Background: Hospitals, and particularly intensive care units (ICUs), are demanding and stressful workplaces. Physicians and nurse staff are exposed to various stressors: emergency situations, patients' deaths, and team conflicts. Correspondingly, several studies describe increased rates of PTSD symptoms and other mental health problems in hospital staff. Therefore, it is important to identify factors that lower the risk of psychopathological symptoms. High levels of sense of coherence (SOC) and general resilience as well as an internal locus of control (LOC) have already been identified as important health-benefitting factors in medical staff. The current study aimed to evaluate their unique impact in an ICU and an anesthesiology unit.Method: The cross-sectional online survey investigated SOC, LOC, general resilience, general mental health problems as well as PTSD symptoms in nurses and physicians within an ICU and an anesthesiology unit (N = 52, 65.4% female). General mental health problems were assessed using the ICD-10-Symptom-Rating (ISR) and PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5). The Sense of Coherence Scale (SOC-L9) assessed SOC, the Resilience Scale (RS-11) measured general resilience, and LOC was determined using a 4-item scale for the assessment of control beliefs (IE-4).Results: As expected, SOC, r = −0.72, p < 0.001, general resilience, r = −0.46, p < 0.001, and internal LOC, r = −0.51, p < 0.001, were negatively correlated with general mental health problems while an external LOC showed a positive association, r = 0.35, p = 0.010. However, in a multiple regression model, R2 = 53.9%, F(4, 47) = 13.73, p < 0.001, only SOC significantly predicted general mental health problems by uniquely accounting for 13% of the variance. For PTSD symptoms, which were highly correlated with general mental health problems, a similar pattern of results was found.Conclusion: SOC was found to be the most important correlate of both general mental health problems and PTSD symptoms in an ICU and an anesthesiology unit. Thus, if further evidenced by longitudinal studies, implementing interventions focusing on an enhancement of SOC in training programs for ICU and anesthesiology unit staff might be a promising approach to prevent or reduce psychopathological symptoms.

Dogs are known to have stress and anxiety reducing effects. Several studies have shown that dogs are able to calm people during cognitive and performance stressors. Recently, therapy dogs have been proposed as a treatment adjunct for post-traumatic stress disorder patients. In this study we aimed to investigate, whether dogs also have anxiety- and stress reducing effect during “traumatic stressors.” 80 healthy female participants were randomly assigned to one of four conditions. They were exposed to a “traumatic” film clip (trauma-film-paradigm). For one group of participants a friendly dog was present during the film, one group of participants was accompanied by a friendly human, another control group watched the film with a toy animal and the last group watched the film clip alone. Participants that were accompanied by the dog during the film reported lower anxiety ratings and less negative affect after the film clip as compared to the “toy dog group” and the “alone group.” Results of the “dog group” were comparable to the group that was accompanied by a friendly human. There were no differences in physiological stress responses between the four conditions. Our results show that dogs are able to lessen subjectively experienced stress and anxiety during a “traumatic” stress situation. This effect was comparable to that of social support by a friendly person. Implications for PTSD patients are discussed.

Posttraumatic Stress Disorder (PTSD) is a severe mental disorder characterized by distressing intrusions. Since not all traumatized individuals develop PTSD, it is important to understand its underlying risk factors. So far, several psychological and physiological risk factors have been identified. However, these factors have rarely been examined together. An excellent tool to assess analogue PTSD in a prospective manner is the trauma film paradigm. This study examined relevant psychological and physiological factors in 60 healthy participants before, during and after the presentation of a “traumatic” film clip, including rumination, dissociation, anxiety, mood, cortisol and psychophysiology measures. Moreover, we assessed intrusions and administered the Impact of Event Scale – Revised (IES-R) for one week following the “trauma”. Surprisingly, the only significant predictor for both intrusion frequency and IES-R was rumination about the film (state rumination). Furthermore, intrusion distress was predicted by both state rumination and an increase in anxiety after the film clip. Our study highlights the relevance of rumination in PTSD. Further well designed clinical studies with PTSD patients should investigate these key variables prospectively to confirm our findings.

Intrusive memories are a hallmark symptom of posttraumatic stress disorder (PTSD). They reflect excessive and uncontrolled retrieval of the traumatic memory. Acute elevations of cortisol are known to impair the retrieval of already stored memory information. Thus, continuous cortisol administration might help in reducing intrusive memories in PTSD. Strong perceptual priming for neutral stimuli associated with a “traumatic” context has been shown to be one important learning mechanism that leads to intrusive memories. However, the memory modulating effects of cortisol have only been shown for explicit declarative memory processes. Thus, in our double blind, placebo controlled study we aimed to investigate whether cortisol influences perceptual priming of neutral stimuli that appeared in a “traumatic” context. Two groups of healthy volunteers (N = 160) watched either neutral or “traumatic” picture stories on a computer screen. Neutral objects were presented in between the pictures. Memory for these neutral objects was tested after 24 hours with a perceptual priming task and an explicit memory task. Prior to memory testing half of the participants in each group received 25 mg of cortisol, the other half received placebo. In the placebo group participants in the “traumatic” stories condition showed more perceptual priming for the neutral objects than participants in the neutral stories condition, indicating a strong perceptual priming effect for neutral stimuli presented in a “traumatic” context. In the cortisol group this effect was not present: Participants in the neutral stories and participants in the “traumatic” stories condition in the cortisol group showed comparable priming effects for the neutral objects. Our findings show that cortisol inhibits perceptual priming for neutral stimuli that appeared in a “traumatic” context. These findings indicate that cortisol influences PTSD-relevant memory processes and thus further support the idea that administration of cortisol might be an effective treatment strategy in reducing intrusive reexperiencing.

Animal-assisted therapy has been proposed as a treatment adjunct for traumatized patients. In animal-assisted crisis response, dogs are used directly after a traumatic event to reduce stress and anxiety. However, to date there are few controlled studies investigating the effects of therapy dogs on PTSD symptoms and to our knowledge there is no study investigating the effects of a therapy dog intervention directly after a traumatic event. In this study, 60 healthy female participants were randomly assigned to one of three groups: after exposure to a “traumatic” film clip (trauma-film paradigm), one group of participants interacted with a friendly dog for 15 min, another group of participants watched a film clip showing a person interacting with a friendly dog and the last group was instructed to relax. Participants who had interacted with the dog after the film reported lower anxiety levels, less negative affect, and more positive affect after the intervention as compared to the other two groups. However, the participants who interacted with the dog showed a smaller decrease in physiological arousal after the traumatic film clip compared to both other groups. There were no differences in intrusion symptoms between the three groups. Our results show that dogs are able to lessen subjectively experienced stress and anxiety after a “traumatic” stress situation.