Association among resilience, post-traumatic stress disorder, and somatization in frontline healthcare workers in COVID-19: The mediating role of perceived stress

Li, Minjie; Yu, Xingxing; Wang, Dan; Wang, Ying; Yao, Lipei; Ma, Yuehong; Liu, Xiaomei; Zhang, Yulian

doi:10.3389/fpsyt.2022.909071

Cited by 5 publications

(20 citation statements)

References 33 publications

(29 reference statements)

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“…Perceived stress ( 42 ) level at work was assessed weekly, on a scale that ranged from 0 (not stress at all) to 10 (very high stress). Perceived stress has been associated with PTSD in HCWs during the pandemic ( 43 , 44 ). The pandemic emergency required services to modify procedures, most of which were related to sanitation and infection control, and redeploying personnel in a relatively short time.…”

Section: Methodsmentioning

confidence: 99%

Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada

et al. 2023

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IntroductionPrevious research has demonstrated the negative impact of the COVID-19 pandemic emergency on the wellbeing of healthcare workers. However, few research contributions reported a longitudinal evaluation of psychological distress and examined determinants of its duration and course over time. The present study aims to explore the impact of the pandemic emergency on HCWs mental health by adopting a longitudinal design and assessing mental health as combination of overlapping clinical symptoms (post-traumatic stress disorder, depression and anxiety).MethodsData were collected weekly through a mobile application during and after the first wave of COVID-19 in the province of Quebec, Canada, in 2020. Analysis was conducted on a final sample of 382 participants. Participants were grouped into “resilient” (RES) if they did not manifest clinical-level psychological distress during monitoring, “short-term distress” (STD) if distress exceeded the clinical threshold for 1–3 weeks, and longer-term distress (LTD) if it occurred for four or more weeks, even if not consecutively. Descriptive statistics for all variables were computed for each subgroup (RES, STD and LTD), and pairwise comparisons between each group for every descriptive variable were made using chi square statistics for categorical variables and t-test for continuous variables. Predictors of distress groups (STD and LTD vs RES) were assessed running multinomial hierarchical logistic regression models.ResultsIn our sample, almost two third (59.4%) HCWs did not manifest moderate or severe distress during the monitoring time. Short-term distress, mostly post-traumatic symptoms that lasted for less than 4 weeks, were the most common distress response, affecting almost one third of participants. Longer psychological distress occurred only in a smaller percentage (12.6%) of cases, as a combination of severe posttraumatic, depressive and anxiety symptoms. Perceived occupational stress was the most significant risk factor; moreover individual, peritraumatic work and family risk and protective factors, were likely to significantly affect the stress response.DiscussionResults tend to provide a more complex and resiliency-oriented representation of psychological distress compared to previous cross-sectional studies, but are in line with stress response studies. Findings allow us to better describe the profiles of distress response in STD and LTD groups. Participants that manifest short term distress experience acute stress reaction in which the interplay between personal, family and professional life events is associated with the stress response. Conversely, longer term distress response in HCWs presents a more complex mental health condition with an higher level of impairment and support needs compared to participants with short-term distress.

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Section: Methodsmentioning

confidence: 99%

Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada

et al. 2023

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“…In total, 57 studies satisfied the inclusion and exclusion criteria of this study (Table 1), involving a total of 28 965 physicians. Fifty-five studies (96.4%) [39][40][41][42][43][44][45][46][47][48] were cross-sectional while 2 (3.5%) were longitudinal. The number of participants in each study ranged from 7 to 5440 (mean, 508; median, 291).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…1 in each: Pakistan, Israel, Qatar), 17,19,24,26,30,32,41,47,55,57,58,61,68,69,71,72 4 in Africa (1 in each:…”

Section: Study Characteristicsmentioning

confidence: 99%

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Physician Posttraumatic Stress Disorder During COVID-19

Kamra,

Dhaliwal,

et al. 2024

JAMA Netw Open

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ImportanceThe COVID-19 pandemic placed many physicians in situations of increased stress and challenging resource allocation decisions. Insight into the prevalence of posttraumatic stress disorder in physicians and its risk factors during the COVID-19 pandemic will guide interventions to prevent its development.ObjectiveTo determine the prevalence of posttraumatic stress disorder (PTSD) among physicians during the COVID-19 pandemic and examine variations based on factors, such as sex, age, medical specialty, and career stage.Data SourcesA Preferred Reporting Items for Systematic Reviews and Meta-analyses–compliant systematic review was conducted, searching MEDLINE, Embase, and PsychInfo, from December 2019 to November 2022. Search terms included MeSH (medical subject heading) terms and keywords associated with physicians as the population and PTSD.Study SelectionPeer-reviewed published studies reporting on PTSD as a probable diagnosis via validated questionnaires or clinician diagnosis were included. The studies were reviewed by 6 reviewers.Data Extraction and SynthesisA random-effects meta-analysis was used to pool estimates of PTSD prevalence and calculate odds ratios (ORs) for relevant physician characteristics.Main Outcomes and MeasuresThe primary outcome of interest was the prevalence of PTSD in physicians, identified by standardized questionnaires.ResultsFifty-seven studies with a total of 28 965 participants and 25 countries were included (of those that reported sex: 5917 of 11 239 [52.6%] were male and 5322 of 11 239 [47.4%] were female; of those that reported career stage: 4148 of 11 186 [37.1%] were medical trainees and 7038 of 11 186 [62.9%] were attending physicians). The estimated pooled prevalence of PTSD was 18.3% (95% CI, 15.2%-22.8%; I2 = 97%). Fourteen studies (22.8%) reported sex, and it was found that female physicians were more likely to develop PTSD (OR, 1.93; 95% CI, 1.56-2.39). Of the 10 studies (17.5%) reporting age, younger physicians reported less PTSD. Among the 13 studies (22.8%) reporting specialty, PTSD was most common among emergency department doctors. Among the 16 studies (28.1%) reporting career stage, trainees were more prone to developing PTSD than attendings (OR, 1.33; 95% CI, 1.12-1.57).Conclusions and RelevanceIn this meta-analysis examining PTSD during COVID-19, 18.3% of physicians reported symptoms consistent with PTSD, with a higher risk in female physicians, older physiciansy, and trainees, and with variation by specialty. Targeted interventions to support physician well-being during traumatic events like pandemics are required.

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“…Somatization is suggested to be an adaptive response to psychological distress [ 39 ]. Several previous studies pointed to a close link between PTSD and excess of somatization [ 40 ], and to newly developed somatic symptoms in people with PTSD [ 36 ], Disasters, such as the COVID-19 pandemic, carry a risk of both PTSD and somatization to directly and indirectly affected people [ 41 , 42 ]. Specifically, PTSD is found to be associated with a range of somatic problems (e.g., unexplained tinnitus, blurry vision, dizziness), and multiple medical conditions (e.g., respiratory, cardiovascular, and gastrointestinal disorders) [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Expressive suppression moderates the relationship between PTSD from COVID-19 and somatization and validation of the Arabic version of Patient Health Questionnaire-15 (PHQ-15)

Nehme,

Moussa,

Fekih-Romdhane

et al. 2024

PLoS ONE

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Background Lebanese adults have been crippled for years by several crises, including the lately COVID-19 pandemic. These massive civilian traumas have increased the risk of post-traumatic stress disorder (PTSD) in this population. Extensive literature pointed to the association between PTSD and somatization; however, the nature of this relationship remains unknown. We sought to contribute further to work in this area by testing the moderating role of emotion regulation in the relationship between COVID-19- related PTSD and somatization. As a secondary objective, we aimed to examine the psychometric properties of an Arabic translation of the somatization measure Patient Health Questionnaire-15 (PHQ-15) in terms of factorial validity and internal consistency before its use in the present study. Methods This cross-sectional study was conducted between September and October 2021. A total of 403 Lebanese adults residing in Lebanon were recruited. Eligible participants received an online link to the survey. The Patient Health Questionnaire-15 was used to assess somatization, PTSD Checklist–Civilian Version for PTSD and Emotion Regulation Questionnaire for emotion regulation. Results The results of the exploratory factor analysis (EFA) revealed a three-factor solution explaining 48.79% of the common variance. Confirmatory Factor Analysis results of the three-factor model obtained in the EFA indicated a good fit with a significant CFI of 0.98, TLI 0.98 and a GFI of .97, a RMSEA of .04 [90% CI .01, .06]. Higher PTSD symptoms were associated with somatization. In addition, we found that one specific ER component, i.e. expressive suppression, significantly moderated the relationship between PTSD from the COVID pandemic and somatization. In particular, the interaction PTSD from the COVID-19 pandemic by expressive suppression was significantly associated with somatization; at low, medium and high levels of expressive suppression, higher PTSD from the COVID-19 pandemic was significantly associated with higher somatization scores. As for our secondary objective, findings revealed that the Arabic version of the PHQ-15 exhibited good psychometric properties. In particular, the scale yielded a three-factor structure, and good internal consistency (Cronbach’s alpha = 0.87). Conclusion The moderating role of expressive suppression on the link between PTSD and somatization presents a novel finding in the field of trauma. Additionally, making a psychometrically sound Arabic version of the PHQ-15 available is a valuable addition to the literature.

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Association among resilience, post-traumatic stress disorder, and somatization in frontline healthcare workers in COVID-19: The mediating role of perceived stress

Abstract: and Zhang Y (2022) Association among resilience, post-traumatic stress disorder, and somatization in frontline healthcare workers in COVID-19: The mediating role of perceived stress.

Cited by 5 publications

References 33 publications

Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada

Longitudinal assessment and determinants of short-term and longer-term psychological distress in a sample of healthcare workers during the COVID-19 pandemic in Quebec, Canada

Physician Posttraumatic Stress Disorder During COVID-19

Expressive suppression moderates the relationship between PTSD from COVID-19 and somatization and validation of the Arabic version of Patient Health Questionnaire-15 (PHQ-15)

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