Secondary Traumatic Symptoms Research Articles

Primary and secondary trauma in adoptive parents.

Secondary trauma is recognised as one of the negative effects for professionals working with people that have experienced trauma. Research has demonstrated secondary trauma in foster carers but little research has explored trauma symptoms within adoptive parents, facing the emotional impact of parenting a child with adverse early experiences. This study aimed to document the rates of primary and secondary trauma symptoms in adoptive parents. It further explores the association between the extent of current behavioural and emotional challenges and the extent of the child's pre-adoption adverse experiences in predicting parental trauma responses. 190 adoptive parents completed an online survey including self-report measures of primary and secondary trauma. Almost one fifth of adoptive parents exhibited primary trauma scores of clinical concern; with 10% reaching the threshold for a probable diagnosis of PTSD. Participants also reported significantly higher levels of secondary trauma and burnout, and significantly lower levels of compassion satisfaction than population norms. The current behavioural and emotional challenges, including child-to-parent violence, predicted higher trauma scores more so than the extent of their child's past adverse experiences. The findings have clinical implications for identifying trauma symptoms within adoptive parents and wider implications for how we understand secondary and primary trauma. They further highlight the importance of firstly addressing current child behaviour, including child-to-parent violence when treating trauma symptoms. Limitations of this study and recommendations for further research are discussed.

Occupational Health Services in policing: identifying the psychological burden to OHS team members.

Occupational Health Services (OHS) workers in the police are exposed to stressful and pressurized environments where they try to help employees deal with serious physical and mental health conditions. This study used psychological surveillance to identify the level of mental health conditions within each of the police OHS (POHS) roles and to identify whether it was possible to identify the main hazards and resilience factors related to these conditions. Data on mental health conditions (anxiety, depression, post-traumatic stress disorder [PTSD] and secondary trauma) were gathered with questionnaires measuring lifestyle, coping skills, workability and illness behaviour. Personal information and average symptoms, hazards, and resilience factors were measured and compared between the POHS groups. Stepwise linear regression was used to identify the variable that explained the symptoms' level. Data were gathered from 251 POHS team members working in multidisciplinary services, including OH physicians, psychologists, advisors, nurses, technicians, well-being and administrators. The results showed that POHS teams are experiencing levels of symptoms significantly higher than those found in the general population and that OH counsellors had lower levels of symptoms and sickness absence than their colleagues. The stepwise regression identified managing workloads to be associated with lower symptom levels. The findings illustrated the importance of a manageable workload, a stable, resilient personality and a positive attitude towards work. Using coping skills, including physical fitness, social support, involvement and getting enough sleep is associated with lower anxiety, depression, PTSD and secondary trauma symptoms.

Mental health effects of working as a legal professional in the field of asylum law: a systematic review

AimsLegal professionals work closely with asylum seekers at many points during an asylum claim. While there is an increasing literature examining the mental health effects of working with traumatised populations,...

Improving Emotional Safety, Coping, and Resilience Among Women Conducting Research on Sexual and Domestic Violence and Abuse.

Secondary trauma arises through indirect exposure to trauma through engaging with first-hand accounts and narratives of traumatic events. While a significant amount of research has explored secondary trauma experienced by professionals who work with survivors of trauma, such as clinicians and front-line service providers, there is little research exploring the experiences of secondary trauma among violence researchers who routinely engage with traumatic first-hand accounts through their work. This study qualitatively explored violence researcher's professional experiences of secondary trauma and their perceptions of what enables and constrains their own coping and resilience. Participants were recruited using purposive sampling methods. Semi-structured interviews were conducted online with seven female violence researchers from the United Kingdom. Questions explored participant's experiences of secondary trauma symptoms related to their research, perceptions of their own coping and resilience, and experiences of organizational support that have enabled or constrained their resilience. Data were analyzed thematically using a coding framework applied reflexively across interview transcripts. All participants reported experiencing symptoms of secondary trauma from their work including cognitive disturbances; altered beliefs of themselves, others or the world; and challenges connecting with others. Participants' assessment of their own expertise in violence research did not generally impact their perception of their own resilience. Organizational support for violence researchers was rarely provided and participants felt generally unsupported-left to manage any resultant distress alone. Research organizations and universities should implement trauma-informed policies which positively transform workplace culture, provide peer support spaces, and conduct effective training in order to mitigate psychological harm and promote resilience among violence researchers. Support should be tailored to the requirements of violence researchers, and institutions should develop policies that are specifically attentive to the needs of researchers who also have lived experience of violence and abuse.

The Thread of Trauma: A Critical Analysis of the Criminal Legal System

A thread of trauma weaves throughout the U.S. criminal legal system, beginning with individual childhood experiences that are situated within families, communities, and systems that are embedded in structural oppression, thereby increasing the risk of initial and subsequent traumas. The criminal legal system, where individuals who experience prior trauma are more likely to be system-involved, exposes racial minority youths especially to further trauma. This thread also impacts criminal legal system professionals who bear witness to the indirect trauma of victims and people who have harmed, which is often manifested in secondary and vicarious trauma symptoms, while may also cause them to grapple with their own prior trauma. The author offers a critical theory of trauma based on Bronfenbrenner’s ecological framework, first by examining select scholarly research on individual-, relationship-, community-, and system-level trauma, including trauma within the criminal legal system. The system is then examined through the lens of critical race theory, which both explains the persistence of oppression within the system and provides a path to reform by centering on the lived experiences of those most impacted. The author then applies the concepts of secondary and vicarious trauma, psychological safety, and institutional betrayal to explore original research on the impacts of working sex crimes on prosecutors. Finally, implications for system- and organizational-level change and recommendations for future research are offered, including the meaningful engagement of individuals with lived experiences in the development, implementation, and evaluation of victim-centered, trauma-informed, and culturally responsive programs and services.

A meta-analysis on the crossover of workplace traumatic stress symptoms between partners.

Workers who are exposed to severe situations such as death, harassment, and others' suffering at work are vulnerable to symptoms of posttraumatic stress disorder (PTSD) and severe distress. This distress may extend to their intimate partners, despite their lack of firsthand experience with the traumatic stressors. Although theory and empirical research suggest that employees' traumatic distress can transmit to their partners, the magnitude of these effects and when, how, and why intimate partners develop secondary traumatic symptoms and distress are not as clear. Drawing from crossover theory as an organizing framework (Westman, 2001), our meta-analysis of 276 articles indicates that the relationship between employee PTSD/distress and spouse PTSD/distress is as strong as the relationship between employee trauma exposure and employee PTSD/distress (ρ = .26), suggesting that workers' PTSD/distress is as distressing for partners as the traumatic stressors are for workers encountering them firsthand. Our moderation tests further revealed that the trauma-exposed workers' vulnerability to traumatic stress symptoms was stronger in military than in nonmilitary settings, whereas the extent to which their symptoms crossover to their intimate partners did not vary across occupations. Mediation tests suggest that traumatic stress crossover is partially explained by the worsened quality of the couple's relationship (e.g., increased social support burden and undermining), consistent with the crossover via couple interaction explanation in crossover theory. On the other hand, there was mixed support for the mediating role of the partner's empathy, indicating further research and clarification are needed. Implications for crossover theory and practice are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

“Horrible Slime Stories” When Serving Victims: The Labor of Role-taking and Secondary Trauma Exposure

The emotional and psychological consequences associated with providing services to traumatized others have been well established with extant scholarship highlighting these workers’ susceptibility to vicarious trauma and secondary traumatic stress. But less is known about the underlying interactional processes by which symptoms of secondary trauma emerge. This research investigates the consequences of taking the role of a person who is victimized and experiencing emotional turmoil by analyzing interviews with workers who serve victims seeking legal services. Role-taking is the process of mentally and affectively placing the self in the position of another, understanding another’s perspective. Workers described listening to victims’ experiences or coworkers’ accounts of difficult cases as being “slimed.” Those engaging in both cognitive and empathic role-taking often struggled to “shake” this content and became susceptible to mirroring the distress of the traumatized clients and coworkers. In response to this exposure, workers often shared troubling intakes or cases with coworkers as a type of interpersonal emotion management. Workers who provided emotional support to colleagues often experienced indirect exposure to trauma on two fronts: in the service of clients who had experienced intimate partner violence and from coworkers. Thus, those best able to role-take with victims or coworkers are most likely to experience greater secondary trauma exposure and its potential toll.

Identifying child protection workers at risk for secondary traumatization: A latent class analysis of the Professional Quality of Life Scale-5.

Secondary traumatization (ST) is a topical area among trauma-exposed employees, where many are at risk of occupational mental health problems due to their work with trauma survivors. Challenges related to the accurate operationalization of ST symptoms persist, and there is no valid method for identifying employees at risk of clinically significant symptom levels. This study aimed to test the applicability of latent class analysis (LCA) to identify employees at risk for clinically relevant ST symptoms. LCA was used to identify patterns of ST symptom endorsement using the Professional Quality of Life Scale-5 (ProQoL) in a national sample of Danish child protection workers (CPW; N =545). Predictors and associated levels of distress and functional impairment across the symptom presentations were tested using regression analysis, and three classes were identified. A total of 3.8% (n =21) of participants were at high risk of endorsing symptoms of ST that were associated with significant levels of distress and increased functional impairment. The LCA approach outperformed existing scoring procedures in differentiating between employees with varying levels of distress, impairment, and well-being. A minority of Danish CPWs are at risk for levels of ST that may be considered clinically significant for their associations with anxiety and social and cognitive impairment. Although the ProQoL is not a diagnostic tool, per se, a revised scoring procedure may render the measure useful when screening for employees who are at risk for levels of distress and impairment that require intervention.

Supporting the Mental Health Needs of Military Partners Through the Together Webinar Program: Pilot Randomized Controlled Trial.

BackgroundDespite an increased risk of psychological difficulties, there remains a lack of evidence-based support for the mental health needs of military partners.ObjectiveThis study aims to investigate whether the Together Webinar Programme (TTP-Webinar), a 6-week structured, remote access group intervention would reduce military partners’ experience of common mental health difficulties and secondary trauma symptoms.MethodsA pilot randomized controlled trial was used to compare the TTP-Webinar intervention with a waitlist control. The sample was UK treatment-seeking veterans engaged in a mental health charity. A total of 196 military partners (1 male and 195 females; aged mean 42.28, SD 10.82 years) were randomly allocated to the intervention (n=97) or waitlist (n=99) condition. Outcome measures were self-reported measures of common mental health difficulties, secondary trauma symptoms, and overall quality of life rating.ResultsCompared with the waitlist, military partners in the TTP-Webinar had reduced common mental health difficulties (P=.02) and secondary trauma symptoms (P=.001). However, there was no difference in quality-of-life ratings (P=.06).ConclusionsThe results suggest that TTP-Webinar is an effective intervention to support the mental health difficulties of military partners. This study provides promising evidence that webinars may be an appropriate platform for providing group-based support.Trial RegistrationClinicalTrials.gov NCT05013398; https://clinicaltrials.gov/ct2/show/NCT05013398

Secondary Trauma and Parenting Practices in Internet Crimes against Children Task Force Investigators.

Investigating cases of child pornography requires daily exposure to sexually explicit material involving children and may have negative implications on the mental well-being of those in this line of work. This study aimed to identify whether secondary traumatic stress symptoms were associated with participants’ parenting behaviors and concerns about their own children’s use of the internet. Internet Crimes Against Children Task Force workers (n = 212) completed online questionnaires measuring work exposure to sexually explicit material, secondary traumatic stress symptoms, and parenting behaviors. Professionals in this field reported a wide range of secondary trauma symptoms, and their parenting behaviors were both directly and indirectly (via secondary trauma) affected by prolonged exposure to sexually explicit material involving children. Internet monitoring behaviors were more prevalent for parents of younger children, and mothers’ parenting behaviors were more strongly associated with secondary trauma symptoms than were fathers. Results have implications for mental health and parenting services for professionals in this field.

Secondary Traumatic Stress, Mental State, and Work Ability in Nurses-Results of a Psychological Risk Assessment at a University Hospital.

Psychological risk assessment is a legal obligation for companies and part of occupational safety and employment protection in Germany. However, data from psychological risk assessments in nursing staff are scarce, although this population is at increased risk for secondary traumatic stress by patient experienced trauma. Therefore, our study aimed at examining the frequency of reported secondary trauma events, secondary traumatic stress, and its possible consequences for psychological well-being and work ability in nurses. N = 320 nurses (n = 280 female) were assessed at a University Hospital in Germany as part of the psychological risk assessment. Secondary traumatic events, secondary traumatic stress, and symptoms of depression and anxiety were measured using self-report questionnaires (PHQ-2, GAD-2), and work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). Of 320 nurses, 292 (91.2%) experienced secondary trauma, and 74 nurses (25.3%) reported secondary traumatic symptoms. Nurses with secondary traumatic symptoms reported higher depression (p < 0.001) and anxiety scores (p < 0.001) compared to nurses without secondary trauma experience, and to nurses with secondary trauma experience but without secondary traumatic stress (both p < 0.001). Further, nurses with secondary traumatic stress reported significantly reduced work ability, social support and control over work, and increased emotional strain and labor time. Nurses with secondary traumatic stress may be at increased risk of developing major depression and anxiety disorders, and particularly need support in overcoming secondary traumatic experiences. Psychological risk assessment is a useful tool to identify groups at risk, and pave the way to implement strategies to improve mental well-being and prevent work ability in high risk groups.

The Role of Medical Specialization on Posttraumatic Symptoms in Pediatric Nurses

PurposeComparison of medical specialization of repeated exposure to secondary trauma and Post-Traumatic Stress Disorder (PTSD) symptoms in pediatric nurses was examined. Design and methodsThe PTSD Checklist-Civilian Version (PCL-C) was administered to 182 nurses over their first year on the job at a pediatric hospital (three time-points: baseline, 3 month follow-up, and 1 year follow-up). Demographic characteristics (age groups, gender, education, and race) and previous healthcare experience on whether nurses met criteria for no, partial, or full PTSD across all three time-points was examined. Differences in unit assignment on total PTSD symptoms and symptoms of each criterion of PTSD (re-experiencing, avoidance, and arousal) were also examined. ResultsNo significant differences of both demographic characteristics and previous healthcare experience were found on these PTSD categories. However, both ICU and Hematology/Oncology units were more at risk for developing partial and full PTSD, respectively compared to other units. Nurses in the rehabilitation units had significantly higher re-experiencing, avoidance, and arousal symptoms than those assigned to medical/surgical and intensive care units. ConclusionsResults demonstrate a need for hospitals to assess why nurses from certain units are reporting more PTSD symptoms and screen for PTSD symptoms and other mental health concerns throughout their career. Practice implicationsBeing aware of which units may be more at-risk should inform unit-specific prevention and intervention programs to decrease negative outcomes, including burnout, compassion fatigue, and job dissatisfaction.

Exploring the Acceptability of The Together Webinar Programme for Military Partners: A Qualitative Study

Background: Military partners appear at risk for developing psychological difficulties such as depression, generalized anxiety, and secondary trauma symptoms. Yet, evidence suggests that participants report an array of barriers that prevent them from seeking and engaging with mental health support. This includes stigma-related beliefs, work and childcare responsibilities, and distance to venue where support is offered. Introduction: The Together Webinar Programme (TTP-Webinar) was developed to increase the accessibility of mental health support for military partners. The efficacy of this program has been explored in a previous study. Materials and Methods: Data for this study were taken from 68 partners who provided qualitative feedback of the program. Thematic qualitative analysis was used to explore the views of participants about the acceptability of TTP-Webinar. Results: Four main themes were identified, namely perceived benefit, modality, general barriers, and areas for improvement. Discussion: Participants found it favorable to develop a better understanding of veterans' difficulties, to have their own difficulties normalized through sharing and discussion, and to feel part of a wider community. They also found the webinar format favorable as it increased the accessibility of support and provided them with an interactive safe platform. Conclusions: The study provides promising qualitative evidence for the use of TTP-Webinar in supporting the mental health needs of military partners.

Secondary Traumatic Stress: Relationship With Symptoms, Exhaustion, and Emotions Among Cemetery Workers.

Background: Cemeteries workers are deserving of attention because they are exposed to various psychosocial risks: these workers are subject to painful contacts and daily exposed to a work content linked to death experiences and the emotions associated with them. Secondary trauma develops from this continuous contact with others’ suffering; operators working with this type of traumatic content and dynamic could suffer from emotional disorders (Figley, 1995). Therefore, the secondary traumatic stress (STS) is seen as an occupational risk factor (Bride et al., 2004) and cemetery workers are subject to this risk. Studies on this topic have focused on the operators of emergencies, social, and health sectors; little attention has been given to cemetery workers.Aim: The present study considers the relations between the dimensions composing the STS and the psychological and physical symptoms, the perception of exhaustion, and the positive and negative emotions at work in a group of cemetery workers. Moreover, differences among occupational tasks are explored considering the different possibilities of contact with clients and trauma contagion.Methods: The study included a qualitative phase (interviews and focus groups) and subsequently a quantitative phase (self-report questionnaire) and involved 114 participants in a cemetery organization in northern Italy, divided into technicians employees (TE), technicians and specialists of decoration and garden (TS), gravediggers (GR) administrative and front office employees (AFO). Levels of secondary trauma and psychophysical symptoms were assessed, and correlations were calculated in the total sample and for the different job categories of employees.Results: AFO and TS showed the highest levels of STS and psychophysical symptoms, in particular for symptoms related to anxiety, sadness, insomnia, and gastric and musculoskeletal disorders.Conclusion: This study highlights the importance of considering the STS among also this category of workers, since they are exposed daily not only with death, but also with suffering people; grief and emotional skills are important to cope with these job characteristics cemetery workers are not trained on this. It is important to monitor symptomatic levels not only to avoid chronicity, but also to provide employees with psychological support and training about secondary trauma and its consequences.

Guiding the Dark and Secondary Trauma Syndrome: Tour Guides’ Coping Mechanisms for Guiding in Dark Tourism Sites

This research is a part of PhD research exploring how tour guides interpret the dark chapters of Berlin’s history. The theoretical framework brings together the strands of dark tourism, tour guide, and interpretation literature. In guiding tourists through topics and sites of death, atrocity and genocide, tour guides are subjected to a form of Secondary Trauma. The article examines the part of the research which looks at what kinds of coping mechanisms guides adopt in order to deal with regularly interpreting acts of violence, cruelty and human tragedy. The article reviews the context of this examination and the literature written on Secondary Trauma. It goes on to present early findings and to discuss the ad-hoc ways in which guides deal with the psychological effects of guiding the dark, with various levels of awareness to the symptoms of secondary trauma. Finally, the article coins this phenomenon as Guiding the Dark Accumulative Psychological Stress, allowing room for more research in the future to fill this gap in the literature.

Complex PTSD and intergenerational transmission of distress and resilience among Tutsi genocide survivors and their offspring: A preliminary report

The research on survivors of genocide has focused on PTSD, but complex PTSD (CPTSD) and its potential effect on intergenerational transmission are understudied. This study assessed complex PTSD and resilience among Tutsi genocide survivors (n = 60, mean age = 52.27 [SD = 6.27]) and their offspring (n = 60, mean age = 21.21 [SD = 1.78]). Offspring of parents suffering from PTSD or CPTSD reported more secondary traumatization symptoms relative to offspring of parents without PTSD (p < 0.0001). Moreover, parental CPTSD was related to lower resilience among both survivors and offspring (p < 0.0001). The current findings suggest that parental CPTSD may have broader influences manifested in offspring lower resilience.

The Development of the Secondary Trauma in Student Affairs Professionals Scale (STSAP)

College student affairs professionals increasingly act as first responders to student crises. This article describes the development and validation of an instrument designed to measure symptoms of secondary trauma within a sample of student affairs professionals (n = 617). Using exploratory and confirmatory factor analysis, the instrument and its subscales were found to demonstrate evidence of validity and reliability. Authors discuss implications for research and practice regarding secondary trauma in student affairs.

The sensitive prosecutor: Emotional experiences of prosecutors in managing criminal proceedings

For over three decades, therapeutic jurisprudence (TJ) has produced rich scholarship highlighting the inseparable connection between law and personal wellbeing. Only recently, however, have TJ scholars begun to explore the influence that the law has on those practicing it. The current research aims to contribute to this developing area of study. It explores the “emotional map” of public prosecutors in relation to defendants and crime victims, their awareness to these emotions and the impact that these emotions have on their professional decisions. The research involves in-depth interviews with 14 public prosecutors handling criminal cases in Israeli courts. The qualitative, phenomenological analysis of the documented interviews revealed three exposure levels in which interviewees discussed the emotional aspects of their work. The tension between resisting emotions and accepting them was lurking upon each one of the subjects. Their descriptions of specific raw emotions emerged at the deepest level of exposure, and at that level, anger was the most prominent emotion. Our findings raise some skepticism regarding the prosecutor image as a completely rational and provide the insight that prosecutors' emotional world is boiling underneath the surface. Moreover, the exposure of the continuous tension between acceptance and rejection of emotions provides an explanation for the prosecutors' difficulty in acknowledging their emotions in full. This tension negatively impacts the prosecutors' personal and professional lives in ways that resemble psychological symptoms of secondary trauma. The findings may contribute to the development of a “knowledge base” of emotional experiences of prosecutors that could enable the creation of models for regulating and managing emotions of legal agents, for the benefit of litigants, legal agents, and the legal process more broadly.

Child-Parent Relationship Therapy with Extra-Familial Abused Children

ABSTRACTSexual abuse by a perpetrator outside of the family is the most prevalent form of child sexual abuse. It is associated with serious consequences for both the child and his family. Surprisingly, however, the issue of extra-familial sexual abuse has received very little research and clinical attention. The purpose of the current study was to explore the effectiveness of Child-Parent Relationship Therapy (CPRT), which uses nondirective play therapy tools, among parents of extra-familial abused children and their parents. In order to do so, data was collected from 51 parents who participated in CPRT, at three points in time: pretreatment stage, at the beginning of the first meeting; and in the post treatment stage. The data included the parents’ reports via three questionnaires: Parenting Stress Inventory (PSI), Compassion Fatigue Self-Test (CFST), Child Behavior Checklist (CBCL). Overall, the results indicated a decrease in internalizing and externalizing symptoms among the children, as well as in parenting stress and in parental secondary trauma symptoms. This study contributes to the literature on interventions with victims of extra-familial child abuse and their parents. Specifically, the results highlight the benefits and importance of involving both parents and children in therapeutic interventions for victims of extra-familial child sexual abuse, with particular emphasis on the benefits of Child-Parent Relationship Therapy.

Visiting Auschwitz: Evidence of secondary traumatization among high school students.

Secondary traumatic stress has been intensively studied among survivors' therapists, family members, and trauma researchers. We claim that people who are exposed to reminders of past traumatic experiences when visiting places of memory or museum exhibitions could also develop secondary trauma symptoms. Thus, scholars and practitioners must better understand how such places related to historical traumatization (e.g., Holocaust memorial sites) can affect the psychological well-being of visitors. The main aim of this quantitative longitudinal study was to assess the scale of secondary traumatization among visitors to such places. The study found that the syndrome of secondary traumatic stress was observed among 13.2% of high school visitors to the Auschwitz memorial museum. Longitudinal analysis revealed that empathic reactions to the visit in Auschwitz (e.g., a greater inclusion of victims into the self) were associated with higher levels of secondary traumatic stress levels 1 month after the visit. This study suggests that visits to places related to traumatic past events should be preceded by a more intense elaboration of Holocaust history and by proper psychological preparations. (PsycINFO Database Record