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Mutuyimana C, Maercker A. How meaning in life and vitality are associated with posttrauma outcomes: A systematic review. J Trauma Stress 2024. [PMID: 38580621 DOI: 10.1002/jts.23040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 04/07/2024]
Abstract
When confronted with a traumatic event, people may suffer from adverse posttraumatic outcomes, such as posttraumatic stress disorder (PTSD) or complex PTSD (CPTSD). Positive psychology research has shown that meaning in life and vitality are potentially correlated protective factors against negative developments following trauma exposure that can lead to PTSD or CPTSD. This systematic review aimed to synthesize global empirical research findings, emphasizing the impact of meaning in life and vitality on both PTSD and CPTSD. A search of empirical studies was performed within the Embase, Scopus, and Web of Science core collection databases, as well as PsycInfo, using the PRISMA checklist. A total of 29 studies were included after a systematic exclusion process. The collective findings from 22 studies examining meaning in life and five studies focusing on vitality revealed a consistent negative association with symptoms of PTSD. No study that explored the associations among meaning in life, vitality, and CPTSD was found. In contrast to vitality, meaning in life has been extensively studied in relation to traumatic stress worldwide, and few discrepancies in results were found. This systematic review identified the need to intensify scientific efforts in capitalizing on meaning in life as a possible target for psychological interventions, especially for trauma survivors globally, and to consider vitality as a protective factor that needs more empirical attention in relation to posttraumatic stress. Furthermore, there is a need for studies that encompass diverse target samples and employ longitudinal study design to examine the associations between protective factors and CPTSD.
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Affiliation(s)
- Celestin Mutuyimana
- Division of Psychopathology and Clinical Intervention, Institute of Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Collegium Helveticum, Switzerland
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, Institute of Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
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Sabahi Z, Hasani P, Salehi-Pourmehr H, Beheshti R, Sadeghi-Bazargani H. What Are the Predictors of Post-traumatic Stress Disorder Among Road Traffic Accident Survivors: A Systematic Review. J Nerv Ment Dis 2024; 212:104-116. [PMID: 38290103 DOI: 10.1097/nmd.0000000000001739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
ABSTRACT Traffic accidents put tremendous burdens on the psychosocial aspects of communities. Post-traumatic stress disorder (PTSD), after an accident, is one of the most prevalent and incapacitating psychiatric conditions worldwide. In this systematic review, we aimed to investigate the predictors of PTSD in traffic accident victims. Primary search was conducted in November 2021 and updated in 2023. Studies were excluded if they used any analysis except regression for predictors. Cumulatively, primary and update searches retrieved 10,392 articles from databases, and of these, 87 studies were systematically reviewed. The predictors were categorized into sociodemographics, pretrauma, peritrauma, and post-trauma factors. The PTSD assessment time varied between 2 weeks and 3 years. Being a woman, having depression and having a history of road traffic accidents pretraumatically, peritraumatic dissociative experiences, acute stress disorder diagnosis, rumination, higher injury severity, and involvement in litigation or compensation after the trauma were significant predictors of PTSD.
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Affiliation(s)
- Zahra Sabahi
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parham Hasani
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Rasa Beheshti
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Moritz S, Nguyen C, Jelinek L, Borsutzky S, Scheunemann J, Hegerl U, Püschel K, Gallinat J. Behavioral and location-related antecedents of train suicides. Suicide Life Threat Behav 2023; 53:303-311. [PMID: 36714989 DOI: 10.1111/sltb.12941] [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: 09/12/2022] [Revised: 09/18/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the European Union, over 2000 suicides on railway premises were reported in 2020. Identifying individuals' behavioral and location patterns just before they die or attempt to die by train suicide (ITS) is critical for effective prevention of suicides by train. We conducted a naturalistic study using a newly developed instrument for the assessment of fatalities in rail traffic that used information from on-site video cameras. METHODS A total of 56 case files and surveillance recordings of ITS prior to their suicide or suicide attempt were compared to 46 surveillance recordings of matched regular train passengers (RTP) before they boarded their trains. Groups were compared on individuals' behavior as well as location and contextual parameters. RESULTS ITS performed unusual movement patterns more frequently, carried luggage less often, stayed on the platform longer, and let more trains pass relative to RTP. CONCLUSIONS If this study is replicated with a larger sample, artificial intelligence could be used to detect suspicious/unusual (movement) patterns in order to prevent train suicide. Social awareness campaigns that foster the identification of people in distress at train stations in combination with lower thresholds for the use of emergency devices on platforms may help to detect potential train suicides and reduce their incidence.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Celine Nguyen
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Swantje Borsutzky
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Hegerl
- Johann Christian Senckenberg Distinguished Professorship, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Carnall LA, Mason O, O'Sullivan M, Patton R. Psychosocial hazards, posttraumatic stress disorder, complex posttraumatic stress disorder, depression, and anxiety in the U.K. rail industry: A cross-sectional study. J Trauma Stress 2022; 35:1460-1471. [PMID: 35733296 PMCID: PMC9796412 DOI: 10.1002/jts.22846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 04/01/2022] [Accepted: 04/22/2022] [Indexed: 01/01/2023]
Abstract
This study examined posttraumatic stress disorder (PTSD), complex PTSD, depression, and anxiety among U.K. rail workers. A cross-sectional survey examining exposure to seven psychosocial hazards (bullying/harassment; verbal abuse; physical and sexual assault; and hearing about, seeing the aftermath of, or witnessing a fatality), working conditions, physical health, and the impact of COVID-19 was administered to 3,912 participants. Outcome measures were the ITQ, PHQ-9, and GAD-7. Among trauma-exposed participants, 24.3% met the criteria for PTSD or CPTSD; 38.6% and 29.2% of all participants scored in the moderate-to-severe range on the PHQ-9 and GAD-7, respectively. Data were analyzed using logistic and linear regression. Bullying/harassment was positively associated with GAD-7 scores, f2 = .001, and PTSD and CPTSD, ORs = 1.83-2.02. Hearing about and witnessing a fatality were associated with PTSD and CPTSD, ORs = 1.77-2.10. Poorer ergonomics at work were positively associated with PHQ-9 and GAD-7 scores, f2 = .001. Higher job satisfaction was associated with lower odds of PTSD and CPTSD, ORs = 0.87-0.91, and negatively associated with PHQ-9 and GAD-7 scores, f2 = .008-.01. Work intensity was associated with PTSD and CPTSD, ORs = 1.79-1.83, and positively associated with PHQ-9 and GAD-7 scores, f2 = .02-.03. Reporting more physical health problems was associated with PTSD, OR = 1.07, and positively associated with GAD-7 and PHQ-9 scores, f2 = .008-.01. The results suggest bullying/harassment and work intensity are important variables in employee mental health and could drive future research and industry initiatives.
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Affiliation(s)
| | - Oliver Mason
- School of PsychologyUniversity of SurreyGuildfordUnited Kingdom
| | | | - Robert Patton
- School of PsychologyUniversity of SurreyGuildfordUnited Kingdom
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Bardon C, Dargis L, Mishara BL. Impact of Railway Critical Incidents on Train Drivers and Effectiveness of Critical Incident Management and Support Protocols: A Recovery Trajectory Analysis. J Occup Environ Med 2022; 64:e70-e77. [PMID: 34879030 DOI: 10.1097/jom.0000000000002456] [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: 11/27/2022]
Abstract
OBJECTIVE Train drivers are regularly involved in railway critical incidents (CI) and critical incident management and support protocols (CIMSPs) have been developed to support them. This study describes the impact of CIs and evaluates the effectiveness of CIMSPs. METHODS We interviewed 74 train drivers 1 week, 1, 3, and 6 months after a CI. We performed Linear growth model analyses to describe recovery paths and the effect of CIMSPs, considering the effect of CI complexity, proximity to victims, social support, self-assessment of health, use of resources, and attribution of responsibility. RESULTS CIs have a significant negative impact on train drivers. Recovery paths can be explained by the level of implementation of CIMSPs, and other contributing factors. CONCLUSIONS CIMSPs are effective in reducing the negative impact of CIs and should be implemented rigorously by employers.
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Affiliation(s)
- Cécile Bardon
- Psychology Department (Dr Bardon, Mr Dargis, Dr Mishara); Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices (CRISE) (Dr Bardon, Mr Dargis, Dr Mishara), Université du Québec à Montréal, Montreal, Quebec, Canada
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Preventing railway suicides through level crossing removal: a multiple-arm pre-post study design in Victoria, Australia. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2261-2266. [PMID: 35864271 PMCID: PMC9636092 DOI: 10.1007/s00127-022-02340-9] [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: 03/17/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Rail level crossing removals to improve transport performance across metropolitan Melbourne (state of Victoria) resulted in new rail fencing and grade-separation of tracks from the surrounding environment at several sites. These design changes restricted pedestrian access to the rail tracks, which is a countermeasure known to prevent railway suicide in other settings. We examined whether any such suicide prevention effect followed the removals. METHODS We used a multiple-arm pre-post design to test whether a decrease in monthly frequency of railway suicides occurred at level crossing removal sites (intervention sites), compared to randomly matched sites where level crossings had not yet been removed (control sites). We used data available in the Victorian Suicide Register covering the period 1st January 2008 to 30th June 2021. RESULTS The mean monthly number of railway suicides decreased by 68% within a 500 m radius of intervention sites (RR: 0.32; CI 95% 0.11-0.74) and by 61% within a 1000 m radius of intervention sites (RR: 0.39; CI 95% 0.21-0.68). There was no evidence that the mean monthly number of railway suicides changed at the control sites, either within a 500 m radius (RR: 0.88; CI 95% 0.47-1.56) or a 1000 m radius (RR: 0.82; CI 95% 0.52-1.26). CONCLUSION The reduction in railway suicides at locations where level crossings were removed, demonstrates the suicide prevention benefits that can be derived from a major infrastructure project even if not initially intended. Planning for major infrastructure projects should include consideration of these benefits, with designs incorporating features to maximise suicide prevention impact.
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Irizar P, Puddephatt JA, Gage SH, Fallon V, Goodwin L. The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations: A meta-analysis and meta-regression. Drug Alcohol Depend 2021; 226:108858. [PMID: 34214883 DOI: 10.1016/j.drugalcdep.2021.108858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Trauma exposure is associated with hazardous and/or harmful alcohol use. Occupational groups frequently exposed to trauma may be at risk of alcohol harm. This meta-analysis determined the prevalence of hazardous and harmful alcohol use across trauma-exposed occupations and meta-regressions explored the impact of pre-defined covariates on the variance in prevalence estimates. METHOD Literature was searched from 2000 to March 2020, using Scopus, Web of Science and PsycINFO. Studies were included in the meta-analysis if they used a standardized measure of alcohol use (e.g., Alcohol Use Disorder Identification Test (AUDIT)). Studies were excluded if they measured alcohol use following an isolated sentinel event (e.g., 9/11). The following occupations were included: first responders, health care workers, Armed Forces, war journalists and train drivers. RESULTS 1882 studies were identified; 55 studies were eligible. The pooled prevalence of hazardous use was 22% (95% Confidence Intervals [CI]: 17%-27%) and 11% (95% CI: 8%-14%) for harmful use. Hazardous alcohol use was significantly lower in health care workers (13%; 95% CI: 10%-16%) than first responders (26%; 95% CI: 20%-32%) and Armed Forces (34%; 95% CI: 18%-52%). There was marked heterogeneity across studies and higher prevalence rates in low-quality studies. The meta-regression identified higher proportion of males and younger mean age as predictors of variance. CONCLUSIONS Male-dominated occupations, such as police officers and military personnel, showed higher levels of hazardous and harmful alcohol use, indicating that interventions tailored specifically for these occupational groups may be needed.
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Affiliation(s)
- Patricia Irizar
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom.
| | - Jo-Anne Puddephatt
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Suzanne H Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Laura Goodwin
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
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8
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Bardon C, Dargis L, Mishara B. Evaluation of the Implementation of a Railway Critical Incident Management and Support Protocol to Help Train Drivers Cope With Accidents and Suicides. J Occup Environ Med 2021; 63:e495-e504. [PMID: 33990527 DOI: 10.1097/jom.0000000000002262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Railway accidents and suicides can have severe psychological consequences for train drivers. This study evaluates the implementation of railway critical incident management and support protocols (CIMSP) by employers. It also identifies environmental factors, characteristics of critical incidents, and types of work relations affecting implementation. METHODS A longitudinal study was conducted with 74 train drivers. Participants were interviewed 1 week, 1, 3, and 6 months after a critical incident. Correlational analyses were performed to identify factors associated with implementation and satisfaction. RESULTS CIMSP are generally partially applied by employers when a railway incident occurs. Workers' satisfaction toward implementation of the protocol is moderate. Obstacles to implementation are: geographic isolation, severity of the incident, and poor quality of work relations. CONCLUSIONS These obstacles should be addressed in CIMSP design and implementation strategies.
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Affiliation(s)
- Cécile Bardon
- Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices (CRISE) (Dr Bardon, Ms Dargis, Dr Mishara); Département de Psychologie, Université du Québec à Montréal (UQAM) (Dr Bardon, Ms Dargis, Dr Mishara), Montréal, Québec, Canada
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van Houwelingen CAJ, Di Bucchianico A, Beersma DGM, Kerkhof AJFM. Railway Suicide in The Netherlands Lower Than Expected. CRISIS 2021; 43:368-374. [PMID: 34003022 PMCID: PMC9578363 DOI: 10.1027/0227-5910/a000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract.Background: Increasing rail transportation requires appropriate railway suicide preventive measures. Aims: The investigation of trends in railway suicide during 2008–2018, a period in which preventive measures were taken by Dutch railway infrastructure manager ProRail. Methods: Generalized linear regression models for railway suicide were developed for the period 1970–2007 with general suicide rate, railway traffic intensity, and a combination of these variables as regressors. Subsequently, the best-fitting model was used to investigate trends in railway suicide after 2007 by comparing in retrospect observed values with the expected outcomes of the regression model. Results: An adequate regression model for railway suicide was obtained using both general suicide rate and railway traffic intensity as regressors. Based on this model, while national suicide mortality and railway traffic increased, a distinct relative decline in railway suicides was found from 2012 onward. Conclusions: This decline of railway suicides in the Netherlands may indicate that preventive measures taken by ProRail were effective and prevented around 85 railway suicides annually, a reduction of 30%.
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Affiliation(s)
| | | | - Domien G M Beersma
- Research Unit of Chronobiology, Rijksuniversiteit Groningen, The Netherlands
| | - Ad J F M Kerkhof
- Department of Clinical Psychology, Amsterdam Public Health Research Institute (APH), Vrije Universiteit Amsterdam, The Netherlands
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Sousa H, Oliveira J, Figueiredo D, Ribeiro O. The clinical utility of the Distress Thermometer in non-oncological contexts: A scoping review. J Clin Nurs 2021; 30:2131-2150. [PMID: 33555631 DOI: 10.1111/jocn.15698] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/18/2021] [Accepted: 01/29/2021] [Indexed: 12/22/2022]
Abstract
AIMS To assess the clinical utility of the Distress Thermometer (DT) in non-cancer populations. METHODS The search was performed between the 6th and the 18th of April 2020, on the following databases: Web of Science (all databases included), Scopus and Science Direct. One last update was performed on 5 June 2020. The findings were reported using the PRISMA-ScR. RESULTS Fifty-three studies were included. Overall results indicated that this tool has been used in several contexts and populations (clinical and non-clinical). The DT is highly accessible, suitable and relevant for health professionals and/or researchers who aim to use it as a distress screening tool, particularly in patients with chronic physical conditions. Assumptions about its practicality and acceptability in non-oncology care should be made with caution since few studies have explored the psychometric qualities of this instrument, the completers' perceptions about completing the DT and the perceptions of health professionals who administer the tool. CONCLUSIONS This lack of information undermines conclusions about the overall clinical utility of the DT as a screening tool for distress in individuals who do not have cancer. IMPLICATIONS FOR PRACTICE Future research should aim to fill this gap and investigate the psychometric qualities of the DT through validation studies and, thus, increase the rigour of its application and clinical utility in non-oncological contexts.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Jaime Oliveira
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Oscar Ribeiro
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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McIlveen R, Curran D, Mitchell R, DePrince A, O'Donnell K, Hanna D. A Meta-Analytic Review of the Association Between Alienation Appraisals and Posttraumatic Stress Disorder Symptoms in Trauma-Exposed Adults. J Trauma Stress 2020; 33:720-730. [PMID: 32384587 DOI: 10.1002/jts.22530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/30/2019] [Accepted: 12/10/2019] [Indexed: 11/06/2022]
Abstract
Ehlers and Clark's (2000) cognitive model of posttraumatic stress disorder (PTSD) highlights the importance of negative appraisals in maintaining posttraumatic stress. Recent research suggests that alienation appraisals, defined as feeling disconnected from the self and others, mediate the association between traumatic experiences and subsequent PTSD symptoms. To our knowledge, no systematic review has yet explored the relation between alienation appraisals and PTSD symptoms in trauma-exposed adults, despite the important clinical implications posed by this association. A systematic search of the SCOPUS, Web of Science, PsycInfo, MEDLINE, CINAHL Plus, and PILOTS databases resulted in 470 studies, nine of which met full inclusion criteria. Studies were quality-assessed for risk of bias using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) quality assessment tool. A random-effects meta-analysis for the association between alienation appraisals and PTSD symptoms showed a large total effect size, r = .57, 95% CI [.46, .66], z = 8.41, p < .001. This large effect suggests that as alienation appraisals increase, PTSD symptoms increase. Although a strong positive association was found between alienation and PTSD symptoms, the mechanism of this association remains unclear. Limitations of the research included significant heterogeneity across studies and the fact that data were correlational. Future research to explore why alienation appraisals are significant in posttraumatic stress may further help to inform therapeutic approaches to targeting alienation appraisals in trauma survivors. Recommendations are made for the clinical assessment of alienation appraisals when exploring the impact of the traumatic experience on the survivor.
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Affiliation(s)
- Rachel McIlveen
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - David Curran
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Ryan Mitchell
- Southern Health & Social Care Trust, Support & Recovery Psychology, Bluestone Unit, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Anne DePrince
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Katie O'Donnell
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Donncha Hanna
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland.,Centre for Evidence and Social Innovation (CESI), Queen's University Belfast, Belfast, Northern Ireland
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12
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Radun I, Parkkari I, Radun J, Kaistinen J, Kecklund G, Olivier J, Tervo T, Theorell T. Suicide by crashing into a heavy vehicle: Focus on professional drivers using in-depth crash data. TRAFFIC INJURY PREVENTION 2019; 20:575-580. [PMID: 31329464 DOI: 10.1080/15389588.2019.1633466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
Objective: Road traffic suicides typically involve a passenger car driver crashing his or her vehicle into a heavy vehicle, because death is almost certain due to the large mass difference between these vehicles. For the same reason, heavy-vehicle drivers typically suffer minor injuries, if any, and have thus received little attention in the research literature. In this study, we focused on heavy-vehicle drivers who were involved as the second party in road suicides in Finland. Methods: We analyzed 138 road suicides (2011-2016) involving a passenger car crashing into a heavy vehicle. We used in-depth road crash investigation data from the Finnish Crash Data Institute. Results: The results showed that all but 2 crashes were head-on collisions. Almost 30% of truck drivers were injured, but only a few suffered serious injuries. More than a quarter reported sick leave following their crash. Injury insurance compensation to heavy-vehicle drivers was just above €9,000 on average. Material damage to heavy vehicles was significant, with average insurance compensation paid being €70,500. Three out of 4 truck drivers reported that drivers committing suicide acted abruptly and left them little opportunity for preventive action. Conclusions: Suicides by crashing into heavy vehicles can have an impact on drivers' well-being; however, it is difficult to see how heavy-vehicle drivers could avoid a suicide attempt involving their vehicle.
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Affiliation(s)
- Igor Radun
- a Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki , Helsinki , Finland
- b Stress Research Institute, Stockholm University , Stockholm , Sweden
| | - Inkeri Parkkari
- c The Finnish Transport and Communications Agency Traficom , Helsinki , Finland
| | - Jenni Radun
- d Turku University of Applied Sciences , Turku , Finland
| | - Jyrki Kaistinen
- e Liikenneturva-Finnish Road Safety Council , Helsinki , Finland
| | - Göran Kecklund
- b Stress Research Institute, Stockholm University , Stockholm , Sweden
| | - Jake Olivier
- f School of Mathematics and Statistics, University of New South Wales, Sydney , Australia
- g Transport and Road Safety Research Centre, UNSW Sydney , Australia
| | - Timo Tervo
- h Department of Ophthalmology and Otorhinolaryngology, Institute of Clinical Medicine , Helsinki , Finland
| | - Töres Theorell
- b Stress Research Institute, Stockholm University , Stockholm , Sweden
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Schäfer SK, Becker N, King L, Horsch A, Michael T. The relationship between sense of coherence and post-traumatic stress: a meta-analysis. Eur J Psychotraumatol 2019; 10:1562839. [PMID: 30693079 PMCID: PMC6338278 DOI: 10.1080/20008198.2018.1562839] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 01/23/2023] Open
Abstract
Background: Antonovsky's concept of sense of coherence (SOC) - as a global orientation reflecting an individual's feeling of confidence in both the predictability of their internal and external environment and their ability to cope with stressful and challenging situations in life - shows a negative association with symptoms of post-traumatic stress. However, single studies varying in study characteristics provide heterogeneous effect size estimations. Objective: The purpose of the current study is to investigate the relationship between SOC and post-traumatic stress disorder (PTSD) symptom severity for the first time on a meta-analytical level. Method: The random-effects meta-analysis is based on zero-order correlations (r) and consists of 47 independent samples out of 45 studies (N = 10,883). Results: After correcting for sampling error, the mean correlation between SOC and PTSD symptoms was M(r) = -.41 (excluding four outliers: -.39). However, this effect could not be generalized to all types of PTSD samples owing to substantial remaining heterogeneity. Subsequent moderator analyses investigating the influence of different SOC and PTSD measures, trauma type and duration, mean age and gender imbalances per sample did not reveal significant moderating effects. Conclusions: The meta-analysis reveals a substantial correlation between SOC and PTSD symptom severity: higher SOC levels are associated with lower symptom severity. Thus, future research should progress to the question of whether the relationship between SOC and post-traumatic stress is causal, and by which factors it is moderated. Abbreviations: CD, Cook's distance; DSM, Diagnostic and Statistical Manual of Mental Disorders; (G)RR, general (and specific) resistance resources; IES(-R), Impact of Event Scale (Revised); PDS, Posttraumatic Stress Diagnostic Scale; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PTSD, post-traumatic stress disorder; SDR, standard deleted residual; SOC, sense of coherence; SOC-R, Sense of Coherence Scale - Revised.
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Affiliation(s)
- S K Schäfer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - N Becker
- Individual Differences & Psychodiagnostics, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - L King
- The Oxford Institute of Clinical Psychology Training, Isis Education Centre, Warneford Hospital, Oxford, UK
| | - A Horsch
- Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.,Institute of Higher Education in Healthcare Research, University of Lausanne, Lausanne, Switzerland
| | - T Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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Ross A, Reavley N, Too LS, Pirkis J. Evaluation of a novel approach to preventing railway suicides: the community stations project. JOURNAL OF PUBLIC MENTAL HEALTH 2018. [DOI: 10.1108/jpmh-06-2017-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to describe an evaluation of the Community Stations Project. The Community Stations Project was designed to address railway suicides in two ways: by improving the station environment in a manner that might improve community members’ feelings of wellbeing; and raising community members’ awareness of poor mental health and likelihood of reaching out to at-risk individuals. It involved four types of interventions (arts and culture, music, food and coffee, and “special events”) delivered at four stations in Victoria.
Design/methodology/approach
A short anonymous survey was administered to community members on iPads at the four participating railway stations during the implementation of the interventions (between October and December 2016). The survey included questions about respondents’ demographics, their awareness of the intervention(s), their views of the station, their attitudes towards people with poor mental health and their emotional wellbeing.
Findings
A total of 1,309 people took part in the survey. Of these, 48 per cent of community members surveyed reporting noticing an intervention at their station. Noticing the events was associated with positive views of the station, improved understanding of poor mental health, and a greater likelihood of reaching out to someone who might be at risk of poor mental health. Awareness of intervention events was not associated with respondents’ own emotional wellbeing.
Practical implications
Continuing to focus efforts on mental health awareness activities may further strengthen the impact of the Community Stations Project interventions and ultimately prevent suicides at railway stations.
Originality/value
This paper evaluates a novel approach to improving wellbeing and understanding of poor mental health in the train station environment.
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Acquadro Maran D, Zedda M, Varetto A. Organizational and Occupational Stressors, Their Consequences and Coping Strategies: A Questionnaire Survey among Italian Patrol Police Officers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E166. [PMID: 29361728 PMCID: PMC5800265 DOI: 10.3390/ijerph15010166] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/10/2018] [Accepted: 01/18/2018] [Indexed: 12/01/2022]
Abstract
Background: Traditionally, workers employed in police forces have been found to be exposed to a high risk of distress. Several studies reported that the main stressors were associated more with organizational aspects, whilst other researchers underlined that the main stressor were associated more with operational issues. The aim of this research was to investigate operational and organizational stressors, their consequences also in terms of anxiety and the coping strategies adopted. Methods: We compared Patrol Police Officers working in the Operational Service (Outdoor Patrol Officers) and those in the Interior Department (Indoor Patrol Officers) in the same Municipal Police force. Results: The results revealed that both Outdoor Patrol Officers and Interior Patrol Officers suffered from organizational and occupational stressor. Outdoor Patrol Officers appeared more willing to use different coping strategies, whereas Indoor Patrol Officers used avoidance strategies. This allows Outdoor Patrol Officers to explore new responses and approaches to deal with situations which-owing to the type of work-it is impossible to change. Outdoor Patrol Officers appeared better equipped to change their attitude to work than Indoor Patrol Officers. Conclusion: Interventions on both organizational and operational stressors would improve the quality of Patrol Police Officers' working life and have positive repercussions on the service offered to the general public.
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Affiliation(s)
| | - Massimo Zedda
- Department of Psychology, Università di Torino, Via Verdi, 10, 10124 Torino, Italy.
| | - Antonella Varetto
- Città della Salute e della Scienza, Corso Bramante, 88, 10126 Torino, Italy.
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Abstract
Aims and Method Suicidal acts on underground railway networks are an area of public health concern. Our aim was to review recent epidemiological patterns of suicidal acts on the London Underground to inform future preventive interventions. Data from 2000 to 2010 were obtained from the British Transport Police via a Freedom of Information request. Results The mean annual rate of suicidal acts from 2000 to 2010 was 5.8 per 100 million passenger journey stages. Of those who died by suicide, 77.3% were of White Northern European ethnicity. A fifth had a history of mental illness. Clinical implications The widening gap between the number of recorded suicide attempts and completed suicides is encouraging. Further research is required regarding the role of drug and alcohol use, psychiatric history and area of residence. Installation of platform screen doors should be considered in future railway network expansion.
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Affiliation(s)
| | - Muffazal Rawala
- Luton Mental Health and Wellbeing Service, East London NHS Foundation Trust
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Too LS, Bugeja L, Milner A, McClure R, Spittal MJ. Predictors of using trains as a suicide method: Findings from Victoria, Australia. Psychiatry Res 2017; 253:233-239. [PMID: 28395228 DOI: 10.1016/j.psychres.2017.03.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 02/08/2017] [Accepted: 03/31/2017] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the factors associated with the choice of trains over other means of suicide. We performed a case-control study using data on all suicides in Victoria, Australia between 2009 and 2012. Cases were those who died by rail suicide and controls were those who died by suicide by any other means. A logistic regression model was used to estimate the association between the choice of trains and a range of individual-level and neighbourhood-level factors. Individuals who were never married had double odds of using trains compared to individuals who were married. Those from areas with a higher proportion of people who travel to work by train also had greater odds of dying by railway suicide compared to those from areas with a relatively lower proportion of people who travel to work by train. Prevention efforts should consider limiting access to the railways and other evidence-based suicide prevention activities.
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Affiliation(s)
- Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Lyndal Bugeja
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Allison Milner
- Deakin Population Health SRC, School of Health and Social Development, Deakin University, Victoria, Australia; Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Roderick McClure
- Harvard Injury Control Research Center, Harvard School of Public Health, Massachusetts, United States
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
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18
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Chang JC, Yen AMF, Chen HH, Chen SLS, Chiu SYH, Fann JCY, Lee CS. Comorbid diseases as risk factors for incident posttraumatic stress disorder (PTSD) in a large community cohort (KCIS no.PSY4). Sci Rep 2017; 7:41276. [PMID: 28128220 PMCID: PMC5269576 DOI: 10.1038/srep41276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/16/2016] [Indexed: 11/19/2022] Open
Abstract
Nature disasters and terrorist attacks have occurred globally in recent years. Posttraumatic stress disorder (PTSD) has gained increasing attention, but its incidence and comorbidities in the general population are different from those inside the disaster areas. The present study estimated incident PTSD and comorbid diseases for over a decade in a cohort from a community-based integrated screening program. Factors associated with the incidence of PTSD were analyzed using Cox regression models. PTSD incidence was estimated as 81 per 105 person-years. Incidence was higher in females than in males and one-year increments in age lowered the risk for PTSD by 3%. Adjusting for other factors, cardiovascular heart disease (adjusted hazard ratio (aHR) = 1.45, 95% confidence interval (CI): 1.03–2.04), bipolar disorder (aHR = 1.86, 95% CI: 1.07–3.24) and major depressive disorder (aHR = 7.03, 95% CI: 5.02–9.85) all significantly increased 45%, 86% and 603%, respectively, the risk of developing PTSD. The low rate of people with incident PTSD receiving treatment in this community health screening population implies there is room for improvement in terms of early detection and intervention. Clinical preventive efforts may be made for patients seeking general medical help, especially those with cardiovascular disorders or mood disorders.
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Affiliation(s)
- Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University Hospital, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Hsi Chen
- Division of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan
| | - Jean Ching-Yuan Fann
- Department of Health Industry Management, College of Healthcare Management, Kainan University, Taoyuan County, Taiwan
| | - Chau-Shoun Lee
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
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19
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Chavda S. Sickness absence of LU train drivers after track incidents. Occup Med (Lond) 2016; 66:571-5. [DOI: 10.1093/occmed/kqw088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Koburger N, Mergl R, Rummel-Kluge C, Ibelshäuser A, Meise U, Postuvan V, Roskar S, Székely A, Ditta Tóth M, van der Feltz-Cornelis C, Hegerl U. Celebrity suicide on the railway network: Can one case trigger international effects? J Affect Disord 2015; 185:38-46. [PMID: 26143403 DOI: 10.1016/j.jad.2015.06.037] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/20/2015] [Accepted: 06/20/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND After the railway suicide of the German national goalkeeper Robert Enke in 2009, a significant increase of railway suicides was observed nationally. This study analyses whether this incident also triggered copycat effects in other European countries. Additionally, media coverage proxied by Google Trends and long-term changes taking into account general changes in suicide rates and kilometres driven by trains were examined. METHODS The numbers of railway suicides before and after Enke´s suicide were analysed for short and long-term periods (2 weeks and 2 years post-event) across five European countries. Incidence ratios and resulting percentage changes were computed. RESULTS Similar to Germany, there were significant short and long-term effects for the combined data of the four other countries (increase of 93.9%; p=0.004 and 16.7%; p=0.003). There was no indication that long-term effects are a mere reflection of an overall increase in suicide frequencies or due to increased numbers of kilometres driven by trains. Analyses on country level revealed heterogeneous results. LIMITATIONS Due to incomplete data, analyses regarding age and gender were not performed. Media coverage was only proxied by a Google Trends analysis. The study includes a small sample of European countries. CONCLUSIONS Enke's suicide in 2009 was followed by increasing train suicide numbers in Europe. Although this incident may have reinforced an existing European trend of growing railway suicides, an international copycat effect and/or an increased overall awareness about this particular suicide method appears to be one likely explanation for the changes.
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Affiliation(s)
- Nicole Koburger
- Depression Research Centre, German Depression Foundation, Leipzig, Germany.
| | - Roland Mergl
- Depression Research Centre, German Depression Foundation, Leipzig, Germany; Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Depression Research Centre, German Depression Foundation, Leipzig, Germany; Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | | | - Ullrich Meise
- Society for Mental Health - pro mente tirol, Innsbruck, Austria
| | - Vita Postuvan
- Slovene Centre for Suicide Research, Institute Andrej Marusic, University of Primorska, Koper, Slovenia
| | - Saska Roskar
- National Institute for Public Health, Ljubljana, Slovenia
| | - András Székely
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Mónika Ditta Tóth
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Christina van der Feltz-Cornelis
- Faculty of Social Sciences, Department Tranzo, University of Tilburg, Tilburg, Netherlands; Topclinical Center for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands
| | - Ulrich Hegerl
- Depression Research Centre, German Depression Foundation, Leipzig, Germany; Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
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Jeon HJ, Kim JH, Kim BN, Park SJ, Fava M, Mischoulon D, Kang EH, Roh S, Lee D. Sleep quality, posttraumatic stress, depression, and human errors in train drivers: a population-based nationwide study in South Korea. Sleep 2014; 37:1969-75. [PMID: 25325495 DOI: 10.5665/sleep.4252] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 06/16/2014] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Human error is defined as an unintended error that is attributable to humans rather than machines, and that is important to avoid to prevent accidents. We aimed to investigate the association between sleep quality and human errors among train drivers. DESIGN Cross-sectional. SETTING Population-based. PARTICIPANTS A sample of 5,480 subjects who were actively working as train drivers were recruited in South Korea. The participants were 4,634 drivers who completed all questionnaires (response rate 84.6%). INTERVENTIONS None. MEASUREMENTS The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Impact of Event Scale-Revised (IES-R), the State-Trait Anxiety Inventory (STAI), and the Korean Occupational Stress Scale (KOSS). RESULTS Of 4,634 train drivers, 349 (7.5%) showed more than one human error per 5 y. Human errors were associated with poor sleep quality, higher PSQI total scores, short sleep duration at night, and longer sleep latency. Among train drivers with poor sleep quality, those who experienced severe posttraumatic stress showed a significantly higher number of human errors than those without. Multiple logistic regression analysis showed that human errors were significantly associated with poor sleep quality and posttraumatic stress, whereas there were no significant associations with depression, trait and state anxiety, and work stress after adjusting for age, sex, education years, marital status, and career duration. CONCLUSIONS Poor sleep quality was found to be associated with more human errors in train drivers, especially in those who experienced severe posttraumatic stress.
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Affiliation(s)
- Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ji-Hae Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Eun-Ho Kang
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sungwon Roh
- Department of Mental Health Research, Seoul National Hospital, Seoul, Korea
| | - Dongsoo Lee
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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22
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Clarner A, Graessel E, Scholz J, Niedermeier A, Uter W, Drexler H. Work-related posttraumatic stress disorder (PTSD) and other emotional diseases as consequence of traumatic events in public transportation: a systematic review. Int Arch Occup Environ Health 2014; 88:549-64. [PMID: 25267495 DOI: 10.1007/s00420-014-0980-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Drivers in public transportation are at risk of experiencing potential traumatic events such as accidents involving persons, collisions, or suicides. In this context, the question arises to what extent psychological traumatization and posttraumatic diseases occur. PURPOSE The aim of this systematic review was to describe the frequency and nature of work-related posttraumatic disorders, to analyze risk and prognostic factors after potentially traumatic events (accidents resulting in damage to property and/or in injury or death), and address sick leave after such events in the realm of public transportation, based on the available literature. METHODS Systematic review based on four databases (PubMed, PSYNDEX/MEDLINE, ScienceDirect, PILOTS) between 1980 and June 2013. RESULTS We identified seven studies (four longitudinal, three cross-sectional) that examine employees after person under train (PUT) events. PTSD prevalences varied broadly between 0.7 and 17 %. The same applies to dysthymia/neurotic depression (1-26 %). However, similarly low prevalences of major depression (1.3-2.8 %) and panic disorder (0.5-1.3 %) have been observed. Risk factors of PTSD comprised individual, work-related, event-related, and prognostic aspects. Following the traumatic event, a total of 69-81 % of the drivers were absent, and if sick leave occurs, this was on average 3-19 days. CONCLUSIONS It became evident that drivers in public transportation run a high risk of sick leave. It was also striking that despite the immense impact of PUT and high number of suicides, only an infinitesimal number of studies exists. Due to various differences (period of follow-up, instrument of measurement and study period), it turned out that the comparability of the results of the studies is limited. For various reasons, further research is urgently needed, as from an occupational health point of view the issue of posttraumatic diseases and implications for fitness for service should be addressed.
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Affiliation(s)
- Annika Clarner
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany,
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