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COVID-19

Theme Leaders: Sara Freedman and Tatiana Davidson

Global COVID-19-related traumatic stress activities

The COVID-19 outbreak is a global problem, an unprecedented pandemic, a public health emergency of international concern that threatens lives and well-being of the world population. It is also affecting health care professionals on the front lines, as well as mental health professionals providing psychosocial support. 

As the COVID-19 outbreak is a global problem, it also requires a global solution. Therefore, global collaborating is vital, i.e. working together on COVID-19-related traumatic stress aspects (policies, best practices and research).

We will need to address how people may respond differently to the crisis around the world, how to best communicate about the outbreak and its consequences - taking culture, gender and age aspects into account - how to provide peer support to health workers or other affected professionals, and what are (online) interventions that are needed at a later stage.

Resources

The traumatic stress societies that are united in the Global Collaboration on Traumatic Stress (GCTS) have collected relevant information (listed below) on the COVID-19 virus and measures we can take, the consequences and how to respond to those who suffer from the consequences and how we support our health professionals. 

COVID-19 information on STSS websites:

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Projects

1. C19 MentalHealthNet

The COVID-19 Mental Health Research Network 

Project leaders: Soraya Seedat & Nancy Kassam-Adams

Project completed, find details here.

2. Traumatic Stress and Adversity Faced by COVID-19 Frontline Healthcare Workers and Mental Healthcare Providers

Project leader:  Julian Ford

Study A

Temporal trends in health worker social media communication during the COVID-19 pandemic – Text Mining Approach 

Project completed, find details here.

Study B

Impact of the COVID-19 pandemic on mental health and human services providers – An international Global Collaboration on Psychotrauma survey 

Study group: Julian Ford, Rocio Chang, Ramez Dagher, Daniel Eichert, Damion Grasso, Wissam El Hage, Patricia Kerig, Tomoko Kishimoto, Chris Kristensen, Davide Marengo, Joshua Mersky, Misari Oe, Andrea Phelps, Sami Richa, Carolina Salgado, Soraya Seedat, Patricia Correia Santos, Chaoran Sun, Ulrich Schnyder, James Topitzes

Aims 

As we enter the fourth year of the COVID-19 pandemic, the impact on healthcare workers and organizations is well recognized – but the toll on mental health and human services counselors in practice and in training has never been systematically evaluated.

Using a Qualtrics platform for secure data acquisition and privacy protection the survey of mental health providers from multiple disciplines is being done by an international team of traumatic stress from Australia, Brazil, China, France, Italy, Japan, Portugal, and the United States,  beginning two years after the start of the pandemic (June 2022) with repeated waves every 6 months.

Survey items include: (1) sociodemographics, (2) a newly developed measure of personal and social impacts of the pandemic for mental health providers (EPII-Brief and-MH; Grasso et al., 2021), (3) depression and anxiety symptoms, (4) trauma history and PTSD symptoms (Global Psychotrauma Screen), (5) CPTSD DSO symptoms (International Trauma Questionnaire) (6) moral injury symptoms, (7) experiential avoidance symptoms, (8) secondary traumatic stress reactions, (9) burnout symptoms, (10) resiliency factors, and (11) social support (~200 items, 20-30 minute estimated completion time). Translation into multiple languages is done by co-investigators.

Descriptive statistics, correlations, linear regression, and tests of group differences will be conducted with SPSS and Mathworks Inc. Matlab. Exploratory and confirmatory factor analyses (EFA/CFA) and latent class and growth analyses will be conducted using MPlus software.

Moderators (e.g., nationality; training; sociodemographics, practice setting) and mediators (e.g., trauma/loss exposure, prior wave symptoms/support) will be tested, with a target sample size of up to N=3,000.

Mental health providers: 

please access the survey here! 

The survey is designed for mental and behavioral health counseling, social work legal/forensic, and marriage and family therapy professionals and paraprofessionals (including pre-professional trainees).  

The survey is anonymous to ensure privacy, with brief, well validated and meaningful measures. Please circulate this invitation and link to other colleagues who might be interested in participating. 

So far, more than 1000 mental health and social work professionals internationally have completed the survey, and a second cohort is beginning in Africa, Australia, and Singapore.

For more information on these projects, please contact Julian Ford 

Study Related Publications

  • Grasso, D. J., Briggs‐Gowan, M. J., Carter, A. S., Goldstein, B. L., & Ford, J. D. (2021). Profiling COVID‐related experiences in the United States with the Epidemic‐Pandemic Impacts Inventory: Linkages to psychosocial functioning. Brain and Behavior, e02197. https://doi.org/10.1002/brb3.2197

3. Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic 

Project leaders: Annett Lotzin & Ingo Schäfer on behalf of ESTSS

Project group members: Helene Flood Aakvaag, Elena Acquarini, Dean Ajdukovic, Vittoria Ardino, Maria Böttche, Kristina Bondjers, Maria Bragesjö, Małgorzata Dragan, Piotr Grajewski, Margarida Figueiredo-Braga, Odeta Gelezelyte, Jana Darejan Javakhishvili, Evaldas Kazlauskas, Matthias Knefel, Brigitte Lueger-Schuster, Nino Makhashvili, Trudy Mooren, Luisa Sales, and Aleksandra Stevanovic. Please contact Annett Lotzin if you are interested in joining the study.

 

Aims and method

The primary aim of this longitudinal cohort study launched by the European Society of Traumatic Stress Studies (ESTSS) was to examine the relationships between risk and resilience factors, stressors and adjustment disorder symptoms during the pandemic, and to investigate whether these relationships were moderated by coping behaviors. All data were assessed by an online-questionnaire longitudinally, with an interval of six months. Following a conceptual framework based on the WHO’s social framework of health, an assessment of individual and country-level risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behavior were measured to estimate their contribution to symptoms of adverse adjustment. Primary measure: adjustment disorder symptoms (ADNM-8). Secondary measure: Posttraumatic stress disorder symptoms (PC-PTSD-5).

 

Results

From June to November 2020, 15,563 adults from eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) participated in this study. Several risk and protective factors as well as pandemic-related stressors were identified.

 

Study publications can be accessed here.

4. High-risk occupational groups responding to the COVID-19 pandemic

Project leaders: Talya Greene, Jo Billings, Michael Bloomfield

Project members: tbd

 

Aims and method

It is essential that the psychological response to the COVID-19 outbreak is coordinated, trauma-informed and evidence-based. This project aims to collate and develop globally transferable guidance for the psychosocial support of high-risk occupational groups responding to the COVID-19 pandemic. These groups include healthcare workers (e.g., doctors, nurses, technicians, porters, paramedics, hospital administrators), other essential workers (e.g., social workers, care home staff, cleaners, delivery workers), and their family members. Guidance should be evidence-based and is focused on which interventions are likely to be helpful, and which may be harmful, in coping with peritraumatic stress exposure, and mitigating long-term trauma reactions.

  • Billings, J., Greene, T., Kember, T., Grey, N., El-Leithy, S., Lee, D., ... & Bloomfield, M. A. (2020). Supporting hospital staff during COVID-19: Early interventions. Occupational Medicine. DOI: 10.1093/occmed/kqaa098

  • Greene, T., Bloomfield, M. A., & Billings, J. (2020). Psychological trauma and moral injury in religious leaders during COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(1), 143-145. DOI: 10.1037/tra0000641

 

5. Posttraumatic adjustment in nurses

Project leader: Prof Dr Judith Daniels (j.k.daniels@rug.nl)

Project completed, find details here.

5. Posttraumatic adjustment in nurses

Project leader: Prof Dr Judith Daniels (j.k.daniels@rug.nl)

Project group: Judith Daniels, Astrid Lampe, Birgit Kleim, and others. Please contact Dr Daniels if interested to join.

 

Aims and method

Nurses are at the frontline of the current pandemic. They often have to handle emotionally impactful situations and at times make decisions that are against their moral judgements. We will assess the impact this has on their mental health and how the adjust following the peak of the crisis

It will be longitudinal online study with 3 assessment time points: after the local peak in Covid cases, 3 months later, and 6 months later.

Ideally, all nurses of the clinic would receive the invitation via their work email. We will have control groups (nurses in maternity etc) to compare to nurses in ICU/oncology etc. The questionnaire will take approx. 15 minutes per time point.

6. REACH for Mental Health
Project leaders: Amantia Ametaj, Archana Basu, Karmel Choi, Christy Denckla, Bizu Gelaye, Shaili Jha, Karestan Koenen, Kristina Korte

Please contact: Shaili Jha  <sjha@hsph.harvard.edu> if interested to join.

Aims and method
The mission of the REACH project is to bring evidence-based skills on managing stress and enhancing resilience to everyone around the world. This coordinated effort to “Do the Five for Mental Health” in the COVID-19 pandemic is summarized by the acronym REACH, which stands for 'Recognize the Problem', 'Expand the Social Safety Net', 'Assist Those Most at Risk', 'Cultivate Resilience', and 'Have Empathy.' One example of this initiative is the COVID-19 Mental Health Forums offered through the Harvard T.H. Chan School of Public Health designed to: 1) introduce evidence-based skills for managing stress related to the coronavirus (COVID-19) outbreak; and 2) provide techniques for adapting and enhancing resilience. Each week, Dr. Karestan Koenen and colleagues host international experts in the field of clinical psychology and trauma epidemiology research to address important emotional, psychological, and physical health issues related to daily life during a pandemic. These forums are global in focus, hosting for example African psychiatrists covering issues facing sub-Saharan Africa at this time. These forums are always open to the global public and include a discussion and Q&A with attendees. If you would like to join our mailing list, please add your contact information to our listserv [link to Google Form: https://forms.gle/QQ9vbzfNCuVKnL6k8]

We are open to global collaboration for evaluating REACH worldwide and to adapt the interventions to local cultures.

7. Psychological Effects of the Corona Virus COVID19

Project Leaders:

Prof Sara Freedman,  Sara.freedman@biu.ac.il, Dr Talya Greene, Prof Cherie Armour

Project Group Members: Azu Garcia Palacios, Eduardo Fernandez, Emily McGlinchey,Kareena McAloney, Kerri McPherson, Pietro Cipresso. Please contact Sara Freedman if you are interested to join.

 

Aims and method

This study aims to further our understanding of psychological effects of the Coronavirus, assessing these as they change over time. We are specifically interested in PTSD symptoms and their relationship with Corona related exposure and worry.

The first stage of this project (launched a month ago) included demographic questionnaires, Coronavirus exposure and worry, PTSD, LEC, GAD7 and PHQ9. Participants (from English, Spanish and Hebrew speaking countries) are now answering questionnaires on a weekly basis.

8. Global Psychotrauma Screen – Cross-Cultural responses to COVID-19 versus other traumatic events (GPS-CCC)

Project group:

Miranda Olff, Helene Aakvaag, Zafer Altunbezel, Anne Bakker, Lucia Cantoni, Emma Grace, Wissam El Hage, Ani Hovnanyan, Jana Javakhishvili, Juliana Lanza, ​Patrick Lorenz, Misari Oe, Muirne Paap, Indira Primasari, Daniela Rabellino, Yulan Qing, Luisa Sales, Carolina Salgado, and Soraya Seedat. ​

We are looking for collaborators and ambassadors of this project who help us collect the data cross-culturally, and/or analyze data and work on a joint publication of the results, please contact Miranda Olff.

 

Aims and method

The Global Psychotrauma Screen (GPS) developed by the Global Collaboration on Traumatic Stress (GC-TS) is a brief measure screening for a wide range of potential outcomes of trauma, as well as for risk and protective factors. It is currently available in 22 languages. The measure was designed to be simple, cross-culturally valid, and easy to administer in a variety of circumstances, e.g. shortly after mass trauma, but would also tap potential consequences up to decades after trauma (Olff., et al 2020, or GPS page).

A GPS web-app has been built for individuals to easily fill out the GPS in currently 18 languages. The app additionally includes questions on the type and time of the event experienced (COVID-19 has been added), as well as an item on global functioning. It provides – at this time – conservative feedback on the scores with advice on seeking further help if needed, using international websites that provide contact information for mental health crisis hotlines internationally. Norm scores are being collected in various languages and ongoing validation research will allow for more detailed feedback in the future.

To be better informed about how reactions to COVID-19 related traumatic events versus other traumatic events may be different, across different cultures and populations, and across different phases of the pandemic, we are currently collecting data via this portal:

https://www.global-psychotrauma.net/take-gps-test

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Prof. Dr. Karestan Koenen, project leader of project 6. REACH for Mental Health was interviewed by Miranda Olff about her work. Karestan is a former ISTSS president, an international expert in the field of PTSD and advocate for victims of sexual violence. She is breaking taboos by also sharing personal experiences.

Watch it here.

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