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Compassion for Oneself and Others Protects the Mental Health of First Responders.

ABSTRACT: Objectives:First responders are at elevated risk for psychological distress from frequent exposure to potentially traumatic events. Self-compassion may buffer against the negative impact of these stressors, and the potential emotional challenges of having high levels of compassion for others. However, little is known about the psychological impact of compassion in first responders. We examined how self-compassion, compassionate love for others, and service role interacted to predict mental health in a diverse group of first responders. Methods:First responders (N = 171) with both traditional and emotional support roles completed an online survey including measures of self-compassion, compassionate love, psychological distress, post-traumatic stress, secondary traumatic stress, burnout, resilience, compassion satisfaction, and life satisfaction. Results:Greater self-compassion and compassionate love both independently predicted less depersonalization (|?|s ? .18, ps < .01). Greater self-compassion predicted less general psychological distress, post-traumatic stress, secondary traumatic stress, and emotional exhaustion, as well as greater resilience and life satisfaction (|?|s ? .35, ps < .001). Greater compassionate love predicted greater personal accomplishment and compassion satisfaction for all first responders (|?|s ? .30, ps < .001); for traditional first responders only, greater self-compassion predicted greater personal accomplishment and compassion satisfaction (role x self-compassion; |?|s ? .16, ps < .05). Emotional support first responders reported less emotional exhaustion and greater resilience than traditional first responders (|?|s ? .21, ps < .05). Conclusions:Self-compassion and compassionate love each play important roles in promoting mental health among first responders. Programs designed to increase compassion could be beneficial in this population. Supplementary Information:The online version contains supplementary material available at 10.1007/s12671-020-01527-y.

SUBMITTER: McDonald MA

PROVIDER: S-EPMC7662019 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Compassion for Oneself and Others Protects the Mental Health of First Responders.

McDonald Mollie A MA Meckes Samantha J SJ Lancaster Cynthia L CL

Mindfulness 20201113 3

<h4>Objectives</h4>First responders are at elevated risk for psychological distress from frequent exposure to potentially traumatic events. Self-compassion may buffer against the negative impact of these stressors, and the potential emotional challenges of having high levels of compassion for others. However, little is known about the psychological impact of compassion in first responders. We examined how self-compassion, compassionate love for others, and service role interacted to predict ment ...[more]

PMID: 33204359

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Project description:ObjectivesThe study was designed to estimate the prevalence of mental disorders in a cohort of firefighters who had been deployed to a devastating fire in Fort McMurray, Alberta, in 2016.MethodsA cohort of firefighters was established and followed up by online questionnaires. The contact in October 2018 to March 2019 included the PCL-5 questionnaire screening for post-traumatic stress disorder (PTSD) and the Hospital Anxiety and Depression Scale (HADS) screening for anxiety and depression. A sample was selected comprising all scoring ≥31 on the PCL-5 or ≥12 on either scale of the HADS, 30% of those scoring 8 to 11 on the HADS, and 10% of those with lower scores on all scales. This sample was assessed through a structured clinical interview to categorize disorders as defined in Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). Interviews were carried out face-to-face or by telephone between August 2019 and February 2020. Diagnoses in the interview sample were reweighted to obtain prevalence estimates for the whole cohort. In an analysis of receiver operating characteristics (ROC), possible cut points for scores from each screening questionnaire were examined.ResultsIn 2018 to 2019, 1,000 of the cohort of 1,234 firefighters completed the HADS and 998 completed the PCL-5. Of these, 282 were identified for structured clinical interviews for DSM-5 (SCID) assessment. Interviews were carried out with 192. Among those assessed, 40.6% met the criteria for PTSD, 30.7% for an anxiety disorder, and 28.5% for a depressive disorder. When reweighted to allow for sampling and losses to assessment, cohort prevalence estimates were as follows: PTSD 21.4% (15.7% to 29.1%), anxiety disorders 15.8% (11.0% to 22.5%), and depressive disorders 14.3% (9.9% to 20.8%). Lower prevalence estimates were obtained when using the cut point with least misclassification in the ROC analysis.ConclusionUsing the gold-standard SCID assessment, high rates of mental disorders were found in this cohort of firefighters who had experienced a devastating fire. Fewer cases would have been identified by screening questionnaire alone.

Project description:BackgroundThe COVID-19 pandemic has greatly affected front-line health care workers (HCW) and first responders (FR). The specific components of COVID-19 related occupational stressors (CROS) associated with psychiatric symptoms and reduced occupational functioning or retention remain poorly understood.ObjectivesExamine the relationships between total and factored CROS, psychiatric symptoms, and occupational outcomes.DesignObservational, self-report, single time-point online assessment.ParticipantsA total of 510 US HCW (N = 301) and FR (N = 200) with occupational duties affected by the COVID-19 pandemic.Main outcomes and measuresCROS were assessed using a custom 17-item questionnaire. Post-traumatic stress disorder (PTSD), depression, insomnia, and generalized anxiety symptoms were assessed using the PTSD Checklist-5 (PCL5), Patient Health Questionnaire-9 (PHQ9), Insomnia Severity Index (ISI), and General Anxiety Disorder-7 (GAD7). Respondents' likelihood of leaving current field and occupational functioning were assessed with 2-item PROMIS subscales. Relationships were modeled using multivariable regression. Open-ended responses were coded using rapid template analysis.ResultsCROS total scores correlated significantly with all four psychiatric symptom domains (R's = .42-.53), likelihood of leaving one's current occupation (R = .18), and trouble doing usual work (R = .28), all p's < .001. Half of HCW indicated a decreased likelihood of staying in their current occupation as a result of the pandemic. CROS were fit to a 3-factor model consisting of risk, demoralization, and volume factors. All CROS factors were associated with psychiatric symptom burden, but demoralization was most prominently associated with psychiatric symptoms and negative occupational outcomes. Among psychiatric symptoms, PTSD symptoms were most strongly associated with negative occupational outcomes. Open-ended statements emphasized lack of protection and support, increased occupational demands, and emotional impact of work duties.Conclusions and relevanceThese results demonstrate potentially treatable psychiatric symptoms in HCW and FR experiencing CROS, impacting both wellbeing and the health care system. Mitigating CROS, particularly by addressing factors driving demoralization, may improve HCW and FR mental health, occupational functioning, and retention.

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Compassion for Oneself and Others Protects the Mental Health of First Responders.

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Compassion for Oneself and Others Protects the Mental Health of First Responders.

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