"You can't wash your hands in a house without running water": pandemic precautionary behaviors after Hurricane Laura.

Hurricane Laura made landfall in southwestern Louisiana in August 2020 while the world was several months into the COVID-19 pandemic. In the present research, we examined pandemic precautionary behaviors in a sample of adults who varied in exposure and damage due to Hurricane Laura, a destructive Category 4 hurricane. A total of 127 participants responded to an online survey that assessed pandemic worry and precautionary behaviors, hurricane exposure and damage, and health-related quality of life. We found that Hurricane Laura victims neglected pandemic precautionary behaviors at significantly higher levels in the weeks immediately following Hurricane Laura than did indirectly impacted control participants, although the two comparison groups did not differ in COVID-19 worry or adherence to precautionary pandemic behavior 14-22 months after Hurricane Laura made landfall. Older age was negatively correlated with COVID-19 worry prior to Hurricane Laura, which was unexpected given that older people in general were more vulnerable to COVID-19 by their membership in a high-risk group. Future directions for research on post-disaster vulnerabilities during a global pandemic are discussed.

Assessing and intervening with children who have been traumatized

Nearly a billion children have had their lives disrupted by the 2019-2021 SARS CoV 2 (Severe Acute Respiratory Syndrome Coronavirus 2;COVID-19) global pandemic, with some estimates suggesting that the economic devastation may result in nearly 725 million children living in poverty in the absence of any mitigating policies (UNICEF, 2020). Given the likelihood of trauma exposure and the almost certainty of being impacted by the global pandemic, it is vital for educators, parents, and public health officials to have a better understanding of the neuropsychological factors underscoring both trauma and resilience in order to better meet the needs of our students. After all, not all children exposed to trauma and adversity experience detrimental outcomes, and many children are capable of devising internal coping and resilience strategies to grow from these experiences. This chapter discusses the various types of trauma that children typically encounter, how trauma impacts key regions in the brain responsible for learning and social-skills development, offer assessment strategies, and suggest targeted intervention strategies for schools and parents in light of some of the unprecedented circumstances our children must face. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Individual and community psychological experiences of the COVID-19 pandemic: The state of emergency in Portugal.

Individuals have different ways of coping with crisis. Individual factors, family and contextual features, and community support may influence how individuals feel, think and act during a crisis. COVID-19 was an unexpected pandemic that forced many European countries to take confinement measures and restrict social face to face interactions. This study is an effort to understand how Portuguese residents dealt with the pandemic during the first confinement period, considering different sociodemographic characteristics and trauma exposure perceptions. Five hundred and five adults, between 18 and 79 years old participated in this study via an online self-report assessment protocol. Sociodemographic characteristics such as gender, age, marital status, employment status, and caring responsibilities had an impact on individuals' perceptions regarding their exposure to the pandemic and their quality of life. Perceived exposure to the pandemic was found to predict quality of life in the physical, psychological, and environmental domains. Results have practical implications for European and local policy-making, as well as for targeting psychological interventions for those whose mental health has been negatively affected by the pandemic and for those who may become more affected if confinement measures are implemented again.

The SEED Wellness Model: A Workplace Approach to Address Wellbeing Needs of Healthcare Staff During Crisis and Beyond.

Workplace wellness has gained new meaning and significance in the healthcare workforce in the face of the COVID-19 pandemic. Healthcare workers across the world have carried the burden of responding to the public health crisis by having to work under new pressures and constantly changing environments, take on additional shifts, risk their own health and lives, and cope with the ongoing psychological and emotional strain. The purpose of this paper is to articulate a workplace wellness model applied across hospitals in the Illawarra Shoalhaven Local Health District, a regional area in New South Wales, Australia. The description of the development, components, and lessons learned from the SEED Wellness Model illustrates one possible solution about how to provide better care for the staff thus not only preventing staff burnout and turnover, but also creating lasting organizational benefits. The detailed model description can assist in developing a larger and more rigorous evidence-base to improve staff wellness in healthcare settings, both within Australia and internationally.

Pain Interference, Resilience, and Perceived Well-Being During COVID-19: Differences Between Women With and Without Trauma Exposure Prior to the Pandemic.

Objectives: The aim of this study was to investigate the consequences of the COVID-19 pandemic in women with non-malignant chronic pain, and to determine whether women exposed to traumatic situations prior to the outbreak would be at a higher risk of negative health impacts. Methods: A total of 365 women were divided into three subgroups according to whether or not they had experienced a traumatic event prior to COVID-19. They completed an online survey. Results: Significant differences were found between groups during lockdown: 1) more psychological abuse was experienced by the group of women who had experienced an interpersonal traumatic event prior to the pandemic than in the other subgroups; 2) physical activity levels were higher and scores on pain interference were lower in women in the non-traumatized subgroup than in the other subgroups; 3) pain interference was predicted by pain intensity, decreased social support, and resilience, whereas perceived well-being was predicted by pain interference. Conclusion: Women who had experienced a traumatic event prior to the pandemic suffered worse consequences of the COVID-19 lockdown, particularly greater pain interference, although resilience was shown to both mitigate pain interference and enhance perceived well-being.

A Positive Legacy of Trauma? The Role of Perceived Social Support on Mental Health Among Earthquake Survivors During the COVID-19 Outbreak.

Background: People with prior experience of severe trauma may be particularly vulnerable in the face of the COVID-19 pandemic. However, little is known about mental health problems among prior trauma survivors during the pandemic outbreak. Methods: A total of 362 Wenchuan earthquake survivors were assessed using Patient Health Questionnaire, Generalized Anxiety Disorder Scale, as well as Multidimensional Scale of Perceived Social Support, as part of an online survey between February 3 and 10, 2020. Results: Our results showed that 6.6 and 4.7% of the participants experienced depression and anxiety during the COVID-19 outbreak, respectively. Perceived social support was negatively associated with depressive and anxiety symptoms. Earthquake exposure has no direct effect on current depressive and anxiety symptoms, but it would moderate the direct relationship between perceived social support and psychological symptoms. Conclusions: Our findings suggested that trauma exposure may lead to salutogenic outcomes. The protective effect of perceived social support on psychological symptoms was greater in people with a higher level of trauma exposure than in a lower one.

Episodic future thinking and COVID-19 vaccination intent in trauma-exposed military veterans: A pilot study

Explored the prospective association between the quality of episodic future imagining and subsequent COVID-19 vaccination intent in 19 trauma-exposed military veterans who had previously undergone an assessment of PTSD and participated in a larger study of episodic future imagining. Results found that generation of more internal details on an the episodic future thinking task was prospectively associated with greater vaccination intent, as measured by intention to seek COVID-19 vaccination or being vaccinated. However, more severe lifetime PTSD symptoms were associated with less detailed future imagining. Finally, greater restraint from higher risk behaviors, beliefs that minimized health risks of COVID-19, and beliefs that vaccinations were dangerous were also associated with vaccination hesitancy. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Trauma exposure and depression among frontline health professionals during COVID-19 outbreak in China: the role of intrusive rumination and organizational silence.

BACKGROUND: Healthcare professionals bared particularly high risk and stress during the COVID-19 outbreak. Previous studies have demonstrated that healthcare professionals exposed to COVID-19 incurred various affective disorders including depressive symptoms, anxiety, insomnia, and distress. However, the mechanism underlying the relationship between trauma exposure and depressive symptom among frontline hospital staff has yet to be investigated. This study aims to assess the prevalence of depressive symptoms among frontline healthcare professionals in Shenzhen, China, and elucidate the complex relationship among trauma exposure, intrusive rumination, and organizational silence. METHODS: The data of this study were collected through a time-lagged panel questionnaire survey with three rounds of measurements from February 2020 to May 2020 at an infectious disease hospital in Shenzhen, in which all the confirmed cases of COVID-19 patients were accommodated. Based on cluster sampling design, a total of 134 frontline healthcare professionals directly involved in providing diagnosis, treatment, and nursing services for COVID-19 patients completed three times of web survey. The depressive symptom and trauma exposure were measured via the 12-items General Health Questionnaire and the Explosion Exposure Questionnaire respectively. A moderated mediation model examined the complex interplay among the major study variables. Gender and working year were included as control variables. RESULTS: Trauma exposure was significantly associated with depression in frontline healthcare professionals. Intrusive rumination mediated the effect of trauma exposure on the depressive symptom, which was moderated by organizational silence. Intrusive rumination presented a more substantial impact on depression while organization silence was lower. CONCLUSIONS: This research demonstrates that intrusive rumination and organizational silence are imperative for predicting the depressive symptoms among the frontline healthcare professionals during the COVID-19 pandemic.

The development of a UK police traumatic events checklist

One in five UK police officers suffers from Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, yet there is no gold standard measure of trauma exposure available. This study coded 4,987 exposures reported by 1,531 UK police officers, using their own language. The resulting checklist describes over 70% of typical ‘worst’ reported traumatic incidents (plus situational factors, including Covid19). The Police Traumatic Experiences Checklist is a practical tool of value for self-assessment and peer support, and can facilitate attempts by Occupational Health and management to improve monitoring and treatment access. © The Author(s) 2021.

The Deathworld of First Responders: Being a Stranger to Oneself

The study of trauma incident response is a topic of relevance for research as the world faces the unforeseeablein the Covid-19 pandemic. First responders and those on the front lines attempt to navigate both the Lifeworld and the Deathworld of occupational exposure to trauma. The chapter presented is one based on a Schützian Lifeworld study (Crockford 2019) of six first responders excavating a deeper understanding to the phenomena of unprocessed, unaddressed trauma exposure;a factor that correlates to first responders’ high rates of completed suicides, which are 10 times that of the general public (Heyman et al. 2018). The chapter considers the concept of the “The Stranger” (Schütz 1976, p. 91–105) in relation to first responders who purposely run toward trauma and dominate that realm;the affects from trauma exposure internalize as habituated patterns, a means for coping through the many and unsurmountable experiences they endure. Through managing chaotic situations, an emerging theme of coping in the aftermath of trauma exposure was to hold a sense of culpability and selfdoubt. Emotional repression emerged as a way to cope in a Lifeworld where they are never off duty. This chapter draws on the first responder experience, in particular, to convey how the Lifeworld and Deathworld is negotiated in a type of hypervigilance and a splitting off of the emotional self for survival. © 2021 Walter de Gruyter GmbH, Berlin/Boston.

Somatic Comorbidities of Trauma Exposure and Post Traumatic Stress Disorder

During the COVID-19 pandemic, psychotrauma and its potential sequelae, such as posttraumatic stress disorder (PTSD), are of increased concern to family medicine. Trauma exposure and PTSD both increase the risks of a broad range of physical diseases. The knowledge of these diseases supports targeted prevention and early diagnosis. This paper provides a brief overview of diseases associated with psychotrauma and PTSD. The identified diseases include inadequate immune response, infectious diseases, dermatoses, cardiovascular and pulmonary diseases, cancer, metabolic dysfunction, traumatic brain injury, pain disorders, and musculoskeletal, gastrointestinal, and urogenital disorders. Various possible relationships between trauma exposure, PTSD, and somatic disorders are highlighted. Not only can trauma exposure and PTSD increase the risk for or be a consequence of illnesses, but also affect the course of sequelae or comorbid diseases and their treatment. Family physicians play an essential role in the health care of patients with traumatic experiences or PTSD. Knowledge of the associations between trauma exposure, PTSD, and somatic diseases can facilitate targeted prevention of somatic diseases, early diagnosis, and structured treatment planning for multimorbid patients. © Deutscher Ärzteverlag ;ZFA ;Zeitschrift für Allgemeinmedizin.

Online therapy in a shared reality: The novel coronavirus as a test case

When the novel coronavirus began to spread, many countries mandated lockdowns, quarantines, and social distancing, posing a threat to both clients and therapists and perhaps representing a "shared traumatic reality" (STR). Simultaneously, many mental health professionals moved to "online therapy," a mode that might increase the sense of having a shared reality. This study aimed to examine the extent to which therapists consider the pandemic an STR and the associations among helping professionals' sociodemographic and professional profiles, their perceptions of STR, their attitudes toward psychological online interventions (POI), and their satisfaction using such interventions. A total of 150 therapists completed an online Google Forms survey between April 17 and May 6, 2020, before therapists returned to their workplaces. The survey included questionnaires about STR and about attitudes toward and satisfaction with online therapy. Participants perceived the pandemic as an STR, particularly in the trauma dimension. The newly developed index of "shared concerns" showed that this perception was mainly a result of financial and health concerns. The satisfaction of using POI depended on participants' attitudes toward online therapy. The more experience therapists had, the less they perceived the current situation as an STR. This study, extending the theoretical concept of STR via the newly developed index, recommends that pandemics be included within the typology of shared traumatic events. Moreover, although positive attitudes toward online therapy are prevalent, young professionals require training to use POI for various traumatic situations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement.

The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed.

Prospective prediction of PTSD and depressive symptoms during social unrest and COVID-19 using a brief online tool.

Large-scale protracted population stressors, such as social unrest and the coronavirus disease 2019 (COVID-19), are associated with increased symptoms of post-traumatic stress disorder (PTSD) and depression. Cost-effective mental health screening is prerequisite for timely intervention. We developed an online tool to identify prospective predictors of PTSD and depressive symptoms in the context of co-occurring social unrest and COVID-19 in Hong Kong. 150 participants completed baseline and follow-up assessments, with a median duration of 29 days. Three logistic regression models were constructed to assess its discriminative power in predicting PTSD and depressive symptoms at one month. Receiver-operating characteristic analysis was performed for each model to determine their optimal decision thresholds. Sensitivity and specificity of the models were 87.1% and 53.8% for probable PTSD, 77.5% and 63.3% for high-risk depressive symptoms, and 44.7% and 96.4% for no significant depressive symptoms. The models performed well in discriminating outcomes (AUCs range: 0.769-0.811). Probable PTSD was predicted by social unrest-related traumatic events, high rumination, and low resilience. Rumination and resilience also predicted high-risk and no significant depressive symptoms, with COVID-19-related events also predicting no significant depression risk. Accessible screening of probable mental health outcomes with good predictive capability may be important for early intervention opportunities.

Peritraumatic reactions during the COVID-19 pandemic - The contribution of posttraumatic growth attributed to prior trauma.

Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors' adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one's health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic.

Psychological distress related to COVID-19 - The contribution of continuous traumatic stress.

OBJECTIVE: The novel coronavirus (COVID-19) is a substantial stressor that could eventuate in psychological distress. Evidence suggests that individuals previously exposed to traumatic events, and particularly to continuous traumatic stress (CTS), might be more vulnerable to distress when facing additional stressors. This study aimed to investigate these suppositions in the context of the ongoing shelling of Israel from the Israel-Gaza border, which continues even amidst the COVID-19 crisis. METHOD: An online survey was conducted among Israel's general population. The sample included 976 participants. Seven-hundred-and-ninety-three participants had been exposed to traumatic events, with 255 participants reporting CTS. Trauma exposure, COVID-19-related stressors, and psychological distress related to COVID-19 (anxiety, depression, and peritraumatic stress symptoms) were assessed. RESULTS: Most participants reported experiencing at least one psychiatric symptom related to COVID-19. Being younger, female, not in a relationship, having a below-average income, being diagnosed with the disease, living alone during the outbreak, having a close other in a high-risk group, and negatively self-rating one's health status were associated with elevated distress. Individuals who had been exposed to trauma, and to CTS in particular, had elevated anxiety, depression, and peritraumatic stress symptoms compared to individuals without such a history or to survivors of non-ongoing traumatic events. CTS moderated the relations between PTSD symptoms, anxiety symptoms, and peritraumatic stress symptoms, with significantly stronger relations found among individuals exposed to CTS. LIMITATIONS: This study relied on convenience sampling. CONCLUSIONS: Trauma survivors, and particularly traumatized individuals exposed to CTS, seem at risk for psychological distress related to COVID-19.