housing damage), as well as depressive and PTS symptoms, were collected during a follow-up survey in 2013, 2.5 years after the earthquake and tsunami. Multiple logistic regression models were utilized to evaluate the associations between disaster experiences, optimism, and depressive/PTS symptoms among 962 participants.

RESULTS

Higher pre-disaster dispositional optimism was associated with lower odds of developing depressive symptoms (OR = 0.78, 95% CI: 0.65 to 0.95) and PTS symptoms (OR = 0.83, 95% CI: 0.69 to 0.99) after the earthquake. Contrary to the mismatch hypothesis, high dispositional optimism buffered the adverse impact of housing damage on depressive symptoms (interaction term coefficient = -0.63, p = 0.0431), but not on PTS symptoms.

CONCLUSIONS

In contrast to the mismatch hypothesis, the results suggest that dispositional optimism is a resilience resource among survivors of a disaster.

Victimology from clinical psychology perspective: psychological assessment of victims and professionals working with victims

Victimology concerns victims of various traumas from accidents, disasters, assaults to wars. Survivors of trauma are also an area in clinical psychology since it is interested in the assessment and diagnosis of psychopathology and psychotherapy. Stress and mental health are intertwined; increased stress results in difficulties in feeling, thinking and behaving. The stress symptoms are an intrusion, avoidance, negative cognitions and mood, and arousal and reactivity. A trauma survivor might develop post-traumatic stress disorder. Healing trauma is so comprehensive that many professionals work from different aspects. From attorneys to mental health workers, many professionals deal with the aftereffects of trauma. Engaging with details of the trauma endangers not only the victims but also the professionals working with the victims. These professionals end up having psychological effects such as secondary trauma, vicarious trauma, compassion fatigue, countertransference and occupational burnout. Trauma has serious effects on its victims but not all effects are negative and paralyzing. Trauma victims might change their priorities in a way that they report more personal control over their life. This phenomenon is called posttraumatic growth. The paper aims to collaborate victimology with clinical psychology by highlighting psychopathology and psychological assessment.

What makes one feel eustress or distress in quarantine? An analysis from conservation of resources (COR) theory

OBJECTIVE

Health quarantines produce serious deterioration in psychological health, which becomes more affected the longer the quarantine lasts. According to the Conservation of Resources theory from Hobfoll (1989, American Psychologist, 44, 513), those people who have a good supply of resources will be able to cope better with the adversities and will show less distress. The objective of this research is to identify what are the resources that, in a situation of confinement under the threat of COVID-19, predict eustress or well-being, and the loss or lack of which resources predict distress or discomfort.

DESIGN AND METHOD

A total of 839 people complete an online questionnaire during the first week of COVID-19 confinement in Spain. The sample is weighted to obtain a distribution that is similar to the Spanish population. Using multiple linear regression analysis, factors are identified that are associated with eustress and distress based on the Conservation of Resources theory.

RESULTS

A model is identified that explains 55% of the variance of eustress consisting mostly of personal resources, with vitality as the recourse having the most weight. The factors that explain distress (18.9% of the variance) are those related to work (employment situation, work satisfaction, and time devoted to work) and conditions in the home (space).

CONCLUSIONS

The models that predict eustress and distress are completely different. Based on these results, a series of recommendations are proposed aimed at increasing eustress and reducing distress in a situation of confinement. Additionally, proposals are offered for future research.

Characteristics of Resilience Among Disaster Rescue Workers: A Systematic Review

Disasters can cause long-lasting damage to survivors and rescue workers. Some rescue workers suffer negative physical and psychological consequences, while others do not. Thus, it is of value to fully understand the characteristics of rescuers who have not been affected by rescue activities. Resilience refers to the ability or capacity to cope with adversity. The aim of this review is to explore and identify the characteristics of resilience among rescue workers. A systematic literature search was conducted of seven electronic databases from inception to May 2019, using keywords and medical subject heading terms related to the resilience of rescuers. Hand searches and searches of leading authors were also performed. A total of 31 articles were eligible for review. Six domains were identified to characterize the resilience of rescuers namely, demographic and physical characteristics, personality traits, coping strategies, perceived resources, being equipped with special skills for disaster rescue, and having less adverse consequences from exposure to disaster. Researchers and disaster managers can take note of these characteristics to comprehensively understand the 'positive concept' of resilience. This enhanced understanding of 'positive resilience' can in turn be used to develop a framework to assess and establish interventions, and consequently to improve the psychological wellbeing of rescuers after disaster rescue efforts.

Risk Perception of COVID-19, Meaning-Based Resources and Psychological Well-Being amongst Healthcare Personnel: The Mediating Role of Coping

The well-being of healthcare personnel during the COVID-19 pandemic depends on the ways in which they perceive the threat posed by the virus, personal resources, and coping abilities. The current study aims to examine the mediating role of coping strategies in the relationship between risk perception of COVID-19 and psychological well-being, as well as the relationship between meaning-based resources and psychological well-being amongst healthcare personnel in southern Poland. Two hundred and twenty-six healthcare personnel who worked in hospitals, outpatient clinics, and medical laboratories during the first few months of the coronavirus pandemic (March–May 2020) filled in questionnaires measuring risk perception of COVID-19, meaning-based resources, coping, and psychological well-being. The results demonstrate that risk perception was negatively related to psychological well-being, whereas meaning-based resources were positively associated with well-being. Two coping strategies—problem-focused and meaning-focused coping—mediated the relationship between risk perception and psychological well-being as well as the relationship between meaning-based resources and psychological well-being. This indicates that perception processes and personal factors do not directly influence healthcare personnel’s psychological well-being, but rather they do indirectly through coping processes.

Psychological interventions to foster resilience in healthcare students

BACKGROUND

Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes.

OBJECTIVES

To assess the effects of interventions to foster resilience in healthcare students, that is, students in training for health professions delivering direct medical care (e.g. medical, nursing, midwifery or paramedic students), and those in training for allied health professions, as distinct from medical care (e.g. psychology, physical therapy or social work students).

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.

SELECTION CRITERIA

Randomised controlled trials (RCTs) comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, waiting list, usual care, and active or attention control, in adults (18 years and older), who are healthcare students. Primary outcomes were resilience, anxiety, depression, stress or stress perception, and well-being or quality of life. Secondary outcomes were resilience factors.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only).

MAIN RESULTS

We included 30 RCTs, of which 24 were set in high-income countries and six in (upper- to lower-) middle-income countries. Twenty-two studies focused solely on healthcare students (1315 participants; number randomised not specified for two studies), including both students in health professions delivering direct medical care and those in allied health professions, such as psychology and physical therapy. Half of the studies were conducted in a university or school setting, including nursing/midwifery students or medical students. Eight studies investigated mixed samples (1365 participants), with healthcare students and participants outside of a health professional study field. Participants mainly included women (63.3% to 67.3% in mixed samples) from young adulthood (mean age range, if reported: 19.5 to 26.83 years; 19.35 to 38.14 years in mixed samples). Seventeen of the studies investigated group interventions of high training intensity (11 studies; > 12 hours/sessions), that were delivered face-to-face (17 studies). Of the included studies, eight compared a resilience training based on mindfulness versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. universities, foundations), or a combination of various sources (four studies). Seven studies did not specify a potential funder, and three studies received no funding support. Risk of bias was high or unclear, with main flaws in performance, detection, attrition and reporting bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare students receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.43, 95% confidence interval (CI) 0.07 to 0.78; 9 studies, 561 participants), lower levels of anxiety (SMD -0.45, 95% CI -0.84 to -0.06; 7 studies, 362 participants), and lower levels of stress or stress perception (SMD -0.28, 95% CI -0.48 to -0.09; 7 studies, 420 participants). Effect sizes varied between small and moderate. There was little or no evidence of any effect of resilience training on depression (SMD -0.20, 95% CI -0.52 to 0.11; 6 studies, 332 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.15, 95% CI -0.14 to 0.43; 4 studies, 251 participants; very-low certainty evidence). Adverse effects were measured in four studies, but data were only reported for three of them. None of the three studies reported any adverse events occurring during the study (very-low certainty of evidence).

AUTHORS' CONCLUSIONS

For healthcare students, there is very-low certainty evidence for the effect of resilience training on resilience, anxiety, and stress or stress perception at post-intervention. The heterogeneous interventions, the paucity of short-, medium- or long-term data, and the geographical distribution restricted to high-income countries limit the generalisability of results. Conclusions should therefore be drawn cautiously. Since the findings suggest positive effects of resilience training for healthcare students with very-low certainty evidence, high-quality replications and improved study designs (e.g. a consensus on the definition of resilience, the assessment of individual stressor exposure, more attention controls, and longer follow-up periods) are clearly needed.

Psychological interventions to foster resilience in healthcare professionals

BACKGROUND

Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes.

OBJECTIVES

To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists).

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.

SELECTION CRITERIA

Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only).

MAIN RESULTS

We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence).

AUTHORS' CONCLUSIONS

For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.

The effects of psychological first aid training on disaster preparedness perception and self-efficacy

OBJECTIVE

This study was conducted with the aim of investigating the impact of psychological first aid training on the perception of disaster preparedness and self-efficacy.

METHODOLOGY

This study is an experimental randomized control study design with monitoring measurement. The study was carried out with a total of 76 nursing students including 38 in the intervention group and 38 in the control group. The data were collected using a Personal Information Form, the Disaster Preparedness Perception Scale for Nurses and the General Self-Efficacy Scale (GSS). Sessions of Psychological First Aid training that lasted 60 min were carried out with the students in the experiment group once a week along 6 weeks. The statistical analysis on the data involved descriptive statistical methods (means, standard deviations, frequencies), Mann Whitney U test, Spearman Correlation, Friedman and Wilcoxon Signed Ranks tests.

FINDINGS

It was found that the mean scores of the intervention group under all sub-dimensions of the disaster preparedness perception scale for nurses (preparation phase, intervention phase, and post-disaster phase) increased significantly after the training and in follow-ups, and these were significantly higher than the mean scores of those in the control group. It was determined that the mean post-training and follow-up general self-efficacy scores of the intervention group increased significantly, and these were significantly higher than the mean scores of those in the control group.

CONCLUSION

It was determined that psychological first aid education positively affected the subject's perception for disaster preparation as well as their perception of general self-efficacy. In line with this conclusion, as per this study it is suggested to provide training that includes psychological first aid training module in undergraduate nursing programs.

Self-Efficacy and Resilience: Mediating Mechanisms in the Relationship Between the Transformational Leadership Dimensions and Well-Being

The objective of this article is to test the roles of self-efficacy and resilience as consecutive mediators in the relationship between the four dimensions of transformational leadership and well-being (operationalized as psychosomatic complaints and psychological distress). The sample consists of 225 social services employees in Spain. Data were gathered at two time points with a time-lag of 6 months. We used path analysis to test the hypothesized model and Monte Carlo confidence intervals to check the significance of the indirect effects. Our results showed that only two of the four transformational leadership dimensions have a direct impact on self-efficacy: inspirational motivation and individualized consideration, although contrary to our hypothesis, the latter had a negative effect on self-efficacy. As for the indirect effects, self-efficacy did not mediate between the leadership dimensions and well-being, whereas resilience mediated between self-efficacy and well-being. Self-efficacy and resilience consecutively mediated between the leadership dimensions and well-being. Our findings contribute to understanding the underlying mechanisms connecting different dimensions of transformational leadership and well-being, and they highlight the importance of developing employees’ personal resources.

Self-Regulation Shift Theory: A Dynamic Personal Agency Approach to Recovery Capital and Methodological Suggestions

Recovery capital highlights person and environmental resources associated with overcoming significant life challenges. This paper utilizes social cognitive theory as a framework for understanding how recovery capital functions in trauma adaptation. This theory outlines the bidirectional, dynamic interactions among person (e.g., cognitive and affective), behavioral (e.g., problem focused coping), and environmental variables (i.e., triadic reciprocal determinism). The value of this approach to understanding human adaptation to trauma is that it targets the self-regulatory processes that unfold for trauma survivors as they attempt to put their lives back together. Self-regulation shift theory (SRST), as an extension to social cognitive theory, is offered to explain how self-regulation is involved in both positive and negative adjustment. The theory uses a dynamical systems approach and highlights the mechanisms related to non-linear shifts in both positive and negative trauma recovery. According to SRST, trauma recovery may not be linear with threshold shifts (i.e., bifurcations) from one organized state (broken self) to another (empowered self). Coping self-efficacy perceptions are a critical factor influencing these threshold shifts. This paper concludes with a brief review of study designs and analytic procedures that can facilitate the application of non-linear dynamic research in this area.

Longitudinal Study of Posttraumatic Stress Disorder in the Community: Risk and Recovery Factors

Posttraumatic stress disorder (PTSD) is a multicausal phenomenon and a final end point of the combination of a number of potential causes. Our study aimed to examine potential risk and recovery factors of PTSD in general adult population at 1-year follow-up period. The sample consisted of 640 subjects in the initial phase, chosen by random walk technique in five regions of the country, and 100 in the follow-up. The assessment has been carried out by the following instruments: Mini-International Neuropsychiatric Interview, Life Stressor Checklist-Revised, Brief Symptom Inventory, and Manchester Short Assessment of Quality of Life Scale. Older age, low education, and lower monthly income are potential risk factors for current PTSD, as well as decreased quality of life, psychiatric comorbidity, and higher personal distress. Urban population, higher quality of life, smaller number of stressors, and lower personal distress contributed to recovery of PTSD. It is essential to know the risk and resilience factors that contribute to the development and recovery of PTSD, which is important for prevention and treatment of this disorder.

International Tourists' Reactions to a Natural Disaster: Experiences of the 2015 Earthquake in Nepal Among Israeli Travelers

There is a scarcity of research exploring the experiences of foreign travelers exposed to natural disasters while abroad. This qualitative study explored the experiences of the 2015 earthquake in Nepal among international travelers immediately following the earthquake. In-depth interviews were conducted with 21 Israeli backpackers who were traveling in Nepal at the time of the earthquake. Thematic analysis revealed 4 themes: emotional turmoil, quick recovery, springing into action, and connection to the army. Findings suggest that foreign travelers initially respond with emotional turmoil to the disaster. Then they actively search for ways to effectively cope with the situation by problem solving, creating a community of action and support, and searching their own history for similar circumstances that can provide a sense of competence or clear directions for coping. Implications and limitations of the study, as well as suggestions for future research are discussed.

Employing a community based participatory research approach to bear witness: psycho-social impact of the 2010 earthquake on Haitians in Somerville, MA

We employed a community-based participatory research approach to assess mental health among the Haitian community in the Somerville, MA area. The development of the survey coincided with the 2010 earthquake in Haiti, and so several questions related to the natural disaster were included in the analysis to increase understanding of the impact locally. We surveyed a convenience sample of 64 Haitians recruited with the assistance of the Somerville Haitian Coalition. The survey assessed demographic data, reasons for migrating to the area, response to the 2010 earthquake, and mental health. Mental health measures included the short versions of the Center for Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale. Participants reported high rates of stress and depression post-earthquake. On the CES-D, men reported higher average depression and stress scores than women (13.8 vs. 11 and 20.6 vs. 17.6). Our results suggest that social and family support resources may be beneficial to Haitians in our sample.

Contextual Positive Coping as a Factor Contributing to Resilience After Disasters

OBJECTIVE

Strategy-situation fit, or contextual coping, posits that the physical and psychological demands associated with stressors are determined in part by the characteristics of each stress situation and may therefore require the use of different coping strategies. In this review, we discuss strategy-situation fit in the context of both natural and manmade disasters as it pertains to positivity and, ultimately, resilience after disasters.

METHOD

We reviewed the relevant literature on positivity and coping with disasters using a contextual approach.

RESULTS

We identified several disaster-related characteristics (i.e., cause of disaster, temporal characteristics of disasters, and degree of resource loss) that might influence the efficacy of positive coping strategies. We then discussed strategies that could be useful for promoting resilience with regard to these different characteristics.

CONCLUSION

This work represents an initial step in conceptualizing disaster resiliency within the framework of contextual positive coping. Recommendations for future avenues of research are discussed.

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

Background

Self-efficacy may be an important factor in individuals’ recovery from posttraumatic stress reactions after a natural disaster. However, few longitudinal studies have investigated whether self-efficacy predicts the course of posttraumatic recovery beyond lower initial levels of distress. The purpose of the present study was to investigate whether general self-efficacy is related to recovery from posttraumatic stress reactions from a longitudinal perspective.

Methods

A total of 617 Norwegians exposed to the 2004 Southeast Asian tsunami completed self-report questionnaires measuring their level of disaster exposure and general self-efficacy at 6 months and posttraumatic stress reactions 6 months and 2 years post-disaster. Predictors of changes in posttraumatic stress reactions were analyzed with multivariate mixed effects models.

Results

Self-efficacy at 6 months post-disaster was unrelated to trauma exposure and inversely related to posttraumatic stress reactions at 6 months and 2 years post-disaster. However, self-efficacy was not related to recovery from posttraumatic stress reactions between 6 months and 2 years post-disaster.

Conclusions

In conclusion, general self-efficacy is related to lower levels of posttraumatic stress reactions in the first months after a disaster but does not appear to be related to improved recovery rates over the longer term.

Meaning Making in the Context of Disasters

OBJECTIVE

Understanding the factors underlying adaptive psychological responses and recovery after disasters has important implications for intervention and prevention efforts. To date, little attention has been paid to successful coping processes in recovering from natural and technological disasters. This article takes a meaning making perspective to explicate how survivors successfully adapt after disasters.

METHOD

Relevant literature is reviewed to illustrate the process of adaptation and resilience after disasters.

RESULTS

Studies to date suggest both survivors' global meaning, particularly their religiousness and sense of meaning, and their appraisals and meaning making after the disaster are important influences on their postdisaster resilience. Meanings made in the form of changes in global beliefs and perceived growth have been reported and shown to have inconsistent relations with adjustment.

CONCLUSIONS

Although much more research is needed, current literature suggests that meaning making processes are central to recovery and resilience after a range of disasters.

Associations between economic loss, financial strain and the psychological status of Wenchuan earthquake survivors

This study examines the effects of economic loss on the life satisfaction and mental health of Wenchuan earthquake survivors. Economic loss is measured by earthquake impacts on the income and houses of the survivors. The correlation analysis shows that earthquake impact on income is significantly correlated with life satisfaction and depression. The regression analyses indicate that earthquake impact on income is indirectly associated with life satisfaction and depression through its effect on financial strain. The research highlights the importance of coping strategies in maintaining a balance between economic status and living demands for disaster survivors.

Trauma or growth after a natural disaster? The mediating role of rumination processes

The aim of this study was to test a cognitive model of posttraumatic symptoms (PTS) and posttraumatic growth (PTG) after exposure to a natural disaster. It was hypothesized that although subjective severity of trauma would be related to the severity of PTS, this relation would be mediated by brooding and cognitive strategies related to the presence of repetitive negative content in thoughts. Furthermore, the relation between severity and PTG would be fully mediated by deliberate rumination (DR), cognitive strategies related to conscious efforts focused on handling the event. To evaluate the cognitive model, adults (N=351) who lost their homes as a result of the earthquake and tsunami that occurred in Chile on February 27, 2010, were selected. Structural equation modeling was used to analyze the data. The resulting model had adequate indices of goodness adjustment and showed that brooding completely mediated the relation between subjective severity and PTS, and DR completely mediated the relation between subjective severity, brooding, and PTG. These results highlight the role of both the content and process of rumination in mediating the association between subjective severity of trauma, PTS, and PTG. The implications of these results for a more comprehensive model of symptom severity that occurs after trauma are discussed.

Gender differences in psychological reactions to Hurricane Sandy among New York Metropolitan Area residents

Hurricane Sandy was a natural disaster of large proportions--a category 3 storm at its peak intensity that struck New York Metropolitan Area on October, 2012. The death and destruction caused by a hurricane can rise numerous of mental health vulnerabilities such as, acute stress disorder, posttraumatic stress disorder, depression, and anxiety. Gender has been identified as one critical variable that can impact vulnerability to adverse effects of trauma, as well as how these reactions are managed. The present research provides an evaluation of gender differences regarding posttraumatic stress symptoms, recollections of national disasters and fears of future negative life events. It also aims to explore information seeking and sources of assistance that were utilized during Hurricane Sandy. An online survey sample of 1,000 people from New York Metropolitan Area completed a battery of self-report questionnaires four weeks after the storm. Results revealed that recollections of national disaster and fear of future events were found to be significantly different among women compared to men. Additionally, women were more inclined toward information seeking through Facebook than men, although no gender differences emerged when examining sources of support. The results indicate that disaster practitioners should tailor gender sensitive interventions.

Applying a Behavioral Model Framework for Disaster Recovery Research in Local Public Health Agencies: A Conceptual Approach

The local public health agency (LPHA) workforce is at the center of the public health emergency preparedness system and is integral to locally driven disaster recovery efforts. Throughout the disaster recovery period, LPHAs have a primary responsibility for community health and are responsible for a large number of health services. In the face of decreasing preparedness funding and increasing frequency and severity of disasters, LPHAs continue to provide essential disaster life cycle services to their communities. However, little is known about the confidence that LPHA workers have in performing disaster recovery-related duties. To date, there is no widely used instrument to measure LPHA workers' sense of efficacy, nor is there an educational intervention designed specifically to bolster disaster recovery-phase efficacy perceptions. Here, we describe the important role of the LPHA workforce in disaster recovery and the operational- and efficacy-related research gaps inherent in today's disaster recovery practices. We then propose a behavioral framework that can be used to examine LPHA workers' disaster recovery perceptions and suggest a research agenda to enhance LPHA workforce disaster recovery efficacy through an evidence-informed educational intervention.

The effect of self efficacy and meaning in life on posttraumatic stress disorder and depression severity among veterans

OBJECTIVE

The current study examined the relationships among combat exposure, presence of and search for meaning in life, general and social self-efficacy, and both posttraumatic stress disorder (PTSD) and depression symptom severity for a Veteran sample (N = 93).

METHOD

Participants completed an online survey comprising the Combat Exposure Scale, Meaning in Life Questionnaire, Self-Efficacy Scale, Depression subscale of the Depression, Anxiety, Stress Scales-21, and PTSD Checklist-Specific Stressor version. The majority of participants were male and Caucasian. Participants served in various service eras

RESULTS

To determine factors that predicted PTSD and depression severity, separate hierarchical linear regressions were performed. In the final PTSD model, rank, combat exposure, and general self-efficacy were significant predictors, with officer rank, lower combat exposure, and higher general self-efficacy associated with lower PTSD severity. The interaction between combat exposure and general self-efficacy was also significant, with self-efficacy moderating the relationship between combat exposure and PTSD severity. For depression, rank, presence of meaning in life, and general self-efficacy were significant predictors in the model, with officer rank, higher presence of meaning in life, and general self-efficacy associated with lower depression severity.

CONCLUSION

A focus on strengthening self-efficacy may assist with lower levels of PTSD and depression symptomatology after combat trauma.

Differential effects of exposure to social violence and natural disaster on children's mental health

Disaster mental health, particularly postdisaster child mental health, is neglected in India. This study compares the impact of a natural disaster versus a spate of communal riots that occurred in Gujarat, India on January 26, 2001, and February 2002 to June 2002, respectively. Children aged 8-15 years from highly exposed earthquake sites (n = 128) and riot sites (n = 171) were approached for participation. A matching control sample of 351 nontrauma-exposed children was sought to compare with the trauma groups. Trauma and postdisaster adversities were studied using the UCLA disaster trauma tool; Goodman's Strengths and Difficulties Questionnaire was used to assess adjustment difficulties. Spearman's correlations were calculated to find associations between trauma items on UCLA's brief trauma scale and Strengths and Difficulties Questionnaire items. Results suggest that 7.6% of the earthquake sample and 38.7% from the riots sample manifested clinically significant mental health problems. The earthquake sample had 24.8% of those above clinical cutoff for probable posttraumatic stress disorder and the riots sample had 27.3% children who displayed posttraumatic stress symptoms. Children exposed to violence were psychologically more affected and in the presence of postdisaster adversities, posttraumatic stress symptoms persisted long term. This finding should enable development of differential psychotherapeutic interventions for children exposed to extreme events.

‘Girls are to be seen, not to be heard’: Understanding the Social Trauma of Kutchi Girls in Post-earthquake Gujarat

The focus on children in the context of everyday life under vulnerable conditions offers great promise for enriching our understanding of how disputations over culture and forms of belongingness are enacted repeatedly and undramatically: here culture takes a living form rather than a fixed one. The proposed paper is part of a larger project that examines psychological and social trauma of child survivors of the 2001–02 Gujarat earthquake and riots. Interactions with Kutchi girls from villages of Lodai, Khengarpur, Khavda and outskirts of Bhuj enabled the researcher to explore the diverse ways in which gender structures the notions of childhood, household work and domesticity defines their identity, ‘inhibition’, ‘absence’ and ‘invisibility’ of a certain kind were emblematic of their personalities. Keeping these thematics in mind, a critical commentary, Child Attachment Interviews (CAIs) narratives, with girl-survivors of the 2001 Gujarat earthquake is offered. Attachment ( anaclisis, in Greek, meaning dependence/leaning on; in Freudian oeuvre often linked with the problematic of need versus drives) is understood as a basic human survival need, embedded within a dialectical intra-psychic/inter-subjective matrix that pervades culture and socialisation. Girls’ impoverished responses during the interviews were marked by long pauses, absent glances, occasional smiles; with mainly monosyllables spoken about their own self though maintaining adultomorphic views of work, their duties and family’s expectations. Each interview was more or less a carbon copy of the other. At one level the interviews try to tap into the nature of ties between child and their families, on another level these act as testimonies where differentiating narrative modes of thought from narrative discourse (Bruner, 2004) allowing an exploration into the psychic vicissitudes of this language of absence and everyday existence marked by painful endurance. The paper develops these observations further to argue that trauma in the case of these girls is a continual disenfranchisement of their voices, needs and desires. Attachment trauma in these young girls is this inability and failure of their families to adequately nurture (psychological and social) capabilities (Robeyns, 2003; Sen, 1982) in the (girl) child and this ‘lack’/trauma has an intergenerational transmission and import (Grubich-Simitis, 1984; Felman & Laub, 1992). The paper illuminates the symptom these girls have become (being mute, stoic [multiple/ongoing] trauma survivors) and behind this symptom lies social depravities such as gender discrimination and child-rights violation where the mother (and remaining family) is not only implicated but caught in the same rigmarole—of patriarchal hubris.