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Evidence summary: How effective are early psychological interventions in preventing posttraumatic stress disorder in health workers exposed to traumatic scenarios in the context of the current COVID-19 pandemic? [v2.1]

dc.contributor.authorNational Health Library & Knowledge Service (NHLKS)
dc.contributor.authorClark, Helen
dc.contributor.authorFay, Nicola
dc.contributor.authorLeen, Brendan
dc.date.accessioned2020-06-12T10:19:46Z
dc.date.available2020-06-12T09:39:01Z
dc.date.available2020-06-12T10:19:46Z
dc.date.issued2020-05-22
dc.identifier.urihttp://hdl.handle.net/10147/627772
dc.descriptionIt is widely acknowledged that health workers dealing with critical incidents or traumatic situations - particularly for an extended period - are at risk of psychological distress which, in some cases, can develop into more serious mental health problems including post-traumatic stress disorder (PTSD). Risk factors can include social isolation, stigma, or concern about family, gender or age. While the focus of attention on PTSD has been in connection with military personnel, there is increasing recognition that its effects are wider and include health workers dealing with critical incidents and prolonged exposure to disease suffering24.While there is considerable evidence relating to the treatment of PTSD, there is a paucity of studies relating to its prevention.Stein et al note the opportunity inherent in the secondary prevention of PTSD:“Whereas many other mental disorders are no doubt fed by experiential inputs and fuelledby life stressors, PTSD cannot occur in the absence of trauma. We have here the chance to catch the traumatic spark before it burns and emotionally scars. This is the promise of the secondary prevention of PTSD.”Studies have been conducted into the effectiveness of psychological interventions for the prevention of PTSD,but two Cochrane reviews35, 36have asserted that there is no conclusive evidence for either single or multiple session psychological interventionin the prevention of PTSD. Rose goes onto state that the routine use of single session debriefing may actually increase the risk pf post-traumatic stress and so cannot be supported. Roberts et al35explored the use of multiple session psychological interventions; and, although finding some beneficial effects, concluded that the poor quality of the studies would not permit any recommendation for multiple session intervention. The concern expressed in these two reviews regarding the effectiveness of early psychological intervention for all those involved in the traumatic event is echoed by other studies which suggest that interventions for the prevention of PTSD are more effective when given to those identified as being most at risk. Other authors cite the need for assessment of those at risk; and organisational planning to address mental health issues arising from trauma or disaster scenarios. Several studies address the prevention of PTSD and other serious mental health issues by emphasizing the importance of psychological interventions that will address the issues that give rise to psychological distress among HCWs. These include CBT, psychological first aid8, resilience training at both individual and organisational level, mindfulness training, critical incident stress management and eye movement desensitization and reprocessing18. Other studies also note the physical concerns of HCWs such as the need for PPE, rest, food and sleep, the unavailability of which can give rise to psychological distress. Several authors also focus on the benefits of social or peer support; and the potential to provide psychological interventions using technology. Due to the limited evidence relating to the current pandemic, this summary incorporates articles relating to previous pandemics and other trauma scenarios. One commentator offers a possible way forward for researchers looking into the effectiveness of psychological interventions in the prevention of PTSD: “What is truly remarkable about the study of traumatic stress, however, is the resilience of human beings, the fact that the majority of individuals who are exposed to truly horrific events do not develop psychopathology. Perhaps the field of PTSD prevention needs this shift in perspective. Preventive efforts may be faltering because the quest to eradicate illness has distracted us from first supporting health. Future prevention of PTSD may be more likely to come from understanding the factors that create resilience and allow individuals to find growth in the most difficult of circumstances. Interventions should be developed to support the psychological and biological processes that lead to effective coping long before it is necessary to address emerging psychopathology.”en_US
dc.language.isoenen_US
dc.publisherHealth Service Executiveen_US
dc.relation.ispartofseriesEvidence summariesen_US
dc.subjectCORONAVIRUSen_US
dc.subjectCOVID-19en_US
dc.subjectPSYCHOLOGICAL TRAUMAen_US
dc.subjectHEALTHCARE WORKERSen_US
dc.subjectOCCUPATIONAL HEALTH AND SAFETYen_US
dc.subjectSTRESSen_US
dc.titleEvidence summary: How effective are early psychological interventions in preventing posttraumatic stress disorder in health workers exposed to traumatic scenarios in the context of the current COVID-19 pandemic? [v2.1]en_US
dc.typeOtheren_US
refterms.dateFOA2020-06-12T09:39:03Z


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