Secondary Traumatic Stress Disorder Research Articles

Concept Analysis

Walker and Avant's method of concept analysis was used to delve into the initial understanding of compassion fatigue, a relatively new concept being explored with critical care nurses and other health care professionals. The term was originally used in 1992 involving research exploring burnout experienced by critical care nurses when a trend emerged where nurses appeared to have lost their "ability to nurture." The term has since been used synonymously with secondary traumatic stress disorder. Two important goals exist for this article: First, theoretically to conduct a concept analysis of compassion fatigue, thereby providing information for critical care nurses to understand the concept as a universal human experience. Second, from a caring perspective, identifying the effects related to critical care nurses provides an opportunity to address physical and somatic consequences of compassion fatigue that will ultimately become important to nursing practice, education, and research.

P-981 - Secondary traumatic stress in wives of war veterans with PTSD

Wives of PTSD affected war veterans experience a wide range of psychosocial difficulties including secondary traumatic stress (STS). To compare level of STS symptoms, emotional functioning and perceived quality of life between wives of PTSD affected veterans, wives of veterans without PTSD and wives of non-veterans in Croatia. To investigate the effect of veterans’ PTSD, wives’ knowing of the veterans’ war trauma, and wives’ personal war experiences on STS. A total of 150 married women participated in the study. Fifty wives of PTSD affected veterans were recruited through Referral Center for Psychotrauma Rijeka, while 50 wives of veterans without PTSD and 50 wives of non-veterans were recruited using the snowball method. Sociodemographic questionnaire, Brief Symptom Inventory, Manchester short assessment of quality of life, and Modified questionnaire for secondary traumatization were administrated. Thirty-six percent of wives of PTSD affected veterans meet the criteria for secondary traumatic stress disorder. Wives of PTSD affected veterans report significantly higher level of STS symptoms compared with wives of non-PTSD veterans. Also, wives of PTSD affected veterans report higher level of psychological difficulties and have lower percieved quality of life compared with other two groups. Multifactor analysis shows main effect of wives' knowing the veteran's traumatic event on STS, and main effect of veterans' PTSD on emotional functioning of their wives. Clinicians working with war related PTSD should be aware of secondary traumatic effect on the spouses. Systemic approach in psychotherapeutic treatment of PTSD should be considered.

Intrapartum Nurses' Lived Experience in a Traumatic Birthing Process

To describe the essence of nine nurses' participation in an unexpected/traumatic birthing process to ascertain what impact this experience had on the nurse. Descriptive phenomenology was the qualitative research design used. A four-person team analyzed the transcribed interviews of each nurse's experience using Colaizzi's method of analysis. We recruited nine intrapartum nurses from a call-out to Indiana Association of Women's Health, Obstetric and Neonatal Nurses Section Chapter members. One overarching theme, From Behind Closed Doors, and the following six subthemes described the essence of the participants' experiences: (1) Feeling the Chaos; (2) Expect the Unexpected; (3) It's Hard to Forget; (4) All Hands on Deck; (5) Becoming; and (6) For the Love of OB (Obstetrics). Intrapartum nurses in this study clearly demonstrated that the impact of an unexpected event can be emblazoned on one's memory for many years, with an immediate response of secondary traumatic stress disorder symptoms.

Distress in spouses of service members with symptoms of combat-related PTSD: secondary traumatic stress or general psychological distress?

Combat-related posttraumatic stress disorder (PTSD) is linked with elevated psychological distress in service members'/veterans' spouses. Researchers use a variety of terms to describe this distress, and recently, secondary traumatic stress and secondary traumatic stress disorder (STS/STSD) have become increasingly commonly used. Although STS/STSD connotes a specific set of symptoms that are linked to service members'/veterans' symptoms, researchers often use general measures of distress or generically worded measures of PTSD symptoms to assess STS/STSD. To determine how often scores on such measures appear to be an accurate reflection of STS/STSD, we examined responses to a measure of PTSD symptoms in 190 wives of male service members with elevated levels of PTSD symptoms. Wives rated their own PTSD symptoms, and then answered questions about their attributions for the symptoms they endorsed. Fewer than 20% of wives who endorsed symptoms on the PTSD measure attributed these symptoms completely to their husbands' military experiences. Moreover, compared with wives who attributed symptoms only to events in their own lives, wives who attributed symptoms completely or partially to their husbands' military experiences had a greater overlap between some of their responses on the PTSD measure and their responses to a measure of general psychological distress. These results suggest that most wives of service members/veterans with PTSD experience generic psychological distress that is not conceptually consistent with STS/STSD, although a subset does appear to endorse a reaction consistent with this construct. Implications of these findings for intervention and research with this vulnerable population are discussed.

Compassion fatigue within nursing practice: A concept analysis

"Compassion fatigue" was first introduced in relation to the study of burnout among nurses, but it was never defined within this context; it has since been adopted as a synonym for secondary traumatic stress disorder, which is far removed from the original meaning of the term. The aim of the study was to define compassion fatigue within nursing practice. The method that was used in this article was concept analysis. The findings revealed several categories of compassion fatigue: risk factors, causes, process, and manifestations. The characteristics of each of these categories are specified and a connotative (theoretical) definition, model case, additional cases, empirical indicators, and a denotative (operational) definition are provided. Compassion fatigue progresses from a state of compassion discomfort to compassion stress and, finally, to compassion fatigue, which if not effaced in its early stages of compassion discomfort or compassion stress, can permanently alter the compassionate ability of the nurse. Recommendations for nursing practice, education, and research are discussed.

Secondary Traumatic Stress and Burnout among Law Enforcement Investigators Exposed to Disturbing Media Images

This study examines the psychological impact of viewing disturbing media on investigators engaged in computer forensics work. Twenty-eight federal law enforcement personnel who investigate Internet child pornography cases completed measures of secondary traumatic stress disorder (STSD) and burnout. Substantial percentages of investigators reported poor psychological well-being. Greater exposure to disturbing media was related to higher levels of STSD and cynicism. STSD and burnout scores were related to increased protectiveness of family, reliance on co-workers, general distrust, and turnover intentions. On a positive note, investigators scored high in professional efficacy, indicating they feel their work makes a difference. Furthermore, personnel with supportive relationships scored lower on both STSD and burnout.

Compassion Fatigue: The Experience of Nurses

The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses’ experience of compassion fatigue are presented. Nurses, self-identified as having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses’ personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants’ identity, causing them to reflect on the kind of nurse they were. The participants’ compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue.

Exploring the impact on counsellors of working with spiritually abused clients

This small-scale study explores the impact on counsellors of working with clients who have experienced spiritual abuse. Participants were five counsellors who have worked with spiritually abused clients. They were interviewed and the data analysed using a bricolage of heuristic and interpretative phenomenological analysis. The data indicate that counsellors experience symptoms of visceral traumatization and secondary traumatic stress disorder characterized by feelings of anger, outrage, sadness, grief, powerlessness, cynicism, helplessness, frustration, disassociation, needing to justify or vindicate God and protect the spiritual community—rather than the abuser—and wariness of leadership of spiritual communities. However, working with clients who were spiritually abused deepened and strengthened the counsellors’ relationship with God in a profound way. The research also highlights the need for greater awareness to be had of spirituality and spiritual abuse in supervision and training courses.

Helping Direct and Indirect Victims of National Terror: Experiences of Israeli Social Workers

In this study we explored the subjective experience and the meaning attached to it by Israeli social workers who provide help to direct and indirect victims of national terror attacks. A qualitative methodology, based on grounded theory tradition, was used to conduct and analyze interviews with 29 social workers from three types of agencies (municipal social services, general hospitals, and the National Insurance Institute) from various parts of the country. Based on the data, three main themes were constructed: (a) professional and personal functioning during intervention, (b) the immediate and long-term impact of intervening with terror attacks, and (c) the meaning attached to the social worker's role in intervening with victims. Overall, the findings show that the social workers experienced symptoms similar to those of secondary traumatic stress disorder (STSD) for a few days only, but in the long-term, they perceived their experience of helping victims of terror attacks as leading to personal and professional growth.

Secondary Traumatic Stress in Nurses Who Care for Traumatized Women

Each year, thousands of women experience violence, and many of these are survivors of intimate partner violence. Each year, thousands of nurses provide physical and emotional care to these women. Nurses and employers need to recognize that exposures to traumatized women place nurses at risk for the development of secondary traumatic stress disorder. This article describes secondary traumatic stress, its risk factors, and its consequences. Workplace interventions and policies are recommended to reduce the avoidance, numbness, intrusive imagery, and other negative symptoms associated with secondary traumatic stress disorder.

Does vicarious traumatisation affect oncology nurses? A literature review

It is widely documented that nurses experience work-related stress [Quine, L., 1998. Effects of stress in an NHS trust: a study. Nursing Standard 13 (3), 36-41; Charnley, E., 1999. Occupational stress in the newly qualified staff nurse. Nursing Standard 13 (29), 32-37; McGrath, A., Reid, N., Boore, J., 2003. Occupational stress in nursing. International Journal of Nursing Studies 40, 555-565; McVicar, A., 2003. Workplace stress in nursing: a literature review. Journal of Advanced Nursing 44 (6), 633-642; Bruneau, B., Ellison, G., 2004. Palliative care stress in a UK community hospital: evaluation of a stress-reduction programme. International Journal of Palliative Nursing 10 (6), 296-304; Jenkins, R., Elliott, P., 2004. Stressors, burnout and social support: nurses in acute mental health settings. Journal of Advanced Nursing 48 (6), 622-631], with cancer nursing being identified as a particularly stressful occupation [Hinds, P.S., Sanders, C.B., Srivastava, D.K., Hickey, S., Jayawardene, D., Milligan, M., Olsen, M.S., Puckett, P., Quargnenti, A., Randall, E.A., Tyc, V., 1998. Testing the stress-response sequence model in paediatric oncology nursing. Journal of Advanced Nursing 28 (5), 1146-1157; Barnard, D., Street, A., Love, A.W., 2006. Relationships between stressors, work supports and burnout among cancer nurses. Cancer Nursing 29 (4), 338-345]. Terminologies used to capture this stress are burnout [Pines, A.M., and Aronson, E., 1988. Career Burnout: Causes and Cures. Free Press, New York], compassion stress [Figley, C.R., 1995. Compassion Fatigue. Brunner/Mazel, New York], emotional contagion [Miller, K.I., Stiff, J.B., Ellis, B.H., 1988. Communication and empathy as precursors to burnout among human service workers. Communication Monographs 55 (9), 336-341] or simply the cost of caring (Figley, 1995). However, in the mental health field such as psychology and counselling, there is terminology used to captivate this impact, vicarious traumatisation. Vicarious traumatisation is a process through which the therapist's inner experience is negatively transformed through empathic engagement with client's traumatic material [Pearlman, L.A., Saakvitne, K.W., 1995a. Treating therapists with vicarious traumatization and secondary traumatic stress disorders. In: Figley, C.R. (Ed.), Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Brunner/Mazel, New York, pp. 150-177]. Trauma not only affects individuals who are primarily present, but also those with whom they discuss their experience. If an individual has been traumatised as a result of a cancer diagnosis and shares this impact with oncology nurses, there could be a risk of vicarious traumatisation in this population. However, although Thompson [2003. Vicarious traumatisation: do we adequately support traumatised staff? The Journal of Cognitive Rehabilitation 24-25] suggests that vicarious traumatisation is a broad term used for workers from any profession, it has not yet been empirically determined if oncology nurses experience vicarious traumatisation. This purpose of this paper is to introduce the concept of vicarious traumatisation and argue that it should be explored in oncology nursing. The review will highlight that empirical research in vicarious traumatisation is largely limited to the mental health professions, with a strong recommendation for the need to empirically determine whether this concept exists in oncology nursing.

Initial evaluation of the Secondary Trauma Questionnaire.

Many measures exist to evaluate posttraumatic stress disorder (PTSD), but there are few ways of assessing secondary traumatic stress disorder and these are limited to specific populations. Secondary traumatic stress disorder involves the transfer of trauma symptoms from those who have been traumatized to those who have close and extended contact with trauma victims. Thus, family members of those who have been traumatized and therapists who treat trauma survivors are vulnerable to developing secondary traumatic stress disorder. In this initial evaluation of the newly developed Secondary Trauma Questionnaire, 261 mental health professionals and 157 college students were evaluated. Analysis indicated that the questionnaire showed good internal consistency and was significantly correlated with known measures of trauma. The Secondary Trauma Questionnaire is presented as a promising way to measure secondary trauma symptoms and further research using this questionnaire appears to be warranted.

Prevalence of Symptoms of Posttraumatic Stress Disorder in German Professional Firefighters

This study investigated the prevalence of posttraumatic stress disorder (PTSD) and comorbid symptoms among professional firefighters in Germany and examined not only primary but also secondary traumatic stress disorder experienced by these firefighters who were exposed to the sufferings of others. To estimate the prevalence of trauma-related disorders, a representative group of 402 professional firefighters from the State of Rheinland-Pfalz in Germany was surveyed through use of the General Health Questionnaire, a PTSD Symptom Scale, a stress coping questionnaire, and a self-rating scale to assess bodily complaints. The current prevalence rate of PTSD symptoms among professional firefighters was 18.2%. About 27% of the recruited subjects had a mental disorder according to the General Health Questionnaire. Predictors for the extent of traumatic stress were longer job experience and the number of distressing missions during the last month. Traumatic stress also predicted psychiatric impairment beyond PTSD, such as depressive mood, psychosomatic complaints, social dysfunction, and substance abuse. The high prevalence of PTSD and other psychiatric impairments in firefighters indicates that they often fail to cope with primary and particularly secondary stress in their daily work. This problem, together with the individual psychological consequences and expenses related to work absenteeism and early retirement, seems to be very specific for the profession of firefighters. The present findings provide a better understanding of the relationship between secondary traumatic stress and PTSD in professional helpers and high-risk populations such as firefighters, emergency workers, and the police.

The transmission of trauma across generations: identification with parental trauma in children of Holocaust survivors.

This study examines the phenomenology of intergenerational transmission of trauma with the aim of elucidating the interactional process of transmission within an object relations framework. The method consisted of systematic textual analysis of semi-structured interviews with six Jewish women born after the war who were children of concentration camp interned Holocaust survivors. Four superordinate themes were identified: heightened awareness of parents' Holocaust survivor status, parenting style, overidentification with parents' experiences and transmission of fear and mistrust. These were found despite the variation in parental communication. The data suggest that unconscious processes are at least partially involved in the transmission of trauma. A form of projective identification is proposed as an explanatory mechanism which brings together diverse aspects of the observed phenomena: projection by the parent of Holocaust-related feelings and anxieties into the child; introjection by the child as if she herself had experienced the concentration camps; and return of this input by the child in the form of compliant and solicitous behaviour associated with enmeshment and individuation problems. Further research may establish these phenomena as a particular form of Secondary Traumatic Stress Disorder.

Nurses, indirect trauma, and prevention.

To begin examining the nature of vicarious or indirect trauma and to discuss risk factors and prevention strategies. Despite the fact that many nurses are traumatized indirectly, few recognize the insidious development of such trauma. The dynamics of indirect trauma are relevant to nursing as are risk factors and prevention strategies. Brief review of the literature (1974-1997) on vicarious trauma, compassion fatigue, secondary traumatic stress disorder, and traumatic countertransference using short vignettes for illustration. Nurses who are informed about vicarious trauma and who actively maintain a balanced personal and professional life are in the best position to bring themselves and their clients through the many hazards of trauma work. The implications of vicarious or indirect trauma for nurses and clients are serious and complex requiring thoughtful analysis and research to clarify its effects.

Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (Psychosocial Stress Series No. 23) Edited by Charles F. Figley. New York: Brunner/Mazel, 1995. 268 pp. $37.95 hardback, ISBN 0-87630-759-4

Journal Article Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized (Psychosocial Stress Series No. 23) Edited by Charles F. Figley. New York: Brunner/Mazel, 1995. 268 pp. $37.95 hardback, ISBN 0-87630-759-4 Get access Barbara Oberhofer Dane Barbara Oberhofer Dane Shirley M. Ehrenkranz School of Social Work, New York University Search for other works by this author on: Oxford Academic PubMed Google Scholar Social Work, Volume 42, Issue 2, March 1997, Page 207, https://doi.org/10.1093/sw/42.2.207-a Published: 01 March 1997

Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder In Those Who Treat the Traumatized

Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder In Those Who Treat the Traumatized

Coping With Trauma: A Guide to Self-Understanding; Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized; Memory and Abuse: Remembering and Healing the Effects of Trauma

Coping With Trauma: A Guide to Self-Understanding; Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized; Memory and Abuse: Remembering and Healing the Effects of Trauma