Mental Health of Homicidally Bereaved Individuals: A Systematic Review of Post-Homicide Factors.

Experiencing the homicide of a loved one has a substantial impact on the mental health of family members and friends who must survive their loved one's tragic death. This systematic review aims to synthesize the current findings on post-homicide factors and identify the factors most frequently related to the mental health of homicidally bereaved individuals (HBI). Four databases were searched (PsycINFO, SCOPUS, Sociological Abstract, PubMed). The selection of studies was based on a peer review process conducted by two independent researchers to ensure interrater reliability. The articles were screened to ensure the presence of homicidally bereaved adults, resulting in a total of 35 eligible papers to be considered in the current review. Factors were organized into categories, with the criminal justice system-related factors (n = 18), social factors (n = 17), and coping factors (n = 13) being the most prevalent. This review identifies clinical avenues for preventing distress and fostering the well-being of HBI.

Morally injurious events among aid workers: examining the indirect effect of negative cognitions and self-care in associations with mental health indicators.

Introduction: Potentially morally injurious events (PMIE) are events that violate one's deeply held moral values or beliefs, and that have the potential to create significant inner conflict and psychological distress. PMIE have been recognized as an important psychological risk factor in many high-risk occupational groups. However, no study to date has investigated how PMIE relate to the mental health of aid workers. Furthermore, little is known about the mechanisms by which PMIE might be associated with mental health indicators. Methods: Participants were 243 aid workers (72% female; M age = 39.31) who had completed at least one aid assignment (M = 8.17). They completed an online questionnaire about their PMIE, trauma history, and mental health. A structural equation model was constructed to examine the roles of negative cognitions and subsequent self-care behaviors in the relationship between PMIE and PTSD symptoms, depression symptoms, and posttraumatic growth, above and beyond the contribution of potentially traumatic events. Results: Within the model, the indirect effect through negative cognitions fully accounted for the associations between PMIE and symptoms of PTSD and depression. For the association between PMIE and posttraumatic growth, two indirect effects emerged: the first through negative cognitions and subsequent self-care and, the second, through self-care alone. Discussion: This study highlighted PMIE as a novel psychological risk factor for aid workers and pointed to two possible mechanisms by which these events may lead to PTSD, depression, and posttraumatic growth. This study adds to the current understanding of how high-risk occupational groups adapt psychologically to PMIE.

Posttraumatic stress symptom profiles of aid workers: Identifying risk and protective factors.

OBJECTIVE: Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in this population. This study examined clinically relevant patterns of PTSD symptomatology in aid workers and examined whether factors such as the degree of trauma exposure (e.g., morally injurious events), social support, and sociodemographic and work characteristics predict symptom profiles. METHOD: Participants were 243 aid workers who had completed 8.2 assignments on average. They completed measures of trauma exposure, PTSD symptoms, and various types of social support. Latent profile analysis was used to identify PTSD symptom profiles using PCL-5 subscale scores. Next, profiles were compared on 15 potential risk and protective factors. RESULTS: Five profiles were identified: a no PTSD profile (49.4%), a low subclinical PTSD profile (21.8%), a dysphoric subclinical PTSD profile (5.8%), an intermediate clinical PTSD profile (14.8%), and a severe clinical PTSD profile (8.2%). Profiles differed in terms of witnessed traumatic events, morally injurious exposure, social support adequacy, age, number of assignments, types of assignments, and organizational support. CONCLUSIONS: This study is the first to identify distinct patterns of PTSD symptomatology in aid workers and to investigate novel psychological risk factors such as potentially morally injurious events. Overall, these findings provide further insight into the risk and protective factors for the psychological well-being of aid workers as well as avenues for improving the psychological assessment and support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations between self-care practices and psychological adjustment of mental health professionals: a two-wave cross-lagged analysis.

Cultivation of self-care is believed to foster more well-being and to mitigate the psychological difficulties that mental health professionals experience. However, how the well-being and psychological distress of these professionals impact their personal self-care practice is rarely discussed. In fact, studies have yet to investigate whether the use of self-care improves mental health, or whether being in a better place psychologically makes professionals more prone to using self-care (or both). The present study aims to clarify the longitudinal associations between self-care practices and five indicators of psychological adjustment (well-being, posttraumatic growth, anxiety, depression, and compassion fatigue). A sample of 358 mental health professionals were assessed twice (within a 10-month interval). A cross-lagged model tested all associations between self-care and psychological adjustment indicators. Results showed that self-care at T1 predicted increases in well-being and in post-traumatic growth, and a reduction in anxiety and depression at T2. However, only anxiety at T1 significantly predicted greater self-care at T2. No significant cross-lagged associations were found between self-care and compassion fatigue. Overall, findings suggest that implementing self-care is a good way for mental health workers to "take care of themselves." However, more research is needed to understand what leads these workers to use self-care.

Translation, validation and exploration of the factor structure in the French version of the Posttraumatic Cognitions Inventory (PTCI).

OBJECTIVES: In order to validate a French version of the PTCI, this study investigates two objectives using two French speaking samples: (1) test 10 factor structures identified in prior studies, and (2) assess the other psychometric properties of the best fitting factor structure. METHOD: The PTCI was translated in French using a reverse translation method and administered to 202 university students and 114 aid workers. Suitability indexes of the appropriate factor structures previously identified in prior studies were examined. Internal consistency, correlations between subscales and convergent, divergent and discriminant validities in the most appropriate structure were evaluated. RESULTS: Results support that only Wells et al.'s short 9-item version of the PTCI and three factors shows excellent suitability indexes. This version also outlines an excellent internal consistency and solid convergent, divergent, and discriminant validities. CONCLUSIONS: This study confirms the empirical validity, fidelity, and utility of Wells et al.'s short version of the PTCI. This is the first PTCI French validation, which is a major advantage when it comes to assess posttraumatic cognitions in French trauma victims.

Psychological distress of mental health workers during the COVID-19 pandemic: A comparison with the general population in high- and low-incidence regions.

OBJECTIVE: Despite their essential role during this health crisis, little is known about the psychological distress of mental health workers (MHW). METHOD: A total of 616 MHW and 658 workers from the general population (GP) completed an online survey including depressive, anxiety, irritability, loneliness, and resilience measures. RESULTS: Overall, MHW had fewer cases with above cut-off clinically significant depression (19% MHW vs. 27%) or anxiety (16% MHW vs. 29%) than the GP. MHW in high-incidence regions of COVID-19 cases displayed the same levels of depressive and anxiety symptoms than the GP and higher levels compared to MHW from low-incidence regions. MHW in high-incidence regions presented higher levels of irritability and lower levels of resilience than the MHW in low-incidence regions. Moreover, MHW in high-incidence regions reported more feelings of loneliness than all other groups. CONCLUSION: Implications for social and organizational preventive strategies to minimize the distress of MHW in times of crisis are discussed.

A randomized clinical trial of cognitive-behavioral therapy and applied relaxation for adults with generalized anxiety disorder.

This randomized clinical trial compared cognitive-behavioral therapy (CBT), applied relaxation (AR), and wait-list control (WL) in a sample of 65 adults with a primary diagnosis of generalized anxiety disorder (GAD). The CBT condition was based on the intolerance of uncertainty model of GAD, whereas the AR condition was based on general theories of anxiety. Both manualized treatments were administered over 12 weekly 1-hour sessions. Standardized clinician ratings and self-report questionnaires were used to assess GAD and related symptoms at pretest, posttest, and at 6-, 12-, and 24-month follow-ups. At posttest, CBT was clearly superior to WL, AR was marginally superior to WL, and CBT was marginally superior to AR. Over follow-up, CBT and AR were equivalent, but only CBT led to continued improvement. Thus, direct comparisons of CBT and AR indicated that the treatments were comparable; however, comparisons of each treatment with another point of reference (either waiting list or no change over follow-up) provided greater support for the efficacy of CBT than AR.