Vicarious Growth, Traumatization, and Event Centrality in Loved Ones Indirectly Exposed to Interpersonal Trauma: A Scoping Review.

It is well-known that interpersonal traumatic events can impact the physical and mental health of those indirectly exposed to the events. Less studied are populations of loved ones who have been indirectly exposed to interpersonal trauma. We conducted a scoping review to synthesize literature related to potential consequences of indirect interpersonal trauma exposure, specifically vicarious traumatization (VT) and vicarious posttraumatic growth (VPTG). We used the Joanna Briggs Institute methodology. Inclusion criteria included: (1) participants were indirectly exposed to the interpersonal trauma of a loved one in adulthood, (2) discussion of VT, VPTG, or related terms, (3) published peer-reviewed empirical journal articles, and (4) available in English. We used a three-step search strategy to find relevant articles. Keywords found from the first two steps were entered into PsycINFO, PsycArticles, PubMed, Scopus, and Web of Science databases. Reference lists of the included articles were also examined. The identified articles were then screened using the inclusion and exclusion criteria. Twenty-eight articles met inclusion and exclusion criteria. Twenty-six articles referenced VT or related terms, one referenced VPTG, and one referenced vicarious trauma keywords. Results of this scoping review are summarized by definitions, measures, key findings, and knowledge gaps. Future research should focus on vocabulary management, diverse samples, and VPTG in this population, including the identification or creation of appropriate measures.

Brain structure and functional connectivity linking childhood cumulative trauma to COVID-19 vicarious traumatization.

BACKGROUND: The COVID-19 pandemic has caused some individuals to experience vicarious traumatization (VT), an adverse psychological reaction to those who are primarily traumatized, which may negatively impact one's mental health and well-being and has been demonstrated to vary with personal trauma history. The neural mechanism of VT and how past trauma history affects current VT remain largely unknown. This study aimed to identify neurobiological markers that track individual differences in VT and reveal the neural link between childhood cumulative trauma (CCT) and VT. METHODS: We used structural and resting-state functional magnetic resonance imaging before the pandemic to identify prospective brain markers for COVID-related VT by correlating individuals' VT levels during the pandemic with the gray matter volume (GMV) and seed-based resting-state functional connectivity (RSFC) and examined how these brain markers linked CCT to VT in a sample of general young adults (N = 115/100). RESULTS: Whole-brain GMV-behavior correlation analysis showed that VT was positively associated with GMV in the right dorsolateral prefrontal gyrus (DLPFC). Using the cluster derived from the GMV-behavior correlation analysis as the seed region, we further revealed that the RSFC between the right DLPFC and right precuneus was negatively associated with VT. Importantly, the right DLPFC volume and DLPFC-precuneus RSFC mediated the effect of CCT on VT. These findings remained unaffected by factors such as family socioeconomic status, other stressful life events, and general mental health. CONCLUSIONS: Overall, our study presents structural and functional brain markers for VT and highlights these brain-based markers as a potential neural mechanism linking CCT to COVID-related VT, which has implications for treating and preventing the development of trauma-related mental disorders.

The effects of social media usage on vicarious traumatization and the mediation role of recommendation systems usage and peer communication in China after the aircraft flight accident.

Background: Previous research has indicated that continuous exposure to disaster-related information through social media can lead to vicarious trauma. However, scholars have recognized the need for further in-depth research into the underlying mechanisms influencing this relationship.Objective: The purpose of this study is to investigate the impact mechanism of social media usage on vicarious traumatization in users and analyze the roles of recommendation systems and peer communication.Methods: This study was conducted with college students in China, focusing on the context of the MU5735 aircraft flight accident in China in which 123 passengers and 9 crew members died. Data were collected through an online questionnaire. The partial least square structural equation modelling (PLS-SEM) method was used to test the data and model.Results: This study obtained valid responses from 1317 participants. The study findings revealed a significant positive correlation between social media usage(ß = 0.180，P < .001), recommendation systems usage (ß = 0.172, P < .001), peer communication (ß = 0.303, P < .001), and the development of vicarious traumatization. Recommendation systems usage (specific indirect effect = 0.063, P < .001) and peer communication (specific indirect effect = 0.138, P < .001) mediated the relationship between social media use and vicarious trauma. Additionally, the impact of peer communication on vicarious trauma was found to be higher compared to the effects of continuous social media use and recommendation system use.Conclusion: The study found that the use of social media to obtain information about accidents, the frequent pushing of accident information by recommender systems, and the frequent discussion of accidents among peers during unexpected accidents contribute to vicarious traumatization. The study suggests that users' reduced retrieval of accident information via social media, as well as reduced peer-to-peer discussions about accidents, and social media platforms' adjustment of recommender system algorithm rules to reduce accident information pushes, may help reduce the likelihood of users experiencing vicarious traumatization.

Social media usage significantly affected college users to develop vicarious traumatization.Recommendation systems usage and peer communication significantly affected the development of vicarious traumatization.Recommendation systems usage and peer communication mediated the relationship of social media usage and vicarious traumatization.

Secondary Traumatic Stress Disorder in the Surgical Profession.

INTRODUCTION: The psychological impact of treating individuals who have undergone severely traumatic experiences is known as secondary traumatic stress (STS). It has been well characterized by mental health therapists and social workers. Analysis of STS in surgeons and medical students is limited to merely a handful of studies, with only 1 paper describing STS in trauma surgeons and two describing STS in medical students. This review aims to provide a comprehensive account of existing work on STS, identify gaps in knowledge of STS in surgeons and medical students, and distinguish STS from other similar phenomena that have been commonly misidentified by recent works. MATERIALS AND METHODS: A review of the literature in English was conducted through PubMed. MeSH terms included "STS, compassion fatigue, vicarious traumatization, and secondary trauma." All papers referenced in the identified works were screened and assessed for relevance. RESULTS: Only two studies that directly assess STS in surgeons were identified. STS levels reported varied widely between the two. Similar studies were identified that focused on burnout, compassion fatigue, or post-traumatic stress disorder, which are similar but not identical. Only 1 study evaluated STS in trauma surgeons and found that 65% of those in the study had at least 1 symptom of STS. Only two studies were identified that studied STS in medical students, but with conflicting results on prevalence. It was identified that there are various measuring tools to assess for STS symptoms but no established standard of assessment that allows for cross-comparisons. CONCLUSION: Knowledge of STS is extremely limited in surgeons and medical students, not only due to a general lack of awareness of STS but also due to confusion and misuse of other related terms. This review calls for more efforts to identify and address STS in surgeons and medical students while also standardizing methodologies that screen for STS symptoms.

"It Makes you Want to Go Out and Change the World": Shifts in Victim Advocates' Perspectives Following the Intimate Partner Homicide of a Client in the United States.

Purpose: Intimate partner violence (IPV) victim advocates are exposed daily to the traumas of their clients, including the potential exposure to an intimate partner homicide (IPH). While research has examined the effects of daily secondary exposure to IPV on victim advocates, little is known about the specific effect of IPH. This study examined how the IPH of a client affected advocates' perception of and approach to their work. Methods: Nine advocates were recruited from the northeastern U.S. and interviewed about their experience of the IPH of a client. Advocate interviews were analyzed using The Listening Guide Analysis which systematically isolates and listens to the different, and often contradictory, voices that a participant uses. Results: Exposure to IPH changed participants' perception of their role, how they defined client, and how they interacted with future clients. At a macro-level, the IPH of a client motivated advocates to advance changes in agency protocol, multisector responses, and state policy based on what they had learned from the IPH. Opportunities to translate shifts in their worldview into tangible changes to protocol and policy were critical to advocate adjustment after the IPH. Conclusions: In order to support advocates after IPH, organizations should acknowledge the potentially transformative effect of IPH and create opportunities for meaning making to assist in advocate adjustment. It is imperative for advocacy organizations to support their employees to prevent advocate burnout and the loss of experienced staff, and to continue to provide effective services to vulnerable members of their communities after IPH.

Trajectories and predictors of vicarious traumatization in Chinese college students during the COVID-19 pandemic: A longitudinal study.

Objectives: This longitudinal study aimed to identify the trajectories and the predictors among sociodemographic and psychosocial variables at baseline of vicarious traumatization (VT) in Chinese college students during the COVID-19 pandemic. Materials and methods: A total of 544 Chinese college students enrolled in a public University in central China, majored in Clinical Medicine, Nursing, Musicology, Physics, etc., participated in this longitudinal study lasting 19 months. Three-wave (wave 1: February 2020; wave 2: November 2020; wave 3: September 2021) of data were collected. Resourcefulness Scale and the 10-item Kessler scale (K10) were only assessed in the first-wave survey, and the Event Scale-Revised (IES-R) was repeatedly measured in all three-wave surveys. A link to an online survey created by Questionnaire Star (https://www.wjx.cn/) was sent to the students to collect data. The Growth mixture modeling (GMM) and multiple logistic regression were used to identify the trajectories of VT and predictors for the distinct trajectories. Results: The incidence of VT at each wave varied from 9.9% at wave 1, 4.0% at wave 2, to 2.6% at wave 3. Three trajectories of VT were the medium-level escalating group (3.0%), medium-level maintaining group (32.3%), and the low-level descending group (64.7%). Seniors (OR = 1.575, 95% CI: 1.059-2.341; OR = 1.161, 95% CI: 1.043-1.293) and those with poor mental health status (OR = 1.101, 95% CI: 1.030-1.177; OR = 1.083, 95% CI: 1.060-1.106) at baseline were more likely to be classified into the medium-level escalating group and medium-level maintaining group, respectively. Additionally, females (OR = 3.601, 95% CI: 1.311-9.887) were more likely to be included in the medium-level escalating group. Conclusion: Targeted psychological interventions are urgently needed for students vulnerable to VT. Further studies with more representative samples, longer period of follow-up, and predictors based on scientific theoretical framework, are needed to update the findings.

Revealing Personality Triggers for Media Vicarious Traumatization: A Fuzzy-Set Qualitative Comparative Analysis.

People may experience media vicarious traumatization due to frequent exposure to media coverage of disasters. Currently, the influential relationship between personality traits and media vicarious traumatization still lacks systematic and in-depth research. Based on the MU5735 airplane crash, this study explored the effects of configurations of personality traits on media vicarious traumatization by analyzing data from 331 Chinese university students (Mage = 22.63 years, SD = 2.67, range = 18 to 29, n = 186 male and n = 145 female) using Fuzzy-set Qualitative Comparative Analysis (fsQCA). The results revealed that five combinations of the Big Five personality traits could lead to media vicarious traumatization, the combinations of configurations are: (1) high conscientiousness, high agreeableness, and high neuroticism; (2) high conscientiousness, high extraversion, and high agreeableness; (3) high extraversion, high neuroticism, low conscientiousness, and low agreeableness; (4) high openness, high extraversion, high agreeableness, and high neuroticism; (5) high extraversion, high agreeableness, low openness, and low neuroticism. Furthermore, sociodemographic variables (gender, age, and education) interacted with personality traits and also resulted in different configurations of media vicarious traumatization. This study indicates the asymmetric relationships between personality traits and media vicarious traumatization, identifies the vulnerable groups to facilitate targeted trauma interventions for university students according to different configurations, and provides a reference for public psychological relief efforts in emergencies.

Vicarious trauma in nursing professionals: A concept analysis.

AIM: To explore the concept of vicarious trauma (VT) and clarify its fundamental meaning and distinctiveness as a psychological phenomenon experienced by nurses. BACKGROUND: The current coronavirus disease 2019 (COVID-19) pandemic has incited significant psychological distress on nursing professionals worldwide. There is growing knowledge of the negative outcomes of this distress including the manifestation of nursing burnout syndrome, compassion fatigue, and vicarious traumatization (VT). These concepts have often been used interchangeably throughout nursing discourse creating confusion surrounding their uses and unique attributes. DESIGN: Walker and Avant's method of concept analysis. RESULTS: VT is a psychological phenomenon that causes a permanent cognitive shift in the inner experience and world views of nurses after prolonged empathetic engagement with a patient's trauma. VT manifests as physical and emotional symptoms of distress, which can disrupt a nurses ability to provide competent care. Contradictions within the literature exist when defining VT, burnout syndrome, and compassion fatigue, creating difficulty identifying attributes and consequences unique to VT. CONCLUSION: More empiric rigor is needed to adequately operationalize VT. Given the traumatic nature of the COVID-19 pandemic, immediate policy and education attention should be directed towards understanding the relationship between nurses working during the COVID-19 pandemic and the prevalence of VT.

COVID-19 vicarious traumatization links functional connectome to general distress.

As characterized by repeated exposure of others' trauma, vicarious traumatization is a common negative psychological reaction during the COVID-19 pandemic and plays a crucial role in the development of general mental distress. This study aims to identify functional connectome that encodes individual variations of pandemic-related vicarious traumatization and reveal the underlying brain-vicarious traumatization mechanism in predicting general distress. The eligible subjects were 105 general university students (60 females, aged from 19 to 27 years) undergoing brain MRI scanning and baseline behavioral tests (October 2019 to January 2020), whom were re-contacted for COVID-related vicarious traumatization measurement (February to April 2020) and follow-up general distress evaluation (March to April 2021). We applied a connectome-based predictive modeling (CPM) approach to identify the functional connectome supporting vicarious traumatization based on a 268-region-parcellation assigned to network memberships. The CPM analyses showed that only the negative network model stably predicted individuals' vicarious traumatization scores (q2 = -0.18, MSE = 617, r [predicted, actual] = 0.18, p = 0.024), with the contributing functional connectivity primarily distributed in the fronto-parietal, default mode, medial frontal, salience, and motor network. Furthermore, mediation analysis revealed that vicarious traumatization mediated the influence of brain functional connectome on general distress. Importantly, our results were independent of baseline family socioeconomic status, other stressful life events and general mental health as well as age, sex and head motion. Our study is the first to provide evidence for the functional neural markers of vicarious traumatization and reveal an underlying neuropsychological pathway to predict distress symptoms in which brain functional connectome affects general distress via vicarious traumatization.

From Their Angle: A Look at the Emotional World of Defense Attorneys Who Represent Sex Offenders.

This research focused on how defense attorneys who represent sex offenders perceive their work with them and whether this representation affects their daily life and mental well-being. Fifteen defense attorneys working for the Public Defender's Office in Israel were interviewed using a semi-structured interview. The findings indicated two major issues related to defense attorney perception of their work: (1) the distinctiveness of representing sex offenders due to their unique characteristics and (2) the emotional impact of working with sex offenders. The findings suggest complex effects and implications of working with sex offenders. In the interviews, participants reiterated their attempt to remain objective and nonjudgmental. Even so, they also described a wide range of feelings in the face of exposure to sex offenses and their job of defending sex. Feelings of anger, disgust, and revulsion at the offenses co-existed with feelings of pity and empathy for the offender. These descriptions constitute significant support for the emotional cost to attorneys and their consequent distress. Feelings of wariness, loss of trust, and emotional detachment were described as part of coping with exposure to the disturbing nature of sex offenses. In addition, participants noted how these feelings impact daily interactions with their own children.

Treating Sex Offenders: Effects on Male and Female Therapists.

The aim of the present study, based on in-depth semistructured interviews conducted in Israel with 18 social workers (nine women and nine men), working as probation officers who diagnose and treat sex offenders, was twofold: The first goal was to examine how treating sex offenders affects the male and female practitioners' daily lives and specifically, their parenting. Second, in light of the claim that support of colleagues and family members is very important for coping with secondary traumatization, the study investigated how working with sex offenders influenced the practitioners' ability to share their experiences with their colleagues in the workplace and with their partners at home. The study findings, based on a phenomenological analysis, revealed that male and female probation officers working with sex offenders experienced anxiety, suspicion, and concern for their children's safety. Their spousal and collegial relationships were also affected by their work. In addition to not receiving support from their colleagues and partners, they experienced loneliness and attacks "from the inside and from the outside," expressed in criticism, loathing, and disgust in relation to their work. The findings reveal, for the first time, the common and the distinct effects of male and female practitioners' experiences on their spousal and parental relationships. It also expands the understanding of the connection between exclusion and loneliness experienced by them, due to their limited ability of sharing their experience with colleagues and family members. The discussion offers theoretical explanations for these implications and recommends how to provide relief for male and female practitioners, who work with sex offenders.

Possible Vicarious Traumatization Among Psychiatric Inpatients During the Remission Phase of the COVID-19: A Single-Center Cross-Sectional Study.

Background: Far from being a clinical disease, the COVID-19 pandemic has become a threatening social event worldwide exerting long-term impacts on human beings. Objective: This study was designed to determine if and to what extent psychiatric inpatients during the remission phase of the pandemic suffered from vicarious traumatization. Method: Totally 266 eligible participants from psychiatric and psychological wards in a hospital were recruited during October 26th, 2020 to February 4th, 2021 to finish a self-made online questionnaire consisting of Impact of Event Scale-Revised (IES-R), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Obsessive-Compulsive Inventory-Revised (OCI-R), Pittsburgh Sleep Quality Index-Revised (PSQI-R), Social Support Rating Scale (SSRS), Beck Suicide Ideation Scale (SSI), 12-Item Short-Form Health Survey (SF-12). Meanwhile, some socio-demographics and information related to the pandemic were also recorded. Results: The detection rate of vicarious traumatic symptoms (VTS) was 80.83%, including 40.98% for mild ones, 25.56% for moderate ones, and 14.29% for severe ones, among whom 98.14% possessed all three phenotypes. 27.07% of the sample were considered possible vicarious traumatization (pVT). Having acquaintances infected with or died from COVID-19, worries on re-outbreak of COVID-19, a higher score of OCI-R or lower score of SF-12, and long latency of VTS were independent risk factors of pVT. Conclusion: Our study showed that COVID-19 could have profound mental influences on psychiatric inpatients. It is high time we did some screening in the wards to seek for patients at risk.

Vicarious Traumatization and Burnout among Service Providers for Victims of Commercial Sexual Exploitation.

Victims of commercial sexual exploitation (CSE) are in need of multiple community services to aid in their recovery. Service providers are critical to ensuring these victims receive needed treatment. Given the complex trauma of these victims and the necessity of long-term treatment, these service professionals may experience vicarious trauma (VT) and burnout. This qualitative study interviewed 12 professionals who have provided direct services to victims of CSE about their experiences. They had on average about 8 years of experience and three were survivors of CSE. Almost all reported instances of burnout and VT but also had strategies for the prevention of such experiences. Most participants reported experiences of VT and burnout are inevitable when working with this population, but self-care strategies and peer support are essential to combatting these negative experiences. These results can inform agencies that provide services to victims of CSE so as to ensure their staff stay healthy and avoid burnout.

Vicarious Traumatization Questionnaire: Psychometric Properties Using Rasch Model and Structural Equation Modeling.

Frontline healthcare providers are exposed to indirect trauma through dealing with traumatized patients. This puts them at risk of vicarious traumatization. In response to the COVID-19 pandemic, this study seeks to establish the psychometric properties of the Malay version of the Vicarious Traumatization Questionnaire among healthcare providers. A cross-sectional study was conducted. The translated Malay version of the Vicarious Traumatization Questionnaire was completed by 352 healthcare providers in Kelantan, Malaysia. The data was entered using IBM SPSS Statistics version 26.0 (SPSS Inc., Chicago, IL, USA, 2019), and descriptive analysis was performed. The psychometric properties of the scale were assessed in two phases. The Rasch model to assess the validity and reliability was performed using Winsteps version 3.72.3. The confirmatory factor analysis using the structural equation modeling was performed using AMOS version 23.0. The Rasch analysis showed that the 38 items, in two constructs, had high item reliability and item separation at 0.97 and item separation at 5.36, respectively, while good person reliability and person separation were at 0.95 and 4.58, respectively. The correlations of all persons and items are greater than 0.20. There are no misfitting or overfitting items in the outfit MNSQ. There are four items that are challenging in answering the scale. The final model of the confirmatory factor analysis shows two constructs with 38 items demonstrating acceptable factor loadings, domain to domain correlation, and best fit (Chi-squared/degree of freedom = 4.73; Tucker-Lewis index = 0.94; comparative fit index = 0.94; and root mean square error of approximation = 0.10). Composite reliability and average variance extracted of the domains were higher than 0.7 and 0.5, respectively. The Vicarious Traumatization Questionnaire tested among healthcare providers has been shown to valid and reliable to assess vicarious traumatization.

Secondary traumatic stress and vicarious posttraumatic growth in healthcare workers during the first COVID-19 lockdown in Greece: The role of resilience and coping strategies.

Despite the indisputable negative psychosocial consequences of the COVID-19 pandemic, positive consequences are also possible. Resilience and coping strategies have been assumed to contribute to these outcomes. However, findings are still scarce and inconclusive. The study aimed to examine the role of resilience and coping strategies in the secondary stress for the Greek healthcare workers (HCWs) and in the posttraumatic growth following the COVID-19 lockdown in Greece. A sample of 673 HCWs coming from Greece were recruited. A convenience and snowball mixed sampling procedure were used. A questionnaire was distributed through social networking sites, webpages, and personal contacts of the author. Participants were asked to distribute it to their own contacts. Recruitment occurred during April 5 - 30, 2000, amid the lockdown (March 23-May 03), when people were asked to follow the stringent lockdown constraint enforced by the Greek government. Sociodemographic data were collected. The Secondary Traumatic Stress Scale measured secondary traumatic stress (STS) for the HCWs. The Post-Traumatic Growth Inventory, the Brief Resilience Scale, and the Coping Orientation to Problems Experienced Inventory measured posttraumatic growth, resilience, and coping strategies, respectively. Regression analyses demonstrated that resilience and coping strategies were differentially associated with positive and negative (stress/growth) lockdown outcomes. Resilience and mostly maladaptive coping strategies predicted STS. A mixture of adaptive and maladaptive coping strategies predicted PTG. The so-called "second wave" of the outbreak that started in August 2020 indicates that the study of the psychosocial impact of the COVID-19 pandemic and lockdown and of the internal resources (resilience and coping) to deal with, is necessary. The findings contribute to a more comprehensive understanding of the coping strategies used by population subgroups (e.g., HCWs) in dealing with the COVID-19 lockdown in Greece. Enhancing internal resources through supportive services will ameliorate HCWs ability to withstand, recover, and thrive with benefits in their psychological health and well-being. Despite the indisputable negative psychosocial consequences of the COVID-19 pandemic, positive consequences are also possible. Resilience and coping strategies have been assumed to contribute to these outcomes. However, findings are still scarce and inconclusive. The study aimed to examine the role of resilience and coping strategies in the secondary stress for the Greek healthcare workers (HCWs) and in the posttraumatic growth following the COVID-19 lockdown in Greece. A sample of 673 HCWs coming from Greece were recruited. A convenience and snowball mixed sampling procedure were used. A questionnaire was distributed through social networking sites, webpages, and personal contacts of the author. Participants were asked to distribute it to their own contacts. Recruitment occurred during April 5 - 30, 2000, amid the lockdown (March 23-May 03), when people were asked to follow the stringent lockdown constraint enforced by the Greek government. Sociodemographic data were collected. The Secondary Traumatic Stress Scale measured secondary traumatic stress (STS) for the HCWs. The Post-Traumatic Growth Inventory, the Brief Resilience Scale, and the Coping Orientation to Problems Experienced Inventory measured posttraumatic growth, resilience, and coping strategies, respectively. Regression analyses demonstrated that resilience and coping strategies were differentially associated with positive and negative (stress/growth) lockdown outcomes. Resilience and mostly maladaptive coping strategies predicted STS. A mixture of adaptive and maladaptive coping strategies predicted PTG. The so-called "second wave" of the outbreak that started in August 2020 indicates that the study of the psychosocial impact of the COVID-19 pandemic and lockdown and of the internal resources (resilience and coping) to deal with, is necessary. The findings contribute to a more comprehensive understanding of the coping strategies used by population subgroups (e.g., HCWs) in dealing with the COVID-19 lockdown in Greece. Enhancing internal resources through supportive services will ameliorate HCWs ability to withstand, recover, and thrive with benefits in their psychological health and well-being.

A Causal Model of Children's Vicarious Traumatization.

Children may be vicariously traumatized from learning about the trauma of family and friends. To date, a causal model of children's vicarious traumatization has not been empirically validated in the literature. This paper fills the gap in the literature by reporting on the direct effect of vicarious trauma on children independent of caregiving impairment. Data for the study came from the National Survey of Children's Exposure to Violence I (NATSCEV I). This unique dataset features two indicators of vicarious trauma exposure: (1) family victimization and (2) community violence. Hierarchical multiple regression was conducted in order to control for nuisance variables such as caregiver impairment, defined as the degree of warmth or hostility; time elapsed since the trauma occurred and the study taking place; and other trauma exposure (i.e. direct and witnessed trauma). As expected, the study found evidence of a direct and positive relationship between learning about the trauma of close friends and family and children's trauma symptomatology. Both adolescents and young children were found to be vulnerable to experience vicarious traumatization, with gender and ethnicity being contributing factors. Chronological age was not found to be significant in children's vicarious traumatization. These findings support the causal model of vicarious traumatization. They demonstrate that children may be traumatized by exposure to the trauma material of others above and beyond the influence of caregiver impairment. As such, attention should be given to interventions, practices, and policies that intervene in the lives of children exposed to violence.

Midwives' experiences of witnessing traumatic hospital birth events: A qualitative study.

AIMS AND OBJECTIVES: The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies. METHODS: The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis. FINDINGS: As a result of the content analysis, three main themes emerged: psychological impact, defensive practice, and expectations in terms of support from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and they performed an increasingly defensive practice. During the interviews, we observed that 19 midwives needed psychological support. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth. CONCLUSION(S): Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.

Working in the Field of Complex Psychological Trauma: A Framework for Personal and Professional Growth, Training, and Supervision.

The aim of this article is to explore the positive and negative impacts of working therapeutically in complex psychological trauma (CPT), particularly the field of gender-based violence (GBV) and childhood sexual abuse (CSA), from the clinicians' perspective. The focus was on the prospect of positive gains and growth for therapists. Twenty-one clinicians (n = 21; counselors/psychotherapists and psychologists) from National Health Service (NHS) specialist trauma services, a community mental health team, and specialist sexual assault counseling organization participated. Interpretative phenomenological analysis (IPA) was utilized to conduct single one-off interviews and analysis. Six themes were identified: Called to the work; Connection, Separation, and Oneness; Into and out of the darkness; Chaos into meaning; Reparation not repetition; and Expansion and growth. The first "Therapist Led Framework of Growth in Trauma Work" is presented. Vicarious posttraumatic growth (VPTG) was a key finding, with CPT therapists experiencing a "challenge/benefit/change" growth process. Adoption of actively relational strategies to enhance clinicians' growth process through trauma work is being proposed. The benefits of conceptualizing both the positive and negative impacts of such work for supervision, training, shaping the formal curricula, service management, and continuing professional development (CPD) are being discussed. The need for good practice guidelines on self-care internationally is highlighted.

Traumatic Stress in Healthcare Workers During COVID-19 Pandemic: A Review of the Immediate Impact.

The disease caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 resulted in a pandemic that has demanded extraordinary physical and mental effort from healthcare workers. This review provides an overview of studies that have explored traumatic stress in healthcare workers and associated factors between January and May 2020. The focus is on the most relevant literature investigating the prevalence of trauma- and stressor-related symptoms. Articles were selected from PubMed and PsycINFO databases using the search terms, "healthcare workers," "COVID-19," and "posttraumatic stress" in different combinations and with various synonyms. Among the seven studies that fulfilled our criteria, five assessed traumatic stress response, one assessed acute stress symptoms, and one focused on vicarious traumatization. Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms. Future studies should clarify the long-term effects of the COVID-19 pandemic on the mental health of healthcare workers, with particular focus on posttraumatic stress disorder.

Vicarious traumatization among child welfare and child protection professionals: A systematic review.

BACKGROUND: Many individuals and organizations experience vicarious trauma, defined as exposure to traumatic experiences of others. Those who work with children traumatized by abuse and/or neglect, including, but not limited to, child welfare, child protection, counselors, healthcare providers, advocates, law enforcement, and prosecutors investigating crimes against children, are exposed to traumatic stories daily in their work. Negative reactions to this witnessing of other people's trauma results in vicarious traumatization (also referred to as secondary traumatic stress) which can manifest as mental, physical, emotional, spiritual, work-related and/or social consequences. METHODS: A review of research literature on the epidemiology of vicarious traumatization among child welfare professionals was conducted. A systematic search strategy was employed using relevant research databases (PubMed, PsychInfo, PILOTS, and EBSCO) for publications from 1995 to 2018. A four-phase PRISMA selection process was employed. Search terms included vicarious trauma/related terms and child welfare/child protection professions. Trained reviewers considered articles meeting inclusion criteria including: (1) child welfare professions; (2) vicarious traumatization/related terms; and (3) analysis of epidemiological data on prevalence, risk/protective factors, or manifestation of vicarious traumatization. RESULTS: Initially 7,895 unique manuscripts were identified. After multi-stage screening, a total of 39 articles were included. Findings regarding the epidemiology of vicarious traumatization are summarized. CONCLUSIONS: While exposure to traumatic narratives of those they serve is inevitable for those working in child welfare and child protection professions, the growing research base shows potential for preventing negative impacts and promoting positive outcomes of this empathic work. Identification of additional risk/protective factors and future development and evaluation of evidence-based interventions are important next steps.