Assessing psychological resilience: translation and validation of the Chinese version of the resilience evaluation scale (RES).

Background: The Resilience Evaluation Scale (RES) is a novel and freely available measure of psychological resilience (factored into self-confidence and self-efficacy). To date, psychometric properties were evaluated in Dutch and American samples, but not yet in a Chinese sample. Objective: We aimed to validate the RES in a Chinese sample by examining its factor structure, reliability, and construct validity. Methods: The RES was translated into Chinese following a cross-cultural translation and adaptation procedure. Self-report questionnaires including the RES, exposure to potentially traumatic events (PTE's), the PTSD checklist for DSM-5 (PCL-5), and scales for conceptually related constructs of psychological resilience were then administered via an online survey. Results: In total, 484 Chinese adults (females, 66.9%; age: 27.33 ± 6.86 years) participated. Parallel analysis results suggested a one-factor structure for the Chinese RES. The Chinese RES demonstrated good internal consistency (Cronbach's alpha = 0.88). Construct validity was demonstrated through significant associations with hypothesised related constructs and through a relation with lower levels of PTSD among the PTE-exposed subsample (n = 116) via the mediating role of avoidant coping strategies, i.e. behavioural disengagement and self-blame. Conclusion: Our results suggest that the RES is a reliable and valid assessment of psychological resilience to use in Chinese, in addition to its Dutch and English versions. The RES could potentially be adopted to measure psychological resilience in cross-cultural contexts.

Antecedentes: La Escala de Evaluación de la Resiliencia (RES en su sigla en inglés) es una medida nueva y disponible de forma gratuita de la resiliencia psicológica (conformada por los factores de autoconfianza y autoeficacia). A la fecha, las propiedades psicométricas fueron evaluadas en muestras danesas y americanas, pero no en una muestra china todavía.Objetivo: Buscamos validar la RES en una muestra china evaluando su estructura factorial, confiabilidad, y validez de constructo.Métodos: La RES fue traducida al chino siguiendo un procedimiento de traducción y adaptación intercultural. Se administraron en una encuesta en línea los cuestionarios de autoinforme incluyendo la RES, exposición a eventos potencialmente traumáticos (PTE's en su sigla en inglés), y la lista de chequeo del TEPT para el DSM-5 (PCL-5 en su sigla en inglés), y las escalas de constructos conceptualmente relacionados a la resiliencia psicológica.Resultados: En total, participaron 484 adultos chinos (mujeres, 66.9%; edad: 27.33 ± 6.86 años). Los resultados de los análisis paralelos sugirieron una estructura de un factor para la RES china. La RES china demostró una buena consistencia interna (alfa de Cronbach = 0.88). La validez de constructo fue demostrada a través de asociaciones significativas con los constructos hipotéticamente relacionades y a través de una relación con niveles más bajo de TEPT en la sub-muestra expuesta a PTEs (n = 116) por medio del rol mediador de los mecanismos de afrontamiento evitativos, es decir, desconexión conductual y autoculpa.Conclusión: Nuestros resultados sugieren que la RES es una evaluación fiable y valida de resiliencia psicológica para usar en chino, en adición a sus versiones danesa e inglesa. La RES podría potencialmente ser adaptada para medir la resiliencia psicológica en contextos interculturales.

Help in hand after traumatic events: a randomized controlled trial in health care professionals on the efficacy, usability, and user satisfaction of a self-help app to reduce trauma-related symptoms.

Background: Despite the fact that many people are affected by trauma and suffer from posttraumatic stress symptoms (PTSS) there is a lack of easy-accessible interventions to self-manage these symptoms. Mobile apps may deliver low-intensity self-help to reduce trauma-related symptoms and empower individuals following trauma, such as high-risk professionals who are regularly exposed to potentially traumatic events. In this randomized controlled trial, we examined the efficacy, and evaluated the usability and user satisfaction of the app 'SUPPORT Coach' as a self-help tool to reduce trauma-related symptoms. Methods: Health care professionals (e.g. nurses, physicians, paramedics and ambulance drivers) completed an online screening on PTSS (T0). They were randomized when at least one PTSS was reported, either to the intervention (1 month unlimited access to SUPPORT Coach) or control condition (no access to SUPPORT Coach). Self-reported PTSS, negative trauma-related cognitions, psychological resilience, and social support were assessed online at baseline (T1), post-condition (T2), and 1 month follow-up (T3). Results: Of the 1175 participants screened, 287 (24.4%) indicated at least one posttraumatic stress symptom and were randomized. The majority of intervention condition participants (83%, n = 103) used SUPPORT Coach; they were slightly to moderately satisfied with the app. There was no significant group difference in change in PTSS and social support after one-month app usage. However, the intervention condition showed a greater decline in negative trauma-related cognitions at T2 and T3, and a larger increase in psychological resilience at T3 than the control condition. Conclusions: SUPPORT Coach without guidance could potentially provide easy-accessible self-help to diminish negative trauma-related cognitions, and strengthen resilience in coping with adversities. However, since the attrition rate was substantially higher in the intervention than in control condition, our findings should be interpreted with caution and warrant replication.

Antecedentes: Pese al hecho de que muchas personas son afectadas por traumas y sufren de síntomas de estrés postraumático (PTSS por sus siglas en inglés) existe una carencia de intervenciones fácilmente accesibles para auto-manejar estos síntomas. Las aplicaciones móviles pueden entregar autoayuda de baja intensidad para reducir los síntomas relacionados con el trauma y empoderar individuos posterior a un trauma, tales como en profesionales de alto riesgo que están regularmente expuestos a eventos potencialmente traumáticos. En este ensayo controlado randomizado examinamos la eficacia, y evaluamos la usabilidad y satisfacción de la aplicación 'SUPPORT Coach' como una herramienta de autoayuda para reducir síntomas relacionados con el trauma.Métodos: Profesionales de atención en salud (como enfermeras, médicos, paramédicos y conductores de ambulancia) completaron un tamizaje online de PTSS (T0). Fueron randomizados cuando al menos un PTSS fue reportado, ya sea a la intervención (un mes de acceso ilimitado a SUPPORT Coach) o a control (sin acceso a la aplicación). Se evaluó el auto-reporte de PTSS, cogniciones negativas relacionadas al trauma, resiliencia psicológica y apoyo social basalmente (T1), post condición (T2) y un seguimiento al mes de la intervención (T3).Resultados: de los 1175 participantes tamizados, 287 (24.4%) indicaron al menos un síntoma de estrés postraumático y fueron randomizados. La mayoría de los participantes del grupo de la intervención usaron SUPPORT Coach (83% n=103), y se encontraron de leve a moderamente satisfechos con la aplicación. No hubo diferencia significativa entre los grupos en PTSS y en apoyo social después de un mes de haber utilizado la aplicación. Sin embargo, el grupo que recibió la intervención mostró una mayor declinación en cogniciones negativas relacionadas con el trauma en T2 y T3, y un mayor aumento de la resiliencia psicológica en T3 que en el grupo control.Conclusiones: El uso de SUPPORT Coach sin guía podría potencialmente proveer autoayuda fácilmente accesible para disminuir cogniciones negativas relacionadas con el trauma, y fortalecer la resiliencia al lidiar con adversidades. Sin embargo, dado que la tasa de deserción fue sustancialmente más alta en el grupo de intervención que en el de control, nuestros hallazgos debiesen ser interpretados con cautela y justifican replicación.

Web-Based Peer Support Education Program for Health Care Professionals.

BACKGROUND: Health care professionals can routinely face potential critical incidents in the workplace, which can cause high levels of occupational distress and mental health problems. Peer support, in which a trained colleague provides psychosocial support after a work-related critical incident, is an early intervention strategy to support health care professionals. This study describes the development and evaluation of an innovative new online program to educate peer supporters. METHODS: An interactive Web-based peer support education program (e-learning Peer Support) was developed to teach health care professionals the theory of peer support in preparation for face-to-face training (hybrid learning). User acceptance was determined with a 21-item online survey and technical user data. RESULTS: Forty-four health care professionals completed the e-learning Peer Support and the online evaluation survey. Participants were nurses (68.2%), physicians (18.2%), residents (6.8%), and staff (6.8%). The e-learning was well received and positively evaluated with regard to all studied indicators of acceptance, including perceived usefulness, ease of use, actual use, and effectivity. All participants would recommend the e-learning to future trainees. CONCLUSION: The e-learning is a valuable addition to the theoretical peer support training curriculum. Future steps include implementing the e-learning as a yearly continuing education meeting, as a clinical lecture, or as part of the standard curriculum for health care professionals in medical training. Developments like this e-learning may contribute to a standardized training method and, eventually, the implementation of peer support programs.

Predictors of Outcome and Residual Symptoms Following Trauma-Focused Psychotherapy in Police Officers With Posttraumatic Stress Disorder.

Police officers exposed to potentially traumatic events (PTE) are at a heightened risk of developing posttraumatic stress disorder (PTSD). Little is known about trauma-focused psychotherapy outcomes in the police. In this naturalistic study, we evaluated whether PTE exposure and baseline clinical characteristics predicted PTSD symptom reduction during treatment and residual PTSD symptoms posttreatment. In consecutive referrals to a specialized mental health service for police officers (N = 665), PTSD was measured pre- and posttreatment using structured clinical interviews. Treatment consisted of brief eclectic psychotherapy for PTSD. We grouped PTE as follows: injury/maltreatment, loss (colleague or private), other job-related, other private traumatic events. Data were analyzed multivariably using structural equation modeling and logistic regression. Treatment effect size was large, d = 3.6, 95% CI [3.4, 3.8]. Police officers who reported more injury/maltreatment or private traumatic had more baseline PTSD symptoms as well as larger symptom reduction during treatment; police officers who reported more losses of loved ones showed smaller PTSD symptom reduction. Concentration problems persisted in 17.7% of police officers posttreatment, and these were predicted by baseline PTSD symptoms and loss of loved ones. Proportions of variance explained by the multivariable models ranged from 0.08 to 0.14. Our findings increase insight into the type of PTE and clinical characteristics of police officers with PTSD who benefit most from trauma-focused treatment. Because loss of loved ones can be presumed to have a profound impact on social and interpersonal functioning, a more specific treatment focus on grief processes may further enhance efficacy.

Assessing Psychological Resilience: Development and Psychometric Properties of the English and Dutch Version of the Resilience Evaluation Scale (RES).

Background: Psychological resilience is a distinct factor that affects mental health outcomes after adversities. This study describes the development, validity and measurement invariance (MI) of a Dutch and English scale on psychological resilience, called the Resilience Evaluation Scale (RES). Methods: Separate online surveys with the Dutch and English version of the RES and hypothesized related measures were distributed in a Dutch- and English-speaking group, both drawn from the general population. Results: Exploratory factor analysis, using data from 522 respondents (n = 296 Dutch, n = 226 English), yielded a two-factor structure for the final 9-item RES. The factors reflected the hypothesized underlying constructs of psychological resilience: self-confidence and self-efficacy. The items and constructs of psychological resilience as measured by the RES were interpreted and conceptualized in the same way by both language groups, with the exception of one item. The RES showed good convergent validity and good internal consistency. Conclusions: The current study establishes sound psychometric properties of a new, brief, and freely available scale on psychological resilience. This study contributes to the identification and measurement of psychological resilience after adversities. The final 9-item RES may serve as a valuable instrument in research and in clinical practice.

Turning wounds into wisdom: Posttraumatic growth over the course of two types of trauma-focused psychotherapy in patients with PTSD.

BACKGROUND: Treatment studies in PTSD patients have mostly focused on adverse psychopathological outcomes whereas positive outcomes have received less attention. Objectives of this study were to investigate posttraumatic growth in response to two different psychotherapies, to examine the relationship between symptom improvement and growth, and to determine if posttraumatic growth predicted treatment response. METHODS: Outpatients diagnosed with PTSD after various types of trauma (n = 116) participated in a randomized controlled trial that compared Brief Eclectic Psychotherapy for PTSD (BEP) and Eye Movement Desensitization and Reprocessing therapy (EMDR). Posttraumatic growth was assessed pre- and post-treatment. PTSD severity was measured weekly. RESULTS: Posttraumatic growth scores significantly increased after trauma-focused psychotherapy, as well as scores in the subdomains personal strength, new possibilities, relating to others, and appreciation of life. Greater self-reported and clinician-rated PTSD decline was significantly related to greater increase in posttraumatic growth. No changes were found between treatment conditions, except for a stronger correlation between PTSD symptom decrease and increase in relating to others in BEP as compared to EMDR. No predictive effects were found. LIMITATIONS: We were unable to control for time effects because for ethical reasons, no control group not receiving treatment was included, and the stability of the changes could not be determined. CONCLUSIONS: Findings indicate that increases in posttraumatic growth accompany symptom decline in EMDR and BEP, and that these changes occur independent of whether the treatment specifically addresses posttraumatic growth as therapeutic process. Further research is encouraged to disentangle the contribution of therapeutic elements to growth.

Screening for trauma-related symptoms via a smartphone app: The validity of Smart Assessment on your Mobile in referred police officers.

To facilitate easily accessible screening for trauma-related symptoms, a web-based application called Smart Assessment on your Mobile (SAM) was developed. In this study, we examined whether SAM was able to accurately identify posttraumatic stress disorder (PTSD) and depression in adults. Eighty-nine referred police officers completed SAM, containing the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (PCL-5) and the Depression Anxiety and Stress Scale (DASS-21), on their own device prior to a diagnostic interview where the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and Structured Clinical Interview for DSM-IV (SCID-I/P) were administered. Results showed a substantial agreement between SAM and the diagnostic interview in the assessment of PTSD and depression. An optimal trade-off between sensitivity (89%) and specificity (68%) levels was found at a cut-off score of 31 on the PTSD Checklist for DSM-5 (area under the curve = 0.845, 95% CI [0.765, 0.925], diagnostic odds ratio = 15.97). This is one of the first studies to support the validity and reliability of a mobile screener following trauma. SAM may facilitate screening for trauma-related symptoms on a large scale and could be a first step in a stepped-care model for trauma survivors to help identify individuals who need further diagnostics and care.

Gender and Age Differences in Trauma and PTSD Among Dutch Treatment-Seeking Police Officers.

Little is known about how age and gender are associated with posttraumatic stress disorder (PTSD) symptoms and traumatic experiences in treatment-seeking police offers. In this study, we examined 967 diagnostic files of police officers seeking treatment for PTSD. Six hundred twelve (63%) of the referred police officers were diagnosed with PTSD (n = 560) or partial PTSD (n = 52). Police officers reported on average 19.5 different types of traumatic events (range 1-43). Those who experienced a greater variety of traumatic events suffered from more PTSD symptoms. Also, women reported more often direct life-threatening or private events as their index trauma than men and suffered from more PTSD symptoms than their male colleagues. Results indicate that police officers experience a considerable number of different traumatic events, which is significantly associated with PTSD symptoms. The results highlight the importance of early detection of PTSD symptoms in the police force.