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Rentmeesters N, Wynsberghe D, Hermans D. Development of a stepped care intervention model of evidence-based interventions for the management of posttraumatic stress in the Belgian Police. Eur J Psychotraumatol 2024; 15:1-12. [PMID: 38828913 PMCID: PMC11149569 DOI: 10.1080/20008066.2024.2349448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/21/2024] [Indexed: 06/05/2024] Open
Abstract
Background: Police officers are frequently exposed to a wide variety of potentially traumatic events (PTE) and are therefore at a considerable risk of developing posttraumatic stress disorder (PTSD). Previous research estimated the point prevalence of PTSD in Belgian police officers at 7.4%, significantly higher than in the general population. An effective organisational strategy to manage posttraumatic stress is essential.Objective: We aimed to develop a novel organisational approach regarding traumatic stress for Belgian police, combining evidence-based strategies for the prevention and treatment of posttraumatic stress in a stepped care intervention model.Method: In a broad development process, we combined scientific literature, case studies of best practices from other police organisations with insights gathered from a number of expert panels, thematic working groups and feedback groups.Results: A comprehensive stepped care intervention model was developed, consisting of evidence-based interventions for the prevention and treatment of posttraumatic stress.Conclusions: The intervention model is a promising organisational strategy for the management of posttraumatic stress in police organisations based on evidence-based interventions. Its effectiveness will be studied in the coming years.
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Affiliation(s)
- Nils Rentmeesters
- Psychological Medical Service, Federal Police, Brussels, Belgium
- Center for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium
| | - Dirk Wynsberghe
- Psychological Medical Service, Federal Police, Brussels, Belgium
| | - Dirk Hermans
- Center for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Leuven, Belgium
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Gabay G. The protective role of sense of coherence in resident physicians facing secondary trauma due to patient death in intensive care-A qualitative inquiry. DEATH STUDIES 2024:1-12. [PMID: 38696822 DOI: 10.1080/07481187.2024.2348058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
The salutogenic paradigm is increasingly used in research and practice but remains to be investigated in secondary trauma of health professionals. This qualitative study explored the main anchor of salutogenics, the sense-of-coherence, as a coping mechanism among resident physicians facing secondary trauma due to continuous exposure to patient suffering and deaths. Participants were sixteen resident physicians from intensive care units at emergency departments of two Israeli public tertiary hospitals. Data analysis employed reflexive thematic analysis. Findings suggest that while all residents described having comprehensibility, manageability and meaningfulness differed among residents. Some residents thrived, coped well with secondary trauma, centered on patient emotional needs, and drew meaningfulness from the challenges. Other residents suffered while providing care, reported poor well-being, were too overwhelmed to center patients, and doubted their career choices. Salutogenic-based interventions to cultivate the resilience of resident physicians experiencing secondary trauma are proposed.
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Affiliation(s)
- Gillie Gabay
- Faculty of Social Sciences, Achva Academic College, Shikmim, Israel
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Yu BYM, Lam CS, Tam KYY, Cheung DST, Chen SC, Yeung WF. The Role of Insomnia and Exercise in COVID-19 Worries for Psychological Distress in Hong Kong Chinese: A Moderated Mediation Model. Behav Sleep Med 2024; 22:378-392. [PMID: 37842738 DOI: 10.1080/15402002.2023.2270095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency. METHODS A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants' insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress. RESULTS A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14-0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02-0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency. CONCLUSION COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries.
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Affiliation(s)
- Branda Yee-Man Yu
- Department of Psychology, the University of Hong Kong, Hong Kong, SAR, China
| | - Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Katy Yuen Yan Tam
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shu Cheng Chen
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Wing Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, China
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D'Andrea W, Aboagye A, Lee KA, Freed S, Joachim B, Khedari-DePierro V, Yates EH, Wilmes A, Krohner S, Madhoun S, Hennawi A, Bergholz L. Growing Up on the Edge: A Community-Based Mental Health Intervention for Children in Gaza. Res Child Adolesc Psychopathol 2024; 52:833-848. [PMID: 37966687 DOI: 10.1007/s10802-023-01124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 11/16/2023]
Abstract
The Gaza Strip is a notoriously high-conflict area, but few large-scale studies have examined the rates of psychiatric distress and emotional/behavioral problems among Gaza youth, and there are few trauma-informed, scaleable intervention options. Studies in existence have used smaller samples or have examined focal problems such as posttraumatic stress disorder (PTSD) or aggression. Here, we examine the mental health burden of young individuals (ages 8-13) in Gaza across a broad range of symptoms, and demonstrate the impact of a community-based, trauma-informed program, Eye to the Future. At the outset of this supportive youth program, over 2000 children and adolescent youth and their parents reported on child well-being using standardized measures with established global norms (the Child Behavior Checklist and Youth Self Report). These measures examine symptoms broadly (e.g. anxiety, depression, social problems, attention problems, aggression, etc.). Relative to U.S. population estimates, children in Gaza had between 2.5- and 17-times higher point prevalence of clinical mental health problems. The most significant clinical concern was anxiety, but overall, their symptoms were not confined to posttraumatic stress as a disorder and were instead broadly dispersed. However, these concerns were responsive to intervention: over the course of a six-month community psychosocial program, symptoms ameliorated, with approximately 50-70% showing reliable improvement at post-program (varying by measure). These gains were maintained in a 9-month follow-up. Future work should consider the broader mental health impact, beyond PTSD and aggression, and incorporate community supports into addressing mental health among children in the region.
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Affiliation(s)
- Wendy D'Andrea
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA.
| | - Adjoa Aboagye
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Kellie Ann Lee
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Steven Freed
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Brandon Joachim
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Vivian Khedari-DePierro
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Ellen H Yates
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Annedore Wilmes
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Shoshana Krohner
- The New School, Department of Psychology, 80 Fifth Avenue, Floor 6, New York, NY, 10011, USA
| | - Saaed Madhoun
- CARE Palestine (West Bank/Gaza), 6 AlJozeh St., Bet Hanina, Jerusalem, P.O.Box 54258, Jerusalem, 91541, Israel
| | - Ahmed Hennawi
- CARE Palestine (West Bank/Gaza), 6 AlJozeh St., Bet Hanina, Jerusalem, P.O.Box 54258, Jerusalem, 91541, Israel
- Save the Children International, Middle East, North Africa, and Eastern Europe Regional Office, PO Box 941878, Amman, 11194, Jordan
| | - Lou Bergholz
- Edgework Consulting, 114 State St, 4th Floor, Boston, MA 02109, USA
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Agrest M, Tapia-Muñoz T, Encina-Zúñiga E, Vidal-Zamora I, Ardila-Gómez S, Alvarado R, Leiderman EA, Reavley N. Development of mental health first-aid guidelines for a person after a potentially traumatic event: A Delphi expert consensus study in Argentina and Chile. BMC Psychiatry 2024; 24:291. [PMID: 38632577 PMCID: PMC11025165 DOI: 10.1186/s12888-024-05631-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Exposure to potentially traumatic events increases the risk of a person developing a mental disorder. Training community members to offer support to a person during and after a traumatic situation may help lower this risk. This study reports on the cultural adaptation of Australian mental health first aid guidelines for individuals exposed to a potentially traumatic event to the Chilean and Argentinian context. METHODS A Delphi expert consensus study was conducted with two panels of experts, one of people with lived experience of trauma (either their own or as a carer; n = 26) and another one of health professionals (n = 41). A total of 158 items, drawn from guidelines developed by Australian experts in 2019, were translated to Spanish and evaluated in a two-round survey process. The panellists were asked to rate each item on a five-point Likert scale; statements were included in the final guidelines if 80% of both panels endorsed the item as "essential" or "important". RESULTS Consensus was achieved on 142 statements over two survey rounds. A total of 102 statements were included from the English-language guidelines, and 40 locally generated statements were accepted in the second round. Local experts endorsed a larger number of items compared to their counterparts in Australia and emphasised the importance of acknowledging the first aider's limitations, both personally and as part of their helping role. Additional items about working as a team with other first responders and considering helping the person's significant others were endorsed by the local panellists. CONCLUSIONS The study showed a high level of acceptance of the original actions suggested for inclusion in the guidelines for Australia, but also a significant number of new statements that highlight the importance of the adaptation process. Further research on the dissemination of these guidelines into a Mental Health First Aid training course for Chile and Argentina is still required.
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Affiliation(s)
- Martín Agrest
- Proyecto Suma. Güemes 4130 (1425), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
- Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Thamara Tapia-Muñoz
- Department of Behavioural Science and Health, University College London, London, UK
| | - Esteban Encina-Zúñiga
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Psychology, Faculty of Social Sciences, Universidad de Chile, Santiago, Chile
| | - Isidora Vidal-Zamora
- Department of Psychology, Faculty of Social Sciences, Universidad de Chile, Santiago, Chile
| | - Sara Ardila-Gómez
- Facultad de Psicología, Instituto de Investigaciones, Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Rubén Alvarado
- Department of Public Health, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Eduardo A Leiderman
- Departamento de Neurociencias, Facultad de Ciencias Sociales, Universidad de Palermo, Buenos Aires, Argentina
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Contreras C, Cruz JS, Galea JT, Chu AL, Puma D, Ramos L, Tovar M, Peinado J, Lecca L, Keshavjee S, Yuen CM, Raviola G. Programmatic implementation of depression screening and remote mental health support sessions for persons recently diagnosed with TB in Lima, Peru during the COVID-19 pandemic. Glob Ment Health (Camb) 2024; 11:e59. [PMID: 38751725 PMCID: PMC11094547 DOI: 10.1017/gmh.2024.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Few studies have explored a stepped care model for delivering mental health care to persons with tuberculosis (TB). Here, we evaluated depression screening and remote low-intensity mental health interventions for persons initiating TB treatment in Lima, Peru during the COVID-19 pandemic. Methods We used the Patient Health Questionnaire 9 (PHQ-9) to screen participants for depressive symptoms (PHQ-9 ≥ 5). Participants with PHQ-9, 5-14 received remote Psychological First Aid (PFA) or Problem Management Plus (PM+). Participants were reevaluated 6 months after intervention completion. We then compared the change in median PHQ-9 scores before and after intervention completion. Those with PHQ-9 ≥ 15 were referred to higher-level care. Findings We found that 62 (45.9%) of the 135 participants had PHQ-9 ≥ 5 at baseline. Then, 54 individuals with PHQ-9, 5-9 received PFA, of which 44 (81.5%) were reevaluated. We observed significant reductions in median PHQ-9 scores from 6 to 2 (r = 0.98; p < 0.001). Four participants with PHQ-9, 10-14 received PM+ but were unable to be reevaluated. Four participants with PHQ-9 ≥ 15 were referred to higher-level care. Conclusions Depressive symptoms were common among persons recently diagnosed with TB. We observed improvements in depressive symptoms 6 months later for most participants who received remote sessions of PFA.
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Affiliation(s)
- Carmen Contreras
- Socios En Salud Sucursal Peru, Lima, Peru
- Harvard Global Health Institute, Harvard University, Cambridge, MA, USA
| | | | - Jerome T. Galea
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Alexander L. Chu
- Department of Medical Education, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | | | - Lourdes Ramos
- Socios En Salud Sucursal Peru, Lima, Peru
- Escuela Profesional de Tecnología Médica, Universidad Privada San Juan Bautista, Lima, Peru
| | - Marco Tovar
- Socios En Salud Sucursal Peru, Lima, Peru
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Jesús Peinado
- Socios En Salud Sucursal Peru, Lima, Peru
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Leonid Lecca
- Socios En Salud Sucursal Peru, Lima, Peru
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Partners In Health, Boston, MA, USA
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA
| | - Courtney M. Yuen
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA
| | - Giuseppe Raviola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Partners In Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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7
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Lang AJ, Hamblen JL, Holtzheimer P, Kelly U, Norman SB, Riggs D, Schnurr PP, Wiechers I. A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder. J Trauma Stress 2024; 37:19-34. [PMID: 38184799 DOI: 10.1002/jts.23013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/08/2024]
Abstract
A clinical practice guideline (CPG) is a rigorously established set of recommendations based on currently available evidence about the efficacy, safety, acceptability, and feasibility of interventions to assist with clinical decision-making. The 2023 Department of Veterans Affairs /Department of Defense Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder is described herein. The CPG recommendations are accompanied by a clinical algorithm, which incorporates principles of evidence-based practice, shared decision-making, and functional and contextual assessments of goals and outcomes. An overview of the CPG recommendations is combined with a discussion of questions that clinicians and patients may face in implementing the CPG and suggestions for how to effectively work with the CPG.
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Affiliation(s)
- Ariel J Lang
- VA San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Jessica L Hamblen
- National Center for PTSD, White River Junction, Vermont, USA
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Paul Holtzheimer
- National Center for PTSD, White River Junction, Vermont, USA
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Ursula Kelly
- VA Atlanta Healthcare System, Decatur, Georgia, USA
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Sonya B Norman
- VA San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- National Center for PTSD, White River Junction, Vermont, USA
| | - David Riggs
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Paula P Schnurr
- National Center for PTSD, White River Junction, Vermont, USA
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Ilse Wiechers
- Veterans Health Administration Office of Mental Health and Suicide Prevention, Washington, DC, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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8
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Bücker J, Czepielewski LS. Psychosocial support urgently needed in high-risk flood areas in southern Brazil. Lancet Psychiatry 2024; 11:97. [PMID: 38245025 DOI: 10.1016/s2215-0366(23)00408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Joana Bücker
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Vale do Taquari (UNIVATES), Lajeado, Brazil
| | - L S Czepielewski
- Programa de Pós-Graduação em Psicologia, Instituto de Psicologia, Serviço Social, Saúde e Comunicação Humana, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-003, Brazil.
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Wang L, Norman I, Edleston V, Oyo C, Leamy M. The Effectiveness and Implementation of Psychological First Aid as a Therapeutic Intervention After Trauma: An Integrative Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380231221492. [PMID: 38281196 DOI: 10.1177/15248380231221492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Psychological First Aid (PFA) is known to be an initial early intervention following traumatic exposure, yet little is known about its optimal implementation and effectiveness. This review aims to examine the evidence for the effectiveness of PFA interventions and how PFA interventions have been designed, implemented, and experienced. MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PsychINFO, Embase, Web of Science, PILOTS, and China National Knowledge Infrastructure (in Chinese) databases were searched. Twenty studies from 4,735 records were included and quality rated, followed by an integrative synthesis of quantitative and qualitative evidence. PFA intervention following trauma exposure shows a positive effect for reducing anxiety and facilitating adaptive functioning in the immediate and intermediate term, yet the evidence for reducing Post-traumatic stress disorder/depressive symptoms is less compelling. Furthermore, commonalities in the components and techniques across different PFA approaches identified tend to align with four of Hobfoll's five essential elements: safety, calm, efficacy, and connectedness (as reflected among 7/11 PFA protocols), whereas the "hope" element was less developed. These commonalities include active listening, relaxation/stabilization, problem-solving/practical assistance, and social connection/referral. Intensive techniques such as cognitive reconstruction have also been incorporated, intensifying PFA delivery. The substantial variation observed in PFA format, timing, and duration, coupled with inadequate documentation of fidelity of implementation and adaptation, further constrains the ability to inform best practices for PFA. This is concerning for lay frontline providers, vital in early trauma response, who report implementation challenges despite valuing PFA as a time-sensitive, supportive, and practical approach.
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Cowlishaw S, Gibson K, Alexander S, Howard A, Agathos J, Strauven S, Chisholm K, Fredrickson J, Pham L, Lau W, O’Donnell ML. Improving mental health following multiple disasters in Australia: a randomized controlled trial of the Skills for Life Adjustment and Resilience (SOLAR) programme. Eur J Psychotraumatol 2023; 14:2284032. [PMID: 38073550 PMCID: PMC10993813 DOI: 10.1080/20008066.2023.2284032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/20/2023] [Indexed: 12/18/2023] Open
Abstract
Background: The mental health impacts of climate change-related disasters are significant. However, access to mental health services is often limited by the availability of trained clinicians. Although building local community capability for the mental health response is often prioritised in policy settings, the lack of evidence-based programs is problematic. The aim of this study was to test the efficacy of the Skills for Life Adjustment and Resilience programme (SOLAR) delivered by trained local community members following compound disasters (drought, wildfires, pandemic-related lockdowns) in Australia.Method: Thirty-six community members were trained to deliver the SOLAR programme, a skills-based, trauma informed, psychosocial programme. Sixty-six people with anxiety, depression and/or posttraumatic stress symptoms, and impairment were randomised into the SOLAR programme or a Self-Help condition. They were assessed pre, post and two months following the interventions. The SOLAR programme was delivered across five 1-hourly sessions (either face to face or virtually). Those in the Self-Help condition received weekly emails with self-help information including links to online educational videos.Results: Multigroup analyses indicated that participants in the SOLAR condition experienced significantly lower levels of anxiety and depression, and PTSD symptom severity between pre - and post-intervention (T1 to T2), relative to the Self-Help condition, while controlling for scores at intake. These differences were not statistically different at follow-up. The SOLAR programme was associated with large effect size improvements in posttraumatic stress symptoms over time.Conclusion: The SOLAR programme was effective in improving anxiety, depression and posttraumatic stress symptoms over time. However, by follow-up the size of the effect was similar to an active self-help condition. Given the ongoing stressors in the community associated with compounding disasters it may be that booster sessions would have been useful to sustain programme impact.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12621000283875..
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Affiliation(s)
- S. Cowlishaw
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - K. Gibson
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - S. Alexander
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - A. Howard
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - J. Agathos
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - S. Strauven
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - K. Chisholm
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - J. Fredrickson
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - L. Pham
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - W. Lau
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - M. L. O’Donnell
- Phoenix Australia - Centre for Posttraumatic Mental Health, Carlton, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Australia
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11
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Geoffrion S, Leduc MP, Bourgouin E, Bellemare F, Arenzon V, Genest C. A feasibility study of psychological first aid as a supportive intervention among police officers exposed to traumatic events. Front Psychol 2023; 14:1149597. [PMID: 36993901 PMCID: PMC10040866 DOI: 10.3389/fpsyg.2023.1149597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 02/17/2023] [Indexed: 03/15/2023] Open
Abstract
IntroductionPolice officers are often exposed to traumatic events, which can induce psychological distress and increase the risk of developing post-traumatic stress injuries. To date, little is known about support and prevention of traumatic events in police organizations. Psychological first aid (PFA) has been promoted as a promising solution to prevent psychological distress following exposure to a traumatic event. However, PFA has not yet been adapted to policing reality, let alone to the frequent exposure to traumatic events faced by this population. This study aimed to evaluate the feasibility of PFA as an early intervention for the prevention of post-traumatic stress injuries among police officers in Quebec, Canada. Specifically, the objectives were to evaluate: (1) the demand. (2) the practicality, and (3) the acceptability of PFA in a police organization.MethodsA feasibility study was conducted to evaluate the implementation of PFA among Quebec’s provincial police force. To do so, 36 police officers participated in semi-structured interviews between October 26th, 2021, and July 23rd, 2022. Participants were comprised of responders (n = 26), beneficiaries (n = 4) and managers (n = 6). Interviews were transcribed, coded, and evaluated according to a thematic analysis.ResultsEleven themes emerged from participants’ responses. Results suggested that PFA met individual and organizational needs. References were also made regarding the impacts of this intervention. Moreover, participants provided feedback for improving the implementation and sustainability of a PFA program. All three groups of participants shared similar thematic content.DiscussionFindings revealed that implementation of a PFA program in a law enforcement agency was feasible and could be accomplished without major issues. Importantly, PFA had beneficial consequences within the organization. Specifically, PFA destigmatized mental health issues and renewed a sense of hope among police personnel. These findings are in line with previous research.
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Affiliation(s)
- Steve Geoffrion
- Trauma Studies Center, Research Centre of the University Institute in Mental Health of Montreal, Montreal, QC, Canada
- School of Psychoeducation, Université de Montréal, Montreal, QC, Canada
- *Correspondence: Steve Geoffrion,
| | - Marie-Pierre Leduc
- Trauma Studies Center, Research Centre of the University Institute in Mental Health of Montreal, Montreal, QC, Canada
| | - Elody Bourgouin
- Trauma Studies Center, Research Centre of the University Institute in Mental Health of Montreal, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - François Bellemare
- Trauma Studies Center, Research Centre of the University Institute in Mental Health of Montreal, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Valérie Arenzon
- Trauma Studies Center, Research Centre of the University Institute in Mental Health of Montreal, Montreal, QC, Canada
| | - Christine Genest
- Trauma Studies Center, Research Centre of the University Institute in Mental Health of Montreal, Montreal, QC, Canada
- Department of Nursing, Université de Montréal, Montreal, QC, Canada
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Jackson DB, Jones MS, Semenza DC, Testa A. Adverse Childhood Experiences and Adolescent Delinquency: A Theoretically Informed Investigation of Mediators during Middle Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3202. [PMID: 36833897 PMCID: PMC9959059 DOI: 10.3390/ijerph20043202] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The purposes of this study are twofold. First, we explore the associations between cumulative ACEs at ages 5 and 7 and delinquency at age 14 in a national sample of youth in the United Kingdom (UK). Second, we explore the role of five theoretically relevant mediators in explaining this relationship. METHODS Analyses were based on data from the UK Millennium Cohort Study-a prospective, longitudinal birth-cohort study of more than 18,000 individuals in the United Kingdom. RESULTS The results indicate that early ACEs are significantly associated with adolescent delinquency, with effects becoming significantly larger as ACEs accumulate. Findings also reveal that child property delinquency, substance use, low self-control, unstructured socializing, and parent-child attachment at age 11 all significantly mediate the relationship between early ACEs and delinquency in adolescence, with early delinquency and low self-control emerging as the most robust mediators. CONCLUSIONS Findings point to a need for early ACEs screening and a Trauma-Informed Health Care (TIC) approach in early delinquency prevention efforts. Early intervention efforts that bolster child self-control and curtail early-onset problem behaviors may also disrupt pathways from ACEs to adolescent delinquency.
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Affiliation(s)
- Dylan B. Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Melissa S. Jones
- Sociology Department, College of Family, Home, and Social Sciences, Brigham Young University, Provo, UT 84602, USA
| | - Daniel C. Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers, Camden, The State University of New Jersey, 405-7 Cooper Street, Camden, NJ 08102, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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