Secondary Posttraumatic Stress Research Articles

Review of Protective and Predisposing Factors in the Vicarious Traumatization of Psychotherapists

The impact on psychotherapists' mental health when addressing traumas is an area of research that has scarcely been investigated. This review focuses on the protective and predisposing factors of vicarious trauma in psychotherapists. Out of 202 indexed articles in Proquest, Web of Science, Scopus, and Pubmed databases, 22 met the inclusion criteria. Predisposing factors were identified such as limited experience, treating a high number of trauma cases, psychotherapists' prior traumas, young age, female gender, limited sense of self and meaning of life, having religious beliefs, and professional practice in the private sector. Protective factors that emerged were perceived social support, coping strategies, having clinical supervision, and some personality-linked factors. Additionally, the potential interrelation between vicarious trauma and secondary post-traumatic stress is demonstrated and discussed. The findings underscore the impact of indirect trauma exposure on psychotherapists' mental health, emphasizing the need to implement prevention and intervention programs for those professionally dedicated to healing the traumatic wounds of others.

Predicting secondary posttraumatic stress symptoms among spouses of veterans: Veteran's distress or spouse's perception of that distress?

There is a relatively wide consensus that veterans' posttraumatic stress symptoms (PTSS) may lead to the development of secondary traumatization (ST) among their spouses. However, there is limited knowledge about the way the ST develops over time, as well as its predictors. The current longitudinal study examined ST trajectories among spouses of Israeli war veterans with PTSS, as well as the contribution of veterans' PTSS and wives' assessment of veterans' PTSS to these trajectories. Data were collected from both spouses at 3 time points, 30, 35-37, and 42 years after the 1973 Yom Kippur War (2003, 2008-2010, and 2015, respectively). Using multiple-group Latent Class Growth Analysis (LCGA), we identified 4 distinct ST trajectories. The majority of wives (68%) were in the resilient group, 12% were in the recovery group, approximately 10% were in the chronic PTSS group and another 10% were in the delayed-onset group. Multinomial regressions revealed that veterans' PTSS predicted the 4 different trajectories among their wives. In addition, wives in the recovery and chronic groups who perceived their veteran husbands' PTSS to be higher also reported higher ST. This study highlights the complexity of the development of ST trajectories over time. Findings supports the idea of PTSS contagion, and reveals the contributing role of both objective and perceived levels of veterans' PTSS in ST. Therefore, implementing interventions aimed at alleviating both individual and couple-level distress may be warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Risk of the Development of Secondary Post-Traumatic Stress Disorder among Pediatric Health Care Providers: A Systematic Review

Background: Secondary PTSD is defined as the natural, consequential behaviors and emotions that result from knowledge about a traumatic event experienced by a significant other deriving from working with suffering individuals. Pediatric health providers with symptoms of PTSD report problems with relationships and general life dissatisfaction as well as and anxiety, depression and burnout syndrome. Aim: The aim of this systematic review was to estimate the risk of developing secondary PTSD among pediatric health care providers as well as all additional contributing factors. In more detail, we investigated the PTSD symptomatology between pediatric health care providers and the extent to which parameters such as the job, gender, department and other factors had an impact on the mental health status of pediatric health care providers. Methodology: We searched all published English papers in PubMed, Google Scholar and the Cochrane Library from September to November 2022. We excluded reviews, systematic reviews and meta-analyses as well as letters to editors. From a total of 748 papers, we included only 12 research articles that met the admission criteria. Results: According to our results, the prevalence of secondary PTSD ranges from 13% to 94%. Burnout, nurses, the female gender, intensive care units, past traumatic life events and a psychiatric history identified as factors contributing to the development of secondary PTSD. Conclusions: Health policy-makers should take the specificity in the working environment of the pediatric sector seriously into consideration, especially emergency departments.

A Comparative Study of the Work of Professional Caregivers of Battered Women

The care service for women victims of violence constitutes a risk space for the manifestation of burnout syndrome and secondary post-traumatic stress disorder caused by listening to traumatic experiences. Therefore, this article aims to present a comparative picture of cross-cultural research carried out in Brazil and Spain with 32 subjects. The objectives are: to describe the work conditions, investigate the experience of attending to female victims of violence, and observe the self-care practices the professional group carried out at the personal, professional, collective, and institutional levels. The analysis of data from the Brazilian context was performed with Iramuteq through the descending hierarchical classification, which resulted in five classes, namely: assistance to women victims of violence; conflicts, violence, and professional activity; authors of harassment practices and working conditions; self-care personnel; managing obstacles in the work environment. The results collected from the Spanish professionals were also subjected to the same data analysis, resulting in five classes: trajectory, professional performance and working conditions; assistance to women victims of violence and forms of self-care; complaints about conflict and violence; personal self-care; forms of harassment and conflict. The elaboration that confronted the categories of the two surveys identified similarities regarding the subjective experience and distancing in the self-care characteristics undertaken by Brazilian and Spanish professionals. This study proposes to reflect on the institutional dynamics of these environments.

Professional Quality of Life and Occupational Stress in Healthcare Professionals During the COVID-19 Pandemic in Greece.

Background:Health professionals (HPs) coping with the coronavirus pandemic are at risk of working under stressful conditions impacting their professional well-being. The aim of this paper was to explore HP’s professional quality of life and occupational stress during the COVID-19 pandemic in Greece.Method:A cross-sectional study was conducted (from October to December 2020) in a COVID-19 reference hospital, one of the biggest in Attica. The method of convenience sampling has been used. Data collection was carried out through an anonymous, self-administered questionnaire including, apart from HPs’ demographic and occupational characteristics, Professional Quality of Life Scale (ProQoL) and Job Stress Measure. A total of 250 questionnaires were distributed to physicians and nurses. One hundred eighty-six questionnaires were fully completed (response rate = 78.8%). The analysis was based on descriptive and inductive statistics, using SPSS v25.Results:Participants’ mean age was 41.5 ± 10.4 years; 75.3% were women and 62.4% was nursing staff. ProQoL analysis showed that the majority had moderate compassion satisfaction (74.2%) and burnout (78.5%), while 48.8% had moderate level of secondary post-traumatic stress. The mean value of occupational stress was estimated at 2.76, showing a moderate level of stress. HPs’ demographic and occupational characteristics seemed to affect both work stress and ProQoL (P ⩽ .05). Occupational stress was positively correlated with both burnout (r = 0.461, P = .001) and secondary post-traumatic stress (r = 0.596, P = .001), indicating that an increase in health professionals’ stress at work corresponds to a simultaneous increase in ProQoL.Conclusions:HPs’ professional quality of life and occupational stress seemed to be moderate during the COVID-19 pandemic in Greece. In order to achieve an improvement in HPs’ overall professional well-being, priority should be given to the strengthening of the capacity of the healthcare system as well as to supporting HPs in both stress management and psychological resilience.

The interpersonal implications of PTSD and complex PTSD: The role of disturbances in self-organization

BackgroundIn the aftermath of trauma not only the primary traumatized survivors’ mental health is affected but often also their significant others. The current study explores the specific associations of ICD-11 symptoms of posttraumatic stress disorder (PTSD) and disturbances in self organization (DSO) for secondary traumatic stress and dyadic adjustment among both spouses. MethodsMale Israeli veterans and their wives (N = 216) were assessed 30 years after the war. Primary PTSD/DSO symptoms of the veterans and secondary posttraumatic stress symptoms (secondary PTSS)/DSO of the wives were assessed. Actor Partner Independence Modelling (APIM) evaluated the differential effects of PTSD and DSO for trauma transmission and dyadic adjustment. ResultsWhile veterans’ primary PTSD only related to secondary PTSS of the wives, the veterans’ DSO predicted the wives’ secondary PTSS as well as DSO. Moreover, the APIM revealed that the primary and secondary DSO of both partners were associated with dyadic adjustment while their PTSD symptoms were not. LimitationsThe cross-sectional data did not allow to identify directional or causal effects and DSO symptoms were not assessed with an ICD-specific instrument as such scales did not exist at the time of data collection. ConclusionsICD-11 DSO symptoms seem to drive the transmission of posttraumatic stress among spouses to a more significant extent than PTSD symptoms. As DSO are also strongly implicated in decreased dyadic adjustment, they are valuable targets for couple therapy after one spouse experienced severe trauma, both in order to prevent interpersonal trauma transfer as well as to enhance dyadic adjustment.

Secondary posttraumatic stress symptom trajectories and perceived health among spouses of war veterans: a 12-year longitudinal study

Objective: War-related trauma may indirectly affect veterans’ spouses both in terms of secondary posttraumatic stress symptoms (PTSS) and negative perceived health. The present study aimed to examine trajectories of secondary PTSS over a twelve-year period and its association with various measures of subjectively perceived health, among spouses of war veterans. Methods: Spouses of war veterans (n = 155) were assessed prospectively 30 (T1, 2003), 37 (T2, 2010), and 42 (T3, 2015) years after the 1973 Yom Kippur War. Participants completed self-report questionnaires of PTSS (PTSD inventory) in all three measurement waves, while perceived health measures (Short-Form Health Survey-SF-36) were assessed only at T3. Results: Most spouses were classified to the ‘resilient’ trajectory with low and stable secondary PTSS over time, followed by recovered, chronic, and delayed onset PTSS trajectories. Importantly, spouses in the ‘chronic’ and ‘delayed’ secondary PTSS trajectories reported a higher severity of general negative subjective health perceptions and health-related social malfunctioning. Conclusion: Veterans’ spouses who were grouped in the ‘chronic’ and ‘delayed’ PTSS trajectories are to be considered as at-risk populations for both PTSS and negative perceived health perceptions. Mental health professionals as well as family physicians should be aware of the ongoing nature of secondary PTSS which might negatively affect veterans’ spouses medical conditions and ability to cope with the aging process.

Obciążenie pracą i przejawiana empatia a objawy wtórnego stresu traumatycznego u profesjonalistek pracujących z osobami po doświadczeniach przemocy

Introduction: Professionals working with trauma victims are exposed to secondary traumatic stress (STS). Factors determining its occurrence include various aspects of work, especially occupational load, as well as individual properties of helpers, including empathy. The aim of the study was to establish a relationship between workload, manifestation of empathy and symptoms of STS in professionals who, as part of their work, help people who have experienced trauma related to violence. Material and methods: The results of 154 women representing three professional groups (therapists, social workers and probation officers) aged 26–67 (M = 43.98, SD = 10.83) were analyzed. The study used a survey developed for the purpose of the study, containing questions about workload indicators and two standard measurement tools, i.e. a modified Posttraumatic Stress Disorder Checklist and the Empathic Sensitiveness Scale, measuring three aspects of empathy, i.e. empathic concern, personal distress and perspective taking. Results: High severity of STS symptoms, meaning a high probability of diagnosis of secondary posttraumatic stress disorder was recorded in 14.3% of respondents. This risk was higher for social workers (26.7%) than for probation officers (14.5%) and therapists (8.7%). Positive correlations of STS with workload and all three aspects of empathy were revealed. Regression analysis showed that the main predictor of STS is personal stress, i.e. a tendency to experience anxiety and discomfort in response to strong negative experiences (suffering) of other people. Conclusions: There is a need to cover preventive actions for professionals working with victims of trauma, especially social workers.

Impact of chromotherapy on professional quality of life in intensive care unit nurses: a randomized controlled trial

ABSTRACT Background: Professional quality of life (ProQOL) comprises two aspects: compassion satisfaction and compassion fatigue. Although intensive care unit (ICU) nurses obtain professional satisfaction from their work, their repeated exposure to the aftermath of critical illness puts them at high risk for compassion fatigue. Aim: This study aimed to investigate the impact of chromotherapy-based interventions on the ProQOL in ICU nurses. Methods: In this randomized controlled trial, 80 ICU nurses were assigned into 2 groups (experiment and control). A demographic form and ProQOL questionnaire were used for data collection. The interventions included three parts; (A) changing color of decoration in experimental ICU, such as the installation of color panels in ICU ward, (B) providing a mobile cover and a pencil case in yellow, orange, and green colors based on the principles of chromotherapy, for each of experimental group nurses, and (C) in addition, three educational sessions on chromotherapy were held and then participants received individualized consulting sessions weekly on chromotherapy applying in their personal life for 3 months. Results: Applying chromotherapy increased ProQOL score in all of its dimensions (satisfaction of compassion, fatigue due to compassion, and secondary post-traumatic stress) in the experimental group (p < .05). Conclusion: Chromotherapy may enhance ProQOL in ICU nurses. Interventions such as chromotherapy can be implemented easily to combat compassion fatigue and secondary post-traumatic stress in ICU nurses. Trial registration: Iranian Registry of Clinical Trials identifier: IRCT2017101431588N3.

Far away, so close: The role of self-differentiation in psychopathology among spouses of ex-POWs and comparable combatants.

War captivity entails severe posttraumatic implications for ex-prisoners of war (POWs) and their partners. This study examines the role of self-differentiation in secondary traumatization and dyadic adjustment among ex-POWs' spouses. A total of 106 spouses of Israeli ex-POWs and 56 matched spouses of ex-combatants completed self-report questionnaires assessing secondary posttraumatic stress disorder symptoms (SPS), self-differentiation (fusion, cut-off, balanced), general psychiatric distress (GPD), and dyadic adjustment. Ex-POWs' spouses reported lower dyadic adjustment and higher levels of SPS, GPD, and fusion and cut-off differentiation, compared to ex-combatants' spouses. A "mixed" differentiation style characterized by high levels of both fusion and cut-off was associated with particularly high distress levels. Fusion differentiation moderated the association between SPS/GPD and dyadic adjustment. Self-differentiation plays an important role in posttraumatic spousal relationships. Women showing unstable differentiation may be particularly vulnerable when living with a veteran. Treatments for posttraumatic couples should target dysregulated interpersonal distance and promote adaptive differentiation.

The Role of Self-Compassion and Ego Strength on Secondary Post-Traumatic Stress Disorder in Wives of War Veterans

The Role of Self-Compassion and Ego Strength on Secondary Post-Traumatic Stress Disorder in Wives of War Veterans

The Relationship and Predicting Role of Sleep Quality and Sexual Self-esteem in Secondary Post-traumatic Stress Disorder among Wives of Veterans

The Relationship and Predicting Role of Sleep Quality and Sexual Self-esteem in Secondary Post-traumatic Stress Disorder among Wives of Veterans

Secondary Posttraumatic Stress and Nurses' Emotional Responses to Patient's Trauma.

Secondary Posttraumatic Stress and Nurses' Emotional Responses to Patient's Trauma.

Secondary Posttraumatic Stress and Nurses' Emotional Responses to Patient's Trauma.

Alarmingly high percentages of secondary posttraumatic stress have been reported in several nursing domains such as critical care and emergency nursing, oncology, pediatric nursing, mental health nursing, and midwifery. The purpose of this review is to examine and describe nurses' emotional responses in the face of their exposure to patients' trauma. Lack of understanding of the dynamics of trauma may limit nurses' ability to interact in a meaningful and safe way with patients and their families. Spirituality can be a precious compass in the long-term journey of resolving feelings of grief and loss at work and of building a strong professional identity.

The Effects of Mindfulness-based Stress Reduction on Emotional Regulation and Psychological Well-being of Iranian Veteran's Homemakers with Secondary Posttraumatic Stress Disorder

Background: Problems of emotional regulation and lack of social skills in veterans' families are very common and like psychological complications have unpleasant consequences for them. Therefore, effective and helpful interventions and therapies are highly important. Objectives: The current study aimed at evaluating the effect of mindfulness-based stress reduction (MBSR) on the improvement of emotional regulation and psychological well-being in veterans' homemakers with secondary posttraumatic stress disorder. Patients and Methods: In the current study, the permuted blocked randomization method was used. Participants were selected from veterans' homemakers referred to the counseling center of veterans in Kashan city (Iran) in 2015. They were randomly assigned into two groups (30 controls and 31 cases). The case group underwent the MBSR treatment. Results: Results showed no significant difference between the two groups at the baseline (P

Terremoto en Chile: estrés agudo y estrés post-traumático en mujeres en tratamiento por depresión grave

Depression is a risk factor for developing secondary post-traumatic stress disorder. The earthquake on February 27th, 2010, destroyed the Hospital of Curicó. Despite the prevailing chaos, patients in treatment for severe depression actively maintained their treatment from the first post-earthquake working day To determine prevalence of acute stress (AS) and post-traumatic stress disorder (PTSD) after the earthquake among women in treatment for severe depression. Seventy five women aged 20 to 73 years in treatment for depression for at least six months before the oceurrence of the earthquake, who continued in follow up after the event, were studied. According to the Tenth International Classification of Diseases, the frequency of AS was assessed during the consultation oceurring one month after the event and the frequency of PTSD was assessed during the consultation oceurring six months after the event. Fifty nine percent of women had AS symptoms at the first month and 53.3% had PTSD, six months later. AS was significantly associated with a low educational level. PTSD was significantly associated with prior oceurrence of AS and a history of childhood trauma history. A high frequeney of PTSD was observed in this group of depressive patients, which was significantly associated with a history of previous AS and childhood trauma.

Evaluation of secondary post-traumatic stress disorder symptoms in the spouses of chemical warfare victims 20 years after the Iran–Iraq war

Aims and methodPost-traumatic stress disorder (PTSD) has been reported in 90% of chemical warfare victims in previous studies. An individual's traumatic experience(s) may affect the lives of other family members as well. This cross-sectional case–control study compared the prevalence of PTSD symptoms in the husbands, the secondary PTSD symptoms in the wives and also aimed to identify if there was an association between the PTSD symptoms of the couples in the case group. Cases were 150 husband–wife couples where husbands were civilians exposed to chemical warfare; the controls were 156 husband–wife couples where there was no such exposure. Both cases and controls were recruited from Sardasht in Iran; this Kurdish city was attacked by four 250 kg sulphur mustard warheads in June 1987.ResultsAcross three sets of cut-off points for the Mississippi Scale for Combat-Related PTSD symptomotology (&lt;120 and ⩾121; &lt;106 and ⩾107; and &lt;65, 65–130 and &gt; 130) wives in the case group demonstrated higher rates of PTSD symptoms than did those in the control group; the difference was statistically significant. Furthermore, husbands in the case group had a significantly higher overall mean score (123.0 (s.d. = 17.2)) than the husbands in the control group (112.3 (s.d. = 21.7); P&lt;0.001, t = 4.80). There was no statistically significant association between the overall PTSD score of the husbands in the case group with that of their wives (P = 0.274, correlation coefficient 0.092).Clinical implicationsHusbands who were exposed to the chemical agents reported higher PTSD symptoms and there were higher rates of PTSD symptoms among the wives of individuals who were exposed to chemical warfare. Study results suggest the need for coordinated treatments, policy efforts and interventions to improve the wellbeing of chemical warfare victims and their caregiver wives.

The Israel Defense Forces Secondary Post-Traumatic Stress Disorder Prevention Program for Casualty Notification Officers

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The use of poetry therapy with domestic violence counselors experiencing secondary posttraumatic stress disorder symptoms

Domestic violence counselors who are exposed to the traumatic material of clients may be at risk of secondary posttraumatic stress disorder (SPTSD) and are in need of effective interventions that combat symptoms of SPTSD. The focus of this study is on the examination of the effectiveness of poetry therapy for domestic violence counselors experiencing SPTSD symptoms; and on an investigation of the predictors of SPTSD symptoms. The results showed that poetry therapy reduced SPTSD symptoms in domestic violence counselors. Gender, openness to experiences, and agreeableness were significant predictors of SPTSD symptoms. Implications on the use of poetry therapy are discussed.

Posttraumatic Stress Disorder Among Hospital Surgical Physicians Exposed to Victims of Terror

Surgical physicians often treat victims of terror-related multiple-casualty incidents. This may cause secondary posttraumatic stress disorder (PTSD), impairing their ability to care for patients. The objective of this study was to determine whether professional exposure to victims of terror caused PTSD in Israeli physicians from surgical disciplines. This was a validated questionnaire survey of physicians (November 2002 through March 2003) from 2 Jerusalem hospitals (a tertiary trauma center and a secondary regional hospital) divided into study (physicians from surgical disciplines regularly exposed to victims of terror) and control (physicians not regularly exposed) groups. Questionnaires included the PTSD Symptom Scale-Self-Report to diagnose PTSD (DSM-IV criteria) and allowed exclusion of other causes of similar symptoms. The main outcome measure was the difference in the prevalence of PTSD between groups. Included were 212 (102 study, 110 control) participants. The study group experienced a significantly higher level of exposure to terror victims at work, validating prospective group definitions. The prevalence of PTSD was similar in both groups (study group = 16%, control group = 15%; p = 1.00). The study and control groups were similar in all predicting variables except for number of years in medical practice, occupational status, and workplace. The groups had similar levels of exposure to terror outside work (p = .24). The probability that a physician would have PTSD was related to use of nonadaptive coping strategies (OR = 5.1; p = .009) and a higher level of exposure to terror out of work (OR = 3.5; p = .013). Hospital physicians from surgical disciplines who were professionally exposed to victims of terror did not demonstrate a higher incidence of PTSD than their less exposed counterparts.