The influence of coping and cognitive appraisal in predicting Posttraumatic Stress Disorder: A prospective study on workplace violence in psychiatric staff in Denmark
Restricted accessResearch articleFirst published online March 25, 2022
The influence of coping and cognitive appraisal in predicting Posttraumatic Stress Disorder: A prospective study on workplace violence in psychiatric staff in Denmark
Since psychiatric staff experience a high occurrence of workplace violence and subsequent Posttraumatic Stress Disorder (PTSD), it is important to assess the behavioral and cognitive risk factors of PTSD in this population.
OBJECTIVE:
The current study assesses the incidence of PTSD 12 months after the occurrence of WV. Furthermore, it examines possible prospective associations between coping strategies and cognitive appraisals, respectively, and PTSD.
METHODS:
This prospective cohort study was conducted with staff from 18 psychiatric wards in Denmark (n = 183) who had reported an incidence of workplace violence. Most subjects were women (83.3%).
RESULTS:
The incidence of PTSD was 9.8%. The main analysis showed a significant relationship between negative cognitive appraisals about the self and PTSD (OR = 2.87, p < .05), and a coping strategy of self-blame and PTSD (OR = 2.21, p < .05).
CONCLUSIONS:
Certain dysfunctional coping strategies and negative cognitive appraisals seems to predict posttraumatic stress in an occupational context. Information about these processes could be important for preventive strategies in the workplace.
Antai-OtongD. Critical Incident Stress Debriefing: A health promotion model for workplace violence, Perspectives in Psychiatric Care. 2001;37(4).
2.
The National Research Center forWork Environment. Work environment and health in Denmark 2018. Retrieved from: 2018. https://arbejdsmiljodata.nfa.dk/
3.
ArnetzJE, HamblinL, RussellJ, UpfalMJ, LuborskyM, JanisseJ, EssenmacherL. Preventing patient-to-worker violence in hospitals:outcome of a randomized controlled intervention, Journal of Occupational and Environmental Medicine. 2017;59(1):18–27.
4.
LanctôtN, GuayS. The aftermath of workplace violence amonghealthcare workers: A systematic literature review of theconsequences, Aggression and Violent Behavior. 2014;19(5):492–501.
5.
CaldwellMP. Incidence of PTSD among staff victims of patientviolence, Hospital and Community Psychiatry. 1992;43:838–839.
6.
RichterD, BergerK. Post-traumatic stress disorder followingpatient assaults among staff members of mental health hospitals: aprospective longitudinal study, BMC Psychiatry. 2006;6(15).
7.
WalshBR, ClarkeE. Post-trauma symptoms in health workers following physical and verbal aggression, Work & Stress. 2003;17:170–181.
8.
WykesT, WhittingtonR. Prevalence and predictors of early traumatic stress reactions in assaulted psychiatric nurses, Journal of Forensic Psychiatry. 1998;9:643–658.
9.
ChenWC, HwuHG, KungSM, ChiuHJ, WangJD. Prevalence anddeterminants of workplace violence of health care workers in apsychiatric hospital in Taiwan, Journal of Occupational Health. 2008;50(3):288–293.
10.
BondeJP, JorgensenKT, BonziniM, PalmerKT. Miscarriage and occupational activity: a systematic review and meta-analysisregarding shift work, working hours, lifting, standing, and physical workload, Scandinavian Journal of Work, Environment & Health. 2013;39:325–334.
11.
Utzon-FrankN, BreinegaardN, BertelsenM, BorritzM, EllerNH, NordentoftM, OlesenK, RodNH, RuguliesR, BondeJP. Occurence of delayed-onset post-traumatic stress disorder: a systematic reviewand meta-analysis of prospective studies, Scandinavian Journal of Work, Environment & Health. 2014;40(3):215–229.
12.
AgaibiCE, WilsonJP. Trauma, PTSD, and resilience: a review of theliterature, Trauma Violence Abuse. 2005;6:195–216.
13.
AndersenLP, HoghA, ElklitA, AndersenJH, BieringK. Work-related threats and violence and post-traumatic symptoms in four high-riskoccupations: short- and long-term symptoms, International Archivesof Occupational and Environmental Health. 2019;92:195–208.
14.
Pihl-ThingvadJ, AndersenLL, BrandtLPA, ElklitA. Are frequencyand severity of workplace violence etiologic factors ofposttraumatic stress disorder? A 1-year prospective study of 1,763 social educators, Journal of Occupational Health Psychology. 2019;24(5):543–555.
15.
Gómez-GutiérrezM, Bernaldo-de-QuirósM, LarcoATP, CerdeiraJC. Posttraumatic Stress Symptomatology inPre-Hospital Emergency Care Professionals Assaulted by Patientsand/or Relatives, Journal of Interpersonal Violence. 2014;31(2).
16.
DunmoreE, ClarkDM, EhlersA. A prospective investigation of therole of cognitive factors in persistent posttraumatic stressdisorder (PTSD) after physical or sexual assault, Behaviour Researchand Therapy. 1063;39(9):1084.
17.
MaerckerA, MohiyeddiniC, MüllerM, XieW, YangZH, WangJ, MüllerJ. Traditional versus modern values, self-perceivedinterpersonal factors, and posttraumatic stress in Chinese andGerman crime victims, Psychology and Psychotherapy: Theory, Researchand Practice. 2009;82(2):219–232.
18.
FolkmanS. Stress: Appraisal and Coping. In: Gellman, M.D. & Turner, J.R. (eds). Encyclopedia of Behavioral Medicine. Springer, New York, NY. 2013.
19.
OlffM, LangelandW, GersonsBPR. Effects of appraisal and coping onthe neuroendocrine response to extreme stress, Neuroscience and Biobehavioral Reviews. 2005;29:457–467.
20.
EhlersA, MayouRA, BryantB. Psychological predictors of chronicposttraumatic stress disorder after motor vehicle accidents, Journalof Abnormal Psychology. 1998;107:508–519.
21.
WenningerK, EhlersA. Dysfunctional cognitions and adultpsychological functioning in child sexual abuse survivors, Journalof Traumatic Stress. 1998;11(2):281–300.
22.
LazarusRS, FolkmanS. Stress, appraisal and coping. Springer, New York, NY. 1984.
23.
McNallyRJ. Psychological mechanisms in acute response to trauma, Biological Psychiatry. 2003;53:779–788.
24.
EhlersA, ClarkDM, HackmannA, McManusF, FennellM, HerbertC, MayouR. A Randomized Controlled Trial of Cognitive Therapy, a Self-Help Booklet, and Repeated Assessment as Early Interventions for Posttraumatic Stress Disorder, Archives of General Psychiatry. 2003;60(10):1024–1032.
25.
BryantRA, GuthrieRM. Maladaptive Appraisals as a Risk Factor for Post traumatic Stress: A Study of Trainee Firefighters, Psychological Science. 2005;16(10):749–752.
26.
AgarE, KennedyP, KingN.S. The Role of Negative CognitiveAppraisals in PTSD Symptoms Following Spinal Cord Injuries, Behavioural and Cognitive Psychotherapy. 2006;34(4):437–452.
27.
ChangCM, LeeLC, ConnorKM, DavidsonJRT, JeffriesK, LaiTJ. Posttraumatic distress and coping strategies among rescue workersafter an earthquake, J. Nerv. Ment. Dis. 2003;191:391–398.
28.
FolkmanS. Personal control and stress and coping processes: Atheoretical analysis, Journal of Personality and Social Psychology. 1984;46(4):839–852.
29.
AldwinCM, YancuraLA. Coping and health: A comparison of the stress and trauma literatures. In Schnurr, P.P. & Green, B.L. (Eds.), Trauma and health: Physical health consequences of exposure to extreme stress (p. 99–125). American Psychological Association. 2004.
30.
GinzburgK, SolomonZ, BleichA. Repressive coping style, acutestress disorder, and posttraumatic stress disorder after myocardialinfarction, Psychosomatic Medicine. 2002;64:748–757.
31.
SchniderKR, ElhaiJD, GrayMJ. Coping style use predictsposttraumatic stress and complicated grief symptom severity amongcollege students reporting a traumatic loss, Journal of CounselingPsychology. 2007;54(3):344–350.
32.
SkeffingtonPM, ReesCS, MazzucchelliTG, KaneRT. The primary prevention of PTSD in firefighters: Preliminary results of an RCTwith 12-month follow-up, PLoS ONE. 2016;11(7).
33.
LillyMM, Graham-BermannSA. Intimate partner violence and PTSD: themoderating role of emotion-focused coping, Violence and Victims. 2010;25(5):604–616.
34.
VrablikMC, ChipmanAK, RosenmanED, SimcoxNJ, HuynhL, MooreM, FernandezR. Identification of processes that mediate the impact ofworkplace violence on emergency department healthcare workers in theUSA: results from a qualitative study, BMJ Open. 2019;9(8).
KowalenkoT, GatesD, GillespieGL, SuccopP, MentzelTK. Prospective study of violence against ED workers, The AmericanJournal of Emergency Medicine. 2013;31(1):197–205.
37.
WolfL, DelaoA, PerhatsC. Nothing changes, nobody cares:understanding the experience of emergency nurses physically orverbally assaulted while providing care, Journal of Emergency Nursing. 2014;40(4):305–310.
38.
MorkenT, JohansenIH, AlsakerK. Dealing with workplace violence inemergency primary health care: a focus group study, BMC FamilyPractice. 2015;16(51).
39.
CarverCS. You want to measure coping but your protocol’ too long: Consider the brief cope, International Journal of Behavioral Medicine. 1997;4(1):92–100.
40.
FoaEB, EhlersA, ClarkDM, TolinDF, OrsilloSM. The PosttraumaticCognitions Inventory (PTCI): Development and validation, Psychological Assessment. 1999;11(3):303–314.
41.
MollicaRF, Caspi-YavinY, BolliniP, TruongT, TorS, LavelleJ. Harvard trauma questionnaire: Validating a cross-cultural instrumentfor measuring torture, trauma, and post traumatic stress disorder in Indochinese refugees, Journal of Nervous and Mental Disease. 1992;180(2):111–116.
42.
BachME. An empirical illumination and analysis of emotional numbingas a potential independent factor in PTSD, Psykologisk Skriftserie. 2003;6:1–199.
43.
JosephS, AndrewsB, WilliamsR, YuleW. Crisis Support and Psychiatric Symptomatology in Adult Survivors of the Jupiter Cruise Ship Disaster, British Journal of Clinical Psychology. 1992;31(1):63–73.
44.
ElklitA, PedersenSS, JindL. The Crisis Support Scale: Psychometric qualities and further validation, Personality and Individual Differences. 2001;31(8):1291–1302.
45.
BrewinCR, AndrewsB, ValentineJD. Meta-analysis of risk factorsfor posttraumatic stress disorder in trauma-exposed adults, Journalof Consulting and Clinical Psychology. 2000;68:748–766.
46.
CooperCL, DewePJ, O’DriscollMP. Organizational Stress: A Review and Critique of Theory, Research and Applications. Sage Publications, CA. 2001.
47.
GohYW, SawangS, OeiTP. The revised transactional model (RTM) ofoccupational stress and coping: an improved process approach, Australian and New Zealand Journal of Organizational Psychology. 2010;3:13–20.
48.
DruryJ, WilliamsR. Children and young people who are refugees,internally displaced persons or survivors or perpetrators of war,mass violence and terrorism, Current opinion in Psychiatry. 2012;25(4):277–284.
49.
NeedhamI, AbderhaldenC, HalfnsRJ, FischerJE, DassenT. Non-somatic effects of patient aggression on nurses: a systematicreview, Journal of Advanced Nursing. 2005;49(3):283–296.
50.
FolkmanS, LazarusRS, Dunkel-SchetterC, DeLongisA, GruenR.J. Dynamics of a Stressful Encounter: Cognitive Appraisal, Coping, andEncounter Outcomes, Journal of Personaliy and Social Psychology. 1986;50(5):992–1003.
51.
PapathanasiouIV, TsarasK, NeroliatsiouA, RoupaA. Stress: concepts, theoretical models and nursing interventions, American Journal of Nursing Science. 2015;4(2-1):45–50.
