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Projects within the heme: Global Crises COVID-19

Global COVID-19-Related Traumatic Stress Activities

Theme Leaders: Sara Freedman and Tatiana Davidson

1. C19 MentalHealthNet

The COVID-19 Mental Health Research Network 

 

Project leaders: Soraya Seedat & Nancy Kassam-Adams

Project group: Natasha Kitchin (natashak@sun.ac.za), Nancy Kassam-Adams, Soraya Seedat, Ulrich Schnyder, Miranda Olff.

Interested to join the project group as a project ambassador? Please email Natasha.

Aims and method

The Global Collaboration of Traumatic Stress is collecting information on COVID-19 related mental health research that is being conducted or planned around the world. The aim of this project is to offer opportunities for collaboration, encourage sharing of resources (and data), and promote interchange amongst researchers in this area. 

 

The Global Collaboration has particular interest in facilitating multi-country and cross-cultural research and interchange, and in encouraging research that addresses the experiences of vulnerable populations. 

Read more and join the network here…

2. Traumatic Stress and Adversity Faced by COVID-19 Frontline Healthcare Workers and Mental Healthcare Providers

Project leader:  Julian Ford

Study A – Text Mining Approach

Project group: Miranda Olff, Cherie Armour, Jon Elhai, Davide Marengo, Marit Sijbrandij, Katharina Schultebraucks

Abstract

During the COVID-19 pandemic, healthcare professionals are exposed to extreme hazards and workplace stressors. Social media postings by physicians and nurses related to COVID-19 from January 21 to June 1, 2020 were obtained from the Reddit website. Topic modeling via Latent Dirichlet Allocation (LDA) using a machine-learning approach was performed on 1723 documents, each posted in a unique Reddit discussion. We selected the optimal number of topics using a heuristic approach based on examination of the rate of perplexity change (RPC) across LDA models. A two-step multiple linear regression was done to identify differences across time and between nurses versus physicians. Prevalent topics included excessive workload, positive emotional expression and collegial support, anger and frustration, testing positive for COVID-19 and treatment, use of personal protective equipment, impacts on healthcare jobs, disruption of medical procedures, and general healthcare issues. Nurses' posts initially reflected concern about workload, personal danger, safety precautions, and emotional support to their colleagues. Physicians posted initially more often than nurses about technical aspects of the coronavirus disease, medical equipment, and treatment. Differences narrowed over time: nurses increasingly made technical posts, while physicians' posts increasingly were in the personal domain, suggesting a convergence of the professions over time.

 

Study B – International Survey

Study group: Rocio Chang, Damion Grasso, Wissam El Hage, Patricia Kerig, Chris Kristensen, Davide Marengo, Misari Oe, Andrea Phelps, Carolina Salgado, Patricia Correia Santos, Ulrich Schnyder, James Topitzes

Aims and method

Results of surveys of healthcare workers during the COVID-19 pandemic demonstrate adverse effects on psychological well-being (De Kock et al., 2021) over the first year (Sasaki et al., 2021). However, the pandemic’s impact on mental health providers has been largely overlooked, with only one survey of 110 psychotherapists’ burnout in the United Kingdom (Kotera et al., 2021). Surveys of licensed psychologists in April 2020, September 2020, and June 2021 in the USA documented the shift to telehealth services and rapidly increasing caseloads of with greater symptom acuity and suicidality (Sammons et al., 2021). It is crucial to prospectively assess the impact on mental health providers internationally as the pandemic becomes an endemic context.

Using a Qualtrics platform for secure data acquisition and privacy protection the survey of mental health providers from multiple disciplines is being done by an international team of traumatic stress from Australia, Brazil, China, France, Italy, Japan, Portugal, and the United States,  beginning two years after the start of the pandemic (June 2022) with repeated waves every 6 months.

Survey items include: (1) sociodemographics, (2) a newly developed measure of personal and social impacts of the pandemic for mental health providers (EPII-Brief and-MH; Grasso et al., 2021), (3) depression and anxiety symptoms, (4) trauma history and PTSD symptoms (Global Psychotrauma Screen), (5) CPTSD DSO symptoms (International Trauma Questionnaire) (6) moral injury symptoms, (7) experiential avoidance symptoms, (8) secondary traumatic stress reactions, (9) burnout symptoms, (10) resiliency factors, and (11) social support (~200 items, 20-30 minute estimated completion time). Translation into multiple languages is done by co-investigators.

Descriptive statistics, correlations, linear regression, and tests of group differences will be conducted with SPSS and Mathworks Inc. Matlab. Exploratory and confirmatory factor analyses (EFA/CFA) and latent class and growth analyses will be conducted using MPlus software.

Moderators (e.g., nationality; training; sociodemographics, practice setting) and mediators (e.g., trauma/loss exposure, prior wave symptoms/support) will be tested, with a target sample size of up to N=3,000.

For more information on these projects, please contact Julian Ford 

Study Related Publications

  • Grasso, D. J., Briggs‐Gowan, M. J., Carter, A. S., Goldstein, B. L., & Ford, J. D. (2021). Profiling COVID‐related experiences in the United States with the Epidemic‐Pandemic Impacts Inventory: Linkages to psychosocial functioning. Brain and Behavior, e02197. https://doi.org/10.1002/brb3.2197

3. Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic 

Project leaders: Annett Lotzin (A.Lotzin@uke.de) & Ingo Schäfer on behalf of ESTSS

Project group members: Helene Flood Aakvaag, Elena Acquarini, Dean Ajdukovic, Vittoria Ardino, Maria Böttche, Kristina Bondjers, Maria Bragesjö, Małgorzata Dragan, Piotr Grajewski, Margarida Figueiredo-Braga, Odeta Gelezelyte, Jana Darejan Javakhishvili, Evaldas Kazlauskas, Matthias Knefel, Brigitte Lueger-Schuster, Nino Makhashvili, Trudy Mooren, Luisa Sales, and Aleksandra Stevanovic. Please contact Annett Lotzin if you are interested in joining the study.

 

Aims and method

The primary aim of this longitudinal cohort study launched by the European Society of Traumatic Stress Studies (ESTSS) was to examine the relationships between risk and resilience factors, stressors and adjustment disorder symptoms during the pandemic, and to investigate whether these relationships were moderated by coping behaviors. All data were assessed by an online-questionnaire longitudinally, with an interval of six months. Following a conceptual framework based on the WHO’s social framework of health, an assessment of individual and country-level risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behavior were measured to estimate their contribution to symptoms of adverse adjustment. Primary measure: adjustment disorder symptoms (ADNM-8). Secondary measure: Posttraumatic stress disorder symptoms (PC-PTSD-5).

 

Results

From June to November 2020, 15,563 adults from eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) participated in this study. Several risk and protective factors as well as pandemic-related stressors were identified. Study results can be accessed below:

  • Annett Lotzin, Elena Acquarini, Dean Ajdukovic, Vittoria Ardino, Maria Böttche, Kristina Bondjers, Maria Bragesjö, Małgorzata Dragan, Piotr Grajewski, Margarida Figueiredo-Braga, Odeta Gelezelyte, Jana Darejan Javakhishvili, Evaldas Kazlauskas, Matthias Knefel, Brigitte Lueger-Schuster, Nino Makhashvili, Trudy Mooren, Luisa Sales, Aleksandra Stevanovic & Ingo Schäfer (2020). Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic – study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study, European Journal of Psychotraumatology, 11(1), DOI: /20008198.2020.1780832 

  • Gelezelyte, O., Dragan, M, Grajewski, P., Kvedaraite, M., Lotzin, A., Skrodzka, M,  Nomeikaite, A., & Kazlauskas, E. (2021). Predictors of suicide ideation in Lithuania and Poland amid the COVID-19 pandemic. The Journal of Crisis Intervention and Suicide Prevention. Advance online publication. https://doi.org/10.1027/0227-5910/a000814

 

4. High-risk occupational groups responding to the COVID-19 pandemic

Project leaders: Talya Greene, Jo Billings, Michael Bloomfield

Project members: tbd

 

Aims and method

It is essential that the psychological response to the COVID-19 outbreak is coordinated, trauma-informed and evidence-based. This project aims to collate and develop globally transferable guidance for the psychosocial support of high-risk occupational groups responding to the COVID-19 pandemic. These groups include healthcare workers (e.g., doctors, nurses, technicians, porters, paramedics, hospital administrators), other essential workers (e.g., social workers, care home staff, cleaners, delivery workers), and their family members. Guidance should be evidence-based and is focused on which interventions are likely to be helpful, and which may be harmful, in coping with peritraumatic stress exposure, and mitigating long-term trauma reactions.

  • Billings, J., Greene, T., Kember, T., Grey, N., El-Leithy, S., Lee, D., ... & Bloomfield, M. A. (2020). Supporting hospital staff during COVID-19: Early interventions. Occupational Medicine. DOI: 10.1093/occmed/kqaa098

  • Greene, T., Bloomfield, M. A., & Billings, J. (2020). Psychological trauma and moral injury in religious leaders during COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(1), 143-145. DOI: 10.1037/tra0000641

 

5. Posttraumatic adjustment in nurses

Project leader: Prof Dr Judith Daniels (j.k.daniels@rug.nl)

Project group: Judith Daniels, Astrid Lampe, Birgit Kleim, and others. Please contact Dr Daniels if interested to join.

 

Aims and method

Nurses are at the frontline of the current pandemic. They often have to handle emotionally impactful situations and at times make decisions that are against their moral judgements. We will assess the impact this has on their mental health and how the adjust following the peak of the crisis

It will be longitudinal online study with 3 assessment time points: after the local peak in Covid cases, 3 months later, and 6 months later.

Ideally, all nurses of the clinic would receive the invitation via their work email. We will have control groups (nurses in maternity etc) to compare to nurses in ICU/oncology etc. The questionnaire will take approx. 15 minutes per time point.

 

6. REACH for Mental Health

Project leaders: Amantia Ametaj, Archana Basu, Karmel Choi, Christy Denckla, Bizu Gelaye, Shaili Jha, Karestan Koenen, Kristina Korte

Please contact: Shaili Jha  (sjha@hsph.harvard.edu) if interested to join.

Aims and method

The mission of the REACH project is to bring evidence-based skills on managing stress and enhancing resilience to everyone around the world. This coordinated effort to “Do the Five for Mental Health” in the COVID-19 pandemic is summarized by the acronym REACH, which stands for 'Recognize the Problem', 'Expand the Social Safety Net', 'Assist Those Most at Risk', 'Cultivate Resilience', and 'Have Empathy.' One example of this initiative is the COVID-19 Mental Health Forums offered through the Harvard T.H. Chan School of Public Health designed to: 1) introduce evidence-based skills for managing stress related to the coronavirus (COVID-19) outbreak; and 2) provide techniques for adapting and enhancing resilience. Each week, Dr. Karestan Koenen and colleagues host international experts in the field of clinical psychology and trauma epidemiology research to address important emotional, psychological, and physical health issues related to daily life during a pandemic. These forums are global in focus, hosting for example African psychiatrists covering issues facing sub-Saharan Africa at this time. These forums are always open to the global public and include a discussion and Q&A with attendees. If you would like to view previous forums and resources, learn more about upcoming forums, or join our mailing list, please visit our website at https://hsph.me/covid-19-mental-health. We are open to global collaboration for evaluating REACH worldwide and to adapt the interventions to local cultures.

7. Psychological Effects of the Corona Virus COVID19

Project Leaders:

Prof Sara Freedman (Sara.freedman@biu.ac.il), Dr Talya Greene, Prof Cherie Armour

Project Group Members: Azu Garcia Palacios, Eduardo Fernandez, Emily McGlinchey,Kareena McAloney, Kerri McPherson, Pietro Cipresso. Please contact Sara Freedman if you are interested to join.

Aims and method

This study aims to further our understanding of psychological effects of the Coronavirus, assessing these as they change over time. We are specifically interested in PTSD symptoms and their relationship with Corona related exposure and worry.

The first stage of this project (launched a month ago) included demographic questionnaires, Coronavirus exposure and worry, PTSD, LEC, GAD7 and PHQ9. Participants (from English, Spanish and Hebrew speaking countries) are now answering questionnaires on a weekly basis.

  • Ennis, N., Shorer, S., Shoval‐Zuckerman, Y., Freedman, S., Monson, C. M., & Dekel, R. (2020). Treating posttraumatic stress disorder across cultures: A systematic review of cultural adaptations of trauma‐focused cognitive behavioral therapies. Journal of clinical psychology, 76(4), 587-611. https://doi.org/10.1002/jclp.22909

  • Butter, S., McGlinchey, E., Berry, E., & Armour, C. (2020, July 24). Psychological, social, and situational factors associated with COVID-19 vaccination intentions: A study of UK key workers and non-key workers. Preprint: https://doi.org/10.31234/osf.io/cfp3r

  • Groarke, J. M., Berry, E., Wisener, L-G., McKenna-Plumley, P., McGlinchey, E., & Armour, C. (2020, Jun 24). Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from The COVID-19 Psychological Wellbeing Study. Preprint:  https://doi.org/10.31234/osf.io/j2pce

  • McGlinchey, E., Hitch, C., Butter, S., Mccaughey, L., Berry, E., & Armour, C. (submitted, preprit: 2020, July 24). Understanding the lived experiences of Healthcare Professionals during the COVID-19 Pandemic: An Interpretative phenomenological analysis. Preprint: https://doi.org/10.31234/osf.io/7cvzj 

  • Armour, C., McGlinchey, E., Butter, S., McAloney-Kocaman, K., & McPherson, K. E. (2020, May 29). Understanding the longitudinal psychosocial impact of the COVID-19 pandemic in the United Kingdom; a methodological overview of The COVID-19 Psychological Wellbeing Study. Preprint: https://doi.org/10.31234/osf.io/9p4tv

Prof. Dr. Karestan Koenen, project leader of project 6. REACH for Mental Health was interviewed by Miranda Olff about her work. Karestan is a former ISTSS president, an international expert in the field of PTSD and advocate for victims of sexual violence. She is breaking taboos by also sharing personal experiences.

 

Watch it here.

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6. REACH for Mental Health
Project leaders: Amantia Ametaj, Archana Basu, Karmel Choi, Christy Denckla, Bizu Gelaye, Shaili Jha, Karestan Koenen, Kristina Korte

Please contact: Shaili Jha  (sjha@hsph.harvard.edu) if interested to join.

Aims and method
The mission of the REACH project is to bring evidence-based skills on managing stress and enhancing resilience to everyone around the world. This coordinated effort to “Do the Five for Mental Health” in the COVID-19 pandemic is summarized by the acronym REACH, which stands for 'Recognize the Problem', 'Expand the Social Safety Net', 'Assist Those Most at Risk', 'Cultivate Resilience', and 'Have Empathy.' One example of this initiative is the COVID-19 Mental Health Forums offered through the Harvard T.H. Chan School of Public Health designed to: 1) introduce evidence-based skills for managing stress related to the coronavirus (COVID-19) outbreak; and 2) provide techniques for adapting and enhancing resilience. Each week, Dr. Karestan Koenen and colleagues host international experts in the field of clinical psychology and trauma epidemiology research to address important emotional, psychological, and physical health issues related to daily life during a pandemic. These forums are global in focus, hosting for example African psychiatrists covering issues facing sub-Saharan Africa at this time. These forums are always open to the global public and include a discussion and Q&A with attendees. If you would like to view previous forums and resources, learn more about upcoming forums, or join our mailing list, please visit our website at https://hsph.me/covid-19-mental-health. We are open to global collaboration for evaluating REACH worldwide and to adapt the interventions to local cultures.

7. Psychological Effects of the Corona Virus COVID19

Project Leaders:

Prof Sara Freedman (Sara.freedman@biu.ac.il), Dr Talya Greene, Prof Cherie Armour

Project Group Members: Azu Garcia Palacios, Eduardo Fernandez, Emily McGlinchey,Kareena McAloney, Kerri McPherson, Pietro Cipresso. Please contact Sara Freedman if you are interested to join.

 

Aims and method

This study aims to further our understanding of psychological effects of the Coronavirus, assessing these as they change over time. We are specifically interested in PTSD symptoms and their relationship with Corona related exposure and worry.

The first stage of this project (launched a month ago) included demographic questionnaires, Coronavirus exposure and worry, PTSD, LEC, GAD7 and PHQ9. Participants (from English, Spanish and Hebrew speaking countries) are now answering questionnaires on a weekly basis.

8. Global Psychotrauma Screen – Cross-Cultural responses to COVID-19 versus other traumatic events (GPS-CCC)

 

Project group:

Miranda Olff, Helene Aakvaag, Zafer Altunbezel, Anne Bakker, Lucia Cantoni, Emma Grace, Wissam El Hage, Ani Hovnanyan, Jana Javakhishvili, Juliana Lanza, ​Patrick Lorenz, Misari Oe, Muirne Paap, Indira Primasari, Daniela Rabellino, Yulan Qing, Luisa Sales, Carolina Salgado, and Soraya Seedat. ​

We are looking for collaborators and ambassadors of this project who help us collect the data cross-culturally, and/or analyze data and work on a joint publication of the results, please contact Miranda Olff.

 

Aims and method

The aim of the GPS-CCC study is to better understand how reactions to COVID-19 related traumatic events versus other traumatic events may be different, across different cultures and populations, and across different phases of the pandemic via  this link.

We invite individuals aged 16 or older, from around the world, who have experience potentially traumatic events, whether related to Corona virus (COVID-19) or other events such as a serious accident or fire, physical or sexual assault or abuse, earthquake or flood, war, seeing someone be killed or seriously injured, or having a loved one die through homicide or suicide, to participate in this 5 minute survey

A few introductory questions lead to the Global Psychotrauma Screen (GPS) which has been developed by the Global Collaboration on Traumatic Stress (GC-TS) as a brief measure screening for a wide range of potential outcomes of trauma, as well as for risk and protective factors. It is currently available in 22 languages. The measure was designed to be simple, cross-culturally valid, and easy to administer in a variety of circumstances, e.g. shortly after mass trauma, but would also tap potential consequences up to decades after trauma (Olff., et al 2020, or GPS page).

Here we use the GPS web-app to easily fill out the GPS and receive feedback. The app additionally includes questions on the type and time of the event experienced (COVID-19 has been added), as well as an item on global functioning. It provides – at this time – conservative feedback on the scores with advice on seeking further help if needed, using international websites that provide contact information for mental health crisis hotlines internationally. 

It will help us better target preventative and curative interventions.

Participants from all over the world (16 years and older) are invited to go to this portal:

https://www.global-psychotrauma.net/take-gps-test

9.  COVID-19 Unmasked: Understanding the mental health impacts of COVID-19 on young children (1-5 years) and their families

 

Project Leader: Dr Alex De Young

Project Group:

Dr Mira Vasileva , A/Prof Eva Alisic, Dr Elisabeth Hoehn, A/Prof Vanessa Cobham, Prof Sonja March, A/Prof Caroline Donavon, Prof Christel Middeldorp.

We are looking for collaborators for this project who will help us collect the data cross-culturally, and/or analyse data and work on a joint publication of the results. Please contact Alex De Young (Alex.DeYoung@health.qld.gov.au) if you are interested to collaborate.

 

Aims and Method

The aim of this study is to advance urgent research into understanding the mental health impacts of the COVID-19 pandemic on young children (1-6 years) and their families. The online survey will distributed via REDCap throughout Australia and internationally on 4 occasions (baseline and 3-, 6-, 12-months) to determine (1) impact of the COVID-19 pandemic on the social and emotional wellbeing of infants and preschoolers and (2) impact of the COVID-19 pandemic on parent’s mental health, and (3) identify the risk and protective factors for child mental health outcomes.

 

The findings will directly translate into mental health promotion and prevention models for the first 2000 days by (1) providing public health advice to inform future preparedness and response efforts by identifying the typical responses and characteristics of young children and their caregivers most at-risk over a 12-month period; (2) promote resilience and emotional wellbeing by identifying factors which contribute to positive outcome trajectories; and (3) provide accurate and comprehensive information to determine developmentally sensitive, ethically, culturally and economically effective strategies that are best suited to the mental health needs and context for each child/family.

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