The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study.

BACKGROUND: Disaster workers suffer from psychological distress not only through the direct experience of traumatic situations but also through the indirect process of aiding disaster victims. This distress, called secondary traumatic stress, is linked to dispositional empathy, which is the tendency for individuals to imagine and experience the feelings and experiences of others. However, the association between secondary traumatic stress and dispositional empathy remains understudied. METHODS: To examine the relationship between dispositional empathy and mental health among disaster workers, we collected data from 227 Japan Ground Self-Defense Force personnel who engaged in international disaster relief activities in the Philippines following Typhoon Yolanda in 2013. The Impact of Event Scale-Revised and the Kessler Psychological Distress Scale were used to evaluate posttraumatic stress responses (PTSR) and general psychological distress (GPD), respectively. Dispositional empathy was evaluated through the Interpersonal Reactivity Index, which consists of four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Hierarchial linear regression analyses were performed to identify the variables related to PTSR and GPD. RESULTS: High PTSR was significantly associated with high Fantasy (identification tendency, ß = 0.21, p < .01), high Personal Distress (the self-oriented emotional disposition of empathy, ß = 0.18, p < .05), and no experience of disaster relief activities (ß = 0.15, p < .05). High GPD was associated with high Personal Distress (ß = 0.28, p < .001), marital status (married, ß = 0.22, p < .01), being female (ß = 0.18, p < .01), medical unit (ß = 0.18, p < .05), and no experience of disaster relief activities (ß = 0.13, p < .05). CONCLUSIONS: Among Japanese uniformed disaster workers, high PTSR was associated with two subtypes of dispositional empathy: the self-oriented emotional disposition of empathy and high identification tendency, whereas high GPD was associated with high identification tendency. Educational interventions that aim to mitigate these tendencies might be able to relieve the psychological distress of disaster workers.

Post-traumatic Stress and Growth Among Medical Student Volunteers After the March 2011 Disaster in Fukushima, Japan: Implications for Student Involvement with Future Disasters.

The March 2011 "triple disaster" (earthquake, tsunami, and nuclear accident) had a profound effect on northern Japan. Many medical students at Fukushima Medical University volunteered in the relief effort. We aimed to investigate the nature of students' post-disaster involvement and examine the psychological impact of their experiences using a survey containing elements from the Davidson Trauma Scale and Posttraumatic Growth Inventory. We collected 494 surveys (70 % response rate), of which 132 students (26.7 %) had volunteered. Volunteers were more likely to be older, have witnessed the disaster in person, had their hometowns affected, and had a family member or close friend injured. In the month after 3/11, volunteers were more likely to want to help, feel capable of helping, and report an increased desire to become a physician. Both in the month after 3/11 and the most recent month before the survey, there were no significant differences in distressing symptoms, such as confusion, anger, or sadness, between volunteers and non-volunteers. Volunteers reported a significantly higher level of posttraumatic growth than non-volunteers. Participating in a greater variety of volunteer activities was associated with a higher level of posttraumatic growth, particularly in the Personal Strength domain. There may be self-selection in some criteria, since students who were likely to be resistant to confusion/anxiety/sadness may have felt more capable of helping and been predisposed to volunteer. However, participation in post-disaster relief efforts did not appear to have a harmful effect on medical students, an important consideration for mobilizing volunteers after future disasters.

Impact of peritraumatic distress on posttraumatic stress disorder symptoms at 6 months after acute coronary syndrome: a prospective cohort study.

Background: Posttraumatic stress disorder (PTSD) symptoms are known to occur after acute coronary syndrome (ACS). Peritraumatic distress has been indicated as a risk factor for PTSD and can be measured by the Peritraumatic Distress Inventory (PDI). However, no studies have yet measured peritraumatic distress after ACS using the PDI to predict PTSD. Objectives: This prospective cohort study examined the impact of peritraumatic distress on PTSD symptoms at 6 months after ACS. Methods: We used the PDI to assess peritraumatic distress in patients treated for ACS at a teaching hospital in Tokyo within 7 days after percutaneous coronary intervention. They were followed up over the next 6 months and were assessed for PTSD symptoms at 6 months using the Impact of Event Scale-Revised. The association between peritraumatic distress and PTSD symptoms was examined by multiple linear regression analysis. Results: The study enrolled 101 ACS patients, and 97 completed the follow-up assessment. PDI total score was an independent predictor of PTSD symptoms after adjustment for potential covariates (beta = 0.38; p < 0.01). Limitations: The results were obtained from a single teaching hospital and assessment of PTSD symptoms was questionnaire based. Conclusion: We provide the first evidence that PDI score can predict the development of PTSD symptoms in ACS patients. Assessing peritraumatic distress after ACS with the PDI may be useful for initiating early intervention against PTSD symptoms.

Antecedentes: Se sabe que síntomas del trastorno de estrés postraumático (TEPT) se pueden presentar después del síndrome coronario agudo (SCA). El malestar peritraumático se ha señalado como un factor de riesgo de TEPT y puede medirse mediante el Inventario de malestar peritraumático (PDI). Sin embargo, ningún estudio ha medido todavía el malestar peritraumático después de un SCA utilizando el PDI para predecir el TEPT.Objetivos: Este estudio de cohorte prospectivo examinó el impacto del malestar peritraumático en los síntomas del TEPT a los 6 meses después del SCA.Métodos: Utilizamos el PDI para evaluar el malestar peritraumático en pacientes tratados por SCA en un hospital universitario de Tokio dentro de los 7 días posteriores a una intervención coronaria percutánea. Fueron seguidos durante los siguientes 6 meses y se evaluaron los síntomas de TEPT a los 6 meses utilizando la Escala de Impacto de Eventos Revisada. La asociación entre malestar peritraumático y síntomas de TEPT se examinó mediante análisis de regresión lineal múltiple.Resultados: El estudio reclutó a 101 pacientes con SCA y 97 completaron la evaluación de seguimiento. La puntuación total del PDI fue un predictor independiente de los síntomas de TEPT después del ajuste de las posibles covariables potenciales (beta = 0,38; p <0.01).Limitaciones: Los resultados se obtuvieron de un solo hospital universitario y la evaluación de los síntomas del TEPT fueron basadas en un cuestionario.Conclusión: Proporcionamos la primera evidencia de que la puntuación PDI puede predecir el desarrollo de síntomas de TEPT en pacientes con SCA. La evaluación del malestar peritraumático después de un SCA con el PDI puede ser útil para iniciar una intervención temprana contra los síntomas del TEPT.