Mental Health in Residential Healthcare Workers During the COVID-19 Pandemic: The Moderating Role of Selfobject Needs.

The COVID-19 outbreak has affected healthcare across all levels. Older adults and those with chronic illness are at greatest risk for infection complications and mortality, which presents significant psychological distress for residential healthcare workers. The concept of selfobject needs, consisting of Mirroring, Idealizing, and Twinship, may be relevant in explaining psychological distress. This study seeks to enhance our understanding of the needs of healthcare workers responsible for elderly patients and evaluate the role of psychosocial support through selfobject needs to mitigate the effects of trauma during the pandemic. Participants (N = 103) employed in residential healthcare facilities in the metropolitan Detroit, MI (USA) region completed an online survey during the peak initial infection. Assessments included standardized measures of trauma-related symptoms, depression, anxiety, and general distress symptoms, as well as a validated measure of selfobject needs. Residential healthcare workers reported mental health symptoms across domains, including clinical elevations in symptoms of trauma, depression, and anxiety. Selfobject needs and mental health outcomes were positively correlated, indicating that greater unmet relational need was associated with greater severity of symptoms. Greater trauma symptom severity as a proxy index of current experience during the pandemic predicted high depressive symptoms, and greater Mirroring need worsened the effect. These results suggest that interventions targeting selfobject needs, specifically Mirroring, may be effective at mitigating acute mental health symptoms among healthcare workers during a distressing event.

An Analysis of Self: The Development and Assessment of a Measure of Selfobject Needs.

Based on the psychoanalysis of adults with borderline and narcissistic personality disorder symptoms, Kohut ( 1971 , 1977, 1980, 1984) formulated a theory of self psychology that emphasized the importance of early developmental experiences; most centrally, the empathic attunement of caregivers as key ingredients for fostering the capacity for healthy self-regulation and interpersonal relations. Kohut elaborated 3 critical selfobject needs (i.e., idealizing, mirroring, and twinship) that were ideally satiated by these early experiences, deeming the fulfillment of these needs as essential for developing a healthy sense of self. The research presented here sought to develop a self-report measure, titled the Arble Estimate of Selfobject Pursuits (AESOP), capable of assessing the selfobject needs identified by Kohut. Across 2 studies involving 686 and 672 respondents, participants completed the AESOP. In the first study, an exploratory factor analysis supported the theorized 3-factor structure. In the second study, a confirmatory factor analysis indicated adequate-to-strong model fit and cluster analysis with theoretically related measures supported the AESOP's discriminant and convergent validity. Further research is encouraged to elaborate the implications of these preliminary findings.

Assessment of a prevention program for work-related stress among urban police officers.

OBJECTIVE: To determine the efficacy of a primary prevention program designed to improve psychobiological responses to stress among urban police officers. METHODS: A random sample of 37 police cadets received complementary training in psychological and technical techniques to reduce anxiety and enhance performance when facing a series of police critical incidents. Training was done by Special Forces officers, trained by the authors in imaging. A random sample of 38 cadets, receiving training as usual, was followed in parallel. Assessment of somatic and psychological health, and stress biomarkers, was done at baseline, immediately following training, and after 18 months as regular police officers. Comparison was done using two-way repeated analysis of variance (ANOVA) and logistic regression. RESULTS: The intervention group improved their general health and problem-based coping as compared to the control group. They also demonstrated lower levels of stomach problems, sleep difficulties, and exhaustion. Training was associated with an OR of 4.1 (95% CI, 1.3-13.7; p < 0.05) for improved GHQ scores during the study as compared to no changes or worsening score. CONCLUSIONS: This first primary prevention study of high-risk professions demonstrates the validity and functional utility of the intervention. Beneficial effects lasted at least during the first 2 years on the police force. It is suggested that preventive imagery training in first responders might contribute to enhanced resiliency.