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Langner F, Börke AK, Muschner P, Muther M, Reichelt A, Willmund GD, Wesemann U, Zimmermann PL, Schönsee I. Burnout and moral injuries after foreign deployment among medical personnel of the German armed forces: a pre-post study. Front Psychiatry 2024; 15:1408849. [PMID: 39319353 PMCID: PMC11420045 DOI: 10.3389/fpsyt.2024.1408849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/15/2024] [Indexed: 09/26/2024] Open
Abstract
Introduction Given a high amount of workplace stressors, burnout syndrome, as a depression-related syndrome, is highly relevant for medical service soldiers. This study aims to examine their effects with regard to moral injuries and personal values following foreign deployment. Materials and methods This longitudinal study included 91 soldiers of the German Armed Forces Medical Service. Participants completed the Maslach Burnout Inventory (MBI) and the Portrait-Value-Questionnaire (PVQ) before and after a foreign deployment as well as the Moral Injury Scale (SMBE) after deployment. Analysis has been conducted using t-tests to assess potential changes in MBI and PVQ scales between pre-test - t1 (2-4 weeks before deployment) and post-test - t2 (up to 6 months after deployment). In addition, correlations were examined between moral injuries (MI) after deployment and MBI scores at t1 and t2 as well as between personal values (PVQ t1) and MBI scores at t1 and t2. Results The MBI subscales showed mild to moderate burnout symptoms at both pre- and post-tests, with a slight deterioration during the study period, albeit not significant. There were no significant mean differences in PVQ between measurement points. Nevertheless, PVQ self-direction and tradition at t1 correlated negatively with MBI INV at t2 (PVQ SD r = -.21, p = .043) and MBI PA at t2 (PVQ TR r = -.23, p = .027). Furthermore, the subscale PVQ power at t1 correlated positively with MBI PA at t2 (PVQ PO r = .28, p = .006), meanwhile PVQ universalism at t1 correlated positively with MBI INV at t1 (PVQ UN r = .25, p = .018). Furthermore, positive correlations were found between moral injuries at t2 (SMBE total score, SMBE_Sub1, SMBE_Sub2) and MBI subscales Emotional Exhaustion (EE; r = -.54, p = .001), Depersonalization (DP; r = .38, p = .001), and Involvement (INV; r = .30, p = .004) before and after the deployment period. No correlation was found between MI and MBI subscale Personal Accomplishment (PA). Conclusion The results indicate that medical service soldiers exhibit mild to moderate burnout symptoms even before deployment. Significant associations between moral injuries and burnout were found in 3 out of 4 MBI subscales (EE, DP, INV). There was a significant association with a stronger moral injury and higher burnout levels, persisting both before and after the study period. Furthermore, our results suggest that personal value orientations might be meaningful predictors of burnout. Hence, causal questions regarding general work stress among medical service soldiers should be further explored in more detailed studies. Further research could lay the foundation for future approaches in psychotherapy as well as primary and secondary prevention in this field.
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Affiliation(s)
- Franziska Langner
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Anna Katharina Börke
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Patric Muschner
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Maria Muther
- Department of Marriage, Family And Life Councelling, Diocese Augsburg, Augsburg, Germany
| | - Andreas Reichelt
- Department of Occupational Medicine, Sanitätsunterstützungszentrum Berlin, Berlin, Germany
| | - Gerd-Dieter Willmund
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Ulrich Wesemann
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Peter Lutz Zimmermann
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Isabel Schönsee
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
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Adugna B, Tesfaye B, Ali D, Mirkena Y, Getinet W. Prevalence of post-traumatic stress disorder and associated factors among police officers in Central Gondar Zone, North West Ethiopia, 2023: institutional-based cross-sectional study. Front Psychiatry 2024; 15:1338833. [PMID: 39290312 PMCID: PMC11405250 DOI: 10.3389/fpsyt.2024.1338833] [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: 11/15/2023] [Accepted: 06/27/2024] [Indexed: 09/19/2024] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a psychiatric disorder that follows exposure to a traumatic or stressful life event. Police officers are exposed to a number of traumatic events that put them at risk of developing post-traumatic stress disorder. Previous studies have found the prevalence of post-traumatic stress disorder among police officers to be varied and inclusive. However, in Ethiopia, little is known about the prevalence of post-traumatic stress disorder and associated factors among police officers. Therefore, assessing the prevalence and associated factors of post-traumatic stress disorder among police officers might have a plausible role in future investigations. Objective The aim of this study was to assess the prevalence of post-traumatic stress disorder and associated factors among police officers in Central Gondar Zone, North West Ethiopia, 2023. Methods An institutional-based cross-sectional study was conducted in Central Gondar Zone by using self-administered and semi-structured questionnaires. A multi-stage cluster sampling technique was employed to select a sample of 634 participants. Post-traumatic stress disorder was assessed using the PTSD Checklist DSM-5. The collected data were coded and entered using Epi data Software version 4.6.02 and then exported to STATA version 14 for analysis. Bivariable and multivariable logistic regression analyses were done to identify factors associated with post-traumatic stress disorder. Statistically significant results were declared at a 95% confidence interval (CI) of a p-value less than 0.05. Results The prevalence of post-traumatic stress disorder was found to be 15.2%, with a 95% CI of 12.5% to 18.3%. In the multivariate analysis, female (AOR = 3.36, 95% CI 1.95-5.78), being directly exposed to traumatic events (AOR = 2.01, 95% CI 1.16-3.48), current alcohol use (AOR = 2.90, 95% CI 1.65-5.12), and having poor social support (AOR = 4.25, 95% CI 1.58-11.36) were factors significantly associated with post-traumatic stress disorder. Conclusion According to this study, police officers suffered from a significant burden of post-traumatic stress disorder. Female sex, police personnel directly exposed to traumatic events, current alcohol users, and those who had poor social support were found to be strongly associated with post-traumatic stress disorder. Therefore, early detection and intervention are crucial to mitigating the overall problem.
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Affiliation(s)
- Biruk Adugna
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bizuneh Tesfaye
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Dawed Ali
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yohannes Mirkena
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Wondale Getinet
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Wesemann U, Rowlands K, Renner KH, Konhäuser L, Köhler K, Himmerich H. Impact of life-threatening military incidents during deployments abroad on the relationships between military personnel and their families. Front Psychiatry 2024; 15:1419022. [PMID: 39091456 PMCID: PMC11291243 DOI: 10.3389/fpsyt.2024.1419022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/18/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction The influence of deployments on family relationships has hardly been investigated. Following a recently proposed new research strategy, military personnel with and without deployment-related life-threatening military incidents during deployment were compared. The hypothesis was that partner and family relationships of military personnel who experienced such an event would deteriorate more. Methods This study included N = 255 military personnel who had a romantic partner (n = 78 of them had children) when deployed to Afghanistan. Of these, n = 68 military personnel experienced a deployment-related critical event during the deployment, n = 187 did not. Partnership quality was assessed using a semi-structured pre- and post-deployment interview. Results The partner relationships of military personnel who experienced a deployment-related life-threatening military incident during deployment broke up significantly more often. The partner relationships of all military personnel deteriorated significantly, with greater deterioration after deployment in the group who faced such incidents. These results were independent of age, rank or number of previous deployments. In addition, there was a significant deterioration in the relationships between all military personnel and their children with greater deterioration after deployment in the group who faced such incidents. Conclusion Life-threatening military incidents during a deployment abroad appear to have a considerable influence on the quality and stability of the partner and family relationships of military personnel. These findings can be used to inform the development of specific pre- and post-deployment measures and training.
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Affiliation(s)
- Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Katie Rowlands
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Karl-Heinz Renner
- Institute of Psychology, Faculty of Human Sciences, Bundeswehr University Munich, Neubiberg, Germany
| | - Lucas Konhäuser
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Kai Köhler
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Hubertus Himmerich
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Berlin, Germany
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United Kingdom
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Posch L, Zube AL. Experiences of (Potentially) Traumatizing Deployments and Posttraumatic Stress in Police Officers: An Exploratory Survey of Early Career Police Officers. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024. [PMID: 39008981 DOI: 10.1055/a-2351-2533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
BACKGROUND As part of their career, police officers are faced with traumatic events on a regular basis and are at a higher risk of developing post-traumatic-stress disorder (PTSD) compared to the general population. The aim of this study was to examine if and how many early career police officers had already experienced potentially traumatizing situations and how many met either subsyndromal or complete PTSD criteria. A further subject of interest was if the officers knew the concept of psychosocial emergency care for first responders (PSNV-E) and if such support was made use of. METHOD Early career police officers (n=221) were assessed via an online survey about their posttraumatic stress symptoms. RESULTS More than half of the participants (n=121) reported having experienced at least one traumatic deployment. PTSD prevalence in this group was at 1.7%, an additional 14.9% showed partial PTSD. One-fifth did not know about the PSNV-E concept. CONCLUSION Police officers are confronted with a range of extremely stressful events early in their career leading to first symptoms of PTSD in some of them. Early prevention strategies as well as the identification of those affected for secondary prevention is of very high relevance for long-term mental health. HINTERGRUND Polizeibeamt:innen werden in ihrer beruflichen Karriere oft mit traumatischen Einsätzen konfrontiert und weisen im Vergleich zur Allgemeinbevölkerung ein erhöhtes Risiko eine posttraumatische Belastungsstörung (PTBS) zu entwickeln auf. Ziel der vorliegenden Studie war, zu untersuchen, ob und wie häufig Berufsanfänger:innen der Polizei bereits (potenziell) traumatische Einsätze erlebt haben und wie häufig eine PTBS oder eine subsyndromale Ausprägung der PTBS vorliegt. Ferner war von Interesse, ob ihnen das Konzeptzur psychosozialen Notfallversorgung für Einsatzkräfte (PSNV-E) bekannt ist und ob diese Angebote in Anspruch genommen werden. METHODE N=221 Berufsanfänger:innen der Polizei wurden im Rahmen einer Online-Befragung zum Erleben potenziell traumatischer Einsätze befragt. Zudem wurde mit der PCL-5 das Ausmaß posttraumatischer Belastungssymptome erhoben. ERGEBNISSE Über die Hälfte der Befragten (n=121) hatte mindestens einen (potenziell) traumatischen Einsatz erlebt. Die PTBS-Prävalenz lag in dieser Gruppe bei 1,7%, weitere 14,9% wiesen eine partielle PTBS auf. Einem Fünftel der Befragten war das PSNV-E Konzept nicht bekannt. SCHLUSSFOLGERUNG Bereits in den ersten Berufsjahren sind Polizeibeamt:innen mit extrem belastenden Einsätzen konfrontiert, woraufhin ein Teil von ihnen erste Anzeichen einer PTBS aufweist. Frühe Präventionsmaßnahmen sowie Identifikation von Betroffenen zur sekundären Prävention sind von hoher Relevanz für die langfristige Gesunderhaltung.
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Affiliation(s)
- Lena Posch
- Fachbereich Psychologie, Hochschule der Akademie der Polizei Hamburg, Hamburg, Germany
| | - Anna-Lena Zube
- Fachbereich Psychologie, Hochschule der Akademie der Polizei Hamburg, Hamburg, Germany
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Pinto R, Albuquerque S, de Castro MV, Levendosky AA, Fonseca M, Jongenelen I, Maia Â, Gamito P. A Virtual Reality Simulation to Examine the Relationship Between Post-Traumatic Stress Symptoms and Decision-Making in First Responders. J Trauma Dissociation 2024:1-16. [PMID: 38978229 DOI: 10.1080/15299732.2024.2374370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/21/2024] [Indexed: 07/10/2024]
Abstract
First responders (FRs) are continuously exposed to critical incidents, considered traumatic events (TEs). This cumulative exposure increases the risk for post-traumatic stress disorder (PTSD). However, there is no evidence about the relationship between PTSD symptoms and emergency decision-making (EDM). The objective of this study was to examine the EDM of FRs during a virtual reality through the simulation of two emergency scenarios to collect data on the reaction time and the number of incorrect decisions. We also assessed PTSD symptoms, TE, and sociodemographics. The sample included 368 Portuguese FRs, were 295 (80.20%) males and 73 (19.80%) females, with a mean age of 33.96 (SD = 9.38). Considering the probable PTSD diagnosis according to the DSM-5, 85 (23.10%) of the FRs met the criteria. These individuals who meet the criteria exhibited higher EDM scores (M = 19.60, SD = 5.99) compared to those without probable PTSD (M = 17.87, SD = .5.66) (F(1, 360) = 5.32, p = .02, partial η2 = .015). We found that TEs had a direct effect on EDM, β = -.16, Z = -3.74, p < .001), and the pathway of trauma-PTSD symptoms-decision-making an indirect effect, β = .02, Z = 3.10, p = .002). Individuals exposed to more TEs demonstrated faster and more accurate decision-making in the context of EDM. However, when these individuals developed PTSD symptoms, their decision-making became slower and less accurate. The inclusion of a trauma-informed approach for FRs to prevent individual and job-related consequences is discussed.
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Affiliation(s)
- Ricardo Pinto
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
| | - Sara Albuquerque
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
| | - Maria Vieira de Castro
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
| | - Alytia A Levendosky
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Micaela Fonseca
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
| | - Inês Jongenelen
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
| | - Ângela Maia
- School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Gamito
- HEI-Lab: Digital Human-Environment Interaction Labs, Lusófona University, Lisbon, Portugal
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Quillivic R, Gayraud F, Auxéméry Y, Vanni L, Peschanski D, Eustache F, Dayan J, Mesmoudi S. Interdisciplinary approach to identify language markers for post-traumatic stress disorder using machine learning and deep learning. Sci Rep 2024; 14:12468. [PMID: 38816468 PMCID: PMC11139884 DOI: 10.1038/s41598-024-61557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/07/2024] [Indexed: 06/01/2024] Open
Abstract
Post-traumatic stress disorder (PTSD) lacks clear biomarkers in clinical practice. Language as a potential diagnostic biomarker for PTSD is investigated in this study. We analyze an original cohort of 148 individuals exposed to the November 13, 2015, terrorist attacks in Paris. The interviews, conducted 5-11 months after the event, include individuals from similar socioeconomic backgrounds exposed to the same incident, responding to identical questions and using uniform PTSD measures. Using this dataset to collect nuanced insights that might be clinically relevant, we propose a three-step interdisciplinary methodology that integrates expertise from psychiatry, linguistics, and the Natural Language Processing (NLP) community to examine the relationship between language and PTSD. The first step assesses a clinical psychiatrist's ability to diagnose PTSD using interview transcription alone. The second step uses statistical analysis and machine learning models to create language features based on psycholinguistic hypotheses and evaluate their predictive strength. The third step is the application of a hypothesis-free deep learning approach to the classification of PTSD in our cohort. Results show that the clinical psychiatrist achieved a diagnosis of PTSD with an AUC of 0.72. This is comparable to a gold standard questionnaire (Area Under Curve (AUC) ≈ 0.80). The machine learning model achieved a diagnostic AUC of 0.69. The deep learning approach achieved an AUC of 0.64. An examination of model error informs our discussion. Importantly, the study controls for confounding factors, establishes associations between language and DSM-5 subsymptoms, and integrates automated methods with qualitative analysis. This study provides a direct and methodologically robust description of the relationship between PTSD and language. Our work lays the groundwork for advancing early and accurate diagnosis and using linguistic markers to assess the effectiveness of pharmacological treatments and psychotherapies.
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Affiliation(s)
- Robin Quillivic
- PSL-EPHE, Paris, France.
- ISCPIF, Institut des Systèmes Complexes, Paris île-de-France, France.
| | - Frédérique Gayraud
- Laboratoire dynamique du langage, UMR 5596, CNRS, université ́ Lyon-II, Lyon, France
| | - Yann Auxéméry
- Centre Hospitalier de Jury-les-Metz, centre de réhabilitation pour adultes, Metz, France
- UMR 1319 Inspiire, INSERM, Université de Lorraine, 9 avenue de la forêt de Haye, Nancy, France
| | - Laurent Vanni
- CNRS, UMR 7320 : Bases, Corpus, Langage, Nice, France
| | - Denis Peschanski
- Université PARIS 1 Panthéon-Sorbonne, Paris, France
- CNRS, CESSP, UMR 8209, Paris, France
| | - Francis Eustache
- PSL-EPHE, Paris, France
- INSERM, NIMH U1077, Caen, France
- UNICAEN, Caen, France
| | - Jacques Dayan
- PSL-EPHE, Paris, France
- INSERM, NIMH U1077, Caen, France
- UNICAEN, Caen, France
- CHU de Rennes, Rennes, France
| | - Salma Mesmoudi
- PSL-EPHE, Paris, France
- ISCPIF, Institut des Systèmes Complexes, Paris île-de-France, France
- Université PARIS 1 Panthéon-Sorbonne, Paris, France
- CNRS, CESSP, UMR 8209, Paris, France
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Pacella BJ, Cowlishaw S, Gibbs L, Bryant RA, Brady K, Gallagher C, Molyneaux R, Gibson K, Block K, Harms L, Forbes D, O'Donnell ML. Trajectory of adjustment difficulties following disaster: 10-year longitudinal cohort study. BJPsych Open 2024; 10:e57. [PMID: 38433588 PMCID: PMC10951843 DOI: 10.1192/bjo.2024.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/19/2023] [Accepted: 01/02/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Although much is known about psychopathology such as post-traumatic stress disorder (PTSD) and depression following bushfire (also known as wildfire), little is known about prevalence, trajectory and impacts for those experiencing general adjustment difficulties following exposure to these now-common events. AIMS This was an exploratory analysis of a large cohort study that examined the prevalence, trajectory and risk factors of probable adjustment disorder over a 10-year period following bushfire exposure. METHOD The Beyond Bushfires study assessed individuals exposed to a large and deadly bushfire across three time points spanning 10 years. Self-report survey data from participants from areas with moderate and high levels of fire-affectedness were analysed: n = 802 participants at Wave 1 (3-4 years post-fires), n = 596 at Wave 2 (5 years post-fires) and n = 436 at Wave 3 (10 years post-fires). Surveys indexed fire-related experiences and post-fire stressors, and comprised the six-item Kessler Psychological Distress Scale (probable adjustment disorder index), four-item Posttraumatic Stress Disorder Checklist (probable fire-related PTSD) and nine-item Patient Health Questionnaire (probable major depressive episode). RESULTS Prevalence of probable adjustment disorder was 16% (Wave 1), 15% (Wave 2) and 19% (Wave 3). Probable adjustment disorder at 3-4 years post-fires predicted a five-fold increase in risk for escalating to severe psychiatric disorder (i.e. probable fire-related PTSD/major depressive episode) at 10 years post-fires, and was associated with post-fire income and relationship stressors. CONCLUSIONS Adjustment difficulties are prevalent post-disaster, many of which are maintained and exacerbated over time, resulting in increased risk for later disorder and adaptation difficulties. Psychosocial interventions supporting survivors with adjustment difficulties may prevent progression to more severe disorder.
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Affiliation(s)
- Belinda J. Pacella
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Sean Cowlishaw
- Turner Institute for Brain and Mental Health, Monash School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Lisa Gibbs
- Child and Community Wellbeing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Richard A. Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Kate Brady
- Child and Community Wellbeing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Colin Gallagher
- Centre for Transformative Innovation, Faculty of Business and Law, Swinburne University of Technology, Melbourne, Australia
| | - Robyn Molyneaux
- Child and Community Wellbeing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Kari Gibson
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Karen Block
- Child and Community Wellbeing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Louise Harms
- Department of Social Work, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - David Forbes
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Meaghan L. O'Donnell
- Phoenix Australia, Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
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Beahm JD, McCall HC, Carleton RN, Jones N, Hadjistavropoulos HD. Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework. Internet Interv 2024; 35:100718. [PMID: 38318086 PMCID: PMC10840103 DOI: 10.1016/j.invent.2024.100718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Abstract
Background Within Canada, internet-delivered cognitive behavioural therapy (ICBT) has recently been tailored by PSPNET to meet the needs of public safety personnel (PSP) to help address high rates of mental health problems within this population. Perceptions and outcomes of ICBT among PSP are promising, but it remains unknown how PSPNET is perceived by PSP organizational leaders. It is important to assess this gap because these leaders have significant potential to influence the uptake of ICBT. Methods In the current study, PSP leaders (n = 10) were interviewed to examine their perceptions of PSPNET and opportunities to improve ICBT implementation. The RE-AIM evaluation framework was used to assess PSP leaders' perceptions of PSPNET in terms of reach, effectiveness, adoption, implementation, and maintenance. Results The results evidenced that leaders perceived PSPNET as effective in reaching and serving PSP and PSP organizations. PSP leaders reported perceiving ICBT as effectively implemented, especially for being freely offered to individual PSP and for improving PSP's access to experienced therapists specifically trained to work with PSP. Participants indicated organizations have promoted and will continue promoting PSPNET longer-term, facilitating adoption and maintenance. Factors perceived as facilitating successful service delivery included building relationships and trust with PSP organizations and general support for PSP leadership mental health initiatives. PSP leaders identified perceived areas for improving ICBT implementation (e.g., ensuring leaders have access to data on PSPNET uptake and outcomes, creating promotional videos, expanding availability of PSPNET to other provinces, offering additional options for receiving therapist support). Implications Overall, the study provides insights into PSP leaders' perceptions of the implementation of ICBT among PSP and ideas for optimizing implementation efforts.
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Affiliation(s)
- Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nicholas Jones
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Department of Justice Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
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Riviere LA, Kim PY, Baker MD, Beymer MR. Training, Deployment Preparation, and Behavioral Health of New York National Guard Personnel Deployed to Assist with COVID-19 Decedent Work. Mil Med 2024; 189:e705-e713. [PMID: 37847572 DOI: 10.1093/milmed/usad395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/26/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
INTRODUCTION A small body of research conducted mostly among civilians has shown that adequate training and preparation can prevent or reduce the development of behavioral health problems in first responders. Several civilian studies have shown that social support is protective against behavioral health problems. However, very few studies have examined the impact of these factors on the behavioral health of military first responders. Military first responders, who serve in the aftermath of natural disasters and disease outbreaks such as the coronavirus disease 2019 (COVID-19) pandemic, are often members of the National Guard (NG). The purpose of this study was to examine the impact of mortuary affairs training/handling human remains, role preparation, equipment preparation, and unit social support provided to families on the behavioral health of New York (NY) NG personnel deployed to assist the NY Office of Chief Medical Examiner with handling the remains of COVID-19 decedents. MATERIALS AND METHODS We invited 410 NYNG personnel who deployed for the Office of Chief Medical Examiner mission to complete an anonymous online questionnaire 3 to 6 months post-mission. Of the 158 participants, we used the data of the 141 participants who provided consent. Standard behavioral health measures (depression, anxiety, post-traumatic stress disorder, alcohol misuse, and insomnia) as well as study-specific items designed to understand the unique dynamics of this deployment were included. Hierarchical logistic regression analysis was used to examine the relationships between mortuary training, role preparation, equipment preparation, and unit support with behavioral health. RESULTS Close to two-thirds of the sample reported that they had not been trained in mortuary affairs/handling human remains before the mission. We also found that that lower levels of role preparation and unit support provided to the service members' families increased the odds of meeting criteria for one or more behavioral health problems, but that training in mortuary affairs and equipment preparation was unrelated to behavioral health. CONCLUSIONS Our research points to the importance of emotionally and cognitively preparing service members for the specific dynamics of a deployment and the roles that that they are expected to play. Furthermore, it suggests that supporting the families of NG personnel during domestic missions can benefit the behavioral health of the NG personnel. Additional research is needed to corroborate these findings, particularly the impact of unit support provided to family members on service members' behavioral health.
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Affiliation(s)
- Lyndon A Riviere
- Center for Military Psychiatry & Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Paul Y Kim
- Center for Military Psychiatry & Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Matthew D Baker
- New York Army National Guard, Connecticut Street Armory-C, Buffalo, NY 14213, USA
| | - Matthew R Beymer
- Division of Behavioral and Social Health Outcomes Practice, Defense Centers for Public Health-Aberdeen, Aberdeen Proving Ground, MD 21010, USA
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Stolero N, Elkady S, Labaka L, Siman Tov M, Peleg K, Adini B. Do first responders and populations perceive risks similarly? A comparative study of seven countries. Front Psychol 2024; 14:1219927. [PMID: 38274674 PMCID: PMC10809848 DOI: 10.3389/fpsyg.2023.1219927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Risk perception illustrates the subjective evaluation of individuals concerning the characteristics, severity, and capacity to cope with potential hazards. Risk perception influences attitudes and actions individuals take to protect themselves from future threats. Risk perceptions might change among different stakeholder groups such as society and first responders. Identifying risk perceptions of stakeholders is essential to establish effective protective measures. Method This study investigated the commonalities and diversities in risk perception among first responders and the public, within and between seven European and beyond countries. A self-administered questionnaire was used to gather data from both first responders and civilians. They were asked to assess their risk perception level for five categories of risks (Extreme weather-related events, nature-related events, social disruptions, critical services dependencies, and pandemics). Results Using Univariate Analysis of Variance showed disparity concerning both the levels of risk perception between the public and first responders, as well as their relative ranking. For example, concerning extreme weather-related and nature-related events, risk perception levels of the first responders is higher than that of the population in six out of the seven studied countries. In contrast, the population's risk perception is higher compared to the first responders in six out of the seven countries, concerning critical infrastructure dependencies and pandemics. Discussion The relative gaps between the first responders versus the population, within each country, vary considerably. Norway for example presents significant differences between the two internal populations concerning all risks (except for extreme weather), while in Sweden, no significant gaps were identified, concerning all five risks.
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Affiliation(s)
- Nathan Stolero
- Department of Emergency and Disaster Management, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sahar Elkady
- TECNUN—University of Navarra, San Sebastian, Spain
| | - Leire Labaka
- TECNUN—University of Navarra, San Sebastian, Spain
| | - Maya Siman Tov
- Department of Emergency and Disaster Management, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Magen David Adom, Tel Aviv, Israel
| | - Kobi Peleg
- Israel Academic College, Ramat Gan, Israel
| | - Bruria Adini
- Department of Emergency and Disaster Management, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- ResWell Research Collaboration on Resilience and Well-Being, Tel Aviv University, Tel Aviv, Israel
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Rice VJB, Schroeder P, Allison SC. Effects of mindfulness meditation training offered in-person and via a virtual world on self-compassion: A study with U.S. military active duty and veterans. Work 2024; 78:1225-1245. [PMID: 39121152 DOI: 10.3233/wor-230645] [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] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Mindfulness-based, in-person programs are effective at reducing stress and enhancing resilience in military and civilian samples, yet few studies have examined or compared training offered via real-time, interactive social media. Such a program would have a wider-reach and could include those unable to attend in-person. There is also interest in resolving ambiguity about the effects of mindfulness training on individual difference variables, such as self-compassion. OBJECTIVE The purpose of this research was to compare pre/post self-compassion for three interventions; Mindfulness-based Stress Reduction delivered in-person (IP), mindfulness meditation training delivered via a Virtual World (VW), and a wait-list Control Group (CG) among active duty and veteran U.S. military. METHODS A 2 (pre/post)×3 (group) factorial design was conducted with 250 active duty and veteran U.S. Military service members, with self-compassion measures as dependent variables. RESULTS Self Compassion improved 10% for the IP group and 14% for the VW group, while the CG group did not improve. Combined treatment groups yielded a 10.3% improvement in self-compassion compared with no change in the CG and with a group×time interaction effect (p < 0.01). Participants with lower initial self-compassion experienced greater benefits than those with higher baseline self-compassion (p < 0.01). CONCLUSION IP and VW Mindfulness Meditation training were equally effective in increasing self-compassion. Adding effective on-line mindfulness delivery will promote self-compassion among a more extensive audience, likely yielding improved coping, confidence, connectedness, cheerfulness, steadiness, and self-satisfaction, while lessening anxiety, fear-of-failure, and stress among participants.
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Sydes M, Hine L, Higginson A, McEwan J, Dugan L, Mazerolle L. Criminal justice interventions for preventing radicalisation, violent extremism and terrorism: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1366. [PMID: 38024779 PMCID: PMC10644945 DOI: 10.1002/cl2.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Criminal justice agencies are well positioned to help prevent the radicalisation of individuals and groups, stop those radicalised from engaging in violence, and reduce the likelihood of terrorist attacks. This Evidence and Gap Map (EGM) presents the existing evidence and gaps in the evaluation research. Objectives To identify the existing evidence that considers the effectiveness of criminal justice interventions in preventing radicalisation, violent extremism and terrorism. Search Methods We conducted a comprehensive search of the academic and grey literature to locate relevant studies for the EGM. Our search locations included the Global Policing Database (GPD), eight electronic platforms encompassing over 20 academic databases, five trial registries and over 30 government and non-government websites. The systematic search was carried out between 8 June 2022 and 1 August 2022. Selection Criteria We captured criminal justice interventions published between January 2002 and December 2021 that aimed to prevent radicalisation, violent extremism, and/or terrorism. Criminal justice agencies were broadly defined to include police, courts, and corrections (both custodial and community). Eligible populations included criminal justice practitioners, places, communities or family members, victims, or individuals/groups who are radicalised or at risk of becoming radicalised. Our map includes systematic reviews, randomised controlled trials, and strong quasi-experimental studies. We placed no limits on study outcomes, language, or geographic location. Data Collection and Analysis Our screening approach differed slightly for the different sources, but all documents were assessed in the systematic review software program DistillerSR on the same final eligibility criteria. Once included, we extracted information from studies using a standardised form that allowed us to collect key data for our EGM. Eligible systematic reviews were assessed for risk of bias using the AMSTAR 2 critical appraisal tool. Main Results The systematic search identified 63,763 unique records. After screening, there were 70 studies eligible for the EGM (from 71 documents), of which two were systematic reviews (assessed as moderate quality), 16 were randomised controlled trials, and 52 were strong quasi-experimental studies. The majority of studies (n = 58) reported on policing interventions. Limited evidence was found related to courts or corrections interventions. The impact of these interventions was measured by a wide variety of outcomes (n = 50). These measures were thematically grouped under nine broad categories including (1) terrorism, (2) extremism or radicalisation, (3) non-terror related crime and recidivism, (4) citizen perceptions/intentions toward the criminal justice system and government, (5) psychosocial, (6) criminal justice practitioner behaviours/attitudes/beliefs, (7) racially targeted criminal justice practices, (8) investigation efficacy, and (9) organisational factors. The most commonly assessed outcomes included measures of terrorism, investigation efficacy, and organisational factors. Very limited research assessed intervention effectiveness against measures of extremism and/or radicalisation. Authors’ Conclusions Conducting high-quality evaluation research on rare and hidden problems presents a challenge for criminal justice research. The map reveals a number of significant gaps in studies evaluating criminal justice responses to terrorism and radicalisation. We conclude that future research should focus attention on studies that consolidate sound measurement of terrorism-related outcomes to better capture the potential benefits and harms of counter-terrorism programs, policies and practices which involve criminal justice agencies.
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Affiliation(s)
- Michelle Sydes
- Griffith Criminology InstituteGriffith UniversityBrisbaneAustralia
- School of Criminology and Criminal JusticeGriffith UniversityBrisbaneAustralia
| | - Lorelei Hine
- School of Social ScienceUniversity of QueenslandBrisbaneAustralia
| | - Angela Higginson
- School of Justice, Faculty of Creative Industries, Education and Social JusticeQueensland University of TechnologyBrisbaneAustralia
| | - James McEwan
- School of Social ScienceUniversity of QueenslandBrisbaneAustralia
| | - Laura Dugan
- Department of SociologyThe Ohio State UniversityColumbusOhioUSA
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13
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Posch L, Zube AL. [Experiences of (Potentially) Traumatizing Deployments and Posttraumatic Stress in Police Officers - An Exploratory Survey of Early Career Police Officers]. Psychother Psychosom Med Psychol 2023; 73:441-448. [PMID: 37399832 DOI: 10.1055/a-2087-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND As part of their career police officers are faced with traumatic events on a regular basis and are at a higher risk of developing PTSD compared to the general population. The aim of this study was to examine if and how many early career police officers already experienced potentially traumatizing situations and how many conform to either subsyndromal or complete PTSD criteria. Further subject of interest was if the officers know the concept of psychosocial emergency care for first responders (PSNV-E) and if such support is made use of. METHOD N=221 early career police officers were assessed via an online-survey about their posttraumatic stress symptoms. RESULTS More than half of the participants (n=121) reported having experienced at least one traumatic deployment. PTSD prevalence in this group was at 1.7%, an additional 14.9% showed partial PTSD. One fifth did not know about the PSNV-E concept. CONCLUSION Police officers are confronted with a range of extremely stressful events early in their career leading to first symptoms of PTSD in some of them. Early prevention strategies as well as the identification of those affected for secondary prevention is of very high relevance for long term mental health.
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Affiliation(s)
- Lena Posch
- Fachbereich Psychologie, Hochschule der Akademie der Polizei Hamburg
| | - Anna-Lena Zube
- Fachbereich Psychologie, Hochschule der Akademie der Polizei Hamburg
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14
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Choi KR, Heilemann MV, Romero SA, Peng K, Wu J, Sondereker D, Fisher C, Brymer M. "The Wild West:" Nurse Experiences of Responding to the 2017 Las Vegas Mass Shooting. Disaster Med Public Health Prep 2023; 17:e492. [PMID: 37721013 DOI: 10.1017/dmp.2023.140] [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] [Indexed: 09/19/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the experiences of nurses who responded to a public mass shooting in 2017. METHODS This qualitative study was conducted with a sample of nurses who responded to a mass shooting, recruited purposively from a hospital in Las Vegas, Nevada. Intensive interviews were conducted with a total of 7 nurses, audio-recorded and transcribed for thematic analysis. RESULTS Six themes were developed from interview data: (1) "The worst night of my life": Overrun and overwhelmed; (2) Unexpected altruism and benevolence of patients and staff; (3) "The Wild West": Giving victim care by improvising beyond rules; (4) Experiencing a range of reactions in the immediate aftermath and in the long term; (5) Shifts in nursing practice and evolving team dynamics; and (6) Defining realistic approaches to support staff mental health and mass casualty preparation. CONCLUSION Nurses who were involved in responding to the public mass shooting described the event as life-altering. Given the critical role of nurses in responding to mass shootings, it is essential to consider how nurses can be supported in the aftermath of these events and how mass disaster preparation can include attention to the needs of nurses.
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Affiliation(s)
- Kristen R Choi
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - MarySue V Heilemann
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Stephanie Anne Romero
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Kelly Peng
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Joyce Wu
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | | | | | - Melissa Brymer
- National Center for Child Traumatic Stress, UCLA, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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15
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Ponder WN, Carbajal J, Whitworth J, Schuman DL, Galusha JM, Yockey RA. Predictors of Suicide and Differences in Attachment Styles and Resilience Among Treatment-Seeking First-Responder Subtypes. J Occup Environ Med 2023; 65:321-329. [PMID: 36730737 DOI: 10.1097/jom.0000000000002750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To identify the predictors of suicide for firefighters (FFs), emergency medical technicians (EMTs), and law enforcement officers (LEOs). METHODS We used baseline data from FFs/EMTs (n = 69) and LEOs (n = 81) to investigate the unique predictors for both first-responder subtypes. We conducted confirmatory factor analysis on validated assessments of posttraumatic stress disorder (PTSD) and depression. Measures of attachment, resilience, PTSD, depression, generalized anxiety, trauma history, and substance use were the independent variables in two backward stepwise regressions predicting suicide. RESULTS Substance use and somatic depression were significant predictors for LEOs, whereas affective depression, anhedonia, externalizing behaviors, trauma history, and generalized anxiety were significant predictors for FFs/EMTs. LIMITATIONS These data are cross-sectional and should be modeled longitudinally over the course of treatment. CONCLUSION Separate constructs influence suicide for LEOs and FFs/EMTs.
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Affiliation(s)
- Warren N Ponder
- From the One Tribe Foundation, Fort Worth, Texas (W.N.P.); Stephen F. Austin State University (J.C.); University of Central Florida (J.W.); University of Texas at Arlington (D.L.S.); Private Practice, Dallas Texas (J.M.G.); and University of North Texas Health Science Center (A.Y.)
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Vincent C, Pirard P, Motreff Y, Bertuzzi L, Vandentorren S, Vuillermoz C. Post-traumatic stress disorder among civilians 6 and 18 months after the January 2015 terrorist attacks in the Paris region. Psychiatry Res 2023; 322:115137. [PMID: 36863231 DOI: 10.1016/j.psychres.2023.115137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
In the literature, the association between medium and long-term PTSD (post-traumatic stress disorder) after terrorist attack has rarely been described. The objective of our study was to identify the factors associated with PTSD in the medium and longer term among people exposed to a terrorist attack in France. We used data from a longitudinal survey of 123 terror-exposed people interviewed 6-10 (medium term) and 18-22 (long term) months after. Mental health was assessed by the Mini Neuropsychiatric Interview. PTSD in the medium term was associated with history of traumatic events, low levels of social support and severe peri-traumatic reactions, which were in turn associated with high levels of terror exposure. PTSD in the medium term was linked in turn to the presence of anxiety and depressive disorders, which was also linked to PTSD in the longer term. The factors leading to PTSD are different in the medium and long term. In order to improve future support for people exposed to distressing events, it is important to follow up people with intense peri-traumatic reactions, high levels of anxiety and depression and to measure reactions.
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Affiliation(s)
- Charline Vincent
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of social epidemiology, F75012 Paris, France.
| | - Philippe Pirard
- Santé publique France, Direction des maladies non transmissibles et traumatismes, F94415 Saint-Maurice, France
| | - Yvon Motreff
- Santé publique France, Direction des maladies non transmissibles et traumatismes, F94415 Saint-Maurice, France
| | - Leticia Bertuzzi
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of social epidemiology, F75012 Paris, France
| | - Stéphanie Vandentorren
- Santé publique France, Direction scientifique et internationale, F94415 Saint-Maurice, France; University of Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, F-33000 Bordeaux, France
| | - Cécile Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of social epidemiology, F75012 Paris, France
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Obuobi-Donkor G, Shalaby R, Eboreime E, Agyapong B, Phung N, Eyben S, Wells K, Hilario C, Dias RDL, Jones C, Brémault-Phillips S, Zhang Y, Greenshaw AJ, Agyapong VIO. Text4PTSI: A Promising Supportive Text Messaging Program to Mitigate Psychological Symptoms in Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4215. [PMID: 36901235 PMCID: PMC10001524 DOI: 10.3390/ijerph20054215] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Public safety personnel experience various mental health conditions due to their work's complex and demanding nature. There are barriers to seeking support and treatment; hence, providing innovative and cost-effective interventions can help improve mental health symptoms in public safety personnel. OBJECTIVE The study aimed to evaluate the impact of Text4PTSI on depression, anxiety, trauma, and stress-related symptoms, and the resilience of public safety personnel after six months of providing supportive text message intervention. METHODS Public safety personnel subscribed to Text4PTSI and received daily supportive and psychoeducational SMS text messages for six months. Participants were invited to complete standardized self-rated web-based questionnaires to assess depression, anxiety, posttraumatic stress disorder (PTSD), and resilience symptoms measured on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Brief Resilience Scale (BRS), respectively. The assessment of mental health conditions was conducted at baseline (enrolment) and six weeks, three months, and six months after enrollment. RESULTS One hundred and thirty-one subscribers participated in the Text4PTSI program, and eighteen completed both the baseline and any follow-up survey. A total of 31 participants completed the baseline survey and 107 total surveys were recorded at all follow-up time points. The baseline prevalence of psychological problems among public safety personnel were as follows: likely major depressive disorder (MDD) was 47.1%, likely generalized anxiety disorder (GAD) was 37.5%, low resilience was 22.2%, and likely PTSD was 13.3%. At six months post-intervention, the prevalence of likely MDD, likely GAD, and likely PTSD among respondents reduced; however, a statistically significant reduction was reported only for likely MDD (-35.3%, X2 (1) = 2.55, p = 0.03). There was no significant change in the prevalence of low resilience between baseline and post-intervention. There was a decrease in the mean scores on the PHQ-9, GAD-7, PCL-C, and the BRS from baseline to post-intervention by 25.8%, 24.7%, 9.5%, and 0.3%, respectively. However, the decrease was only statistically significant for the mean change in GAD-7 scores with a low effect size (t (15) = 2.73, p = 0.02). CONCLUSIONS The results of this study suggest a significant reduction in the prevalence of likely MDD as well as the severity of anxiety symptoms from baseline to post-intervention for subscribers of the Text4PTSI program. Text4PTSI is a cost-effective, convenient, and easily scalable program that can augment other services for managing the mental health burdens of public safety personnel.
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Affiliation(s)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Natalie Phung
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Scarlett Eyben
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Kristopher Wells
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB T5J 4S2, Canada
| | - Carla Hilario
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Raquel da Luz Dias
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Chelsea Jones
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Prioux C, Marillier M, Vuillermoz C, Vandentorren S, Rabet G, Petitclerc M, Baubet T, Stene LE, Pirard P, Motreff Y. PTSD and Partial PTSD among First Responders One and Five Years after the Paris Terror Attacks in November 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4160. [PMID: 36901168 PMCID: PMC10001642 DOI: 10.3390/ijerph20054160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Following the Paris terror attacks in November 2015, a large number of first responders (FR) were mobilized and consequently were at risk of developing posttraumatic stress disorder (PTSD). Based on the ESPA 13 November survey, the objectives of this study were to 1) describe the prevalence of PTSD and partial PTSD in FR five years after the attacks, 2) describe the changes in PTSD and partial PTSD from one to five years after the attacks, and 3) examine factors associated with PTSD and partial PTSD five years after the attacks. Data were collected using an online questionnaire. PTSD and partial PTSD were measured using the Post-Traumatic Stress Disorder Checklist based on the DSM-5 (PCL-5). Gender, age, responder category, education level, exposure, mental health history, history of traumatic events, training, social support, concern about the COVID-19 epidemic, and somatic problems present after the attacks were all analyzed as potential factors associated with PTSD and partial PTSD using multinomial logistic regression. A total of 428 FR were included 5 years after the attacks, of which 258 had participated also 1 year after the attacks. Five years after the attacks, the prevalence of PTSD and partial PTSD were 8.6% and 22%, respectively. Presence of somatic problems after the attacks were associated with PTSD. Involvement in dangerous crime scenes was associated with a higher risk of partial PTSD. No awareness of psychological risks in the context of professional activity through specific training was associated with partial PTSD, in particular among participants aged 45 years or more. To mitigate PTSD for FR, monitoring mental health symptoms, providing mental health education, and providing treatment may be needed for several years after the attacks.
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Affiliation(s)
- Clémentine Prioux
- Santé Publique France, Direction des Maladies non Transmissibles et Traumatismes, F-94415 Saint-Maurice, France
| | - Maude Marillier
- Santé Publique France, Direction des Maladies non Transmissibles et Traumatismes, F-94415 Saint-Maurice, France
| | - Cécile Vuillermoz
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Sorbonne Université, F-75012 Paris, France
| | - Stéphanie Vandentorren
- INSERM, Bordeaux Population Health Research Center, University of Bordeaux, U1219, F-33000 Bordeaux, France
- Santé Publique France, Direction Scientifique et Internationale, F-94415 Saint-Maurice, France
| | - Gabrielle Rabet
- Santé Publique France, Direction Appui, Traitements et Analyses des Données, F-94415 Saint-Maurice, France
| | - Matthieu Petitclerc
- Service Médical D’urgence—Bureau de Santé et de Prévention, Brigade de Sapeurs-Pompiers de Paris, 1, Place Jules-Renard, F-75017 Paris, France
- Laboratoire UTRPP, Université Sorbonne Paris Nord, F-93430 Villetaneuse, France
| | - Thierry Baubet
- Laboratoire UTRPP, Université Sorbonne Paris Nord, F-93430 Villetaneuse, France
- APHP Hôpital Avicenne, Psychopathology Department for Children, Adolescents, General Psychiatry and Specialized Addiction, F-93009 Bobigny, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), NO-0409 Oslo, Norway
| | - Philippe Pirard
- Santé Publique France, Direction des Maladies non Transmissibles et Traumatismes, F-94415 Saint-Maurice, France
- CESP, INSERM, MOODS team, Faculté de Médecine Paris–Saclay, Université Paris–Saclay, F-94275 Le Kremlin Bicêtre, France
| | - Yvon Motreff
- Santé Publique France, Direction des Maladies non Transmissibles et Traumatismes, F-94415 Saint-Maurice, France
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Sorbonne Université, F-75012 Paris, France
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Nourry N, Alsayed Obeid S, Rolling J, Lefebvre F, Baumlin S, Nasseri M, Berna F, Charbotel B, Gonzalez M, Vidailhet P, Mengin AC. Posttraumatic stress disorder and depression after the 2018 Strasbourg Christmas Market terrorist attack: a comparison of exposed and non-exposed police personnel. Eur J Psychotraumatol 2023; 14:2214872. [PMID: 37305952 PMCID: PMC10262818 DOI: 10.1080/20008066.2023.2214872] [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: 02/04/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Background: Police personnel are among the first responders exposed to terrorist attacks, raising in number in the late decades. Due to their profession, they are also exposed to repetitive violence, increasing their vulnerability to PTSD and depression.Objective: Our study aims at comparing the prevalence of PTSD and depression, and the risk factors associated with these conditions among directly and indirectly exposed versus non-exposed police personnel during the Strasbourg Christmas Market terrorist attack.Method: Three months after the attack, participants completed a survey assessing their sociodemographic characteristics, occupational data, degree of exposure, sleep debt around the event, event centrality (CES), and three mental health conditions: PTSD (PCL-5), depression (PHQ-9), and suicide risk (yes/no questions).Results: A total of 475 police personnel responded to the questionnaire: 263 were exposed to the attack (182 of them directly) and 212 were non-exposed. Among directly exposed participants, the prevalences of partial and complete PTSD were 12.6 and 6.6%, and the prevalence of moderate-to-severe depression was 11.5%. Multivariate analysis revealed that direct exposure was associated with a higher risk of PTSD (OR = 2.98 [1.10-8.12], p = .03). Direct exposure was not associated with a higher risk of depression (OR = 0.40 [0.10-1.10], p = .08). A significant sleep debt after the event was not associated with a higher risk of later PTSD (OR = 2.18 [0.81-5.91], p = .13) but was associated with depression (OR = 7.92 [2.40-26.5], p < .001). A higher event centrality was associated with both PTSD and depression (p < .001).Conclusions: Police personnel directly exposed to the Strasbourg Christmas Market terrorist attack were at higher risk of PTSD but not depression. Efforts to prevent and treat PTSD should focus on directly exposed police personnel. However, general mental health should be monitored for every personnel member.
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Affiliation(s)
- Nathalie Nourry
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, Lyon Cedex, France
| | - Shadi Alsayed Obeid
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
| | - Julie Rolling
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- Centre National de la Recherche Scientifique Unité Propre de Recherche 3212 (CNRS UPR 3212), Institute for Cellular and Integrative Neurosciences (INCI), Strasbourg, France
| | - François Lefebvre
- Hôpitaux Universitaires de Strasbourg, Département de Santé Publique, GMRC, Strasbourg, France
- Université de Strasbourg, Laboratoire de Biostatistique et Informatique Médicale, Illkirch, France
| | - Sandra Baumlin
- Service de Soutien Psychologique opérationnel, Police Nationale, Ministère de l’Intérieur, Préfecture du Bas Rhin, Strasbourg, France
| | - Mohamed Nasseri
- Hôpitaux Universitaires de Strasbourg, Département de Santé Publique, GMRC, Strasbourg, France
- Université de Strasbourg, Laboratoire de Biostatistique et Informatique Médicale, Illkirch, France
| | - Fabrice Berna
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Barbara Charbotel
- Université de Lyon, Université Claude Bernard Lyon 1, Université Gustave Eiffel, Lyon Cedex, France
| | - Maria Gonzalez
- Hôpitaux Universitaires de Strasbourg, Service de Pathologies Professionnelles et Médecine du Travail, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
| | - Pierre Vidailhet
- Strasbourg University, Faculty of Medicine, Strasbourg, France
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Amaury C. Mengin
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
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20
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Isabirye RA, Namuli JD, Kinyanda E. Prevalence and factors associated with post traumatic stress disorder among field police patrol officers serving in Kampala Metropolitan region. BMC Psychiatry 2022; 22:706. [PMID: 36380315 PMCID: PMC9666967 DOI: 10.1186/s12888-022-04317-z] [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: 03/02/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Occupation groups like police officers and fire fighters are exposed to a number of traumatic events which put them at a risk of developing post-traumatic stress disorder (PTSD). Previous studies have found the prevalence of PTSD in police officers to vary between 7 and 19%. However, most of these studies have been undertaken in western setting with little research having been undertaken in sub-Saharan Africa including Uganda. OBJECTIVE To determine the prevalence and factors associated with post-traumatic stress disorder among field police patrol officers serving in Kampala Metropolitan Police (KMP) North Region. METHODS This was a cross sectional study that was conducted on 392 field police patrol officers serving in KMP North Region. Diagnosis of PTSD was undertaken using the Clinician Administered PTSD Scale for DSM-5. In order to assess for psychiatric comorbidities, the study used the Mini International Neuropsychiatric Interview (M.I.N.I.) RESULTS: In this study, the prevalence of PTSD was 7.4%. An additional 62.5% had sub-threshold PTSD, which was defined as, the presence of at least one PTSD symptom but not meeting full criteria for PTSD diagnosis. The factors found to be significantly associated with PTSD were all related to the presence of psychiatric comorbidities, namely the presence of: a current major depressive episode (aOR = 4.7; 95% CI: 1.5- 14.8; p = .009); an alcohol use disorder (aOR = 5.1; 95% CI: 2.0-13.0; p = .001); and presence of dissociation symptoms (aOR = 6.7; 95% CI: 2.0-22.2; p = .002). CONCLUSION PTSD is one of the common psychiatric disorders experienced by serving police officers in Uganda. The tendency of PTSD in this group to co-occur with other psychiatric disorders means that any treatment program to address it should be part of a comprehensive multi-disorder mental health treatment programme in the police office.
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Affiliation(s)
- Rogers Agenda Isabirye
- Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda.
| | - Justine Diana Namuli
- grid.11194.3c0000 0004 0620 0548Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Eugene Kinyanda
- grid.415861.f0000 0004 1790 6116 Mental Health Section, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
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21
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Feret M, Camart N, Sala L, Fin G, Goujard S. Stress perçu, stratégies de coping et santé générale chez les sapeurs-pompiers de Seine-et-Marne. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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22
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Wang N, Chung MC, Zhang J, Fang S. Network analysis on the relationship between posttraumatic stress disorder, psychiatric co-morbidity and posttraumatic growth among Chinese adolescents. J Affect Disord 2022; 309:461-470. [PMID: 35513114 DOI: 10.1016/j.jad.2022.04.148] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/14/2021] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study investigated the association between posttraumatic stress disorder (PTSD), psychiatric co-morbidity and posttraumatic growth (PTG) among Chinese adolescents using network analysis. METHODS 867 Chinese adolescents (male = 424, female = 443) were recruited from three secondary schools. They completed the Posttraumatic Stress Disorder Checklist for DSM-5, the Posttraumatic Growth Inventory, and the General Health Questionnaire-28. RESULTS Domains of each construct mainly clustered within their respective communities with several bridging edges identified. The prominent roles of bridging nodes and edges (positive and negative) were highlighted. Key bridging nodes were negative alterations in cognitions and mood for PTSD, anxiety and insomnia for psychiatric co-morbidity and appreciation of life for PTG. LIMITATIONS The cross-sectional nature of the present study may preclude the identification of real causal relationships between nodes. CONCLUSIONS Following a trauma, adolescents displayed posttraumatic stress along with general psychological disorder symptoms. These distress reactions could affect the way they appreciated life and their motivation to seek future life possibilities. Findings from the current study may provide some clue for the facilitation of posttraumatic growth among clinical patients.
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Affiliation(s)
- Na Wang
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Man Cheung Chung
- Department of Psychology, Zayed University, Dubai, United Arab Emirates
| | - Jieting Zhang
- College of Psychology, Shenzhen University, Shenzhen, China
| | - Siqi Fang
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong.
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23
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Bertolazi AN, Mann KC, Lima AVPB, Hidalgo MPL, John AB. Post-traumatic stress disorder prevalence and sleep quality in fire victims and rescue workers in southern Brazil: a cross-sectional study. Public Health 2022; 209:4-13. [PMID: 35749927 DOI: 10.1016/j.puhe.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 03/17/2022] [Accepted: 05/08/2022] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This survey was conducted to evaluate the prevalence of post-traumatic stress disorder (PTSD) and the sleep quality in victims and rescue team of the third deadliest nightclub fire in the world. STUDY DESIGN A cross-sectional study. METHODS Participants were victims and rescue workers exposed to a fire at a nightclub, which occurred in January 2013 in Southern Brazil. The Pittsburgh Sleep Quality Index (PSQI), composed of seven subjective sleep variables (including daytime dysfunction), and PTSD Checklist - Civilian version (PCL-C) were applied to all people who sought medical attention at the local reference center in the first year after the event. Comprehensive information was obtained concerning sociodemographic factors, health status, and sleep complaints. RESULTS A total of 370 individuals, 190 victims and 180 rescue workers, were included. Participants were 70% male, with an average age of 29 years. The prevalence of PTSD was 31.9%, ranging from 24.4% for rescue workers to 38.9% for victims. The prevalence of poor sleep quality was 65.9%, ranging from 56.1% for rescue workers to 75.3% for victims. Most of the participants with PTSD (91.5%) had PSQI scores >5 (poor sleepers), against 54.0% of the non-PTSD individuals. All seven PSQI subscores showed significant differences between PTSD and non-PTSD individuals, especially daytime dysfunction. Sex, shift work, previous psychiatric disease, and sleep quality remained associated with PTSD in adjusted models, with a prevalence ratio (95% CI) of 1.76 (1.28-2.43) in females, 1.73 (1.17-2.55) in shift workers, 1.36 (1.03-1.80) in individuals with psychiatric disease history, and 5.42 (2.55-11.52) in poor sleepers. CONCLUSIONS The presence of daytime dysfunction increased by at least tenfold the prevalence of PTSD in this sample. Considering that daytime dysfunction was shown to be strongly associated with PTSD, sleep-related issues should be addressed in the assessment of individuals exposed to traumatic events, both victims and rescuers. Factors like shift work and female sex were also associated with PTSD, especially among victims.
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Affiliation(s)
- A N Bertolazi
- Post-Graduate Program in Psychiatry and Behavior Sciences, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil; Pulmonary Service, Hospital Universitário de Santa Maria (HUSM), Santa Maria, RS, Brazil.
| | - K C Mann
- Pulmonary Service, Hospital Universitário de Santa Maria (HUSM), Santa Maria, RS, Brazil
| | - A V P B Lima
- Pulmonary Service, Hospital Universitário de Santa Maria (HUSM), Santa Maria, RS, Brazil
| | - M P L Hidalgo
- Post-Graduate Program in Psychiatry and Behavior Sciences, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil; Chronobiology and Sleep Laboratory, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - A B John
- Chronobiology and Sleep Laboratory, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Sleep Disorders Center, Pulmonary Service, HCPA, Porto Alegre, RS, Brazil
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24
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Wesemann U, Applewhite B, Himmerich H. Investigating the impact of terrorist attacks on the mental health of emergency responders: systematic review. BJPsych Open 2022; 8:e107. [PMID: 35656574 PMCID: PMC9230690 DOI: 10.1192/bjo.2022.69] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Terrorist attacks have strong psychological effects on rescue workers, and there is a demand for effective and targeted interventions. AIMS The present systematic review aims to examine the mental health outcomes of exposed emergency service personnel over time, and to identify risk and resilience factors. METHOD A literature search was carried out on PubMed and PubPsych until 27 August 2021. Only studies with a real reported incident were included. The evaluation of the study quality was based on the Quality Assessment Tool for Quantitative Studies, and the synthesis used the 'Guidance on the Conduct of Narrative Synthesis in Systematic Reviews'. RESULTS Thirty-three articles including 159 621 individuals were identified, relating to five different incidents with a post-event time frame ranging from 2 weeks to 13 years. The post-traumatic stress disorder prevalence rates were between 1.3 and 16.5%, major depression rates were between 1.3 and 25.8%, and rates for specific anxiety disorders were between 0.7 and 14%. The highest prevalence rates were found after the World Trade Center attacks. Reported risk factors were gender, no emergency service training, peritraumatic dissociation, spatial proximity to the event and social isolation. CONCLUSIONS The inconsistency of the prevalence rates may be attributable to the different severities of the incidents. Identified risk factors could be used to optimise training for emergency personnel before and after catastrophic events. Voluntary repetitive screening of rescue workers for mental health symptoms is recommended.
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Affiliation(s)
- Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital Berlin, Germany
| | - Briana Applewhite
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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25
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Saito T, van der Does FHS, Nagamine M, van der Wee NJ, Shigemura J, Yamamoto T, Takahashi Y, Koga M, Toda H, Yoshino A, Vermetten E, Giltay EJ. Risk and resilience in trajectories of post-traumatic stress symptoms among first responders after the 2011 Great East Japan Earthquake: 7-year prospective cohort study. Br J Psychiatry 2022; 221:1-8. [PMID: 35191369 DOI: 10.1192/bjp.2022.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders. AIMS We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE) - a historically large earthquake that resulted in a tsunami and a nuclear disaster. METHOD A total of 55 632 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this 7-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised. Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analysed using multinomial logistic regression. RESULTS Five symptom severity trajectories were identified: 'resilient' (54.8%), 'recovery' (24.6%), 'incomplete recovery' (10.7%), 'late-onset' (5.7%), and 'chronic' (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave and longer post-deployment overtime. CONCLUSIONS The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection and intervention in individuals at risk of developing symptomatic trajectories.
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Affiliation(s)
- Taku Saito
- Department of Psychiatry, School of Medicine, National Defense Medical College, Japan
| | | | - Masanori Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, Japan
| | - Nic J van der Wee
- Department of Psychiatry, Leiden University Medical Center (LUMC), the Netherlands
| | - Jun Shigemura
- Department of Psychiatry, School of Medicine, National Defense Medical College, Japan
| | - Taisuke Yamamoto
- Division of Behavioral Science, National Defense Medical College Research Institute, Japan
| | - Yoshitomo Takahashi
- Division of Behavioral Science, National Defense Medical College Research Institute, Japan
| | - Minori Koga
- Department of Psychiatry, School of Medicine, National Defense Medical College, Japan
| | - Hiroyuki Toda
- Department of Psychiatry, School of Medicine, National Defense Medical College, Japan
| | - Aihide Yoshino
- Department of Psychiatry, School of Medicine, National Defense Medical College, Japan
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center (LUMC), the Netherlands andARQ National Psychotrauma Center, the Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center (LUMC), the Netherlands
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26
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Alghamdi AA. The Psychological Challenges of Emergency Medical Service Providers During Disasters: A Mini-Review February 2022. Front Psychiatry 2022; 13:773100. [PMID: 35295786 PMCID: PMC8918654 DOI: 10.3389/fpsyt.2022.773100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/02/2022] [Indexed: 11/23/2022] Open
Abstract
The provision of emergency medical services (EMS) is an inherently stressful job. Depression, anxiety, and posttraumatic stress disorder (PTSD) are common psychological challenges affecting EMS providers. As disasters increase worldwide, the need for EMS also increases, as they are an essential part of any disaster management system. Studies have shown that EMS providers experience psychological challenges due to disaster response without receiving the needed psychological support. There is a scarcity of research focusing on EMS providers' psychological challenges in disaster times, especially in the Eastern world. This review highlights the psychological challenges faced by EMS providers in disaster times and discusses the amount of mental health care they receive. By emphasizing the need for mental health support, more research can be conducted to view EMS providers' perspectives on mental health needs before, during, and after disasters, and EMS policy makers can find programs to meet EMS providers' mental health needs, which might reflect positively on EMS and disaster management systems.
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Affiliation(s)
- Abdullah Abdulaziz Alghamdi
- Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
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27
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Coulon N, Grenon M, Consigny M, Simson JP. PTSD in French Adolescent Victims Following the London Attack in March 2017: Data From the First Step of the AVAL Study. Front Psychiatry 2022; 13:728133. [PMID: 35280156 PMCID: PMC8907535 DOI: 10.3389/fpsyt.2022.728133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The terrorist attack at Westminster Bridge on March 22nd, 2017 impacted on French high school students on a school trip in London. This terrorist attack was claimed by the Islamic State. The aim of the study was to assess the mental health consequences of the attack on the French adolescents who were directly exposed (criteria A for Post-Traumatic Stress Disorder, PTSD). This involved three dimensions, namely: (1) clinical; (2) epidemiological; and (3) prevention and therapeutic. MATERIAL AND METHOD The investigation was the first observational step of AVAL (Adolescents Victimes de l'Attentat de Londres) study, a cohort monitoring project and it was then a monocentric, cross sectional, non interventional survey, at only one-year post-trauma. The study was carried out utilizing self- and clinician-administered questionnaires. Volunteers from the medico-psychological emergency unit provided support for these victims during the study protocol. RESULTS From the target population (n = 53), 39 adolescents (73.6%) agreed to participate, with a median age 16.9 years. 12 months after the attack, 25.6% of teenagers suffered from current PTSD (p < 0.0001). Those with, vs. without, PTSD showed several significant differences: (1) heightened levels of major depressive episodes (p = 0.0266) and suicidality (p = 0.0164); (2) increased substance use, including tobacco (p = 0.0284) and cannabis (p = 0.0449); and (3) impaired functioning in school (p = 0.0203), social (p < 0.0001) and family (p < 0.0001) settings. Sixty four percentage of directly exposed teenagers also had a current psychiatric disorder other than PTSD. DISCUSSION The heightened levels of PTSD, psychiatric disorders, and substance use at 12 months highlight the importance of early intervention in adolescents exposed to terrorist-linked potentially traumatic events.
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Affiliation(s)
- Nathalie Coulon
- Department of Psychiatry, Brest University Hospital, Brest, France.,Assistance Publique des Hôpitaux de Paris APHP, DHU Pe-PSY, Medical University Department of Psychiatry and Addictology Henri Mondor, Schizophrenia Expert Center, Paris Est Créteil University, Créteil, France
| | - Marion Grenon
- Department of Psychiatry, Brest University Hospital, Brest, France.,Military Hospital, HIA Clermont-Tonnerre, Departement of Psychiatry, Brest, France
| | - Maëlys Consigny
- Brest University Hospital, Delegation for Clinical Research and Innovation, Clinical Investigation Center, INSERM 14 12, Brest, France
| | - J-P Simson
- Military Hospital, HIA Clermont-Tonnerre, Departement of Psychiatry, Brest, France
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28
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Huang Y, Huang J, Wang T, Xu S, Li J. The Impact of the Corona Virus Disease 2019 Pandemic on Chinese Middle School Students' Self-Perceived Emotional States: A Wuhan Perspective. Front Psychol 2021; 12:740879. [PMID: 34803821 PMCID: PMC8602185 DOI: 10.3389/fpsyg.2021.740879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
This mixed-methods study examined the impact of the COVID-19 pandemic on 1493 Grades 7, 8, and 9 students’ self-perceived emotional states in Wuhan, China when it was locked down for the pandemic on January 23, 2020 and when the lockdown was lifted on April 8, 2020, as well as the changes of their emotional states over the 1-year period after the lockdown was lifted. A five-point Likert scale survey was administered to the participants between March 1 and April 1, 2020 when Wuhan was blocked down; and three focus group interviews were conducted between May 1 and May 31, 2021, 1 year after the lockdown was lifted. The results showed that these students in Wuhan experienced feelings of loss of control and negative emotions when the city was locked down and they were home quarantined; furthermore, there were significant differences for their self-perceived feelings of loss of control and negative emotions across demographic variables of gender, grade level, physical activity, social economic status, and family cohesion; finally, their emotional states changed substantially at different time nodes during this pandemic. Implications for students, parents, and schools are discussed.
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Affiliation(s)
- Yan Huang
- Educational Economics and Management, Law and Business School, Wuhan Institute of Technology, Wuhan, China
| | - Jinyan Huang
- The Research Institute for Educational Assessment and Research Methodology, School of Teacher Education, Jiangsu University, Zhenjiang, China
| | - Tingting Wang
- Educational Economics and Management, Law and Business School, Wuhan Institute of Technology, Wuhan, China
| | - Siying Xu
- Logistics Management and Engineering, School of Management, Wuhan Textile University, Wuhan, China
| | - Jialing Li
- Educational Economics and Management, Law and Business School, Wuhan Institute of Technology, Wuhan, China
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29
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Motreff Y, Pirard P, Vuillermoz C, Rabet G, Petitclerc M, Stene LE, Baubet T, Chauvin P, Vandentorren S. Mental health care utilization by first responders after Paris attacks. Occup Med (Lond) 2021; 72:81-90. [PMID: 34729607 PMCID: PMC8863088 DOI: 10.1093/occmed/kqab150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background First responders (FRs) are frequently exposed to potentially traumatic events, including terror attacks, and may consequently be at risk of developing mental health disorders. Prior research suggests that FRs with mental health disorders often do not receive appropriate treatment. More knowledge is needed about their use of mental health care (MHC). Aims This study aimed to identify factors associated with receiving immediate support, post-immediate support and engagement in MHC among FRs of the November 2015 terror attacks in Paris. Methods A web-based study was conducted 8–12 months after the attacks on 663 FRs who were mobilized during the night and/or the aftermath of the attacks. Logistic regression was performed to analyse factors associated with MHC. Results Overall, 44 FRs sought MHC. Among FRs with post-traumatic stress disorder (PTSD), partial PTSD or depression (n = 60), 38% sought MHC (n = 23). Post-immediate support was associated with immediate support, and both were associated with knowing someone who could help regarding the potential psychological risks following a traumatic event. MHC engagement was associated with a history of MHC, post-immediate support and the presence of PTSD, partial PTSD or depression. Conclusions Among FRs with PTSD, partial PTSD or depression, few sought MHC. Improved access to MHC for FRs after terror attacks is essential. Knowing someone who could help regarding potential psychological risks may facilitate immediate and/or post-immediate support. Furthermore, post-immediate support could encourage engagement in MHC. Efforts should be made before and after potentially traumatic events to ensure mental health education for FR.
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Affiliation(s)
- Y Motreff
- Santé publique France, Direction des maladies non transmissibles et traumatismes, Saint-Maurice, France.,INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
| | - P Pirard
- Santé publique France, Direction des maladies non transmissibles et traumatismes, Saint-Maurice, France.,MOODS, INSERM U 1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre, France
| | - C Vuillermoz
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
| | - G Rabet
- Santé publique France, Direction appui, traitements et analyses des données, Saint-Maurice, France
| | - M Petitclerc
- Service médical d'urgence-bureau de santé et de prévention, Brigade de sapeurs-pompiers de Paris, 1, place Jules-Renard, Paris, France.,Université Sorbonne Paris Nord, Ecole doctorale Erasme, Laboratoire UTRPP, Villetaneuse, France
| | - L Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - T Baubet
- Université Sorbonne Paris Nord, Ecole doctorale Erasme, Laboratoire UTRPP, Villetaneuse, France.,APHP Hôpital Avicenne, Psychopathology Department for Children, Adolescents, General Psychiatry and Specialized Addiction, Bobigny, France.,Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - P Chauvin
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France
| | - S Vandentorren
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, Paris, France.,Santé publique France, Direction des régions, Saint-Maurice, France
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Rigutto C, Sapara AO, Agyapong VIO. Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature. Behav Sci (Basel) 2021; 11:bs11100140. [PMID: 34677233 PMCID: PMC8533613 DOI: 10.3390/bs11100140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Terrorism, though not well-defined, is a violent act that has been shown to have longstanding effects on the mental health of those who witness it. The aim of this general literature review is to explore the effect that terrorism has on posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and anxiety disorders, as well as the bio-psycho-social determinants that mediate its impact. This paper describes the prevalence, risk factors, protective factors, common presentations and interventions identified for PTSD, depression and anxiety disorders occurring following terrorist attacks. We conducted a literature search in MEDLINE using a number of keywords detailed below. After applying inclusion and exclusion criteria, we kept 80 articles, which we summarized in tabular form. A majority of articles found detailed the impact of terrorism on PTSD, and took place in a Western, mainly American setting. The main factors that impacted the presentation of mental illness include gender, ethnicity, social supports, socioeconomic status, level of preparedness, level of exposure, pre-existing trauma and mental illness, and subsequent life stressors. The main intervention detailed in this article as showing evidence post-terrorism is trauma-focused cognitive-behavioural therapy. This study highlights the importance of this topic, and in particular, its implications for public health policy and practice.
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Zhen R, Zhang J, Pang H, Ruan L, Liu X, Zhou X. Full and partial posttraumatic stress disorders in adults exposed to super typhoon Lekima: a cross-sectional investigation. BMC Psychiatry 2021; 21:512. [PMID: 34663269 PMCID: PMC8522036 DOI: 10.1186/s12888-021-03528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 10/06/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Super typhoon Lekima had a maximum wind force of 16 (52 m/s) and hit Wenling city, Zhejiang province in China on August 10, 2019. The typhoon left many victims showing symptoms of posttraumatic stress disorder (PTSD). OBJECTIVE This study aimed to assess the prevalence of full and partial PTSD to inform targeted interventions for adult victims. METHOD In total, four thousand seven hundred and forty-six adults who are parents of students in local primary and middle schools were recruited to participate in this study. Participants completed a trauma exposure scale and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition PTSD Checklist. Logistic regression analysis was used to examine the factors of full and partial PTSD. RESULTS Nine hundred and ten (19.2%) adults had full PTSD and 1775 (37.4%) had partial PTSD. Adults with a monthly income > 10,000 RMB (about 1530 dollars) and a high education level (bachelor's degree or above) were less likely to have full or partial PTSD than those with lower income and lower education levels. In addition, married adults were less likely to have full PTSD than divorced or widowed ones. Higher rates of PTSD were observed among those aged ≥40 years, who were injured/trapped, whose family members/friends were injured/trapped, and who lost property. CONCLUSIONS Partial and full PTSD were common among adults following super typhoon Lekima, and high income, high education level, and married status were protective factors, whereas trauma exposure was a risk factor of PTSD. Target psychological intervention should be provided to these victims who are in low income and education level, divorced and widowed, and experienced more serious trauma.
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Affiliation(s)
- Rui Zhen
- grid.410595.c0000 0001 2230 9154Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121 China
| | - Junjie Zhang
- Teaching and Research Office, Wenling Education Bureau, Wenling, 317500 China
| | - Hongwei Pang
- Zhejiang Research Institute of Education Science, Hangzhou, 310028 China
| | - Lingling Ruan
- Zhejiang Research Institute of Education Science, Hangzhou, 310028 China
| | - Xuanwen Liu
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121, China. .,Research and Training Center of School Mental Health Education of Zhejiang Province, Hangzhou, 311121, China.
| | - Xiao Zhou
- grid.13402.340000 0004 1759 700XDepartment of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028 China
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Jumbe S, Milner A, Clinch M, Kennedy J, Pinder RJ, Sharpe CA, Fenton K. A qualitative evaluation of Southwark Council's public health response to mitigating the mental health impact of the 2017 London bridge and borough market terror attack. BMC Public Health 2021; 21:1427. [PMID: 34281513 PMCID: PMC8290577 DOI: 10.1186/s12889-021-11447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Over recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Although psychologists have completed important work on mental health responses to disaster exposure including terrorist attacks, the mental health impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council's pioneering public mental health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to explore perceptions of the mental health impact of the incident by those living and working in the borough. METHODS A rapid qualitative evaluation informed by the logic underpinning Southwark Council's response was conducted. Seven formative interviews were undertaken with individuals involved in the response planning and/or delivery, enabling the evaluation team to establish the response's theoretical basis. Subsequently, nineteen semi-structured interviews with consenting Council employees, residents, business owners, and workers from the Borough were conducted to understand perceived mental health impacts of the attack and the success of the Council response. Thematic analysis of transcribed interviews was undertaken to evaluate the extent to which the response was implemented successfully. RESULTS Participants reported feeling the attack had a wide-reaching negative impact on the mental health of residents, those working in the borough and visitors who witnessed the attack. Delivering the response was a challenge and response visibility within the community was limited. Participants suggested a comprehensive systematic approach to health needs assessment informed by knowledge and relationships of key Council workers and community stakeholders is imperative when responding to terrorist incidents. Improved communication and working relationships between statutory organisations and community stakeholders would ensure community groups are better supported. Prioritising mental health needs of terror attack responders to mitigate persisting negative impacts was highlighted. CONCLUSIONS This article highlights a potential public health approach and need for developing robust practical guidance in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.
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Affiliation(s)
- Sandra Jumbe
- Institute of Population Health Sciences, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
| | - Adrienne Milner
- College of Health, Medicine Life Sciences, Brunel University London, Heinz Wolff Building 210, Uxbridge, UB8 3PH, UK
| | - Megan Clinch
- Institute of Population Health Sciences, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - Jonathan Kennedy
- Institute of Population Health Sciences, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - Richard J Pinder
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, Reynolds Building, St Dunstans Road, London, W6 8RP, UK
- Southwark Council, 160 Tooley St, London, SE1 2QH, UK
| | - Carolyn A Sharpe
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, Reynolds Building, St Dunstans Road, London, W6 8RP, UK
- Southwark Council, 160 Tooley St, London, SE1 2QH, UK
| | - Kevin Fenton
- Southwark Council, 160 Tooley St, London, SE1 2QH, UK
- Public Health England, Fleetbank House 2-6 Salisbury Square, London, EC4Y 8AE, UK
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Bentz L, Vandentorren S, Fabre R, Bride J, Pirard P, Doulet N, Baubet T, Motreff Y, Pradier C. Mental health impact among hospital staff in the aftermath of the Nice 2016 terror attack: the ECHOS de Nice study. BMC Public Health 2021; 21:1372. [PMID: 34246247 PMCID: PMC8272451 DOI: 10.1186/s12889-021-11438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The Nice terror attack of July 14, 2016 resulted in 84 deaths and 434 injured, with many hospital staff exposed to the attack, either as bystanders on site at the time of the attack ('bystander exposure') who may or may not have provided care to attack victims subsequently, or as care providers to victims only ('professional exposure only'). The objective of this study is to describe the impact on mental health among hospital staff by category of exposure with a particular focus on those with 'professional exposure only', and to assess their use of psychological support resources. METHOD An observational, cross-sectional, multicenter study conducted from 06/20/2017 to 10/31/2017 among all staff of two healthcare institutions in Nice, using a web questionnaire. Collected data included social, demographic and professional characteristics; trauma exposure category ('bystanders to the attack'; 'professional exposure only'; 'unexposed'); indicators of psychological impact (Hospital Anxiety and Depression Scale); PTSD (PCL-5) level; support sought. Responders could enter open comments in each section of the questionnaire, which were processed by inductive analysis. RESULTS 804 staff members' questionnaires were analysed. Among responding staff, 488 were exposed (61%): 203 were 'bystanders to the attack', 285 had 'professional exposure only'. The staff with 'professional exposure only' reported anxiety (13.2%), depression (4.6%), suicidal thoughts (5.5%); rates of full PTSD was 9.4% and of partial PTSD, 17.7%. Multivariate analysis in the 'professional exposure only' category showed that the following characteristics were associated with full or partial PTSD: female gender (OR = 2.79; 95% CI = 1.19-6.56, p = 0.019); social isolation (OR = 3.80; 95% CI = 1.30-11.16, p = 0.015); having been confronted with an unfamiliar task (OR = 3.04; 95% CI = 1.18-7.85; p = 0.022). Lastly, 70.6% of the staff with 'professional exposure only' with full PTSD did not seek psychological support. CONCLUSION Despite a significant impact on mental health, few staff with 'professional exposure only' sought psychological support. Robust prevention and follow-up programs must be developed for hospital staff, in order to manage the health hazards they face when exposed to exceptional health-related events such as mass terror attacks. STUDY REGISTRATION Ethical approval for the trial was obtained from the National Ethics Committee for Human Research (RCBID N° 2017-A00812-51).
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Affiliation(s)
- Laurence Bentz
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
| | - Stéphanie Vandentorren
- Santé publique France, French national public health agency, Direction scientifique et internationale, F-94415 Saint-Maurice, France
- Université Bordeaux, INSERM UMR 1219, Vintage team, F-33000 Bordeaux, France
| | - Roxane Fabre
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
- Côte d’Azur University, CoBTeK lab, Nice University Hospital, CMRR, Nice, France
| | - Jeremy Bride
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
- Côte d’Azur University, Nice University Hospital, Policlinique, Medical and psychological emergency unit (CUMP 06), Nice, France
- Paris 13 Sorbonne University - Paris Cité, Laboratoire UTRPP (EA 4403), Villetaneuse, France
| | - Philippe Pirard
- Santé publique France, French national public health agency, Non-Communicable Diseases and Trauma Division, F-94415 Saint-Maurice, France
- Team MOODS, CESP, Inserm 1178, Paris-Saclay University, UVSQ, Villejuif, France
| | - Nadège Doulet
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
| | - Thierry Baubet
- Centre National de Ressources et de Résilience (CN2R), Lille/Paris, France
- UTRPP ER 4403, Sorbonne Paris Nord University, Villetaneuse, France
- Assistance Publique - Hôpitaux de Paris, Avicenne Hospital, Child and adolescent psychopathology, psychiatry and addiction, Bobigny, France
| | - Yvon Motreff
- Santé publique France, French national public health agency, Non-Communicable Diseases and Trauma Division, F-94415 Saint-Maurice, France
- Sorbonne Université, Inserm, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Department of Social Epidemiology, F-75012 Paris, France
| | - Christian Pradier
- Côte d’Azur University, Nice University Hospital, Public Health Department, Nice, France
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Wesemann U, Bühler A, Mahnke M, Polk S, Willmund G. Longitudinal Mental Health Effects of the 2016 Terrorist Attack in Berlin on Various Occupational Groups of Emergency Service Personnel. Health Secur 2021; 18:403-408. [PMID: 33616414 DOI: 10.1089/hs.2019.0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Emergency service personnel who respond to terrorist attacks may experience persistent stress following the event. This occupational stress must be examined in order to develop occupation-specific response preparation and follow-up measures. An explorative pilot study examined the occupational stress-related effects of the 2016 terrorist attack on Breitscheidplatz in Berlin on emergency service personnel. The present study examines whether the results of the pilot study can be replicated and whether the effects changed after 2 years. The participants were 60 emergency personnel (including 11 police officers and 24 firefighters) who were deployed to the attack, and a control group of 60 personnel (including 37 police officers and 21 firefighters) who were not deployed. Data on stress, quality of life, and current mental state were gathered 3 to 4 months after the attack and 18 to 21 months after the first survey. The data showed that police officers who responded to the attack had significantly higher levels of aggression and hostility at both time points, and firefighters had significantly lower levels of environmental quality of life at both time points. Quality of life in terms of physical health for firefighters could not be replicated. Due to the different types of stress experienced by emergency service personnel, a differentiated approach is necessary. More specific preparation and follow-up measures are necessary to counteract persistent stress. Further research in this area could lead to specific predeployment and postdeployment training measures.
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Affiliation(s)
- Ulrich Wesemann
- Ulrich Wesemann, PhD, is Deputy Research Director, Centre for Psychotraumatology
| | - Antje Bühler
- Antje Bühler, PhD, is a Licensed Clinical Psychologist and Senior Researcher, Centre for Psychotraumatology
| | - Manuel Mahnke
- Manuel Mahnke was Senior Study Nurse, Centre for Psychotraumatology, and Deputy Head of Crisis Management for the Corona Pandemic.,Manuel Mahnke is also Head of the Youth Department of Fire and Rescue Station, Volunteer Fire Brigade, Berlin
| | - Sarah Polk
- Sarah Polk, MSc, is a PhD student at the Max Planck Institute for Human Development and The International Max Planck Research School on the Life Course, Berlin, Germany
| | - Gerd Willmund
- Gerd Willmund, MD, is a Specialist in Psychiatry and Psychotherapy and Head of Research, Centre for Psychotraumatology, and Deputy Department Head of Psychiatry; all at Bundeswehr Hospital Berlin, Berlin, Germany
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Wesemann U, Hadjamu N, Wakili R, Willmund G, Vogel J, Rassaf T, Siebermair J. Gender Differences in Anger Among Hospital Medical Staff Exposed to Patients with COVID-19. Health Equity 2021; 5:181-184. [PMID: 33937603 PMCID: PMC8080924 DOI: 10.1089/heq.2020.0119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose: Occupational exposure to patients with COVID-19 is a stress factor. The aim of this study was to assess gender differences in anger among medical hospital staff. Methods: N=78 hospital employees with direct or indirect contact to patients with COVID-19 completed State-Trait Inventory-2. Results: Female personnel showed higher scores in the main "trait anger" scale and its subscale "anger temperament," whereas "anger control-out" was significant lower. Direct patient contact had no influence. Conclusion: More specific training for female hospital staff could achieve health-related equity. Focusing on anger as a leading indicator could lead to better prevention and self-monitoring. Registered at Clinicaltrials.gov (NCT04368312).
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Affiliation(s)
- Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital, Berlin, Germany
| | - Nino Hadjamu
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
| | - Reza Wakili
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
| | - Gerd Willmund
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital, Berlin, Germany
| | - Julia Vogel
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
| | - Johannes Siebermair
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
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Dias Campos F, Chambel MJ, Lopes S, Dias PC. Post-Traumatic Stress Disorder in the Military Police of Rio de Janeiro: Can a Risk Profile Be Identified? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052594. [PMID: 33807636 PMCID: PMC7967303 DOI: 10.3390/ijerph18052594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/24/2022]
Abstract
Background: Significant exposure to critical incidents characteristic of military police work has a potentially traumatic effect and multiple consequences for the mental health of these professionals, such as Post Traumatic Stress Disorder (PTSD). This study aims to investigate the occurrence of PTSD in this occupational group and its correlations with socio-demographic and occupational variables. Methods: This is a cross-sectional study of Rio de Janeiro’s Military Police officers (n = 3.577). Data was collected from self-reported questionnaires applied in an institutional health program. Post-Traumatic Stress Disorder Checklist—Civilian version was used to assess PTSD. Results: Rates of 16.9% for full PTSD and 26.7% for partial PTSD were found. Based on logistic regression analysis, female officers and police officers in lower ranks of the military hierarchy and performing administrative duties were found to be at most risk of developing PTSD. Conclusions: These results suggest the need to further understand the predictive organizational and individual variables of PTSD correlated with the increased vulnerability of professionals in order to contribute to institutional policies for the prevention and rehabilitation of these cases.
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Affiliation(s)
- Fernanda Dias Campos
- Military Police of the State of Rio de Janeiro, Rio de Janeiro 20031-040, Brazil;
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal; (M.J.C.); (S.L.)
| | - Maria José Chambel
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal; (M.J.C.); (S.L.)
| | - Sílvia Lopes
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal; (M.J.C.); (S.L.)
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 4710-302 Braga, Portugal
| | - Paulo C. Dias
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 4710-302 Braga, Portugal
- Correspondence:
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Hilaire Schneider C, Saint-Cast A, Michelland L, de Stefano C, Radou L, Chouied T, Savary D, Gueye P, Jehel L, Lapostolle F. [Psychological effects of emergency calls management on medical dispatcher assistants in a SAMU-Center 15]. Encephale 2020; 47:388-394. [PMID: 33190817 DOI: 10.1016/j.encep.2020.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 06/08/2020] [Accepted: 06/19/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In France, the emergency call center is called SAMU (service d'aide médicale d'urgence). The Medical Dispatcher Assistant (MDA) is the first responder and is exposed to first calls of distress and has a high risk of stress disorder. AIM Psychological impact of emergency calls on MDA. METHOD National multicenter prospective study from January to August 2018 by electronic surveys, including all MDA of 13 SAMU, subdivided in 5 sections: population characteristics, PCL-5 scale (DSM-5) assessing post-traumatic stress disorder (PTSD), ProQOL assessing professional quality of life, call categories and an MDA's emotional perception, and work impacts on an MDA's quality of life. Univariate descriptive statistical analysis of the group with PCL-5≥34 (=complete PTSD group) and with PCL-5<34 (=group without complete PTSD). RESULTS Of 400 MDA asked to be interviewed, 283 (71 %) replied of whom 72 % (205) were women and 28 % (79) men. Age groups: 9 % (25) for 18-25 yrs, 39 % (110) for 26-35 yrs, 31 % (89) 36-45 yrs, 15 % (43) 46-55 yrs and 6 % (16) for more than 56 yrs. All MDA reported having been exposed to death experience. For 46 % (129) the most recent traumatic event occurred within the last 7 months. 78 % (219) have reported intense fear, feeling helpless, or even sensed horror when answering the calls. 97 % (273) could talk about it with colleagues but only 64 % (180) with family. 72 % (203) felt lack of recognition at work. 78 % (220) had no knowledge about psycho-traumatic disorder. While 11 % (30) suffered symptoms suggestive of a complete PTSD, 15 % (42) an incomplete PTSD, 3 % (8) suffer burnout and 4 % (11) compassion fatigue, none reported secondary traumatic stress. The only significant difference (P<0.05) between the two groups characteristics was on the education level. 74 % (22) of the MDA with a complete PTSD had a High School diploma or less. MDA with symptoms suggestive of complete PTSD developed significantly (P<0.001) more stress reduction strategies (alcohol, drugs, medication) (13 % vs 2 %), had more food disorders (80.5 % vs 38 %), more sleeping problems (75.5 % vs 21 %), more anxiety (67 % vs 17 %), and more sick leaves (13 % vs 4 %) than the group without complete PTSD. CONCLUSION Part of the surveyed MDAs showed symptoms suggestive of PTSD. The study highlights that MDAs is a vulnerable population, and PTSD prevention techniques should be systematically implemented for them. The study also highlights that a higher education level prevents the psycho traumatic process with its accompanying disorders.
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Affiliation(s)
- C Hilaire Schneider
- SAMU 93, UF recherche, enseignement, qualité, université Paris 13, Sorbonne-Paris cité, Inserm U942, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93009 Bobigny, France.
| | - A Saint-Cast
- SAMU 93, UF recherche, enseignement, qualité, université Paris 13, Sorbonne-Paris cité, Inserm U942, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93009 Bobigny, France
| | - L Michelland
- SAMU 93, UF recherche, enseignement, qualité, université Paris 13, Sorbonne-Paris cité, Inserm U942, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93009 Bobigny, France; Hôpital Saint-Louis, Inserm 1153, AP-HP, Paris, France
| | - C de Stefano
- SAMU 93, UF recherche, enseignement, qualité, université Paris 13, Sorbonne-Paris cité, Inserm U942, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93009 Bobigny, France; Service de psychiatrie de l'enfant et de l'adolescent et psychiatrie générale, hôpital Avicenne, université Sorbonne-Paris 13, Paris Cité, laboratoire UTRPP (EA4403), AP-HP, Paris, France
| | - L Radou
- SAMU 72, CH de Le Mans, 194, avenue Rubillard, 72037 Le Mans cedex 9, France
| | - T Chouied
- SAMU 54, Emergency Department, University Hospital of Nancy, Nancy, France; Faculté de médecine, centre d'investigations cliniques plurithématique 1433, institut Lorrain-du cœur et des vaisseaux, France groupe choc, Inserm U1116, Université de Lorraine, 54500 Vandoeuvre-les-Nancy, France
| | - D Savary
- Centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers, France
| | - P Gueye
- SAMU 972, CHU de Martinique, 97200 Fort-de-France, Martinique
| | - L Jehel
- Département de psychiatrie et psychologie médicale, CHU de Martinique, 97200 Fort-de-France, Martinique; Université des Antilles, CESP-Inserm U1178 équipe IPSOM, 97261 Fort-de-France cedex, Martinique
| | - F Lapostolle
- SAMU 93, UF recherche, enseignement, qualité, université Paris 13, Sorbonne-Paris cité, Inserm U942, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93009 Bobigny, France
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Pirard P, Baubet T, Motreff Y, Rabet G, Marillier M, Vandentorren S, Vuillermoz C, Stene LE, Messiah A. Use of mental health supports by civilians exposed to the November 2015 terrorist attacks in Paris. BMC Health Serv Res 2020; 20:959. [PMID: 33076901 PMCID: PMC7574168 DOI: 10.1186/s12913-020-05785-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Background The use of mental health supports by populations exposed to terrorist attacks is rarely studied despite their need for psychotrauma care. This article focuses on civilians exposed to the November 2015 terrorist attacks in Paris and describes the different combinations of mental health supports (MHSu) used in the following year according to type of exposure and type of mental health disorder (MHD). Methods Santé publique France conducted a web-based survey of civilians 8–11 months after their exposure to the November 2015 terrorist attacks in Paris. All 454 respondents met criterion A of the DSM-5 definition of post-traumatic stress disorder (PTSD). MHD (anxiety, depression, PTSD) were assessed using the PCL-5 checklist and the Hospital Anxiety and Depression Scale. MHSu provided were grouped under outreach psychological support, visits for psychological difficulties to a victims’ or victim support association, consultation with a general practitioner (GP), consultation with a psychiatrist or psychologist (specialist), and initiation of regular mental health treatment (RMHT). Chi-squared tests highlighted differences in MHSu use according to type of exposure (directly threatened, witnessed, indirectly exposed) and MHD. Phi coefficients and joint tabulations were employed to analyse combinations of MHSu use. Results Two-thirds of respondents used MHSu in the months following the attacks. Visits to a specialist and RMHT were more frequent than visits to a GP (respectively, 39, 33, 17%). These were the three MHSu most frequently used among people with PTSD (46,46,23%), with depression (52,39,20%), or with both (56,58, 33%). Witnesses with PTSD were more likely not to have RMHT than those directly threatened (respectively, 65,35%). Outreach support (35%) and visiting an association (16%) were both associated with RMHT (Phi = 0.20 and 0.38, respectively). Very few (1%) respondents initiated RMHT directly. Those who indirectly initiated it (32%) had taken one or more intermediate steps. Visiting a specialist, not a GP, was the most frequent of these steps. Conclusion Our results highlight possibilities for greater coordination of mental health care after exposure to terrorist attacks including involving GP for screening and referral, and associations to promote targeted RMHT. They also indicate that greater efforts should be made to follow witnesses.
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Affiliation(s)
- Philippe Pirard
- Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France. .,Team MOODS, CESP, Inserm, Université Paris-Saclay, UVSQ, 94807, Villejuif, France.
| | - Thierry Baubet
- CESP, Inserm, Université Sorbonne Paris Nord, Villetaneuse, France.,APHP, Hôpital Avicenne, Bobigny, France.,Centre National de Ressources et de Résilience (CN2R), Lille/Paris, France
| | - Yvon Motreff
- Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France.,Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| | - Gabrielle Rabet
- Support, Data Treatment and Analysis Division, Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Maude Marillier
- Non Communicable Diseases and Trauma Division, Santé Publique France, French National Public Health Agency, F-94415, Saint-Maurice, France
| | - Stéphanie Vandentorren
- Scientific and International Division, Santé Publique France (The French Public Health Agency), Saint-Maurice, France.,INSERM, Bordeaux Population Health Research Center, UMR 1219, Univ Bordeaux, F-33000, Bordeaux, France
| | - Cécile Vuillermoz
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F75012, Paris, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Antoine Messiah
- Team MOODS, CESP, Inserm, Université Paris-Saclay, UVSQ, 94807, Villejuif, France
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Sahebi A, Yousefi K, Moayedi S, Golitaleb N, Esmaeili Vardanjani A, Golitaleb M. Prevalence of Posttraumatic Stress Disorder among Firefighters in Iran: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PSYCHIATRY 2020; 15:358-365. [PMID: 33240386 PMCID: PMC7610073 DOI: 10.18502/ijps.v15i4.4301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Firefighters are exposed to many different chemicals and physical hazards and experience a significant number of accidents and injuries. They are exposed to high-risk of posttraumatic stress disorder (PTSD). The purpose of this study was to determine the prevalence of PTSD among Iranian firefighters. Method: This was a systematic review and meta-analysis. Valid Persian and English keywords were searched in data resources, including SID, Magiran, Irandoc, Google Scholar, PubMed, Scopus, and Web of Science to retrieve articles on the prevalence of PTSD among Iranian firefighters. The STROBE checklist was used to assess the quality of the articles. Heterogeneity among the studies was assessed by I2 index. The data were analyzed using Stata14 software. Results: Of the 316 articles selected in the initial search, 3 articles the inclusion criteria and were used for the meta-analysis. A total of 274 firefighters were studied. The prevalence of PTSD was 23.17% among Iranian firefighters (I2 = 92.4%, 95% CI = 6.71-39.62, p < 0.001). Conclusion: The prevalence of PTSD is among Iranian firefighters relatively high and has been on the rise over the recent years.
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Affiliation(s)
- Ali Sahebi
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Kosar Yousefi
- Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Siamak Moayedi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, United States
| | - Najaf Golitaleb
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Esmaeili Vardanjani
- Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohamad Golitaleb
- Department of Critical Care Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
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Wesemann U, Mahnke M, Polk S, Willmund G. Long-term effects of the terror attack in Berlin in 2016 on paranoid ideation in female emergency personnel. BJPsych Open 2020; 6:e79. [PMID: 32741399 PMCID: PMC7453799 DOI: 10.1192/bjo.2020.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In a pilot study, female emergency personnel showed increased paranoid ideation following a terror attack. This newly designed confirmatory study aims to replicate these previously found gender-specific results and investigate the progression of effects after 2 years. Participants were exposed and unexposed emergency personnel (n = 120). Exposed female versus exposed male personnel showed higher paranoid ideation at both time points. There was a group × time interaction effect in paranoid ideation: paranoid ideation increased over time in the exposed versus the unexposed female group. The same effect was observed with exposed female emergency personnel showing a significant 2-year post-deployment increase compared with the total group including unexposed female as well as exposed and unexposed male emergency personnel. There is, as yet, no conclusive explanation for this difference. Sexual harassment in a male-dominated profession may be a vulnerability factor. Differentiated preparation and follow-up for emergency responders is recommended moving towards health-related equality.
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Affiliation(s)
- Ulrich Wesemann
- Psychotrauma Center, German Armed Forces Hospital Berlin, Germany
| | - Manuel Mahnke
- Psychotrauma Center, German Armed Forces Hospital Berlin, Germany; and Fire and Rescue Station Wedding, Voluntary Fire Brigade, Germany
| | - Sarah Polk
- Max Planck Institute for Human Development, Germany
| | - Gerd Willmund
- Psychotrauma Center, German Armed Forces Hospital Berlin, Germany
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