scholarly journals The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Edward G. Spilg ◽  
Cynda Hylton Rushton ◽  
Jennifer L. Phillips ◽  
Tetyana Kendzerska ◽  
Mysa Saad ◽  
...  

Abstract Background Global health crises, such as the COVID-19 pandemic, confront healthcare workers (HCW) with increased exposure to potentially morally distressing events. The pandemic has provided an opportunity to explore the links between moral distress, moral resilience, and emergence of mental health symptoms in HCWs. Methods A total of 962 Canadian healthcare workers (88.4% female, 44.6 + 12.8 years old) completed an online survey during the first COVID-19 wave in Canada (between April 3rd and September 3rd, 2020). Respondents completed a series of validated scales assessing moral distress, perceived stress, anxiety, and depression symptoms, and moral resilience. Respondents were grouped based on exposure to patients who tested positive for COVID-19. In addition to descriptive statistics and analyses of covariance, multiple linear regression was used to evaluate if moral resilience moderates the association between exposure to morally distressing events and moral distress. Factors associated with moral resilience were also assessed. Findings Respondents working with patients with COVID-19 showed significantly more severe moral distress, anxiety, and depression symptoms (F > 5.5, p < .020), and a higher proportion screened positive for mental disorders (Chi-squared > 9.1, p = .002), compared to healthcare workers who were not. Moral resilience moderated the relationship between exposure to potentially morally distressing events and moral distress (p < .001); compared to those with higher moral resilience, the subgroup with the lowest moral resilience had a steeper cross-sectional worsening in moral distress as the frequency of potentially morally distressing events increased. Moral resilience also correlated with lower stress, anxiety, and depression symptoms (r > .27, p < .001). Factors independently associated with stronger moral resilience included: being male, older age, no mental disorder diagnosis, sleeping more, and higher support from employers and colleagues (B [0.02, |-0.26|]. Interpretation Elevated moral distress and mental health symptoms in healthcare workers facing a global crisis such as the COVID-19 pandemic call for the development of interventions promoting moral resilience as a protective measure against moral adversities.

2021 ◽  
Vol 12 ◽  
Author(s):  
Eamonn P. Arble ◽  
Sneha Shankar ◽  
Steven W. Steinert ◽  
Ana M. Daugherty

The COVID-19 outbreak has affected healthcare across all levels. Older adults and those with chronic illness are at greatest risk for infection complications and mortality, which presents significant psychological distress for residential healthcare workers. The concept of selfobject needs, consisting of Mirroring, Idealizing, and Twinship, may be relevant in explaining psychological distress. This study seeks to enhance our understanding of the needs of healthcare workers responsible for elderly patients and evaluate the role of psychosocial support through selfobject needs to mitigate the effects of trauma during the pandemic. Participants (N = 103) employed in residential healthcare facilities in the metropolitan Detroit, MI (USA) region completed an online survey during the peak initial infection. Assessments included standardized measures of trauma-related symptoms, depression, anxiety, and general distress symptoms, as well as a validated measure of selfobject needs. Residential healthcare workers reported mental health symptoms across domains, including clinical elevations in symptoms of trauma, depression, and anxiety. Selfobject needs and mental health outcomes were positively correlated, indicating that greater unmet relational need was associated with greater severity of symptoms. Greater trauma symptom severity as a proxy index of current experience during the pandemic predicted high depressive symptoms, and greater Mirroring need worsened the effect. These results suggest that interventions targeting selfobject needs, specifically Mirroring, may be effective at mitigating acute mental health symptoms among healthcare workers during a distressing event.


2021 ◽  
Vol 26 (2) ◽  
pp. 367-380
Author(s):  
Teona Serafimova ◽  
Maria Loades ◽  
Daisy Gaunt ◽  
Esther Crawley

Background: One in three adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have mental health problems. Multi-informant perspectives are key to psychological assessment. Understanding parent-child agreement is crucial to accurate diagnosis, particularly where severe fatigue limits self-report. Methods: Agreement on the revised children’s anxiety and depression scale (RCADs) was assessed between parents and children with CFS/ME ( n = 93) using Bland-Altman plots, cross tabulations and regression analyses. Results: Diagnostic thresholds were met more frequently based on child-report. Parent- and child-report had similar sensitivity and specificity on RCADS compared to gold-standard diagnostic interviews. Regression analysis found similar accuracy between both reports. For anxiety diagnoses, odds ratio (OR) for child-report was 1.10 (CI = 1.06–1.14), and 1.10 (CI = 1.05–1.14) for parent-report. For depression, OR for child report was 1.26 (CI = 1.11–1.43), while for parent-report is was 1.25 (CI = 1.10–1.41). For total score, OR for child-report was 1.10 (CI = 1.05–1.13) while OR for parent-report was 1.09 (CI = 1.05–1.13). Conclusions: Reasonable agreement was observed between parent- and child-report of mental health symptoms in paediatric CFS/ME. While parent-report can facilitate psychological evaluation in CFS/ME, this is not a substitute for a child’s own report.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Kathleen M McTigue ◽  
Elan Cohen ◽  
Alison Hipwell ◽  
Charity Moore ◽  
Rolf Loeber ◽  
...  

Introduction Obesity and mental health problems are increasing in youth; both are often under-treated. The interplay between mental health and body weight development in adolescent girls is not well understood. Hypothesis Bi-directional associations will be established between mental health symptoms (depression and conduct symptoms) and BMI in urban pre-adolescent girls. Methods We examined data from participants in an accelerated longitudinal cohort study of largely disadvantaged urban girls from a single US city (n=2,451; 53% African American). Data were collected annually over 6 years, starting in 2003 when girls were age 8-11. Depression and conduct symptoms (oppositional defiant disorder and conduct disorder symptoms combined) were collected via the validated Child Symptom Inventory (CSI-4) and height and weight were measured. Transitional models assessed for bi-directional associations between mental health symptoms and BMI. Random-effects mixed models identified within-subject and between-subject effects in models examining whether mental health symptoms predicted BMI. All models were adjusted for race, age, and receipt of public assistance, and when applicable, included interaction terms. Results Transitional models showed that prior depression symptoms (β=0.27; p<0.001) predicted an increase in BMI while prior conduct symptoms (β=0.04; p=0.05) showed a small and borderline significant effect on BMI. An increase in prior BMI predicted an increase in depression symptoms (β=0.074, p<0.001) but not conduct symptoms (β=0.028, p=0.125). Mixed models revealed significant between-girl and within-girl effects (β = 0.38 and 0.038, respectively, both with p<0.001) for depression symptoms predicting BMI. Conduct symptoms showed a significant between-girl effect (β=0.51; p=0.045) but a non-significant within-girl effect (β=0.011; p=0.080) when used to predict BMI. Conclusions We identified a clear bi-directional relationship between depression symptoms and BMI in under-privileged girls, and mixed models confirmed that a change in depression score is associated with increased BMI. While an increase in conduct symptoms shows a weak positive association with BMI, the association was not bi-directional. The potential for BMI and depression to each reinforce the other may represent a mechanism for the development of high-risk weight patterns in girls. Early identification of those at risk may facilitate preventive measures for both weight and mental health outcomes.


2021 ◽  
pp. 000486742110653
Author(s):  
Elizabeth M Westrupp ◽  
Christopher J Greenwood ◽  
Matthew Fuller-Tyszkiewicz ◽  
Craig A Olsson ◽  
Emma Sciberras ◽  
...  

Objective: To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world’s first long and strict lockdowns over July–October 2020, while the rest of Australia experienced ‘COVID-normal’ with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and COVID-19-related factors associated with mental health trajectories. Methods: Online community sample of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children’s Anxiety Scale). Results: Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [β] = 0.09–0.46), parent/child diagnoses (β = 0.07–0.21), couple conflict (β = 0.07–0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (β = 0.12–0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers ( https://lingtax.shinyapps.io/CPAS_trend/ ). Conclusion: Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.


2021 ◽  
Author(s):  
Edward Spilg ◽  
Cynda Hylton Rushton ◽  
Jennifer L. Phillips ◽  
Tetyana Kendzerska ◽  
Mysa Saad ◽  
...  

2017 ◽  
Author(s):  
Douglas H. Schultz ◽  
Takuya Ito ◽  
Levi I. Solomyak ◽  
Richard H. Chen ◽  
Ravi D. Mill ◽  
...  

ABSTRACTWe all vary in our mental health, even among people not meeting diagnostic criteria for mental illness. Understanding this individual variability may reveal factors driving the risk for mental illness, as well as factors driving sub-clinical problems that still adversely affect quality of life. To better understand the large-scale brain network mechanisms underlying this variability we examined the relationship between mental health symptoms and resting-state functional connectivity patterns in cognitive control systems. One such system is the frontoparietal cognitive control network (FPN). Changes in FPN connectivity may impact mental health by disrupting the ability to regulate symptoms in a goal-directed manner. Here we test the hypothesis that FPN dysconnectivity relates to mental health symptoms even among individuals who do not meet formal diagnostic criteria but may exhibit meaningful symptom variation. We found that depression symptoms severity negatively correlated with between-network global connectivity (BGC) of the FPN. This suggests that decreased connectivity between the FPN and the rest of the brain is related to increased depression symptoms in the general population. These findings complement previous clinical studies to support the hypothesis that global FPN connectivity contributes to the regulation of mental health symptoms across both health and disease.AUTHOR SUMMARYUnderstanding how large-scale network interactions in the brain contribute to (or serve a protective role against) mental health symptoms is an important step toward developing more effective mental health treatments. Here we test the hypothesis that cognitive control networks play an important role in mental health by being highly connected to other brain networks and able to serve as a feedback mechanism capable of regulating symptoms in a goal-directed manner. We found that the more well-connected the frontoparietal cognitive control network was to other networks in the brain the less depression symptoms were reported by participants. These results contribute to our understanding of how brain network interactions are related to mental health symptoms, even in individuals who have not been diagnosed with a disorder.


2021 ◽  
Vol 11 (12) ◽  
pp. 178
Author(s):  
Kerri E. Rodriguez ◽  
Shelby E. McDonald ◽  
Samantha M. Brown

Adverse childhood experiences (ACEs) are associated with poor mental health. Emerging research demonstrates the protective role of positive childhood experiences, including a positive sense of self and relationships with both humans and animals, in mitigating the impacts of early life adversity on mental health outcomes. This study examined whether benevolent childhood experiences (BCEs) or relationships and interactions with pets during childhood moderated the link between ACEs and current mental health symptoms in a sample of young adults. Students (N = 214) recruited from a public university in the U.S. completed an online survey. The results showed that ACEs were significantly associated with worse mental health symptoms, including anxiety and depression. Neither emotional closeness to a childhood pet dog nor positive interactions with a childhood pet were significant moderators of the relationship between ACEs and mental health. In contrast, more BCEs were associated with better mental health, and their interaction with ACEs was significant such that adversity-exposed young adults with high BCEs reported fewer mental health symptoms than those with low BCEs. The results highlight the need for continued research on differential experiences that may be protective in the relationship between adversity exposures and mental health.


Author(s):  
Roy Rillera Marzo ◽  
Emilio Quilatan Villanueva III ◽  
Udita Chandra ◽  
Mila Nu Nu Htay ◽  
Rajeev Shrestha ◽  
...  

Background: COVID-19 pandemic has caused an extraordinary situation, especially for the healthcare workers (HCWs), leading to increased psychological stress. The aim of the study was to estimate the prevalence of different grades of anxiety and depression across different centers in the Philippines and identify demographic factors associated with them. Design and Method: A cross-sectional, web-based, multi-center study was conducted among HCWs of Philippines from April 20- May 20, 2020. The study instruments used were the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was done to identify factors significantly associated with symptoms of anxiety and depression determined. Results: A total of 516 HCWs were included in the study. Most of them have anxiety symptoms (70.74%), but only half of them have symptoms of depression (50.97%). In addition, gender, age, marital status, living status, occupation, work premises, and availability of mental health services were significantly associated with the participants’ anxiety symptoms; In contrast, gender, marital status, occupation, and work premises were significantly associated with depression symptoms. Conclusion: This study reiterates the fact and demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is a dire need to address mental illness amongst HCWs and frame guidelines based on proven algorithms to overcome these mental illnesses.


2018 ◽  
Vol 8 (2) ◽  
pp. 41
Author(s):  
Roni Mermelshtine ◽  
Jacqueline Barnes

Perceptions of poor care in the family of origin can relate to adverse mental health and poor adaptation for mothers but there is less evidence about fathers. This study investigated the relevance of fathers’ recollections of their own parents (Generation 1) for their (Generation 2) current mental health symptoms and for interactions with their 3-year-old children (Generations 2/3), in a community sample of 482 British fathers. Recollections of G1 maternal and paternal behaviour were associated in uncontrolled correlations with G2 paternal mental health, but taking family social class and maternal (G2) mental health into account they did not significantly predict G2 fathers’ mental health symptoms at 36 months postpartum, though a trend remained for G1 paternal care. Significant predictors were paternal depression symptoms in the first year postpartum and G2 mothers’ current mental health. Predictors of more dysfunctional father-child (G2/G3) interactions at 36 months postpartum were working class status, recall of more G1 maternal controlling behaviour and more concurrent paternal mental health symptoms; predictors of less G2/G3 dysfunction were G2 paternal use of more positive discipline. Potential implications of the results for parenting support and advice are discussed, recognising that intergenerational transmission of parent-child relationships is likely for fathers.


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