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，以减少其职业需要暴露于潜在创伤性事件的员工中发生创伤后痛苦的风险。包括消极情绪、评估方式和低社会支持在内的几个可改变的风险因素似乎增加了创伤后应激障碍的风险，因为它们与处理威胁性信息和调节对应激源的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进行基于网络的预防性干预措施的效力的初步测试，该干预措施旨在改变这些导致创伤后痛苦的危险因素。干预措施将继续在研究不足和高风险的样本--法医和法医办公室工作人员--中进行开发和测试。尽管其他类型的急救人员(即消防、警察、救援)的心理健康需求已经在联邦应急计划工作中得到了很好的识别和承认，但这些问题还没有在法医(MES)中进行调查。疾病预防控制中心负责确定受害者身份，确定死因和死亡方式；他们发挥着至关重要的公共卫生和刑事司法职能，被疾控中心视为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MES和验尸官的精神健康症状的发生率和这些症状的危险因素进行了详细的需求评估，从而制定了干预措施。确定了与风险增加相关的具体工作压力源，其中包括与高度痛苦的家庭的互动和儿童死亡。这项干预旨在提高管理工作压力源和应对困境的能力。拟议的基于网络的自我进度指导为ME办公室的所有员工提供，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，标记他们的内部情感和身体经验，将他们的经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，并提高他们获得社会支持的能力。目前提议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。 与公共卫生的相关性：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效果的初步测试，旨在改变法医办公室工作人员的创伤后应激障碍风险因素。自我评估人员是一个研究不足的高风险样本，他们经常暴露在潜在的创伤性事件中。对于一个发挥着至关重要的公共卫生和刑事司法职能的群体来说，降低创伤后应激障碍和共病症状的风险的能力与公共卫生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.