A Web-Based Program to Prevent Mental Health Risks in Medical Examiners

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DESCRIPTION (provided by applicant): There has been a growing recognition of the importance of developing preventive interventions to decrease the risk for post-traumatic distress among employees whose occupations require exposure to potentially traumatic events. Several modifiable risk factors, including negative emotionality, appraisal style, and low social support appear to increase risk for PTSD, because they are associated with impairments in the ability to process threatening information and modulate affective and psychophysiological responses to stressors. The aim of this project is to further develop and conduct preliminary tests of the efficacy of a web-based preventive intervention designed to modify these risk factors for the development of post-traumatic distress. The intervention will continue to be developed and tested in an under-researched and high-risk sample - medical examiners and personnel working in medical examiner offices. Although the mental health needs of other types of emergency workers (i.e., fire, police, rescue) have been well identified and acknowledged in federal emergency planning efforts, these issues have not been investigated in medical examiners (MEs). MEs are responsible for identifying victims and determining the cause and manner of death; they play a vital public health and criminal justice function, and they are regarded by the CDC as essential participants in the response to mass disasters and the prevention of terrorism. The development of the intervention is informed by a detailed needs assessment that we conducted of the incidence of mental health symptoms and risk factors for these symptoms in over 200 MEs and coroners. Specific work stressors associated with increased risk were identified, and included, among others, interactions with highly distressed families and deaths of children. The intervention is designed to improve the ability to manage work stressors and distress responses. The proposed web-based self- paced instruction is offered to all employees in ME offices and will provide employees with knowledge about stress and stress responses, as well as skills in controlling the focus of their attention, labeling their internal emotional and somatic experiences, integrating their experiences into existing knowledge about themselves, challenging negative appraisals, modulating physiological arousal, and increasing their ability to gain social support. The goal of the current proposal is to further develop the intervention and conduct preliminary tests of its efficacy in reducing risk factors for post-traumatic distress. PUBLIC HEALTH RELEVANCE: The overall aim of this project is to further develop and conduct preliminary tests of the efficacy of a web-based preventive intervention designed to modify PTSD risk factors in personnel working in medical examiner (ME) offices. ME personnel are an under-researched and high-risk sample who are exposed to potentially traumatic events on a regular basis. The ability to decrease risk for PTSD and comorbid symptoms has enormous public health relevance for a group that plays a vital public health and criminal justice function.