Salutogenesis and the Mental Health of First Responders

In this chapter, the author addresses salutogenesis and the mental health of first responders (FRs). Research has observed FRs to be prone to psychological distress and psychopathology resulting from their repeated exposure to potentially traumatic events. Most of the literature is focused on postevent treatment. The author discusses a mental fitness model that includes salutogenically oriented psychoeducation and other activities to enhance mental fitness among FRs and build their psychological strengths as they face adversities on their job.In closing, the author recommends that besides psychopathology-oriented programs intended for providing mental first aid to FRs and for the communities who experience potentially traumatic events, intervention also should include salutogenically based mental preparation programs. These should emphasize the strengths and resources that could help FRs arrive at scenes of disaster equipped with salutogenic resources, at the strategic as well as tactical levels.

Advancing the Study of Resilience to Daily Stressors

Historically, studies of childhood and adult resilience have typically focused on adaptation to chronic life adversities, such as poverty and maltreatment, or isolated and potentially traumatic events, such bereavement and serious illness. Here, we present a complementary view, suggesting that stressors experienced in daily life may also forecast individual health and well-being. We argue that daily process approaches that incorporate intensive sampling of individuals in natural settings can provide powerful insights into unfolding adaptational processes. In making this argument, we review studies that link within-person dynamics with diverse health-related phenomena. Findings from this research provide support for a multiple-levels-analysis perspective that embraces greater unity in pivotal resilience constructs invoked across childhood and adult literatures. Drawing on insights and principles derived from life-span theory, we conclude by outlining promising directions for future work and considering their broader implications for the field of resilience.

Adolescence Outside the Restricted Zone: A Narrative Study of Nuclear Disaster Response Trajectories intertwining with Life (TiL)

Responses to trauma can involve complex meaning-making processes and the perception of ambiguous threats. This study sought to explore response trajectories to a nuclear disaster and their intertwining courses with ecological factors (Trajectories intertwining with Life—TiL) from adolescence onward among a non-evacuated population. Four women and four men (mean age 20) who were adolescents during the 2011 nuclear accident in Fukushima (mean age 14), and who grew up outside the restricted zone participated in the study. Semi-structured life story interviews were conducted in the form of in-depth qualitative inquiries. A holistic analysis was employed to identify the TiL patterns following the Fukushima nuclear disaster in the overall context of the stories and to reveal important themes throughout adolescence. Four TiL patterns were found: three trajectories corresponding with those identified in prior research and one newly identified trajectory. The perceived, distal, and continuous threat of radiation played a central role in all patterns and exerted secondary impacts throughout the lives of non-evacuated adolescents. The study’s implications shed light on rarely studied response trajectories to ambiguous Potentially Traumatic Events (PTEs) throughout adolescence and point out the benefits of using a life story approach to this end for the first time.

Mediating Role of Stress at Work in the Relationship of Alexithymia and PTSD among Emergency Call Operators

Aim: The main purpose of this research was to investigate the relationship between alexithymia, stress at work, and post-traumatic stress disorder (PTSD) in impact emergency call center operators working in Poland (province of Greater Poland). The risk of exposure to critical life events was also considered. Methods: Data were collected using self-report questionnaires administered after dispatchers’ shifts. The emergency call center operators (N = 66) completed the Impact of Event Scale—Revised, 20-item Toronto Alexithymia Scale, Workplace Perceived Stress Questionnaire, and a questionnaire measuring the frequency and intensity of potentially traumatic events faced by emergency operators (a questionnaire developed by the authors). Results: Twenty of the most frequent events (e.g., child sexual harassment, rape, etc.) were identified. Results indicated that post-traumatic stress positively correlated with (a) work-related stress and (b) one aspect of alexithymia: difficulty expressing feelings. Additionally, work-related stress was identified as a mediator for the relation between alexithymia and the intensity of post-traumatic stress. Conclusions: The results of this study confirm that emergency operators are a high-risk group for the development of PTSD. The study results suggest that performing the work of an emergency dispatcher is not only demanding but also inherently involves participation in potentially traumatic events (as encountered through emergency calls).

The Impact of Coping Skills in Post-traumatic Growth of Healthcare Providers: When Mental Health Is Deteriorating Due to COVID-19 Pandemic

Background: Frontline healthcare providers are consistently exposed to potentially traumatic events while assisting patients with COVID-19. Post-traumatic growth (PTG) happens when a person can transform trauma and use adversity in one’s advantage. In response to limited studies on positive outcomes that may occur from the pandemic; this study aimed to elucidate the positive impact of coping with COVID-19 outbreak on mental health, such as PTG.Methodology: The study comprised a sample of 691 healthcare providers 59% female, including physicians (n = 138) and nurses (n = 550), working in public health facilities in Kosovo, with an average age of 41.6 years (SD = 10.79). They were asked to complete a questionnaire with four parts: Socio-demographic, GHQ-28, COPE and PTGI. A deterioration of mental health with somatic symptoms leading to the escalation due to COVID-19 outbreak was found.Results: Female healthcare providers reported more clinical symptoms as well as higher coping skills scores than men. The domains in which positive changes were most frequently observed were Relating to Others, New Possibilities and Personal Strength. There was no significant direct effect of mental health on PTG in the mediation model, though a significant indirect effect was observed for coping skills.Conclusion: The results suggest that levels of mental health exacerbation do not play a conclusive role in determining levels of PTG, as long coping mechanisms are in place. The development and implementation of interventions to minimize COVID-19-related mental health consequences, by fostering PTG among healthcare providers could be highly beneficial in pandemic response work.

Healthcare workers’ heterogeneous mental-health responses to prolonging Covid-19 pandemic: A full year of monthly follow up in Finland

Purpose: To investigate changes in healthcare workers’ mental-health under prolonging Covid-19 pandemic conditions.Methods: A monthly survey over a full year was conducted for employees of the HUS Helsinki University Hospital (n = 4804) between 4th June 2020 to 28th May 2021. Pandemic-related potentially traumatic events (PTEs), work characteristics (e.g., contact to Covid-19 patients), and other covariates were used to predict Mental Health Index-5 (MHI-5) and Insomnia Severity Index (ISI) in generalized multilevel and latent-class mixed model regressions.Results: Local Covid-19 log-incidence (odds ratio, OR = 1.21, with 95% CI = 1.10–1.60), directly caring for Covid-19 patients (OR = 1.33, CI = 1.10–1.60) and PTEs (OR = 4.57, CI = 3.85–5.43) were all independently associated with low mental health, when (additionally) adjusting for age, sex, profession, and calendar time (a 5th degree polynomial expansion). Independence from time suggests effects of incidence change in time. Effects of local Covid-19 incidence on sleep were fully dependent on time. Latent mental-health trajectories were characterized by a large class of “stable mental health” and minority classes for “early shock, improving” and “early resilience, deteriorating” mental health. The minority classes, especially “early shock, improving”, were more likely to live alone and be exposed to PTEs than others.Conclusion: Healthcare workers face increasingly heterogeneous mental-health challenges as the Covid-19 pandemic prolongs. Adversity and mental ill-being may accumulate in some employees. More research is needed on the factors affecting employees’ resilience to the prolonging pandemic. Living arrangements may play a role.

Dental anxiety and potentially traumatic events: a cross-sectional study based on the Tromsø Study—Tromsø 7

Objective The objectives of the study were to describe the prevalence of dental anxiety and the possible associations between dental anxiety and potentially traumatic events in an adult population. Method The study is based on cross-sectional questionnaire data from the 7th wave of the Tromsø Study, a study of the adult general population in the municipality of Tromsø carried out in 2015–2016. The Modified Dental Anxiety Scale was used to measure dental anxiety across potentially traumatic events, oral health, dental attendance (avoidance) and current mental health symptoms (Hopkins Symptom Checklist). Individuals with high and low dental anxiety scores were compared to investigate differences in the distribution of potentially traumatic events, current mental health symptoms, avoidance, sex and oral health, and hierarchical multivariable regression was used to study the influence of traumatic events on dental anxiety. Results High dental anxiety was reported by 2.9% of the sample and was most prevalent among females and in the youngest age groups. Individuals with high dental anxiety reported more current mental health symptoms, and they were more likely to report poorer oral health and more irregular dental visits compared to individuals with no or lower dental anxiety scores. Concerning traumatic events, the reporting of painful or frightening dental treatment showed the biggest difference between those with high dental anxiety and low dental anxiety scores (a moderate effect). The hierarchical regression model indicated that reporting sexual abuse, traumatic medical treatment in hospital and childhood neglect significantly predicted dental anxiety in the step they were entered in, but only sexual abuse remained a significant individual contributor after controlling for current mental health symptoms. Conclusions The prevalence of high dental anxiety was lower than expected (2.9%), but dentally anxious individuals expressed a high burden of mental health symptoms, poor oral health and the avoidance of dental care. The regression analysis indicated that experiences with sexual abuse could affect dental anxiety levels in the absence of generalised symptoms of anxiety and depression.