Abstract
The study aims to examine the latent structure of secondary traumatic stress (STS), its precursors, and the psychological effects of it on the population of service providers working with refugees passing through the Balkan route. A total of 270 service providers (57% female) of different professional backgrounds working directly with refugees took part in the study. Participants were assessed for STS using the Secondary Traumatic Stress Scale, the extent of secondary exposure to trauma (i.e., clients’ traumatic experiences from the countries of origin and travel that were communicated to them directly), depression, anxiety, and quality of life. Comparisons of several confirmatory factor analyses following prominent PTSD conceptualizations showed that the model with three relatively distinct but highly correlated factors–intrusion, avoidance, and the blend of negative alterations in cognitions, mood, and reactivity (NACMR), had the best fit. STS has been shown to be positively correlated both with the amount of different traumatic experiences that were communicated to them as well as with the specific content of those experiences. Path analysis showed that the amount of secondary exposure to the clients’ traumatic experiences during travel, but not in the country of origin, had exclusive relationships with all three factors of STS. NACMR demonstrated direct effects on anxiety and depression symptoms, while intrusions exhibited a direct effect on anxiety-related symptomatology only. The avoidance factor did not have any independent direct effects on anxiety or depression. Finally, the effects of STS factors on quality of life were fully mediated by an increase of depression-related symptomatology. Results provide evidence on the latent structure of the STS which partially deviates from the prominent models of PTSD thus questioning the isomorphism of two constructs on the empirical level. Additionally, findings provide insights on the cascade of events that make professionals working with traumatized people especially vulnerable to STS and broader psychological distress.
Highlights
Practitioners involved in helping professions are often working with vulnerable populations and are, as such, exposed to secondary traumatic stress (STS) or secondary traumatization; a condition that results from helping or wanting to help traumatized or suffering individuals [1,2,3] and which mimics symptoms of post-traumatic stress disorder (PTSD) [4]
The main aim of this study is to examine the latent factor structure of Secondary Traumatic Stress (STS) using prominent Posttraumatic Stress Disorder (PTSD) nomenclature in the sample of service providers working with refugees during refugee crises
According to Bride’s guidelines [61], 38.1% of professionals in the current sample can be considered slightly affected or completely unaffected by secondary traumatic stress symptomatology; 30.0% are mildly affected by secondary traumatic stress related difficulties; 14.4% can be considered as moderately secondary traumatized; 6.3% are suffering from highly pronounced secondary traumatic stress; and 11.1% exhibit severe secondary traumatic stress related difficulties
Summary
Practitioners involved in helping professions are often working with vulnerable populations and are, as such, exposed to secondary traumatic stress (STS) or secondary traumatization; a condition that results from helping or wanting to help traumatized or suffering individuals [1,2,3] and which mimics symptoms of post-traumatic stress disorder (PTSD) [4]. Changes in Statistical Manual of Mental Disorders–fifth edition (DSM-5) [21] related to Criteria A, eliminated subjective reaction, while exposure was expanded to include the wider scope of events that qualify as traumatic, including “experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains: police officers repeatedly exposed to details of child abuse)”. This change qualified secondary exposure as a traumatic event per se [21] and called into question whether the separation of STS from PTSD was still needed [22]
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