Secondary Traumatic Stress Symptoms Research Articles

An Examination of the Moderating Effect of Proactive Coping in NICU Nurses.

Neonatal intensive care unit (NICU) nurses experience increased risk for depression, secondary traumatic stress, and burnout. This study examined whether the use of problem-solving or support-seeking strategies moderated the relationship between secondary traumatic stress levels, depressive symptomology, and burnout in NICU nurses. Multiple linear regression and a hierarchical stepwise technique were used to conduct moderation analyses. Results indicated that support-seeking coping skills significantly moderated the relationship between secondary traumatic stress symptoms and burnout symptoms. Coping did not moderate the relationship between depression and burnout. These findings can be used to inform the development of programs that could promote the well-being and coping of nurses experiencing mental health difficulties or burnout and foster a healthy work environment for all NICU nurses so that they can provide the best possible intervention to vulnerable infants. Future research should aim to identify interventions that promote coping in NICU nurses.

Sudden death in paediatrics as a traumatic experience for critical care nurses.

Research shows that nurses working in critical care units and in particular, paediatric units, are at risk of developing symptoms of secondary traumatic stress (STS). However, little attention has been given to this phenomenon when associated with situations of sudden death in paediatrics. This study aimed to examine the impact of sudden death in paediatrics on nurses working in paediatrics critical care units and to explore nurses' experiences of this event. This study used a mixed-methods design. The Impact of Event Scale-Revised was used for investigating the presence of STS symptoms. In addition, an interview was conducted with six nurses. Fifty-seven percent of nurses responded to the surveys and six nurses were interviewed. The results showed that the sudden death of children and adolescents is an event that elicits symptoms of STS in nurses. The quantitative assessment, revealed that 19·4% presented total scores indicating high impact. The participants interviewed described experiences of subjective distress, such as intrusive thoughts, avoidance and hyperarousal. Other factors were also reported as influencing the experience of the sudden death of a child/adolescent, namely, the child's age, the cause of death and the family's reaction to the loss. According to the participants, the emotional impact was also determined by parenthood, previous training and professional experience. Sudden death in paediatric critical care units is one of the most difficult situations in nursing practice and elicits STS symptoms, which may severely impact the physical and psychological health of nurses and ultimately affect the quality of the provided care. This study emphasizes the need for promoting better conditions for professional practice, namely, with regard to emotional support, as well as training programmes for skills development in the area of management of traumatic situations and of communication with clients.

"Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction": Correction to Butler, Carello, and Maguin (2016).

Reports an error in "Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction" by Lisa D. Butler, Janice Carello and Eugene Maguin (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, Sep 12, 2016, np). In the article, there was an error in Table 4 of the Results. The Outcomes and Predictors columns were not clearly categorized from one another. The corrected table is present in the erratum. (The following abstract of the original article appeared in record 2016-43766-001.) Objective: Courtois and Gold (2009) have called for the inclusion of trauma in the curriculum for all mental health training programs. The present study investigated the impact of trauma-related content, stress, and self-care (SC) on trainees in such a program. Method: The study examined potential risk factors (trauma exposures in training [being faced with or reacting to trauma-related field work experiences and course content] and perceptions of stress in field and coursework) and protective factors (SC effort and importance) in relation to burnout (BO), health status (HS), secondary traumatic stress symptoms (STSS), and compassion satisfaction (CS) among 195 students in a graduate social work training program. Results: All students reported trauma exposures in their field placements and/or coursework, including retraumatization experiences that were associated with higher STSS and BO. Field stress and SC effort were both consistent predictors across outcomes. Higher field stress levels predicted higher BO and STSS, a greater likelihood of decline in HS, and lower CS. Lower SC effort was also associated with higher BO and STSS, and a greater likelihood of decline in HS, while higher SC effort predicted higher CS. Older students, those with traumatized field clients, and those whose field work addressed trauma, also reported higher CS. Conclusions: These findings suggest that clinical training involving trauma content can be both rewarding and stressful, and may evoke distress in some trainees. Given that learning about and working with trauma are essential to adequate clinical training, the authors suggest adopting a trauma-informed approach within clinical training programs. (PsycINFO Database Record

Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction.

[Correction Notice: An Erratum for this article was reported in Vol 9(4) of Psychological Trauma: Theory, Research, Practice, and Policy (see record 2016-54155-001). In the article, there was an error in Table 4 of the Results. The Outcomes and Predictors columns were not clearly categorized from one another. The corrected table is present in the erratum.] Objective: Courtois and Gold (2009) have called for the inclusion of trauma in the curriculum for all mental health training programs. The present study investigated the impact of trauma-related content, stress, and self-care (SC) on trainees in such a program. Method: The study examined potential risk factors (trauma exposures in training [being faced with or reacting to trauma-related field work experiences and course content] and perceptions of stress in field and coursework) and protective factors (SC effort and importance) in relation to burnout (BO), health status (HS), secondary traumatic stress symptoms (STSS), and compassion satisfaction (CS) among 195 students in a graduate social work training program. Results: All students reported trauma exposures in their field placements and/or coursework, including retraumatization experiences that were associated with higher STSS and BO. Field stress and SC effort were both consistent predictors across outcomes. Higher field stress levels predicted higher BO and STSS, a greater likelihood of decline in HS, and lower CS. Lower SC effort was also associated with higher BO and STSS, and a greater likelihood of decline in HS, while higher SC effort predicted higher CS. Older students, those with traumatized field clients, and those whose field work addressed trauma, also reported higher CS. Conclusions: These findings suggest that clinical training involving trauma content can be both rewarding and stressful, and may evoke distress in some trainees. Given that learning about and working with trauma are essential to adequate clinical training, the authors suggest adopting a trauma-informed approach within clinical training programs. (PsycINFO Database Record

Secondary traumatic stress, dissociative and somatization symptoms in spouses of veterans with PTSD in Zahedan, Iran

IntroductionSecondary traumatic stress is a disorder which occurs in spouses and people with close relation to someone with posttraumatic stress disorder. Like PTSD, it seems that STS also occurs with other psychiatric problems like somatization and dissociation. This study aimed to determine the relationship between STS and somatization and dissociation symptoms.MethodsThis cross-sectional study was done in 2015 and lasted for one year. Self-report questionnaires assessing secondary traumatic stress symptoms, dissociation symptoms and somatization symptoms were distributed among spouses of veterans with PTSD in Zahedan, Iran. The relationship between STS symptoms and somatization symptoms and also between STS symptoms and dissociation symptoms were determined by Pearson correlation test. SPSS version 23 was used for data analysis.ResultsOccurrence of secondary traumatic stress symptoms were correlated with dissociation symptoms and also with somatization symptoms.ConclusionsAs the rate of secondary traumatic stress rose, the rate of somatization and dissociation symptoms in spouses of veterans increased.

Retraumatization Mediates the Effect of Adverse Childhood Experiences on Clinical Training-Related Secondary Traumatic Stress Symptoms

ABSTRACTPrevious research (Butler, Carello, & Maguin, 2016) has found that exposure to trauma-related material in graduate clinical coursework and field training can put students at risk for reactivations of feelings/memories from negative past experiences (retraumatization) and for secondary traumatic stress (STS) symptoms. The present report sought to examine the role, if any, of adverse childhood experiences (ACEs) in these outcomes. Using the Butler et al. (2016) sample, we examined: (1) rates of ACEs in 195 graduate social work students, (2) whether the total number of ACEs was associated with training-related retraumatization (TRT) and/or STS symptoms, and (3) if TRT mediated the relationship between ACEs and STS symptoms. The results indicate that more than three quarters of the sample had experienced one or more ACEs before age 18 and almost one third endorsed 4 or more. The most commonly reported ACEs were household mental illness, parental separation/divorce, household alcohol/substance abuse, and emotional abuse or neglect by a parent or household member. Higher ACE scores were associated with increased likelihood of TRT experiences and STS symptoms during training. A mediation analysis confirmed that TRT mediated the effect of ACE scores on STS symptoms; this finding also provides support for the role of proximal emotional reactions in mediating the effects of distal adverse experiences on the development of trauma symptoms. In summary, despite the evident resilience of this graduate student sample, those with ACE histories were at heightened risk for training-related distress. These results underscore the need for a trauma-informed approach to clinical training.

The Relationship Between Vicarious Posttraumatic Growth and Secondary Traumatic Stress Among Health Professionals

ABSTRACTLimited and inconsistent research exists regarding the relationship between vicarious posttraumatic growth (VPTG), which is positive psychological growth experienced as a result of vicarious traumatic exposure, and symptoms of secondary traumatic stress (STS). The current study aimed to investigate whether a curvilinear model explained the VPTG-STS relationship among a sample of 365 nurses, psychologists, counselors, social workers, and medical doctors. Results supported this hypothesis, however this result appeared to largely be governed by the curvilinear relationship found among psychologists; STS was not found to predict VPTG among any other profession. Implications of results are discussed.

Factors Associated with Secondary Traumatic Stress among Emergency Nurses: An Integrative Review

Background: Emergency nurses are exposed to traumatized patients as part of their job. Secondary exposure to trauma may lead to traumatic stress similar to those experienced by the primary victim. Emergency nurses develop secondary traumatic stress symptoms more than other nurses due to nature of emergency departments. The consequences of secondary traumatic stress can be noticed at personal, interpersonal, or organizational level. Objectives: This integrative review aimed to explore the literature on the factors attenuate or enhance occurrence of secondary traumatic stress among emergency nurses, to identify these factors, and to provide recommendations for research in the field. Method: An integrative literature review of quantitative and qualitative studies on secondary traumatic stress in emergency nurses were published in English language between 2000 and 2017 through the following data bases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Medline, PubMed, Google Scholar, SAGE Journals, Wiley on Line Library, Science Direct and EBSCOhost Sources. Results: The review identified that factors associated with secondary traumatic stress can be classified into personal and organizational factors. Findings on personal factors such as age, gender, and experience are controversial, whereas organizational factors such as trauma case load and perceived organizational support were found to predict traumatic stress more than the personal factors. Conclusions: Emergency nurses are at risk to develop traumatic stress and need to be aware to the contributing factors in order to maintain their well being. Further research is required to explore the factors enhance or attenuate occurrence of secondary traumatic stress.

Crimes Against Caring: Exploring the Risk of Secondary Traumatic Stress, Burnout, and Compassion Satisfaction Among Child Exploitation Investigators

Secondary traumatic stress (STS) and burnout are debilitating occupational hazards that inhibit helping professional’s overall well-being. Much of the extant scholarship on this topic has focused on mental health and child welfare workers and not law enforcement officials who investigate Internet child exploitation. This study used data from 433 Internet Crimes Against Children (ICAC) Task Force personnel to explore the impact of individual and work-related factors associated with the risk of STS, burnout, and compassion satisfaction. Findings indicated that nearly one in four ICAC personnel exhibited low compassion satisfaction and high levels of STS and burnout. Individual-level protective factors for increasing compassion satisfaction and mitigating symptoms of STS and burnout included having a strong social support system outside of work and the frequent use of positive coping mechanisms. Work-related risk factors such as frequent indirect exposure to disturbing materials, low organizational support, and frequently feeling overwhelmed at work were all associated with higher STS and burnout and lower levels of compassion satisfaction. Policy implications and future avenues of research are discussed.

Emotion Regulation Strategies, Secondary Traumatic Stress, and Compassion Satisfaction in Healthcare Providers

ABSTRACTThe aim of the present study is to examine the relationships between two emotion regulation strategies (cognitive reappraisal and expressive suppression), secondary traumatic stress, and compassion satisfaction in a sample of 190 healthcare providers. Another aim of this study is to examine if the relations between emotion regulation strategies and traumatic stress symptoms are moderated by compassion satisfaction. The respondents volunteered to take part in the research and completed self-reporting measures describing the use of emotional regulation strategies, the symptoms of secondary traumatic stress, and the compassion satisfaction. The results revealed negative associations between cognitive reappraisal and secondary traumatic stress, while expressive suppression is positively associated with arousal. Moreover, cognitive reappraisal is positively related to compassion satisfaction, while secondary traumatic stress symptoms are negatively correlated with compassion satisfaction. Furthermore, the relationship between expressive suppression and intrusions is moderated by compassion satisfaction. The implications of these results for enhancing professional quality of life in the context of secondary exposure to traumatic life events are discussed.

Intervening to Improve Compassion Fatigue Resiliency in Forensic Nurses.

Evidence suggests that forensic nurses (FNs) may be predisposed to compassion fatigue (CF) as a result of the challenges of the profession including high caseloads, role ambiguity, prosecution goals, vicarious traumatization, attending to survivors' emotional needs, and empowering victims. The purpose of this exploratory study was to determine the prevalence of CF in a convenience sample of 55 FNs and examine the treatment effectiveness of a multifaceted education program in an intervention subset. The intervention was intended to increase compassion satisfaction (CS) and decrease CF symptoms in FNs in one organization who participated in the training. The hypothesis was that the FNs will have moderate to high CF and moderate to high CS and the CF intervention will add in CF prevention and resiliency as measured with an improvement in the Professional Quality of Life test scores (B. H. ). In the prevalence sample, 69% of the FNs had moderate to low CS, 73% had moderate to high burnout, and 73% had moderate to high levels of secondary traumatic stress (STS). In the intervention group, the education program resulted in a statistically significant increase in CS and decreases in STS symptoms.

Secondary traumatic stress and empowerment among social workers working with family violence or sexual assault survivors

Summary The impact of secondary traumatic stress on social workers can be profound. The study reported here examined the relationship between psychological empowerment and secondary traumatic stress among social workers who provide services to family violence or sexual assault survivors on a regular basis. The study participants ( N =154) were recruited from the National Association of Social Workers in the United States; data were collected through mail surveys. Psychological empowerment was defined as having a sense of competency, impact, self-determination, and meaning in one’s organization as the person performs work. Findings Social workers who demonstrated higher levels of psychological empowerment experienced lower levels of secondary traumatic stress controlling for sociodemographic variables. Among the control variables, experiencing more personal traumatic events predicted higher levels of secondary traumatic stress. Applications The findings imply that social service organizations can help social workers prevent or alleviate secondary traumatic stress symptoms by enhancing their psychological empowerment. Several organizational strategies can be developed to empower social workers who assist the survivors of family violence or sexual assault to prevent secondary traumatic stress or reduce its severity.

The Relationship Between Secondary Traumatic Stress and Personal Posttraumatic Growth: Personality Factors as Moderators

This present study examined the relationship between secondary traumatic stress, personality factors, and personal posttraumatic growth for persons indirectly exposed to traumatic life events. A sample of 162 nurses and physicians completed the self-report measures describing symptoms of secondary traumatic stress, personality factors and vicarious posttraumatic growth. The results indicated that secondary traumatic stress negatively correlated with vicarious posttraumatic growth. Moreover, this relation is moderated by personality factors. A low level of secondary traumatic stress symptoms is associated with a higher level of perceived posttraumatic growth for participants with a high level of openness, agreeability and conscientiousness. These findings emphasize the differences in perceiving posttraumatic growth in the context of secondary exposure to traumatic life events.

Secondary Traumatic Stress in Postdisaster Field Research Interviewers.

Numerous studies show that those involved in disaster response may develop posttraumatic stress disorder or experience secondary traumatic stress (STS). There are few reports about the experiences of postdisaster field research interviewers. We report findings from a follow-up study of researchers who conducted postwildfire field research interviews with residents affected by 5 severe wildfire events in Australia over the period 2009-2014. There were 33 postwildfire research interviewers who reported their experiences, and 18 of them (54.5%) described distressing interviews involving deaths, surviving severe threats to life, and destruction of houses. There were 27 (81.6%) who reported having experienced 1 or more STS symptoms on a 20-item measure. Those who conducted interviews following a multifatality wildfire event reported higher levels of STS symptoms compared with researchers whose interviews followed nonfatal wildfires. There were 21 (63.6%) researchers who reported that their interviewing experiences had positive effects on their lives. This indicates that the researcher role of gathering information so that future wildfire risk could be mitigated may have served a protective function.

Reducing primary and secondary traumatic stress symptoms among educators by training them to deliver a resiliency program (ERASE-Stress) following the Christchurch earthquake in New Zealand.

The current investigation evaluated the impact of a universal school-based resiliency intervention (ERASE-Stress) on educators who were working with elementary schoolchildren exposed to the Canterbury earthquake in New Zealand. In the context of major disasters, educators may suffer from "dual trauma"; they can experience symptoms of both primary trauma (as a result of the disaster itself) and secondary trauma (as a result of working with traumatized students). Sixty-three educators were randomly assigned to either the ERASE-Stress intervention or an alternative Managing Emergencies and Traumatic Incidents (METI) program which served as a control group. Efficacy of the program was evaluated at the end of the training as well as at 8 months follow-up. Compared with educators in the control group, those in the ERASE-Stress intervention significantly reduced their posttraumatic distress and secondary traumatization symptoms, improved their perceived level of professional self-efficacy as a helper of earthquake survivors, developed an optimistic outlook regarding their personal future and enhanced their sense of hope, and honed some of their positive coping strategies and reduced the utilization of some maladaptive coping methods. These beneficial consequences of the ERASE-Stress training make it a potentially useful tool for educators working with traumatized students in the context of major disasters. (PsycINFO Database Record

Secondary traumatic stress and posttraumatic growth: Social support as a moderator

This present study examines (1) the relationship between secondary traumatic stress, perceived social support and posttraumatic growth after secondary exposure to traumatic events and (2) the moderating role of perceived social support on the secondary traumatic stress—posttraumatic growth relation. A sample of 135 nurses completed self-reporting measures describing symptoms of secondary traumatic stress, social support, and vicarious posttraumatic growth. The results indicate that secondary traumatic stress negatively correlates with vicarious posttraumatic growth, while social support positively correlates with vicarious posttraumatic growth. Furthermore, persons who self-report less secondary traumatic stress symptoms also report high levels of posttraumatic growth when they perceive to have a high level of social support. These findings emphasize the value of perceived support for persons indirectly exposed to traumatic events.

What Comes First, Job Burnout or Secondary Traumatic Stress? Findings from Two Longitudinal Studies from the U.S. and Poland.

This longitudinal research examined the directions of the relationships between job burnout and secondary traumatic stress (STS) among human services workers. In particular, using cross-lagged panel design, we investigated whether job burnout predicts STS at 6-month follow up or whether the level of STS symptoms explains job burnout at 6-month follow-up. Participants in Study 1 were behavioral or mental healthcare providers (N = 135) working with U.S. military personnel suffering from trauma. Participants in Study 2 were healthcare providers, social workers, and other human services professions (N = 194) providing various types of services for civilian trauma survivors in Poland. The cross-lagged analyses showed consistent results for both longitudinal studies; job burnout measured at Time 1 led to STS at Time 2, but STS assessed at Time 1 did not lead to job burnout at Time 2. These results contribute to a discussion on the origins of STS and job burnout among human services personnel working in highly demanding context of work-related secondary exposure to traumatic events and confirm that job burnout contributes to the development of STS.

Secondary Trauma Among Caregivers Who Work With Mexican and Central American Refugees

Thousands of refugees have fled Mexico, Honduras, Guatemala, and El Salvador to escape violence, criminal victimization, and persecution as a result of the breakdown of public safety that has accompanied the rise of organized crime and drug-related violence. Many of these migrants have experienced torture, rape, abduction, forced labor, arson, and kidnapping. Caregivers and professionals who work with these refugees, including social workers, volunteers, attorneys, and advocates, have repeatedly witnessed severe trauma among refugees as the migrants recount horrific stories about their journeys. We conducted in-depth interviews with 31 individuals who have worked extensively and repeatedly with traumatized refugees. Participants completed the Secondary Traumatic Scale (STSS) and the Professional Quality of Life (ProQOL)-Compassion Fatigue (CF) scale. While most participants reported signs and symptoms of secondary traumatic stress, many also demonstrated high levels of compassion satisfaction. In addition, most were involved in self-care. Hispanic participants reported that elements of their culture were protective.

Preventing secondary traumatic stress in educators.

Teachers can be vulnerable to secondary traumatic stress (STS) because of their supportive role with students and potential exposure to students' experiences with traumas, violence, disasters, or crises. STS symptoms, similar to those found in posttraumatic stress disorder, include nightmares, avoidance, agitation, and withdrawal, and can result from secondary exposure to hearing about students' traumas. This article describes how STS presents, how teachers can be at risk, and how STS can manifest in schools. A US Department of Education training program is presented, and thoughts on future directions are discussed.

Measuring secondary traumatic stress symptoms in military spouses with the posttraumatic stress disorder checklist military version.

Little research to date has examined secondary traumatic stress symptoms in spouses of military veterans. This study investigated the presence and severity of posttraumatic stress symptoms in a sample of 227 Army National Guard veterans and secondary traumatic stress symptoms among their spouses. The veterans completed the posttraumatic stress disorder (PTSD) Checklist Military Version (PCL-M) (Weathers et al., 1993) to determine the probable prevalence rate of posttraumatic stress symptoms. A modified version of the PCL-M was used to assess secondary traumatic stress symptoms in the spouses. A confirmatory factor analysis showed that the modified version of the PCL-M used to assess secondary traumatic stress symptoms in spouses fits using the same four-factor PTSD structure as the PCL-M for veterans. This study provides initial evidence on the underlying symptom structure of secondary traumatic stress symptoms among spouses of traumatic event victims.