Assessing secondary trauma in disaster relief clinicians

评估救灾临床医生的继发性创伤

基本信息

批准号：
6543396
负责人：
ROSE T ZIMERING
金额：
$ 9.26万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-03-12 至 2004-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6543396
关键词：
adult human (21+) clinical research disasters emergency health services human subject interview longitudinal human study mental health epidemiology mental health personnel occupational stressor posttraumatic stress disorder psychological adaptation psychological stressor psychological tests psychometrics

项目摘要

The unprecedented devastating terrorist strikes in New York City and Washington, D.C. on September 11th 2001 were matched by an unparalleled response from emergency personnel to treat the emotional consequences of these events. In a disaster of the scale and scope of September 11th, it is anticipated that in addition to the mental health risk to civilians directly affected by the disaster, emergency mental health providers are at risk for developing secondary symptoms of acute and post stress disorders. A growing body of literature documents the phenomenon of secondary traumatization among mental health providers treating people with histories of traumatic exposure. However, very little is known about the sequelae of treating acutely traumatized survivors. In fact, assessment tools to evaluate the consequences of treating acute stress survivors do not currently exist. The primary aim of this RAPID grant application is to assess acute and post-traumatic stress disorders linked to treatment of survivors (secondary traumatization), in clinicians providing relief services at two different disaster sites in the aftermath of the terrorist attacks. Participants will be recruited from a pool of 120 International Association of Firefighters disaster relief providers (who reported to New York and delivered mental health care to firefighters lost in the collapse of the World Trade Center) and 100 Red Cross providers (who treated surviving family members and surviving airline personnel of those lost on the two hijacked planes that struck the World Trade Center). Clinicians will be identified by two study co-investigators who had primary on-site organizing responsibilities for mental health disaster relief for the New York City Fire Department at ground zero of the World Trade Center and the Red Cross at Boston Logan International Airport, respectively. These co-investigator roles will facilitate the sensitive recruitment necessary for the current project. Acute stress disorder will be measured by a standardized self-report inventory and PTSD will be assessed by standardized clinical interview at a 6-month post-disaster follow-up. Individual difference variables that may be related to the development of, or protection against, secondary trauma among disaster relief clinicians will also be measured. Mental health providers will be mailed a letter with informed consent, assessments, contact information for the follow-up assessments, and return postage. Clinicians who participate will be compensated for the time to complete both the self-report assessments and a six-month follow-up clinical interview. Data analyses will include logistic regression to examine the relationships between therapist factors (e.g., disaster service, type of training, level of experience) and symptom severity, as well as initial psychometric evaluation of the measures under development including factor analysis and reliability and validity analyses. Long-term research objectives for an NIMH R01 submission include a large-scale assessment study of secondary traumatization in mental health disaster relief workers across disaster types and characteristics (e.g. intentional and unintentional disasters).

2001 年 9 月 11 日，纽约市和华盛顿特区发生了史无前例的毁灭性恐怖袭击，与此同时，应急人员也做出了无与伦比的反应，以应对这些事件造成的情感后果。在 9 月 11 日发生的规模和范围如此之大的灾难中，预计除了直接受灾难影响的平民面临心理健康风险外，紧急心理健康服务提供者还面临出现急性和应激后应激障碍继发症状的风险。越来越多的文献记录了治疗有创伤经历的人的心理健康提供者中的继发性创伤现象。然而，人们对治疗严重创伤幸存者的后遗症知之甚少。事实上，目前还不存在评估治疗急性应激幸存者后果的评估工具。这项快速拨款申请的主要目的是评估恐怖袭击后在两个不同灾难地点提供救援服务的临床医生中与幸存者治疗（二次创伤）相关的急性和创伤后应激障碍。参与者将从 120 名国际消防员协会救灾提供者（他们向纽约报告并为世贸中心倒塌中丧生的消防员提供心理保健）和 100 名红十字会提供者（他们治疗幸存的家庭成员）中招募。以及在袭击世贸中心的两架被劫持飞机上失踪的幸存航空公司人员）。临床医生将由两名研究联合研究者确定，他们分别负责纽约市消防局世贸中心归零地和波士顿洛根国际机场红十字会心理健康灾难救援的现场组织工作。这些共同研究员的角色将促进当前项目所需的敏感招募。急性应激障碍将通过标准化自我报告清单进行测量，创伤后应激障碍将通过灾后 6 个月随访中的标准化临床访谈进行评估。还将测量可能与救灾临床医生继发性创伤的发生或预防继发性创伤相关的个体差异变量。精神卫生服务提供者将收到一封信，其中包含知情同意书、评估、后续评估的联系信息以及回邮邮资。参与的临床医生将获得完成自我报告评估和六个月随访临床访谈的时间补偿。数据分析将包括逻辑回归，以检查治疗师因素（例如灾难服务、培训类型、经验水平）与症状严重程度之间的关系，以及对正在开发的措施的初步心理测量评估，包括因素分析以及可靠性和有效性分析。 NIMH R01 提交的长期研究目标包括对跨灾害类型和特征（例如有意和无意的灾害）的心理健康救灾人员的继发性创伤进行大规模评估研究。