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

描述（由申请人提供）：越来越多的人认识到制定预防性干预措施的重要性，以降低其职业需要暴露于潜在创伤事件的员工的创伤后痛苦风险。几个可改变的风险因素，包括负面情绪，评价风格和低社会支持似乎增加了PTSD的风险，因为它们与处理威胁信息和调节情感和心理生理反应的能力受损有关。该项目的目的是进一步开发和初步测试一种基于网络的预防性干预措施的效力，这种干预措施旨在改变造成创伤后痛苦的这些风险因素。 将继续在研究不足和高风险的样本-体检医师和体检医师办公室工作人员-中开发和测试干预措施。虽然其他类型的应急工作人员的心理健康需求（即，火灾、警察、救援）已经在联邦应急计划工作中得到很好的识别和承认，但这些问题尚未在医学检查员（ME）中进行调查。MEs负责识别受害者并确定死亡原因和方式;他们发挥着重要的公共卫生和刑事司法职能，CDC认为他们是应对大规模灾难和预防恐怖主义的重要参与者。 我们对200多名ME和验尸官进行的心理健康症状发生率和这些症状的风险因素进行了详细的需求评估，为制定干预措施提供了信息。确定了与风险增加有关的具体工作压力因素，其中包括与高度贫困家庭的互动和儿童死亡。干预措施旨在提高管理工作压力源和痛苦反应的能力。所提出的基于网络的自定进度的指导提供给ME办公室的所有员工，并且将为员工提供关于压力和压力反应的知识，以及控制他们的注意力焦点的技能，标记他们的内部情绪和身体体验，将他们的体验整合到关于他们自己的现有知识中，挑战负面评价，调节生理唤醒，提高他们获得社会支持的能力。目前提案的目标是进一步发展干预措施，并对其在减少创伤后痛苦风险因素方面的效力进行初步测试。 公共卫生相关性：该项目的总体目标是进一步开发和进行基于网络的预防性干预的有效性的初步测试，旨在修改在体检医师（ME）办公室工作的人员的PTSD风险因素。ME人员是一个研究不足的高风险样本，他们经常暴露于潜在的创伤事件。对于一个发挥着重要公共卫生和刑事司法功能的群体来说，降低创伤后应激障碍和共病症状风险的能力具有巨大的公共卫生相关性。

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.