Secondary traumatization in first responders: a systematic review

Abstract

Background: Finding precise definitions of secondary traumatic stress, vicarious traumatization, and compassion fatigue is not easy. While some researchers define these terms differentially, others use them interchangeably. In the present review, we refer to all three phenomena as secondary traumatization.Objectives: This systematic review aims to provide an overview of prevalence rates of secondary traumatization in first responders and to shed light on corresponding resilience and risk factors.Methods: After identifying 219 studies within the searched databases and 2192 references via hand searching, 31 studies were included in this review. We systematically searched the electronic databases PubMed, PsychINFO, and PSYNDEX (German database). The following inclusion criteria were applied: (1) participants had to be first responders working on-site: police officers, firefighters, search and rescue personnel, or emergency and paramedic team members; (2) secondary traumatization (secondary traumatic stress/vicarious traumatization/compassion fatigue) was assessed quantitatively with a validated questionnaire or subscale explicitly measuring secondary traumatization; and (3) English or German language original papers.Results: We found low levels of secondary traumatization in first responders. Several studies describe protective and risk factors for secondary traumatization, including pretraumatic (e.g. age, gender), peritraumatic (e.g. exposure, emotional exhaustion), and post-traumatic factors (e.g. social support, alcohol and tobacco use).Conclusion: Next to an immunizing effect, the low prevalence of secondary traumatization in first responders could be explained by social desirability and job-loss concerns. Therefore, we may be underestimating the prevalence of secondary traumatization in first responders. Some resilience (social support) and risk factors (female gender) are consistent with previous research in other populations. However, owing to the cross-sectional study designs, we must interpret resilience and risk factors with caution. Future research should focus on longitudinal study designs and preventive as well as curative interventions.

A decennial review of psychotraumatology: what did we learn and where are we going?

“…Thus, today's research reflects both primary and secondary traumatization as well as research into associated risk and protective factors in various occupational groups (e.g. bank employees, ministerial employees, humanitarian staff, military services, police officers, mental care professionals, journalists, first responders, industrial disasters, and therapists (Backholm & Björkqvist, 2012;Christiansen & Hansen, 2015;Greinacher et al, 2019;Hansen & Elklit, 2011;Koch et al, 2017;Nissen, Hansen, Nielsen, Knardahl, & Heir, 2019; Ponce de León, Andersen, Karstoft, & Elklit, 2018;Skogstad et al, 2013: Sodeke-Gregson et al, 2013Strohmeier & Scholte, 2015;Yehuda et al, 2014). Specifically, this has included an increased awareness and focus on risk and protective factors not only at an individual level but also at an organizational level (Greinacher et al, 2019;Koch et al, 2017;Nissen et al, 2019).…”

Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic

“…It has been studied among clinicians and HCPs who treat traumatically injured patients [ 35 ]. Symptoms are identical to PTSD [ 18 ] and STS definition entails psychological phenomena of compassion stress leading to compassion fatigue (CF), as well as vicarious traumatization. Compassion stress entails feeling of confusion, helplessness, and isolation along with STS symptoms.…”

Secondary traumatisation, burn-out and functional impairment: findings from a study of Danish child protection workers

“…Recently, the DSM-5 explicitly recognized indirect trauma-exposure encountered in the course of professional duties as a criterion A-event (American Psychiatric Association [APA], 2013), acknowledging that professionals are at risk for developing posttraumatic stress from working with survivors of trauma, known as secondary traumatization (Figley, 1995). Secondary traumatization is characterized by symptoms of posttraumatic stress following indirect exposure to aversive details of trauma (Greinacher, Derezza-Greeven, Herzog, & Nikendei, 2019) and is particularly prone among professionals working with child survivors of abuse (Sprang, Craig, & Clark, 2011). While secondary traumatization is an important topic for both research and practice in psychotraumatology, there is considerable controversy surrounding its validity, measurement and importance (Elwood, Mott, Lohr, & Galovski, 2011;Molnar et al, 2017;Sprang, Ford, Kerig, & Bride, 2018).…”