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PTSD and depression following armed robbery: Patterns of appearance and impact on absenteeism and use of health care services

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Abstract

Armed robbery is a sudden, life-threatening event affecting the victims' mental health. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in this population have rarely been studied. The objectives of the study were to assess the occurrence of PTSD and MDD in victims of armed robbery, and to evaluate occupational functioning and use of health care services. Eighty-six convenience store employees, victims of armed robbery, were evaluated within days after the robbery, and 1 and 3 months after. A validated diagnostic interview (SCID-I) was used. Data about sick leave, absenteeism, and use of health care services were collected. The total number of individuals who had PTSD, MDD, or both at any time during the 3 months following the robbery was 1 (2%), 4 (6%), and 5 (8%), respectively, showing that comorbid PTSD-MDD is as frequent as or even more frequent than either disorder in isolation. Individuals with PTSD (with or without comorbid MDD) reported more absenteeism (η(2) (p) = .25) and more medical visits (η(2) (p) = .12) following the robbery. Clinicians and management resources personnel must be alert to the possibility that both PTSD and MDD, either alone or comorbid, can develop in victims of armed robbery.

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... Robberies are considered potentially traumatic workplace events (PTEs) because they are unexpected life-threatening events occurring in the course of someone's work 2) . Exposure to bank robberies may engender numerous mental health problems 3) . Among these, attention should be given to post-traumatic stress symptoms (PTSS) that are: intrusion (i.e., re-experiencing the trauma through distressing dreams, flashbacks, feelings), avoidance (i.e., avoiding feelings, thoughts and other reminders of the event) and hyper-arousal (i.e., hyper-vigilance, sleep disturbance, irritability, poor concentration) 4) . ...
... Re-experiencing and arousal symptoms indeed result in poor concentration and difficulties to meet work-related demands 5) . Moreover, the work environment may become a reminder of the critical event 6) , so that employees may become reluctant to return to their job 3) . Additional, disruptive consequences of PTSS include sick leave, missed deadlines, and increased accidents 3,7) . ...
... Moreover, the work environment may become a reminder of the critical event 6) , so that employees may become reluctant to return to their job 3) . Additional, disruptive consequences of PTSS include sick leave, missed deadlines, and increased accidents 3,7) . Thus, it has been estimated that in 2010 PTSS across Europe costed 8.4 billion euros in terms of healthcare expenses 8) . ...
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Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. To test our predictions, we conducted a two-wave study – with a lag of two month between measurements – on 140 employees from a national bank in Italy. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the “isolated exposure” group the job satisfaction score was higher among less symptomatic victims, within the “shared exposure” group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice.
... En los antecedentes bibliográficos se informa que en la población general la probabilidad de padecer un evento traumático en la vida tiene un rango entre el 68% y el 90% (4, 5) y, que la prevalencia de trastorno por estrés postraumático -TEPT-en la vida se ubica entre el 6.8% y el 12.3% (6). También se informa sobre los hallazgos de trastornos psíquicos postraumáticos en poblaciones específicas, como estudiantes universitarios (7), víctimas de violencia sexual, familiar o terrorismo (8)(9)(10)(11)(12)(13)(14)(15)(16), veteranos de guerra (17)(18)(19)(20)(21)(22)(23), en quienes fueron asaltados o amenazados con arma (4,24,25). En estos últimos se encontró que la probabilidad de padecer TEPT se ubica entre el 1.8 % y el 25%, pero la población estudiada incluye personas asaltadas en sus hogares o en la calle (4,24,25). Todos estos antecedentes permiten un acercamiento al conocimiento del fenómeno, pero quedan aún sin responder interrogantes relacionados con el impacto específico que los delitos ocasionan en los comerciantes: ¿generan trastornos psíquicos los delitos que padecen los comerciantes? ...
... También se informa sobre los hallazgos de trastornos psíquicos postraumáticos en poblaciones específicas, como estudiantes universitarios (7), víctimas de violencia sexual, familiar o terrorismo (8)(9)(10)(11)(12)(13)(14)(15)(16), veteranos de guerra (17)(18)(19)(20)(21)(22)(23), en quienes fueron asaltados o amenazados con arma (4,24,25). En estos últimos se encontró que la probabilidad de padecer TEPT se ubica entre el 1.8 % y el 25%, pero la población estudiada incluye personas asaltadas en sus hogares o en la calle (4,24,25). Todos estos antecedentes permiten un acercamiento al conocimiento del fenómeno, pero quedan aún sin responder interrogantes relacionados con el impacto específico que los delitos ocasionan en los comerciantes: ¿generan trastornos psíquicos los delitos que padecen los comerciantes? ¿Qué tipo de trastorno y de qué gravedad? ...
... Entre la escasa bibliografía existente sobre esta población específica, se destaca un reciente estudio que informa que el 2% de los empleados víctimas de delito padeció TEPT, el 6% depresión mayor y el 8% la comorbilidad de ambos trastornos en los 3 meses subsiguientes al evento traumático (24). En otra investigación se detectó que los empleados que experimentaron el robo de los bancos donde trabajaban, sufrieron diversos efectos negativos en áreas psicológica, física, laboral y personal (26). ...
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Crime consequences are not only a security problem; they are also a community health question. Because shop assistants are particularly exposed to crime victimization, they are at risk from suffering posttraumatic stress disorders. To describe posttraumatic symptomatology of crime victimized shop assistants and to explore the relationship between the symptoms and demographic, victim and situational factors. Self-reported information about mental symptomatology was gathered from 126 victimized shop assistants identified during cross-sectional study. Case and control groups were formed to explore association between symptomatology and crime and victim characteristics. The 20.6% of respondents reported information compatible with posttraumatic stress disorder; the 13 %, with moderate/severe depression and the 69.8% with adjustment disorder. The condition of being a case was associated with the violent characteristic of the crime, with the subtraction of goods and the economic value of the goods.
... Depending on the duration of the disorder, we can define PTSD as: acute PTSD, if symptoms last less than 3 months; chronic PTSD, if symptoms last longer than 3 months; delayed-onset PTSD, if symptoms occur at least 6 months after the event. 10,11 The predictors of PTSD are pre-, peri-, and posttrauma variables. Pretraumatic factors are the individual characteristics of the subject: the female sex, age less than 25 years, a low level of education, having experienced traumatic events in the past, and the presence of preexisting psychopathological disorders are all factors favoring the onset of PTSD. ...
... Pretraumatic factors are the individual characteristics of the subject: the female sex, age less than 25 years, a low level of education, having experienced traumatic events in the past, and the presence of preexisting psychopathological disorders are all factors favoring the onset of PTSD. 11,12 However, several studies have confirmed a strong association of posttraumatic syndromes with poorer mental health and with psychological problems such as depression, anxiety, and personality disorders. 13,14 As far as demographic data are concerned, its association appears less solid. ...
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In the literature, there are many studies that have investigated the psychological reactions resulting from traumatic events of varying degrees, such as wars, natural disasters, and acts of violence. Few, however, are the searches performed on employees who are victims of robbery. We carried out a research to assess the psychological reactions of 644 bank employees who had been victims of robbery, especially with regard to the possible development of post-traumatic stress disorder (PTSD). The aim of this study was to evaluate the variables pre-, peri-, and postrobbery trauma in relation to the development of psychopathological symptoms. The exploration of the reactions after the robbery was carried out on 644 employees of a banking institution, present throughout the national territory, through a survey, consisting of a general description of the event, the Impact of Event Scale Revised-6 scale, and the General Health Questionnaire-12, during the days after the robbery. The analysis showed that the development of pretrauma variables is not significant and that peritrauma variables are partially significant. In particular, being directly involved in the robbery, the thought of being hurt, and the feeling of intense fear are associated with posttraumatic symptoms. Finally, among the posttrauma variables, anxiety and depression played a major role. Surprisingly, a lower level of self-confidence seems to be related negatively to the PTSD symptomatology.
... 19,20 The choice of the administration time frame followed previous studies conducted among victims of bank robberies. 15,21 Most of the victims of armed robbery seem to have clinically significant symptoms of posttraumatic stress immediately following the robbery. 21 The survey comprised a total of 202 (57.7%) males and 148 (42.3%) females, and the mean age was 40.8 (±10.1) ...
... 15,21 Most of the victims of armed robbery seem to have clinically significant symptoms of posttraumatic stress immediately following the robbery. 21 The survey comprised a total of 202 (57.7%) males and 148 (42.3%) females, and the mean age was 40.8 (±10.1) years. ...
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Bank robberies are becoming a serious problem in Italy. This study aims to evaluate the validity and the reliability of the Italian version of Impact of Event Scale (IES)-6. It is also hypothesized that a potential posttraumatic disorder, as measured by the IES-6, is associated with mental health problems and several peritraumatic variables. A database was built from data collected through a survey of victims of robbery in an Italian bank. The final sample comprised 350 employees. This study tests different models of IES, comparing the validity of IES-6 with the 22-item original version (IES-R) and the 15-item Italian version (recently adopted in a sample of flood victims). A confirmatory factor analysis supported the IES-6 three-factor solution as the best model. In addition, the internal consistency of the IES-6 and the subscales was good. Outcomes revealed a robust structure supporting the composition of the IES-6 Italian version.
... The authors also found that about half of the cases involved armed robberies, while 38% involved other situations of threats or violence [13]. So far there are only a few studies regarding SA/DP in conjunction with PTSD, however, they indicate that it is very common with SA/DP after traumatic experiences at work [13,16,17]. A small study based on self-reported data on threats and violence within the retail and wholesale industry found that the risk of PTSD was more than twice as high among those who had experienced a robbery at work, however, there were no differences regarding depression among those who had and hadn't experienced such robberies [18]. ...
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Background Most studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers. Aim To examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry. Methods A prospective population-based cohort study of all 192,077 such workers aged 18–67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012–2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit. Results 35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly. Conclusions About a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD.
... 23,35,36 Workplace violence is the fifth most common cause of non-fatal work-related injuries in the United States, 37 and can lead to depressive and anxiety disorders as well as posttraumatic stress disorder even among survivors who are not injured. 38 The high demand and low control nature of retail cannabis work precluded most adaptive coping mechanisms. In addition, workers did not have access to methods for reducing stress like autonomy in task rotation to reduce time in direct customer contact. ...
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California is home to a multibillion-dollar cannabis (marijuana) industry, but little is known about the occupational health and safety hazards faced by cannabis workers and even less of the stress, mental health, and coping mechanisms among these workers. Previous research has been based on long-term workers at legal businesses, but most California cannabis is produced and sold unlawfully. There are many seasonal workers whose experiences have not been studied. A qualitative study based on focus group discussions and key informant interviews was performed to understand cannabis workers’ experiences, knowledge, and perceptions of occupational hazards. Participants reported sources of stress including production pressure and isolation, and mental health outcomes such as depression and mental fatigue. They described primarily maladaptive coping mechanisms. Unique characteristics of the cannabis industry, including criminalization and isolated, remote farms, make interventions challenging. However, policy approaches that involve community organizations could promote worker health.
... It is therefore possible that event centrality drives the considerable findings indicating that interpersonal/victimization traumas have greater psychological impact. This may also explain inconsistent results regarding trauma types that do not fall clearly into interpersonal and non-interpersonal categories (e.g., death threat traumas) [37,38]. For instance, a death threat trauma that significantly affects one's worldview may have as much impact on the development of trauma-related pathology as a victimization trauma. ...
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Objective: Trauma exposure—a contributor to psychological risk for refugee youth—is typically assessed using cumulative indices; however, recent findings indicate that trauma type may better predict psychological outcomes. This study investigated the utility of two methods of classifying trauma exposure—cumulative trauma and exposure to specific types of trauma (i.e., trauma subtypes)—in predicting the severity of symptoms related to posttraumatic stress disorder (PTSD) and anxiety for refugee youth. Method: 96 Syrian and Iraqi youth resettled as refugees in the United States self-reported trauma exposure and psychological symptoms. Multiple regression was used to assess the variance in symptom severity explained by specific trauma subtypes (i.e., victimization, death threat, and accidental/injury) as compared to cumulative trauma scores. Results: Multiple regression models predicting PTSD revealed cumulative trauma (b = 0.07; p = .004) and death threat trauma (b = 0.16; p = .001) as significant predictors of PTSD symptom severity; notably, death threat trauma was the only subtype associated with PTSD and explained more variance than cumulative trauma scores (10.3% and 8.4%, respectively). Cumulative trauma, but no specific trauma subtype, was associated with anxiety (b = .03; p = .043); however, this relation did not survive correction for multiple comparisons. Conclusion: Focused trauma assessment—particularly consideration of death threat trauma and cumulative trauma exposures—may be useful in evaluating the risk of PTSD symptoms in refugee youth, whereas symptoms related to anxiety may be driven by other factors. These findings can be leveraged toward focused identification of youth at highest risk for PTSD symptoms, to improve prevention and early intervention efforts.
... General population studies provide a reason to believe that PTSD may be associated with particularly poor functioning during an already challenging time. In community samples, PTSD is associated with medical illness (Lauterbach et al., 2005;Miller et al., 2011), hospital admissions (Kartha et al., 2008), housing insecurity (Bassuk et al., 1998), economic instability (Elbogen et al., 2012), occupational impairment (Belleville et al., 2012;Matthews, 2005), and lower quality of life (Westphal et al., 2011). These outcomes overlap with challenges that are already common among persons returning to the community from incarceration; for example, in past research, 91% of people recently released from incarceration met USDA definitions for some form of food insecurity (Wang et al., 2013). ...
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Objective: Posttraumatic stress disorder (PTSD) is prevalent among people who have been incarcerated. Here, we examined whether screening positive for PTSD was associated with other indicators of poor health, acute healthcare utilization, and poverty among primary care patients upon release from incarceration. Method: We conducted a cross-sectional survey in a national network of primary care clinics serving people recently released from incarceration. Participants were 416 patients who completed the Primary Care PTSD screen (PC-PTSD) and other questions about mental and physical health, acute healthcare utilization, and economic status within 6 months of release. Results: Screening positive for PTSD was associated with worse status across nearly all variables examined, including being more likely to report: poor/fair health (61.6% vs. 41.7%), current depressive symptoms (89.7% vs. 50.8%), lifetime depression diagnosis (63.3% vs. 35.3%), cannabis use since release (20.7% vs. 9.6%), homelessness (31.9% vs. 18.5%), having no cash on hand (56.3% vs. 39.0%) and severe food insecurity (29.3% vs. 18.2%; all ps < .01). Reporting recent suicidality (14.3% vs. 7.0%), alcohol use since release (30.2% vs. 20.0%), and emergency department utilization (20.4% vs. 12.2%) was also more likely (all ps ≤ .03). These trends were largely upheld when controlling for demographic characteristics and chronic physical health conditions using linear probability regression. Conclusions: Primary care patients recently released from incarceration have a need for wrap-around services that address health challenges and poverty. Patients with significant PTSD symptoms face even greater challenges. Identification and treatment of PTSD both during and after incarceration is warranted.
... event centrality drives the considerable findings indicating that interpersonal/victimization traumas have greater psychological impact. This may also explain inconsistent results regarding trauma types that do not fall clearly into interpersonal and non-interpersonal categories (e.g., death threat traumas) [37,38]. For instance, a death threat trauma that significantly affects one's worldview may have as much impact on the development of trauma-related pathology as a victimization trauma. ...
Article
Full-text available
Pre-migration trauma, a psychological risk factor for refugees, is often measured using cumulative indices. However, recent research suggests that trauma subtypes, rather than cumulative trauma, may better predict psychological outcomes. This study investigated the predictive utility of trauma subtypes in the assessment of refugee mental health. Multiple regression was used to determine whether cumulative trauma or trauma subtypes explained more variance in depression, anxiety, and post-traumatic stress disorder (PTSD) symptom scores in 70 Syrian and Iraqi refugees. Subtype models performed better than cumulative trauma models for PTSD (cumulative R² = 0.138; subtype R² = 0.32), anxiety (cumulative R² = 0.061; subtype R² = 0.246), and depression (cumulative R² = 0.041; subtype R² = 0.184). Victimization was the only subtype significantly associated with PTSD (p < 0.001; r² = 0.210), anxiety (p < 0.001; r² = 0.162), and depression (p = 0.002; r² = 0.140). Cumulative trauma was predictive of PTSD symptoms only (p = 0.003; r² = 0.125). Trauma subtypes were more informative than cumulative trauma, indicating their utility for improving predictive efforts in research and clinical contexts.
... Moreover, PTSD is associated with higher risk of anxiety and depression disorder [41,51], and may lead to increased absenteeism from work or social activities. [52] ...
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Background Congenital gastrointestinal malformation (CGIM) require neonatal surgical treatment and may lead to disease-specific sequelae, which have a potential psychological impact on parents. The aim of this study is to assess distress and symptoms of post-traumatic stress disorder (PTSD) in parents of patients with CGIM. In this cross-sectional study, seventy-nine parents (47 mothers and 32 fathers) of 53 patients with CGIM completed the Distress Thermometer for Parents (DT-P) and the Self Rating Scale for Posttraumatic Stress Disorders (SRS-PTSD) as part of the multidisciplinary follow-up of their children (aged 5–35 months). Group differences were tested between parents and representative Dutch reference groups with regard to rates of (clinical) distress and PTSD, and severity of overall distress and PTSD, for mothers and fathers separately. Mixed model regression models were used to study factors associated with the risk of (clinical) distress, PTSD and with severity of symptoms of PTSD (intrusion, avoidance and hyperarousal). Results Prevalence of clinical distress was comparable to reference groups for mothers (46%) and fathers (34%). There was no difference in severity of overall distress between both mothers as well as fathers and reference groups. Prevalence of PTSD was significantly higher in mothers (23%) compared to the reference group (5.3%) (OR = 5.51, p < 0.001), not in fathers (6.3% vs 2.2.%). Symptoms of intrusion were commonly reported by all the parents (75%). Longer total length of child’s hospital stay was associated with more severe symptoms of intrusion, avoidance and hyperarousal. Child’s length of follow-up was negatively associated with severity of intrusion. Conclusions Having a child with CGIM has a huge impact on parents, demonstrated by a higher prevalence of PTSD in mothers, but not fathers, compared to parents in the general population. Monitoring of symptoms of PTSD of parents in follow-up is necessary.
... Several studies have shown that mental disorders in adulthood have roots in exposure to stressful events in childhood or adolescence, such as child maltreatment, neglect, domestic violence, physical abuse, bullying, familial members death and contexts affected by war or armed conflict (4)(5)(6)(7)(8)(9). In adults, posttraumatic stress disorder related to experiences of robbery has been reported among convenience store and bank employees (10)(11)(12). Moreover, depression, anxiety and social phobia have been found to correlate with community violence (9,13). ...
Article
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Robbery is one of the most common urban crimes, but little is known about its relationship with mental disorders in young adults. This study aimed to assess the relationship between robbery victimization and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and comorbidity between MDD and GAD at 30 years of age. A birth cohort study has followed all children born in the city of Pelotas, southern Brazil, since 1982. At ages 23 and 30 years, participants were interviewed and asked about lifetime and recent experiences of robbery. Covariates were measured in interviews between birth and age 30 years. MDD and GAD were measured using the MINI-International Neuropsychiatric Interview. Adjusted prevalence ratio (aPR) and corresponding 95% confidence interval (CI) for associations between robbery and mental disorders were calculated using Poisson regression with robust standard error. Of 3,701 cohort members interviewed at age 30 years, 42% reported robbery victimization during their lifetime. Victimization across three periods (lifetime, past 10 years, past 12 months) was associated with increased occurrence of MDD, GAD, as well as the MDD and GAD comorbidity. The strongest associations were found to robbery occurring in the previous 12 months with the MDD and GAD comorbidity, both for burglary at home (aPR 2.52; 95% CI 1.52–4.22) or community family victimization (aPR 2.10; 95% CI 1.34–3.27). These findings highlight the importance of community violence for mental health in young adulthood, and the need for public policies to prevent violence as well as support services for victims to mitigate its adverse health consequences.
... People diagnosed with PTSD experience significant impairment in psychosocial functioning, which manifests across multiple domains. For example, occupational functioning is impacted such that people diagnosed with PTSD are less likely to be employed (Smith et al., 2005;Sripada et al., 2018) and may exhibit greater absenteeism (Belleville et al., 2012). Additionally, functional impairment is seen across the spectrum of social relationships for those with PTSD, with effects seen in research on friendships, romantic relationships, and family relationships (Campbell & Renshaw, 2018;Creech & Misca, 2017;Laffaye et al., 2008;Sayers et al., 2009). ...
Article
People with posttraumatic stress disorder (PTSD) experience a wide array of symptoms, often accompanied by significant functional and quality of life impairments. Evidence-based psychotherapies are effective for alleviating symptoms in this group, but functional outcomes following psychotherapy are understudied. This study aimed to synthesize existing work on functional outcomes of psychotherapy to conduct a meta-analytic investigation examining whether people with PTSD experience significant improvements in functioning and quality of life following a course of psychotherapy. A literature search was conducted for studies reporting results of randomized clinical trials of psychotherapies for people diagnosed with PTSD that included a functional or quality of life outcome measured at pre- and post-intervention. Both between-groups and within-groups analyses were conducted using a random effects model. Fifty-six independent samples were included. Results suggest that, on average, people with PTSD experience significant, moderate improvement in functional outcomes after a course of psychotherapy. Taken together, this meta-analysis represents a substantial advance in our understanding of functional outcomes of psychotherapy for people with PTSD. Findings suggest that psychotherapy is one vehicle through which functional outcomes may be improved for this group, though notably to a lesser degree than symptom improvement.
... Much of the available research on workplace-related PTSD focuses on occupational groups that encounter highstress environments, such as first responders, emergency public service providers, and military personnel, who have higher rates of PTSD diagnoses than the general public, with an estimated prevalence above 10% (Berger et al., 2012;Petrie et al., 2018;Richardson et al., 2010). PTSD can make it difficult to stay employed or be successful at work (Belleville et al., 2012;Davis et al., 2012;Hoge et al., 2007). Within military veterans, studies have found that severe PTSD symptoms are correlated with an inability to work full time and that specialized programs may be needed to maintain steady work (Davis et al., 2018;Smith et al., 2005). ...
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Acts of violence are the fifth leading cause of nonfatal occupational injuries in the United States. Experiencing a traumatic event at work can have serious mental health consequences, including the development of posttraumatic stress disorder (PTSD). This study aimed to quantify the prevalence of PTSD caused by workplace violence (WPV) in a statewide workers’ compensation system and compare the outcomes and treatment of WPV cases versus those caused by other traumatic events. Using a retrospective cohort study design, workers who reported PTSD as the primary reason for a workers’ compensation claim and had no coexisting physical injuries were found in California during 2009–2018. A total of 3,772 PTSD cases were identified, 48.9% of which were attributed to WPV. Demographic risk factors associated with WPV PTSD included lower income, younger age, female gender, and employment in retail or finance, p < .001–p = .007. For individuals who returned to work, claims due to WPV resulted in longer medically approved time away from work than non‐WPV causes (Mdn = 132.5 days vs. Mdn = 91 days, respectively), p < .001. Three of the top 10 most frequently prescribed medications were administered against evidence‐based guidelines. This study found that many treatments prescribed to PTSD patients are based on insufficient evidence, and the provision of existing empirically supported treatments is needed, particularly in generalized populations. The findings support the need for additional recognition of the cause of workplace PTSD to facilitate appropriate referrals to WPV or PTSD specialists to support return‐to‐work efforts.
... There was concern participants may be challenged to attend regularly scheduled treatment, as this population sometimes has issues with absenteeism. (24,25) However, each participant attended all appointments and no safety incidents were reported. This suggests massage therapy was well tolerated by participants and may have a role in the treatment of PTSDrelated sleep symptoms. ...
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Background: Post-traumatic stress disorder (PTSD) is a common mental health diagnosis in Canada with prevalence estimated at about 2.4% in the general population. Previous studies have suggested massage therapy may be able to reduce the symptoms of PTSD. One of the symptoms commonly experienced is difficulty falling or staying asleep. No previously published massage therapy research has specifically assessed sleep symptoms of PTSD. Objectives: The research question was, "For individuals who have PTSD as a result of experiencing traumatic events, does MT have an effect on sleep quality?" Methods: A prospective series of case reports describing 10-week MT treatment plans provided by Registered Massage Therapists at Sutherland-Chan Clinic's Belleville location. Three individuals with PTSD were recruited using promotional posters in the community. Treatment focused on improving sleep quality and followed a pragmatic treatment protocol using light to moderate pressure. Outcomes were measured using a sleep diary, Pittsburgh Sleep Quality Index, and the Leeds Sleep Evaluation Questionnaire. Results: Data collected at baseline and throughout the series showed inconsistent improvement and worsening of symptoms amongst participants. Treatment was well tolerated and attended. No harmful incidents were noted. Conclusion: For these participants, MT did not predictably impact sleep quality. It is possible, as the underlying cause of poor sleep quality was unlikely resolved, the participants did not have a significant change in their sleep quality. This differs from findings of previous studies in which MT improved sleep for patients with poor sleep quality due to exposure to traumatic events. There is need for further understanding of how MT affects sleep.
... It always harms or destroys the recipient or is intended to do so'. While violent crime may affect individuals differently, and the impact of crime on victim/ survivors may vary by offence type (see, for example, Burgess and Holmstrom (1976) on rape; Belleville, Marchand, St-Hilaire, Martin and Silva (2012) on armed robbery; Maguire (1980) on burglary; Lejeune and Alex (1973) on being mugged), it is generally accepted that there is some commonality in psychological reactions to criminal victimisation. Janoff-Bulman and Frieze (1983: 5) point out that because crimes are (usually) uncommon events in an individual's life, reactions tend to be immediate and intense and victims have no adaptive strategy for coping at hand. ...
... Nadalje, trebalo bi provesti edukaciju poslodavaca u vezi s potrebom praćenja radnika koji su na radnom mjestu bili izloženi oružanim prepadima, jer stručna i znanstvena istraživanja ukazuju na činjenicu kako se u 27 % slučajeva razvijaju kronične psihičke smetnje/bolesti (Belleville et al., 2012., Pavićević, Bobić, 2011. ...
Article
SAŽETAK: Akutni životno ugrožavajući stresni događaj na radnom mjestu predstavlja ozljedu na radu, te se u godišnjem izvješću o ozljedama na radu i profesionalnim bolestima prijavljuje mjerodavnim inspekcijskim službama. Cilj rada je analizirati strukturu prijavljenih ozljeda na radu od poslodavca za radno mjesto priređivač igara na sreću (PINS) u razdoblju od 2009. do 2013. godine s osvrtom na učestalost i posljedice oružanog prepada na prodajnim mjestima PINS-a. Na temelju dostupnih godišnjih izvješća o ozljedama na radu i profesionalnim bolestima u razdoblju od 2009. do 2013. godine statistički su obrađeni i analizirani podaci za radno mjesto PINS. Protupravno djelovanje treće osobe (oružani prepad) glavni je uzrok svih ozljeda na samom radnom mjestu (od 82 do 92 %). Uspoređujući spolnu distribuciju ozljeda na radu u PINS-u, do 79 % čine žene. U 73 % svih zabilježenih slučajeva ozljeda na radu radilo se o psihičkoj traumi kao posljedici protupravnog djelovanja treće osobe. Uvid u literaturne podatke pokazuje kako osobe nakon oružanog prepada doživljavaju akutni stresni poremećaj unutar prvog tjedna, te započinju izvanbolnički psihijatrijski tretman koji često prerano prekidaju. U 27 % slučajeva razvije se djelomični posttraumatski stresni poremećaj (PTSP) koji zbog prekida liječenja postaje trajan, a u 5 % dolazi do trajnog gubitka radne sposobnosti. Poslodavac je prepoznao opasnost od trajnih posljedica psihičke traume na radnu sposobnost, te je ujedno i organizirao preventivne strategije. Međutim, još postoje mjere kojima se preventivna strategija može upotpuniti u smislu poboljšanja tehničkih uvjeta rada, praćenje i skrb žrtava oružanih prepada od stručnih zdravstvenih radnika i psihologa da bi se spriječila progresija akutnog stresnog događaja u kroničnu psihičku bolest.
... Fichera, Sartori, & Costa, 2009;Setti et al., 2018). This is relevant since PTSD symptomatology-developed as a result of the exposure to robberieswas found to interfere with a broader range of job-related tasks (Taylor, Wald, & Asmundson, 2006), resulting in poorer occupational functioning (Zatzick et al., 2008), long-lasting impairment of work abilities (Fichera et al., 2009), greater workload (Setti et al., 2018) and absenteeism (Belleville et al., 2012). ...
Article
Although some similarities are evident in manifestations, etiology and coping, research suggests that cultural variations may explain different reactions to workplace violence. This study explores similarities and differences between Italian and Irish workers’ well-being in relation to robberies and theft exposure. A sample of Italian (N = 319) and Irish (N = 251) employees working in small businesses completed a self-report questionnaire examining post-traumatic symptoms and trauma-related coping self-efficacy. Results indicated that Italian victims reported higher post-traumatic symptoms than their Irish counterparts. When compared to those who experienced thefts only, Italian victims who had experienced both thefts and robberies experienced more post-traumatic symptoms and lower coping self-efficacy, whereas Irish employees differed significantly only in hyper-arousal symptomatology. Regression analyses revealed that coping self-efficacy had a protective role against the risk of developing post-traumatic symptomatology. In both countries, interventions fostering employees’ coping self-efficacy perceptions might stimulate psychological recovery, especially among victims of both thefts and robberies.
... Experiências diretas ou indiretas, como agressões, ameaças e risco de tiros no local de trabalho podem produzir traumas, estresse, problemas físicos de saúde, ansiedade, medo e frustração, resultando em danos que podem fazer o trabalhador inclusive deixar a organização em que trabalha (De Puy, Romain-Glassey, Gut, Wild, & Magin, 2015;Rogers & Kelloway, 1997;Saragoza & White, 2016). Os sinais e os sintomas da experiência de assalto podem progredir e tornarem-se quadros clínicos, com diferentes níveis de intensidade e períodos de duração, como, por exemplo, o transtorno depressivo maior (Belleville, Marchand, St-Hilaire, Martin, & Silva, 2012), a síndrome de burnout, o transtorno de estresse agudo e o transtorno de estresse pós-traumático (Fichera, Fattori, Neri, Musti, Coggiola, & Costa, 2014;Hansen & Elklit, 2011). ...
Article
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Vulnerability to robbery can transform workers' relationship with their work. The aim of this research was to characterize the organizational and behavioral consequences of workplace robberies in the perception of victimized workers. Semi-structured interviews were carried out with seven workers. The data were analyzed through content analysis, in two axes of analysis: organizational consequences and behavioral consequences. The installation of monitoring cameras, the management of money in the cash register, and caution when closing and leaving the workplace were the main organizational consequences. Intensified attention, occupational disinterest, emotional changes, and religious behavior were the main behavioral consequences identified. It is concluded that the robbery experience can re-signify the meaning of the work, and there is a need for new research that makes it possible to explain and create conditions for this kind of suffering to be accommodated and managed in the organizations and locations for worker health care.
... In addition to the direct negative emotional and cognitive symptoms of PTSD, individuals with PTSD often experience clinically significant psychosocial functional impairment across a range of domains. For example, prior research has shown that individuals with PTSD are more likely to report poorer work performance (due to factors including reduced timemanagement ability) and higher levels of absenteeism than those without PTSD (e.g., Belleville, Marchand, St-Hilaire, Martin, & Silva, 2012;Matthews, 2005). Other research has demonstrated that veterans with PTSD report engaging in romantic relationships characterized by high levels of verbal and physical abuse and violence, and many with PTSD report that their partners and/or children are afraid of them (e.g., Kuhn, Blanchard, & Hickling, 2003;Sayers, Farrow, Ross, & Oslin, 2009). ...
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This study describes the three-phase development and validation of the Inventory of Psychosocial Functioning (IPF), an 80-item, self-report measure of posttraumatic stress disorder (PTSD)-related psychosocial functional impairment. In Phase I, we conducted 12 focus groups with male and female veterans (n = 53) to identify and operationalize the domains of psychosocial impairment associated with PTSD. This information was used to develop the IPF. We subsequently evaluated the psychometric properties of the newly developed inventory in Phases II (n = 276) and III (n = 368) using two independent samples of veterans. We found that the overall IPF score demonstrated stronger correlations with measures of mental health-related impairment (all rs > |.39|; all ps< .05) and weaker correlations with measures of physical health-related impairment (all rs < |.29|; all ps < .05). Overall IPF scores were most strongly associated with PTSD and other disorders associated with the anxious-misery factor of the three-factor model of psychiatric comorbidity (all rs >.56; all ps < .05) and less strongly associated with disorders associated with the fear factor (all rs < .48; all ps < .05) and the externalizing factor (r = .16; p < .05). The IPF demonstrated strong test–retest reliability (r = .77; p < .05). Our results suggest that the IPF is a valid and reliable measure of PTSD-related psychosocial functional impairment.
... In fact, Italy had the twelfth highest robbery rates out of 71 countries in 2006 (Aebi et al., 2010; European Institute for Crime Prevention and Control International Statistics on Crime Justice, 2011). To date, only a few studies have focused on the psychological impact of these types of events on employees working in small, independently owned businesses (Casteel et al., 2008;Söndergaard, 2008;Belleville et al., 2012), with previous research on this topic predominantly focusing on the banking context (Van der Velden et al., 1992;Kamphuis and Emmelkamp, 1998;Elklit, 2011, 2013;Hansen et al., 2012Hansen et al., , 2014Armour and Hansen, 2015;Christiansen and Hansen, 2015;Giorgi et al., 2015a,b;Mucci et al., 2015). The present research focused on jewelers and tobacconists because their job characteristics (e.g., customer-facing, working alone or in a small team, handling valuables and selling items of value) may potentially increase workers' risk for theft and robbery-related violence. ...
Article
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Thefts and robberies may be traumatizing experiences for employees. The aim of this study is to explore to what extent experiencing robberies and/or thefts at work affect workers' mental health, coping-self-efficacy, social support seeking, workload and job satisfaction. Drawing on Conservation of Resources theory, this research contributes to our understanding of the psychological sequelae of robbery and theft for employees working in small businesses. The few studies on the effects of robberies and thefts in the past have predominantly focused on bank employees. A sample of Italian tobacconists and jewelers completed an anonymous self-report questionnaire examining the experience of robbery and/or theft, social support seeking (Coping Orientation to Problem Experienced scale, COPE-IV), psycho-somatic well-being (General Health Questionnaire, GHQ-12), job satisfaction (a single item). Victims of thefts and/or robberies reported their PTSD symptoms (Impact of Event- Revised 6, IES-R-6) and trauma-related coping self-efficacy (Coping Self-Efficacy scale, CSE-7), based on the last event (N = 319). Descriptive analyses, ANOVA, ANCOVA and multiple regressions analyses have been carried out. The results indicated that victims of thefts and robberies experienced greater workload, higher psycho-physical complaints and greater tendency to seek social support in comparison with their non-affected counterparts. They additionally experienced more post-traumatic symptomatology and perceived lower coping self-efficacy, when compared to those who experienced thefts “only.” Multiple regression analyses revealed that CSE was positively related to job satisfaction, although the presence of psycho-physical symptoms was the main predictor of job satisfaction among both non-affected and affected employees. PTSD was not an independent predictor of job satisfaction. In sum, robberies and/or thefts exposure undermines differently workers' well-being.
... Bobic, Pavicevic, & Gomzi (2007) ont quant à eux mis en é vidence une pré valence de l'ESPT d'environ 38,9 % auprè s de 72 victimes d'attaques à main armé e sur leur lieu de travail, dont 19 ont é té agressé es à deux ou trois reprises. Belleville, Marchand, St-Hilaire, Martin, & Silva (2012) ont noté chez 86 employé s victimes, que 2 % pré sentaient un tableau clinique complet d'ESPT, 6 % un é pisode dé pressif majeur et 8 % les deux à la fois. Les consé quences de cette violence peuvent aussi prendre d'autres formes et conduire par exemple à une diminution de l'estime de soi professionnelle (Barling, 1996 ;De Mol, 2002 ;Oh, Uhm, & Yoon, 2016 ;Padyab & Ghazinour, 2015). ...
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Résumé Introduction Les conséquences psychologiques de la violence au travail sont multiples et ont été souvent décrites dans la littérature. Dans notre recherche, ces différences sont analysées en fonction de l’identité de genre des victimes. Ce concept distingue quatre types d’identité : les typés féminins, masculins, androgynes et indifférenciés. Objectifs L’objectif de cet article est de mettre en évidence le lien entre l’identité de genre de salarié(e)s victime(s) d’agressions sur leur lieu de travail et l’intensité de l’impact traumatique. Les spécificités liées à chacune de ces identités de genre nous conduisent à poser les hypothèses suivantes. Les sujets (homme versus femme) disposant d’une identité de genre féminine seront rendus moins vulnérables que les autres aux effets d’une agression (hypothèse 1). Un résultat similaire est attendu pour les sujets disposant d’un schème identitaire de type androgyne (hypothèse 2). Inversement, les sujets typés masculins et typés indifférenciés seront particulièrement touchés psychologiquement par les effets de la violence et leur niveau de stress post-traumatique sera plus important que ceux des sujets à schèmes identitaires féminins et androgynes (hypothèse 3). Méthode L’identité de genre des sujets a été évaluée à l’aide du Bem Sex Role Inventory (Bem, 1974) et les caractéristiques de l’impact psychotraumatiques à l’aide d’une version révisée de l’échelle d’Horowitz : l’Impact Events Scale Revised. Notre étude porte sur un échantillon de 367 salariés : 230 ont été victimes d’agressions, 137 n’ont jamais vécu d’agression. Résultats Les résultats obtenus montrent que les salariés victimes d’agressions présentent des scores significativement plus importants à l’IES-R que les salariés n’ayant jamais fait l’objet de violence sur leur lieu de travail. Cette différence s’observe pour toutes les dimensions de l’IES-R qu’il s’agisse de symptômes d’intrusion, d’évitement et d’hypersensibilité. Les analyses montrent, en outre, que ce sont les sujets avec une identité de genre indifférenciée et masculine qui présentent des scores les plus importants par opposition aux sujets avec une identité de genre androgyne et féminine. Conclusion La prise en compte de l’identité de genre dans la problématique globale de la violence au travail, s’avère être une dimension intéressante à considérer pour une compréhension plus fine encore des impacts psychotraumatiques sur les salariés victimes et dans un second temps pour leur prise en charge. Si cela met en lumière un nouveau paramètre permettant la mesure et la compréhension des effets de la violence au travail, il est nécessaire d’être prudent quant à sa possible généralisation qui supposerait préalablement de répliquer l’étude dans des contextes professionnels différents. Toutefois, cette étude a le mérite de proposer un nouvel angle de compréhension et de proposition de prise en charge psychothérapeutique. Enfin, il serait intéressant de voir les effets d’une prise en charge psychothérapeutique, à court et à long terme en fonction de l’identité de genre.
... 14 Additionally, some individuals may not develop PTSD but other psychotic, anxiety, or affective disorders-or a combination of these-highlighting the heterogeneity of responses to stress. 15,16 Considering that the outcomes following chronic stress exposure differ greatly between individuals, susceptibility to adversity resulting in psychopathology might be determined by how efficiently an individual is able to compensate for adversity at the molecular level. ...
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Exposure to chronic stress, either repeated severe acute or moderate sustained stress, is one of the strongest risk factors for the development of psychopathologies such as post-traumatic stress disorder (PTSD) and depression. Chronic stress is linked with several lasting biological consequences, particularly to the stress endocrine system but also affecting intermediate phenotypes such as brain structure and function, immune function, and behaviour. Although genetic predisposition confers a proportion of the risk, the most relevant molecular mechanisms determining those susceptible and resilient to the effects of stress and trauma may be epigenetic. Epigenetics refers to the mechanisms that regulate genomic information by dynamically changing the patterns of transcription and translation of genes. Mounting evidence from preclinical rodent and clinical population studies strongly support that epigenetic modifications can occur in response to traumatic and chronic stress. Here, we discuss this literature examining stress-induced epigenetic changes in preclinical models and clinical cohorts of stress and trauma occurring early in life or in adulthood. We highlight that a complex relationship between the timing of environmental stressors and genetic predispositions likely mediate the response to chronic stress over time, and that a better understanding of epigenetic changes is needed by further investigations in longitudinal and postmortem brain clinical cohorts.
... Although some types of exposure (direct exposure vs. indirect exposure) are considered, others are not taken into account (e.g., vicarious exposures; Frans, Rimmö, Aberg, & Fredrikson, 2005;Shah, Garland, & Katz, 2007). Finally, samples are composed of individuals who have experienced several traumatic events and participants who have experienced only one (Belleville, Marchand, St-Hilaire, Martin, & Silva, 2012;White et al., 2015). As a consequence, our research aims to identify the different types of events and the different types of exposure at the same time, which is rare in the literature, and their effects on PTSD and dissociative symptoms. ...
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Objective: Traumatic events can lead to posttraumatic (posttraumatic stress disorder [PTSD] specific symptoms) and dissociative symptoms (PTSD nonspecific symptoms). However, the trauma exposure characteristics (type of exposure, categorical form, number of exposures and the age of the exposure) are rarely studied. We hypothesized that the characteristics of a traumatic event are the only predictors of specific posttraumatic symptoms (intrusion, avoidance, negative cognitive impairment) and nonspecific symptoms (dissociation). We also hypothesized that some characteristics of a traumatic event are specific predictors of posttraumatic symptoms, whereas other characteristics are predictors of nonspecific symptoms. Method: Three hundred nine university students participated in the study (201 men, 108 women; mean age : 19.32 years). Students completed questionnaires assessing trauma exposure characteristics, PTSD, dissociation, and burnout. Multiple linear regressions were conducted to identify predictive factors for elevated specific PTSD symptoms and elevated nonspecific PTSD symptoms. Results: A different impact of the characteristics of 1 or more traumatic events was observed on specific posttraumatic symptoms. In men, the model was significant, with 6 predictors explaining 14% to 23% of the variance of specific posttraumatic symptoms. In women, 2 predictors explaining 15% to 28% of the variance of posttraumatic symptoms were found. The characteristics of the traumatic event were not the only predictors of posttraumatic symptoms (specific and nonspecific), with emotional exhaustion playing an unexpected predictive role. Conclusions: Burnout and PTSD might share emotional exhaustion as a common risk factor for PTSD. Further studies in this area are warranted, noteworthy focusing on clinical populations. (PsycINFO Database Record
... A primary symptom of PTSD is the patient's re-experiencing of the initial trauma through nightmares, hallucinations, emotional crises, and IMEs (Taubenfeld et al., 2009;Belleville et al., 2012;Bryant et al., 2013;Cloitre et al., 2013). This study demonstrated that the perceptive quality of IMEs is significantly associated with other clinical symptoms, such as the frequency of IMEs. ...
Article
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Intrusive memory experiences (IMEs) are a common symptom of post-traumatic stress disorder (PTSD). Sensory perceptions of IMEs in the PTSD context vary substantially. The present research examined 20 patients with a single trauma, 20 re-traumatized patients and 80 Holocaust-traumatized patients who suffered from PTSD. Our results revealed significant differences in IME frequency based on the types of trauma experience. The findings suggest that patients with prolonged (Holocaust) traumata suffered from visual (65%) and combined visual/acoustic intrusive memories (29%), whereas visual memory experiences were most frequent (90%) among single-trauma patients. The trauma experience and the intrusive memory trigger stimulus were interdependent. The type of trauma critically affects the traumatic experience. Future studies should focus on these findings to improve PTSD therapeutic options.
... Miller-Burke et al. [5] found that psychological, physical and work performance and personal functioning were affected by the robbery; the most common symptoms were increased awareness of their surroundings, sleep disorders, difficulty concentrating, headaches, exaggerated startle response, anger, stress, worse physical health, being more aware and suspicious of customers, feeling unsafe and having less desire to continue working for the current employer. Other studies have observed clinically significant symptoms of post-traumatic stress immediately after an armed robbery [6], as well as co-morbid major depressive disorder, increased absenteeism, work impairment, poorer physical health and increased use of medical services [7]. ...
Article
Introduction: Exposure to workplace robbery is a very common and traumatic event among workers dealing with the public. Data is scarce about the association between exposure to robbery, robbery-related Post-traumatic Stress Disorder (PTSD) and work ability. Objective: Toassess the association between workplace robbery, robbery-related PTSD, emotional imbalance and work ability in a sample of pharmacy workers. Methods: 136 pharmacy workers - 90 robbery victims and 46 non victims - were recruited from the Milan metropolitan area. They completed a self-report questionnaire including sociodemographic characteristics, history of robberies, a self-report version of the CAPS-I, General Health Questionnaire, Beck Depression Inventory, Work Ability Index. Results: No differences were found between victims and non victims for GHQ and BDI; WAI scores of victims were significantly lower than non-victims. Exposure to robberies was associated with lower WAI in a multivariate analysis. Ten victims reported Full or Partial PTSD following the robbery. Victims with PTSD reported a lower WAI and a higher GHQ and BDI than non-PTSD victims. Conclusions: Workplace robbery may have a mild but long-lasting effect on workers' work ability. This effect is higher for those developing PTSD following robbery. Further research and early intervention programs are needed to promote recovery of psychophysical health, well-being and work ability after a traumatic event in the workplace.
... Substantial heterogeneity exists even for negative outcomes that follow stressor exposure. For example, exposure of different individuals to similar traumatic experiences may lead to the development of PTSD, MDD, or a combination of the two phenotypes (Belleville et al, 2012;Nillni et al, 2013). These pleiotropic effects of stressor exposure likely result from complex interactions among stressful experiences over the lifetime, other environmental factors, and multiple genetic and epigenetic factors that modulate stress responses and can shape stress-related phenotypes (Zannas and West, 2014b). ...
Article
Stress responses and related outcomes vary markedly across individuals. Elucidating the molecular underpinnings of this variability is of great relevance for developing individualized prevention strategies and treatments for stress-related disorders. An important modulator of stress responses is the FK506 binding protein 51 (FKBP5/FKBP51). FKBP5 acts as a co-chaperone that modulates glucocorticoid receptor activity in response to stressors but also a multitude of other cellular processes in both the brain and periphery. Notably, the FKBP5 gene is regulated via complex interactions among environmental stressors, FKBP5 genetic variants, and epigenetic modifications of glucocorticoid-responsive genomic sites. These interactions can result in FKBP5 disinhibition that has been shown to contribute to a number of aberrant phenotypes in both rodents and humans. Consequently, FKBP5 blockade may hold promise as treatment intervention for stress-related disorders, and recently developed selective FKBP5 blockers show encouraging results in vitro and in rodent models. While risk for stress-related disorders is conferred by multiple environmental and genetic factors, the findings related to FKBP5 illustrate how a deeper understanding of the molecular and systemic mechanisms underlying specific gene-environment interactions may provide insights into the pathogenesis of stress-related disorders.Neuropsychopharmacology accepted article preview online, 07 August 2015. doi:10.1038/npp.2015.235.
... Miller-Burke et al. [5] found that psychological, physical and work performance and personal functioning were affected by the robbery; the most common symptoms were increased awareness of their surroundings, sleep disorders, difficulty concentrating, headaches, exaggerated startle response, anger, stress, worse physical health, being more aware and suspicious of customers, feeling unsafe and having less desire to continue working for the current employer. Other studies have observed clinically significant symptoms of post-traumatic stress immediately after an armed robbery [6], as well as co-morbid major depressive disorder, increased absenteeism, work impairment, poorer physical health and increased use of medical services [7]. ...
Article
Post-traumatic stress disorder (PTSD) in the occupational context, especially following workplace robbery, is still under-investigated. To evaluate PTSD incidence and risk factors among bank employee victims of robbery voluntarily joining an employer-sponsored post-robbery support programme. The programme entailed a structured support interview with robbery victims within 15 days of the robbery and a follow-up psychological assessment 45 days after. A self-reported questionnaire on personal variables and robbery characteristics was administered to participants at the first support session (T1). Interviews on employees' psychophysical health and their opinion about the support programme were administered individually at follow-up (T2). The Impact of Event Scale (IES) was administered both at T1 and T2. There were 383 participants. At T2, 13% of subjects had an IES score >34, a cut-off suggestive of PTSD. In a multi-variate model, feelings of helplessness and terror during the robbery and the number of previous robberies were associated with a PTSD diagnosis. After including IES score at T1, other variables lost statistical significance. Our findings showed that PTSD is common among employee victims of workplace robbery. Our results also suggest the importance of subjective variables, such as personal perception of robbery severity and early emotional reaction, in identifying people at higher risk of developing PTSD. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Background: Healthcare professionals frequently encounter various forms of aggression, ranging from verbal abuse to physical assaults, which can compromise both their occupational well-being and patient-care quality. Despite its prevalence and serious consequences, workplace aggression is often underreported due to a lack of standardized assessment tools. This study aims to develop a valid Italian version of the Hospital Aggressive Behaviour Scale-Users. Methods: The scale’s structure was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses on two samples of healthcare professionals during and after the pandemic. Reliability, measurement invariance, and nomological validity were examined. Results: EFA revealed a two-factor structure comprising eight items (χ2 = 59.651, df = 13, p = 0.00; CFI = 0.98; TLI = 0.95; RMSEA = 0.07; SRMR = 0.02), distinguishing non-physical and physical aggression, and meeting all recommended criteria. CFA confirmed this structure, demonstrating good reliability and outperforming alternative models. The same factor structure was confirmed in standard (χ2 = 35.01, df = 19, p = 0.00; CFI = 0.99; TLI = 0.99; RMSEA = 0.03; SRMR = 0.02) and emergency (χ2 = 30.65, df = 19, p = 0.04; CFI = 0.98; TLI = 0.97; RMSEA = 0.06; SRMR = 0.04) contexts. Full residual invariance was found across job tenure groups. Aggression was positively associated with emotional exhaustion, psychological distance, psychosomatic symptoms, post-traumatic stress symptoms, and turnover intentions while negatively related to job satisfaction. Nurses and healthcare assistants reported higher levels of aggression than doctors. Conclusions: This study provides a reliable, context-specific instrument for documenting and analysing outsider aggression. The insights can inform targeted interventions, contributing to a healthier hospital environment.
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This study aims to analyse the impact of the 2006 Yogyakarta earthquake on the mental health and welfare of victims in Bantul and to examine whether disasters they experienced before might increase or decrease their mental health when facing indirect exposure to repeated disasters. This study employs several methods: descriptive analysis; logit; a combination of propensity score matching; and difference in differences. The results find that 7 people (1.78%) in 2007 and 31 people (7.89%) in 2014 have experienced symptoms of depression. Age is confirmed as a significant factor in increasing this probability. The results of this study reveal that direct exposure to the 2006 Yogyakarta earthquake increased the average mental disorder score and decreased the victims’ education expenditure 1 year after the disaster. The direct exposure to the 2006 Yogyakarta earthquake also affected the increase in mental disorder score and decrease in household expenditure of victims 1 year after the disaster, although the effects were insignificant.
Chapter
Accumulating evidence supports epigenetic processes as important determinants of individual susceptibility or resilience to the development of psychiatric disorders. Like every intervention that promotes resilience, psychotherapy necessitates changes in neurocircuitry and neurotransmission, and such changes are in turn associated with underlying lasting changes in cell and genomic function. Consequently, psychotherapy can be hypothesized to promote an epigenetic fingerprint that is conducive to stress resilience. To date, a small number of studies – including either an epigenome-wide approach or a hypothesis-driven examination of genes that regulate the stress response, neural plasticity, or neurotransmission – have addressed the potential relevance of peripheral blood DNA methylation changes in response to psychotherapy. The findings to date suggest that psychotherapy-related symptom reductions are associated with concomitant epigenetic changes in peripheral blood. However, future studies will need to address the potential of epigenetic modifications to serve as biomarkers for psychotherapeutic interventions.
Technical Report
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The UK is currently facing two inter-related socio-economic challenges. One is the now well-documented ‘productivity puzzle’; the crisis of persistent low productivity growth across the economy. The other is low levels in the mental and physical health of the working population, in particular. Wellbeing has been considered as a driver of higher levels of productivity and thus a means of solving the productivity puzzle. However, the relationship between productivity growth and wellbeing is complex and involves many moderating or mediating factors. This report reviews the relationships between the different aspects of wellbeing, productivity, and productivity growth. It is the culmination of a desk-based evidence review, survey, and a mapping workshop held with experts from backgrounds including psychology, sociology, economics, and design. The focus is on wellbeing and labour productivity, although resource productivity and multi-factor productivity are also touched upon at relevant points within the report. Key findings and recommendations for further research are summarised below. Key finding 1: Wellbeing is linked to higher levels of labour productivity. • Individuals who have been diagnosed with a chronic physical health problem and those who engage in risky health behaviours (e.g. smoking, unhealthy diet, and lack of exercise) in the absence of any formal diagnosis both tend to report reduced labour productivity through presenteeism and absenteeism. • Poor mental health appears to be more strongly linked with lost productivity through presenteeism (relative to absenteeism), as people are often reluctant to disclose that they are suffering from mental health problems. • Higher levels of subjective wellbeing has been linked to greater labour productivity, and the causal nature of this link has been demonstrated in experimental studies. • High levels of stress can lead to burnout and reduced labour productivity, but training resilience has been shown to produce positive effects on wellbeing and productivity. • Case studies demonstrate that workplace wellness programmes can deliver benefits in terms of enhanced productivity, but this seems to be reliant on certain conditions being met (e.g. tailoring to the specific organisation and senior management support). Key finding 2: Certain factors may be able to explain the positive relationship between levels of wellbeing and labour productivity. • Human capital is an asset that is considered to enhance an individual’s or organisation’s productivity. At the same time it can enhance wellbeing by facilitating the satisfaction of psychological needs, greater health status and greater social mobility. • Social capital allows for voluntary cooperation and the effective sharing of human capital, thus heightening productivity. At the same time it considered to be a determinant of higher levels of wellbeing in the workplace and everyday life. • Certain environmental factors have been linked to both greater wellbeing and greater labour productivity. These include air quality, greenery and temperatures. • Information and communication technology (ICT) has been considered as a key driver of productivity growth and has the potential to support wellbeing in that it facilitates communication, autonomy, and more flexible working conditions. Key finding 3: Productivity growth may have detrimental effects on wellbeing. • Attempts to reduce costs and increase labour productivity within the healthcare sector can lead to poorer quality care being provided and thus poorer health outcomes. • The pursuit of productivity growth in the workplace can heighten a number of workplace factors such as job demands and job insecurity, both are associated with poorer wellbeing. • Although the adoption of ICT can promote productivity growth, it can also blur the boundaries between work and home life and facilitate sedentary lifestyles, hence reducing wellbeing. • Sustained productivity growth may increase carbon emissions, raise average temperatures, and deplete forms of natural capital that have been shown to be beneficial for wellbeing. We conclude that, although wellbeing may be a determinant of higher levels of productivity, the way in which we pursue productivity growth also appears to have the potential to undermine wellbeing. Our key recommendation is therefore for research that takes a critical approach to understanding how wellbeing and productivity growth may influence each other over time and across contexts. Numerous suggestions for specific areas for future research have been made throughout the review and these are summarised in Table 1. Once we have a more nuanced understanding of the relationship between these two factors we will be better able to decide upon the value we assign to productivity growth and if and how we wish to pursue it.
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Stealing can be a significant health issue. Is stealing described in the Bible? Is stealing prevalent in contemporary times? What is the Biblical attitude towards stealing? What are the mechanisms of stealing? Why do people steal? What are the different types of theft? Can stealing be detected? How can humans cope with stealing behavior? Can stealing be prevented? The Biblical verses in which thieves and acts of stealing are described were studied closely from a contemporary viewpoint.
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This randomized controlled trial study aims to investigate the efficacy of an early psychological intervention called EMDR-RE compared to Critical Incident Stress Debriefing on 60 victims of workplace violence, which were divided into three groups: ‘EMDR-RE’ (n = 19), ‘CISD’ (n = 23), and ‘delayed EMDR-RE’ (n = 18). EMDR-RE and CISD took place 48 hours after the event, whilst third intervention was delayed by an additional 48 hours. Results showed that after 3 months PCLS and SUDS scores were significantly lower with EMDR-RE and delayed EMDR-RE compared to CISD. After 48 hours and 3 months, none of the EMDR-RE-treated victims showed PTSD symptoms.
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Introduction: Robberies are traumatizing events for workers. Consequently, a number of health problems can arise. In the short term, a common reaction is post-traumatic stress (including intrusion, avoidance, and hyperarousal symptoms). Objective: The aim of the present study was to identify, among pre-trauma factors (personal characteristics: gender, age, educational level, and prior exposure to robberies) and peri-trauma factors (kind of weapon, duration of the event, number of robbers, and numbers of colleagues and clients involved), those that were most likely to cause post-traumatic symptoms in a sample of bank employees who were victims of a robbery. Method: One-hundred-seventy-two employees at two banks in northwest Italy were involved in the research. A month after a robbery, the employees completed a self-report questionnaire including the Impact of Event Scale-Revised (IES-R) by Weiss and Marmar (39). Results: Analyses found one pre-trauma factor (prior exposure to robbery/ies, and one peri-trauma factor, number of robbers) as significant predictors of intrusion. Two peri-trauma factors (number of robbers and duration of robbery) were identified as predictors of avoidance. Finally, one pre-trauma factor (prior exposure to robbery/ies) and two peri-trauma factors (number of robbers and number of colleagues involved in the robbery) were found to be predictors of hyperarousal. Conclusion: The results showed that several peri-trauma factors can increase the risk of workers developing post-traumatic stress reaction and suggest that these factors should be kept in mind when planning intervention programmes aimed at preventing and contrasting psychological consequences of robbery.
Article
Robberies are traumatizing events for workers. Consequently, a number of health problems can arise. In the short term, a common reaction is post-traumatic stress (including intrusion, avoidance, and hyperarousal symptoms). The aim of the present study was to identify, among pre-trauma factors (personal characteristics: gender, age, educational level, and prior exposure to robberies) and peri-trauma factors (kind of weapon, duration of the event, number of robbers, and numbers of colleagues and clients involved), those that were most likely to cause post-traumatic symptoms in a sample of bank employees who were victims of a robbery. 172 employees at two banks in northwest Italy were involved in the research. A month after a robbery, the employees completed a self-report questionnaire including the Impact of Event Scale-Revised (IES-R) by Weiss and Marmar. Analyses found one pre- trauma factor (prior exposure to robbery/ies, and one peri-trauma factor, number of robbers) as significant predictor of intrusion. Two peri-trauma factors (number of robbers and duration of robbery) were identified as predictors of avoidance. Finally, one pre-trauma factor (prior exposure to robbery/ies) and two peri-trauma factors (number of robberies and number of colleagues involved in the robbery) were found to be predictors of hyperarousal.
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Victims of an armed robbery are at great risk of psychological distress. This research is a prospective randomized controlled clinical trial of an adapted form of Critical Incident Stress Debriefing (CISD-A) with victims of an armed robbery. The specific goals are to examine whether the CISD-A is superior to the control group in both preventing the development of a posttraumatic stress disorder (PTSD) and attenuating the frequency and severity of posttraumatic stress symptoms. Following pretest, 75 participants were randomly assigned to individual debriefing or to a control group. Results revealed no differences between the CISD-A and the control group in preventing PTSD or attenuating posttraumatic symptoms 1 and 3 months later.
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The purpose of this study was to prospectively evaluate the onset, overlap, and course of posttraumatic stress disorder (PTSD) and major depression following traumatic events. The occurrence of PTSD and major depression and the intensity of related symptoms were assessed in 211 trauma survivors recruited from a general hospital's emergency room. Psychometrics and structured clinical interview (the Structured Clinical Interview for DSM-III-R and the Clinician-Administered PTSD Scale) were administered 1 week, 1 month, and 4 months after the traumatic event. Heart rate was assessed upon arrival at the emergency room for subjects with physical injury. Twenty-three subjects with PTSD and 35 matched comparison subjects were followed for 1 year. Major depression and PTSD occurred early on after trauma; patients with these diagnoses had similar recovery rates: 63 survivors (29.9%) met criteria for PTSD at 1 month, and 37 (17.5%) had PTSD at 4 months. Forty subjects (19.0%) met criteria for major depression at 1 month, and 30 (14.2%) had major depression at 4 months. Comorbid depression occurred in 44.5% of PTSD patients at 1 month and in 43.2% at 4 months. Comorbidity was associated with greater symptom severity and lower levels of functioning. Survivors with PTSD had higher heart rate levels at the emergency room and reported more intrusive symptoms, exaggerated startle, and peritraumatic dissociation than those with major depression. Prior depression was associated with a higher prevalence of major depression and with more reported symptoms. Major depression and PTSD are independent sequelae of traumatic events, have similar prognoses, and interact to increase distress and dysfunction. Both should be targeted by early treatment interventions and by neurobiological research.
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Although mental health professionals have long been aware of the impact of traumatic events, it was not until 1980 that the term posttraumatic stress disorder (PTSD) was introduced into the DSM‐III. Since then, one major goal of research has been to identify factors associated with distress following trauma; as yet, few reliable indicators have emerged. Within the population of armed robbery victims, this is particularly true. The purpose of this study was to investigate possible correlates of posttrauma distress in armed robbery victims, and to assess the overall level of distress within this group. A questionnaire was mailed out to 57 robbery victims, aged 15 to 65, who were recruited as study volunteers via community outreach. Severity of the trauma, vulnerability attributions, and avoidant coping were significantly related to distress level, and victims exhibited a high level of distress.
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The aim of this study was to examine the prevalence of Post Traumatic Stress Disorder (PTSD) symptom clusters in 72 armed robbery victims (AR) at their work place. 19 were assaulted twice or three times, while 15 suffered mild or minor physical injury. Subjects were 47 female and 25 male employees who were having 1 to 11 months of sick leave period at the time of examination. According to psychiatric examination 38.9% fulfilled criteria for PTSD, while others had different combinations of symptoms. Statistical analysis showed that the whole group dominantly expressed persistent re-experience of the event, followed by arousal symptoms. Those with full PTSD diagnosis did not differ from others in age, level of education, number of assaults, length of sick leave period or the fact that they had or had not been physically injured. No difference was found between those who suffered only one attack and those who were assaulted twice or three times in a short period of time. The repetition of identical or very similar trauma situation did not contribute to the increased number of psychological problems measured by PTSD scales. Additionally, we compared the structure of PTSD in AR victims and in a group of 100 male ex-prisoners of war (ex-POW). The results indicate greater occurrence of full PTSD in AR group, as well as re-experience and arousal symptoms combination in those with partial PTSD, while ex-POW group dominantly showed arousal symptoms as isolated cluster, followed by combination of re-experience and arousal symptoms.
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Although mental health professionals have long been aware of the impact of traumatic events, it was not until 1980 that the term posttraumatic stress disorder (PTSD) was introduced into the DSM-III. Since then, one major goal of research has been to identify factors associated with distress following trauma; as yet, few reliable indicators have emerged. Within the population of armed robbery victims, this is particularly true. The purpose of this study was to investigate possible correlates of posttrauma distress in armed robbery victims, and to assess the overall level of distress within this group. A questionnaire was mailed out to 57 robbery victims, aged 15 to 65, who were recruited as study volunteers via community outreach. Severity of the trauma, vulnerability attributions, and avoidant coping were significantly related to distress level, and victims exhibited a high level of distress.
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Post-traumatic stress disorder (PTSD) has become a global health issue, with prevalence rates ranging from 1.3% to 37.4%. As there is little current data on PTSD in Canada, an epidemiological study was conducted examining PTSD and related comorbid conditions. Modified versions of the Composite International Diagnostic Interview (CIDI) PTSD module, the depression, alcohol and substance abuse sections of the Mini International Neuropsychiatric Interview (MINI), as well as portions of the Childhood Trauma Questionnaire (CTQ) were combined, and administered via telephone interview in English or French. Random digit dialing was used to obtain a nationally representative sample of 2991, aged 18 years and above from across Canada. The prevalence rate of lifetime PTSD in Canada was estimated to be 9.2%, with a rate of current (1-month) PTSD of 2.4%. Traumatic exposure to at least one event sufficient to cause PTSD was reported by 76.1% of respondents. The most common forms of trauma resulting in PTSD included unexpected death of a loved one, sexual assault, and seeing someone badly injured or killed. In respondents meeting criteria for PTSD, the symptoms were chronic in nature, and associated with significant impairment and high rates of comorbidity. PTSD is a common psychiatric disorder in Canada. The results are surprising, given the comparably low rates of violent crime, a small military and few natural disasters. Potential implications of these findings are discussed.
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To examine factors other than injury severity that are likely to influence functional outcomes after hospitalization for injury. This study used data from the National Study on the Costs and Outcomes of Trauma investigation to examine the association between posttraumatic stress disorder (PTSD), depression, and return to work and the development of functional impairments after injury. A total of 2707 surgical inpatients who were representative of 9374 injured patients were recruited from 69 hospitals across the US. PTSD and depression were assessed at 12 months postinjury, as were the following functional outcomes: activities of daily living, health status, and return to usual major activities and work. Regression analyses assessed the associations between PTSD and depression and functional outcomes while adjusting for clinical and demographic characteristics. At 12 months after injury, 20.7% of patients had PTSD and 6.6% had depression. Both disorders were independently associated with significant impairments across all functional outcomes. A dose-response relationship was observed, such that previously working patients with 1 disorder had a 3-fold increased odds of not returning to work 12 months after injury odds ratio = 3.20 95% (95% confidence interval = 2.46, 4.16), and patients with both disorders had a 5-6 fold increased odds of not returning to work after injury odds ratio = 5.57 (95% confidence interval = 2.51, 12.37) when compared with previously working patients without PTSD or depression. PTSD and depression occur frequently and are independently associated with enduring impairments after injury hospitalization. Early acute care interventions targeting these disorders have the potential to improve functional recovery after injury.
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This study explored how experiencing a traumatic event in the workplace affects employee physical health, mental health, personal functioning, and work performance. Post-event use of health care services and the effectiveness of critical incident stress debriefing sessions and other coping interventions were also examined. A retrospective self-report methodology and mailed survey were used with 141 employees of 42 different bank branches that had recently been robbed. The results found that most employees had multiple negative consequences from experiencing a bank robbery while at work. Psychological, physical, work, and personal areas were all affected by the robbery. Furthermore, more threatening incidents were associated with more severe consequences. Critical incident stress debriefing interventions delivered after robbery were rated as helpful by 78% of employees who attended. The implications for health care providers and organizations are discussed.
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This article reviews the empirical evidence on post-traumatic stress disorder (PTSD) and physical health and considers this evidence in light of the physical health outcomes associated with other psychiatric disorders. The existing data show that PTSD is associated with poor self-reported health and increased utilization of medical services. To a lesser extent, the data also show an association between PTSD and increased morbidity. Possible psychological, behavioral, and biological mechanisms are discussed, and a model integrating these mechanisms is presented.
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We examine whether traumatic events increase the risk for major depression independent of their effects on posttraumatic stress disorder (PTSD). Data come from the Epidemiologic Study of Young Adults in southeast Michigan (N = 1007). Retrospective and prospective data were used to estimate the risk of major depression in persons with PTSD and persons exposed to trauma with no PTSD, compared with persons who did not experience a trauma. National Comorbidity Survey data were used to evaluate the influence of trauma type. In the retrospective lifetime data, hazard ratios were, for first-onset major depression in exposed persons with PTSD, 2.8 and, in exposed persons with no PTSD, 1.3 (not significant), as compared with persons who were not exposed. Corresponding estimates from the prospective data were 11.7 and 1.4 (not significant). The difference in the risk for depression associated with PTSD versus exposure without PTSD is unlikely to be due to differences in trauma type. The findings of a markedly increased risk for major depression in persons with PTSD, but not in exposed persons without PTSD, do not support the hypothesis that PTSD and major depression in trauma victims are influenced by separate vulnerabilities.
Article
To investigate the relative importance of personal and social variables on post-trauma symptom recovery. Prospective survey of armed robbery victims. Fifty-one consecutive armed robbery victims were assessed immediately and at 1 month post-raid for post-traumatic stress. One month post-raid, crisis support, causal attribution and coping were also measured. Thirty-one of the sample were assessed for symptoms 6 months after the raid. Both the main and follow-up samples had high levels of post-traumatic stress symptoms immediately after the raid which reduced significantly 1 month later and, for the follow-up subsample, further still 6 months later. Higher levels of symptoms at 1 month and poor crisis support were associated with higher levels of symptoms at follow-up. Purposeful coping, symptom severity and social support effect post-trauma recovery.
Statistiques de la criminalité au Canada. Ottawa, Canada: Author. Retrieved from http://www.statcan.gc.ca/bsolc/olc-cel/olc-cel?catno=85-205-X&lang=fra First, Structured Clinical Interview for DSM-IV Axis I Disorders
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doi:10.1016/S0006-3223(00)00933-1 Centre Canadien de la Statistique Juridique. (2003). Statistiques de la criminalité au Canada. Ottawa, Canada: Author. Retrieved from http://www.statcan.gc.ca/bsolc/olc-cel/olc-cel?catno=85-205-X&lang=fra First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.
A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery Impact of traumatic events and organizational response. A study of bank robberies
  • A Marchand
  • S Guay
  • R Boyer
  • S Lucci
  • A Martin
  • M.-H St-Hilaire
Marchand, A., Guay, S., Boyer, R., Lucci, S., Martin, A., & St-Hilaire, M.-H. (2006). A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery. Brief Treatment and Crisis Intervention, 6, 122–129. doi:10.1093/brief-treatment/ mhj007 Miller-Burke, J., Attridge, M., & Fass, P. M. (1999). Impact of traumatic events and organizational response. A study of bank robberies. Journal of Occu-pational and Environmental Medicine, 41, 73–83. doi:10.1097/00043764-199902000-00001
Statistiques de la criminalité au Canada. Ottawa, Canada: Author. Retrieved from http
  • Centre Canadien De La Statistique Juridique
Centre Canadien de la Statistique Juridique. (2003). Statistiques de la criminalité au Canada. Ottawa, Canada: Author. Retrieved from http://www.statcan.gc.ca/bsolc/olc-cel/olc-cel?catno=85-205-X&lang=fra
A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery. Brief Treatment and Crisis Intervention
  • A Marchand
  • S Guay
  • R Boyer
  • S Lucci
  • A Martin
  • M.-H St-Hilaire
Marchand, A., Guay, S., Boyer, R., Lucci, S., Martin, A., & St-Hilaire, M.-H. (2006). A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery. Brief Treatment and Crisis Intervention, 6, 122-129. doi:10.1093/brief-treatment/ mhj007