Few studies have focused on caring professionals and their emotional exhaustion from working with traumatized clients, referred to as compassion fatigue (CF). The present study had 2 goals: (a) to assess the psychometric properties of a CF scale, and (b) to examine the scale's predictive validity in a multivariate model. The data came from a survey of social workers living in New York City following the September 11, 2001, terrorist attacks on the World Trade Center. Factor analyses indicated that the CF scale measured multiple dimensions. After overlapping items were eliminated, the scale measured 2 key underlying dimensions-secondary trauma and job burnout. In a multivariate model, these dimensions were related to psychological distress, even after other risk factors were controlled. The authors discuss the results in light of increasing the ability of professional caregivers to meet the emotional needs of their clients within a stressful environment without experiencing CF. Keywords compassion fatigue; secondary trauma; occupational stressAlthough the psychological consequences of providing social support and care to traumatized individuals have been noted for over 2 decades, relatively few studies have focused on formal caregivers (i.e., therapists, child protection workers, nurses, etc.) and their emotional response to dealing with traumatized clients (Figley, 1995). Studies have shown that providing such care can be both highly rewarding and highly stressful (Ohaeri, 2003). Individuals working in the caring professions, though, may have occupational environments and caregiving demands that increase the likelihood of adverse psychological outcomes (Figley, 2002a;Sabin-Farrell & Turpin, 2003).Theoretically, individuals working in the caring professions often attempt to alter the behaviors and emotions of their clients by providing emotional support (e.g., empathy), strategies for coping with emotions, or better cognitive management skills (Boscarino, 1997;Francis, 1997;Thoits, 1986). Within the context of formal caregiving, providing therapy to clients who have survived a traumatic event can be particularly stressful (Figley, 1995 (Figley, 1995;Nelson-Gardell & Harris, 2003;Schauben & Frazier, 1995). The adverse impact of working with clients who have a history of psychological trauma (e.g., sexual and physical abuse, military combat, or community disaster) has been described under a variety of terms: vicarious traumatization, secondary traumatic stress, and compassion fatigue (CF;Jenkins & Baird, 2002). Compassion Fatigue (CF)For the present study, we use the term CF. Consistent with most current usage, we defined this as the formal caregiver's reduced capacity or interest in being empathic or "bearing the suffering of clients" and is "the natural consequent behaviors and emotions resulting from knowing about a traumatizing event experienced or suffered by a person" (Figley, 1995, p. 7; see also Figley 2002a see also Figley , 2002b. Thus, CF is a hazard associated primarily with the clinical sett...

The objective of this study was to assess prevalence and predictors of mental health service use in New York City (NYC) after the World Trade Center disaster (WTCD). One year after the attacks, we conducted a community survey by telephone of 2368 adults living in NYC on September 11, 2001. In the past year, 19.99% (95% confidence interval [CI]=18.2-21.77) of New Yorkers had mental health visits and 8.1% (95% CI=7.04-9.16) used psychotropic medications. In addition, 12.88% (95% CI=11.51-14.25) reported one or more visits were related to the WTCD. Compared to the year before, 8.57% (95% CI=7.36-9.79) had increased post-disaster visits and 5.28% (95% CI=4.32-6.25) had new post-disaster treatment episodes. Psychotropic medication use related to the WTCD was 4.51% (95% CI=3.75-5.26). Increased postdisaster medication use, compared to the year before, was 4.11% (95% CI=3.35-4.86) and new medication episodes occurred among 3.01% (95% CI=2.34-3.69). In multivariate logistic analyses, mental health visits were associated with younger age, peri-event panic attack, posttraumatic stress disorder (PTSD) and depression. In addition, WTCD-related visits had a positive "dose-response" association with WTCD event exposures (P<0.0001). WTCD-related visits also were positively associated with peri-event panic, anxiety, lower self-esteem, PTSD, and depression. All three medication measures were positively related to PTSD and depression, and negatively associated with African American status. WTCDrelated medication use also was positively related to younger age, female gender, WTCD event exposures, negative life events, anxiety and lower self-esteem. Finally, while the percentage of New Yorkers seeking post-disaster treatment did not increase substantially, the volume of visits among patients apparently increased. We conclude that exposure to WTCD events was related to postdisaster PTSD and depression, as well as WTCD-related mental health service use. African Americans were consistently less likely to use post-disaster medications. Although the WTCD did have an impact on treatment-seeking among current patients, it did not substantially increase mental health treatment among the general population.

Classic urban theory suggests that living in highly urbanized areas of the city results in social isolation, social disorganization, and psychological problems. Living in the suburbs, however, is thought to be much more conducive to happiness, because suburban areas have a lower population density, lower crime, and a more stable population when compared to urban areas. Using data collected in 1974 from the Detroit Metropolitan Area, this study evaluates this “happy suburbanite” hypothesis. Results show that people living in the suburbs are no more likely to express greater satisfaction with their neighborhood, greater satisfaction with the quality of their lives, or stronger feelings of self‐efficacy than people living in the city. The analyses reveal that social integration and perceptions of the neighborhood are associated with neighborhood satisfaction, whereas employment status, age, housing satisfaction, and neighborhood satisfaction are associated with good psychological health. The results also show that length of residence has the strongest effect on neighborhood social ties and participation in local activities. The implication of these findings for a social psychological theory of community life is discussed.

Objective-The present study has two goals: to assess the difference between secondary trauma and job burnout and to examine the utility of secondary trauma in predicting psychological distress. Method-The data come from a survey of social workers (N = 236) living in New York City 20 months following the September 11 terrorist attacks on the World Trade Center (WTC).Results-Social workers' involvement in WTC recovery efforts is related to secondary trauma but not burnout. Analyses also reveal that both secondary trauma and burnout are related to psychological distress after controlling for other risk factors.Conclusion-This study supports the importance of compassion fatigue as a risk factor for social workers counseling traumatized clients and its association with psychological problems. Keywords compassion fatigue; secondary trauma; vicarious trauma; burnout; posttraumatic stress disorder; stress-process model; scale development During the past 20 years, most studies related to psychosocial stressor exposures have tended to focus on individuals seeking social support and coping assistance when dealing with a negative or traumatic life event (Aneshensel, Pearlin, & Schuler, 1993;Pearlin, 1989;Thoits, 1995). Less often has been a concern for those who give social support (e.g., emotional or informational) or coping assistance (e.g., raising self-esteem or self-efficacy) to others. Although studies have shown that providing social support in these situations can be highly stressful (Ohaeri, 2003;Schulz et al., 1997), relatively little research has focused on formal caregivers (e.g., social workers, therapists, child protection workers, paramedics etc.) and their social support efforts on behalf of traumatized clients (Figley, 1995). Yet, social support and coping assistance are the kinds of care these workers provide in clinical and organizational settings.Past researchers have raised concerns about the mental health status of service professionals who work with AIDS patients (Wade, Beckerman, & Stein, 1996), oncology patients (Simon, Pryce, Roff, & Klemmack, 2006), the elderly (Leon, Altholz, & Dziegielewski, 1999), child welfare clients (Bride, Jones, & MacMaster, in press;Bride, Jones, MacMaster, & Shatila, 2003;Conrad & Kellar-Guenther 2006;Daley, 1979;Dane, 2000;Jayaratne, Chess, & Kunkel, 1986;Rycraft, 1994) Peled-Avram, & Ben-Yizhack, 2004), clients who have committed suicide (Ting, Sanders, Jacobson, & Power, 2006), child sexual abuse victims, and social workers working with a variety of clients (Bride, Robinson, Yegidis, & Figley, 2004;Deighton, Gurris & Taue, 2007). Bride (2007) concludes that social workers engaged in direct clinical practice are likely to be secondarily exposed to traumatic events through their work with traumatized populations, and that a significant minority (15%), likely meet the diagnostic criteria for posttraumatic stress disorder (PTSD), conclusions that are consistent with an earlier report by the same author (Bride, 2004) and with Siebert's (2004) finding that 19% of s...

In this study, the authors examined whether concurrent associations between adolescent outcomes and disagreements with mothers, fathers, and best friends vary as a function of perceived relationship quality. Participants were 469 11-to 18-year-old youths from a culturally diverse community. Negative qualities of parent-adolescent and friend relationships were linked to adjustment problems (aggression, anxiety and depression, delinquency, and withdrawal). Positive qualities of parentadolescent relationships were linked to school grades and adjustment problems. Nonlinear associations between conflict and adolescent outcomes were moderated by negative qualities of relationships such that increases in conflict from low to moderate levels were linked to (a) higher school grades for adolescents in better but not poorer quality relationships and (b) greater delinquency and withdrawal for adolescents in poorer but not better quality relationships. Keywords adolescent conflict; mother-adolescent relationship; father-adolescent relationship; friendship Interpersonal conflict can be aversive. For this reason, contention is assumed to be antithetical to individual wellbeing. But is conflict necessarily pernicious? Many scholars believe that the valence of conflict depends on the family in which it arises: Conflict in supportive relationships is thought to be constructive and beneficial, whereas conflict in unsupportive relationships is considered destructive and detrimental. Agreement about this intuitively appealing assumption obscures the fact that it has received scant empirical attention. The present investigation was designed to address this proposition by exploring whether associations between indices of adolescent well-being and self-reports of disagreements with mothers, fathers, and best friends vary as a function of the perceived quality of the relationship in which the disagreement arises.Conflict is an essential form of communication. Over the course of a typical day, adolescents report three or four conflicts with parents and one or two conflicts with friends (Laursen & Collins, 1994). Conflicts signal the significance of topics and relationships, they provide a means for expressing concern and dissatisfaction, and they serve as a vehicle for individual growth and relationship transformation (Sillars, Canary, & Tafoya, 2004). Conflict, defined as overt behavioral opposition, is typically operationalized in terms of disagreement or incompatible behaviors. This designation has the advantage of disentangling conflict from competition and aggression and avoiding problems that arise when conflict is conflated with negative affect. Our goal was to describe the role conflict plays in shaping adolescent outcomes. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptWe defined conflict as disagreement so as to capture all instances of opposition; we focused on conflict with parents and friends because most adolescents report these relationships to be their closest, most influential, and most...