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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings

Authors: Heidi Grundlingh, Louise Knight, Dipak Naker, Karen Devries

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

Secondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors.

Methods

We conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors.

Results

Baseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1). In regression analysis (n = 48), baseline distress increased the odds of end-line distress (OR = 16.1, 95%CI 2.82 to 92.7, p = 0.002). Perceived organisational support (OR = 0.09, 95%CI 0.01 to 0.69, p = 0.02) and belief in God (OR = 0.21, 95%CI 0.03 to 1.26, p = 09) was protective against end-line distress.

Conclusion

We found no evidence that violence researchers experienced elevated emotional distress after doing violence research. There was no difference between group debriefings and leisure activities in reducing distress in our sample. However, the hypotheses presented should not be ruled out in other violence research settings. Our findings suggest that organisational support is a significant protective factor and belief in God may be an important coping mechanism.

Trial registration

Clinical Trials NCT02390778. Retrospectively registered 19 March 2015. The Good Schools Trial was registered at (NCT01678846), on August 24, 2012.
Appendix
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Literature
1.
Devries K, Watts C, Yoshihama M, Kiss L, Schraiber LB, Deyessa N, et al. Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women’s health and domestic violence against women. Soc Sci Med. 2011;73(1):79–86.CrossRefPubMed
2.
3.
Heise LL, Pitanguy J, Germain A. Violence against women: the hidden health burden. World Bank discussion papers. Washington, DC: The World Bank; 1994.
4.
World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013.
5.
6.
Campbell R. Emotionally involved: the impact of researching rape. New York, NY: Psychology Press; 2002.
7.
Coles J, Mudaly N. Staying safe: strategies for qualitative child abuse researchers. Child Abuse Rev. 2010;19(1):56–69.CrossRef
8.
Stoler LR. Researching childhood sexual abuse: anticipating effects on the researcher. Feminism Psychol. 2002;12(2):269–74.CrossRef
9.
10.
Coles J, Dartnall E, Astbury J, Limjerwala S, editors. Vicarious trauma and doing research on sexual violence. 4th Population Council Regional SGBV Network Meeting, 7–9 February 2011; 2011.
11.
Vrklevski LP, Franklin J. Vicarious trauma: the impact on solicitors of exposure to traumatic material. Traumatology. 2008;14(1):106–18.CrossRef
12.
13.
Maier SL. The emotional challenges faced by sexual assault nurse examiners:“ER nursing is stressful on a good day without rape victims”. J Forensic Nurs. 2011;7(4):161–72.CrossRefPubMed
14.
Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet. 2008;371(9619):1165–72.CrossRefPubMed
15.
Vizcarra B, Hassan F, Hunter WM, Muñoz SR, Ramiro L, De Paula CS. Partner violence as a risk factor for mental health among women from communities in the Philippines, Egypt, Chile, and India. Inj Control Saf Promot. 2004;11(2):125–9.CrossRefPubMed
16.
Beusenberg M, Orley JH. World Health Organization. A User’s guide to the self reporting questionnaire (SRQ). Geneva: World Health Organisation; 1994.
17.
Woolhouse S, Brown JB, Thind A. “Building through the grief”: vicarious trauma in a Group of Inner-City Family Physicians. The Journal of the American Board of Family Medicine. 2012;25(6):840–6.CrossRefPubMed
18.
Pearlman LA, Saakvitne KW. Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: WW Norton & Co; 1995.
19.
Beck CT. Secondary traumatic stress in nurses: a systematic review. Arch Psychiatr Nurs. 2011;25(1):1–10.CrossRefPubMed
20.
Figley CR. Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized. Psychosocial Stress Series, vol. 23. New York: Brunner/Mazel; 1995.
21.
22.
Bride BE. Prevalence of secondary traumatic stress among social workers. Soc Work. 2007;52(1):63–70.CrossRefPubMed
23.
Levin A, Besser A, Albert L, Smith D, Neria Y. The effect of Attorneys’ work with trauma-exposed clients on PTSD symptoms, depression, and functional impairment: a cross-lagged longitudinal study. Law Human Behav. 2012;36(6):538–47. doi:10.​1037/​H0093993.CrossRef
24.
25.
Motta RW. Secondary trauma. Int J Emerg Ment Health. 2008;10(4):291–8.PubMed
26.
27.
Everly G, Mitchell JT. The debriefing “controversy” and crisis intervention: a review of lexical and substantive issues. Int J Emerg Ment Health. 2000;2(4):211–26.PubMed
28.
29.
Rose S, Bisson J, Wessely S. A systematic review of single-session psychological interventions (‘debriefing’) following trauma. Psychother Psychosom. 2003;72(4):176–84.CrossRefPubMed
30.
Van Emmerik AA, Kamphuis JH, Hulsbosch AM, Emmelkamp PM. Single session debriefing after psychological trauma: a meta-analysis. Lancet. 2002;360(9335):766–71.CrossRefPubMed
31.
Mitchell JT, Everly GS. Critical incident stress management (CISM): group crisis intervention. Ellicott City: International Critical Incident Stress Foundation; 2003.
32.
Mitchell JT, Everly GS. Critical Incident Stress Debriefing (CISD)e: An Operations Manual for the Prevention of Traumatic Stress Among Emergency Service and Disaster Workers. Ellicott City: Chevron Publishing; 1996.
33.
Wessely S, Deahl M. Psychological debriefing is a waste of time. Br J Psychiatry. 2003;183(1):12–4.CrossRefPubMed
34.
Nurmi LA. The sinking of the Estonia: the effects of critical incident stress debriefing (CISD) on rescuers. Int J Emerg Ment Health. 1999;1(1):23–31.PubMed
35.
Deahl M, Srinivasan M, Jones N, Thomas J, Neblett C, Jolly A. Preventing psychological trauma in soldiers: the role of operational su-ess training and psychological debriefing. Br J Med Psychol. 2000;73:77–85. doi:10.​1348/​000711200160318.CrossRefPubMed
36.
Mangone N, King J, Croft T, Church J. Group debriefing: an approach to psychosocial support for new graduate registered nurses and trainee enrolled nurses. Contemp Nurse. 2005;20(2):248–57.CrossRefPubMed
37.
Mitchell JT. Crisis intervention and critical incident stress management: a defense of the field. Int Crit Incident Stress Foundation. 2004;7(5):12–4.
38.
Devries KM, Allen E, Child JC, Walakira E, Parkes J, Elbourne D, et al. The Good Schools Toolkit to prevent violence against children in Ugandan primary schools: study protocol for a cluster randomised controlled trial. Trials. 2013;14(1):232.CrossRefPubMedPubMedCentral
39.
Devries KM, Knight L, Child JC, Mirembe A, Nakuti J, Jones R, et al. The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda. Lancet Glob Health. 2015;3(7):e378–e86.CrossRefPubMedPubMedCentral
40.
Devries KM, Child JC, Allen E, Walakira E, Parkes J, Naker D. School violence, mental health, and educational performance in Uganda. Pediatrics. 2014;133(1):e129–e37.CrossRefPubMed
41.
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348
42.
Aparicio E, Michalopoulos LM, Unick GJ. An examination of the psychometric properties of the vicarious trauma scale in a sample of licensed social workers. Health Soc Work. 2013;38(4):199–206.CrossRefPubMed
43.
Creamer M, Bell R, Failla S. Psychometric properties of the impact of event scale-revised (IES-R). Behav Res Ther. 2003;41(12):1489–96.CrossRefPubMed
44.
Stamm BH. The concise ProQOL manual. Pocatello: ProQOL.org; 2010.
45.
46.
Schraiber LB, Latorre Mdo R, França I Jr, Segri NJ, D’Oliveira AF. Validity of the WHO VAW study instrument for estimating gender-based violence against women. Rev Saude Publica. 2010;44(4):658–66.CrossRefPubMed
47.
Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, et al. Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Med. 2014;12(1):122.CrossRefPubMedPubMedCentral
48.
Scholte W, Verduin F, van Lammeren A, Rutayisire T, Kamperman A. Psychometric properties and longitudinal validation of the self-reporting questionnaire (SRQ-20) in a Rwandan community setting: a validation study. BMC Med Res Methodol 2011;11(1):1-10. doi:10.​1186/​1471-2288-11-116.
49.
Nakigudde N, Tugumisirize J, Musisi S, editors. Validation of the SRQ-20 in a primary care setting in Kampala, Uganda. Sida-SAREC-Makerere Research Collaboration (2001–2009) Dissemination Conference. Kampala: Makerere University; 2008.
50.
Eun HJ, Kwon TW, Lee SM, Kim TH, Choi MR, Cho SJ. A study on reliability and validity of the Korean version of impact of event scale-revised. J Korean Neuropsychiatric Assoc. 2005;44(3):303–10.
51.
Brunet A, St-Hilaire A, Jehel L, King S. Validation of a French version of the impact of event scale-revised. Can J Psychiatry. 2003;48(1):56–61.PubMed
52.
53.
Coles J, Dartnall E, Astbury J. “Preventing the pain” when working with family and sexual violence in primary care. Int J Fam Med. 2013;2013:198578. doi:10.​1155/​2013/​198578.
54.
55.
Rose S, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;2:2.
56.
Pack M. Vicarious resilience: a multilayered model of stress and trauma. Affilia. 2014;29:18–29.CrossRef
57.
Bell H, Kulkarni S, Dalton L. Organizational prevention of vicarious trauma. Families in society. J Contemp Human Serv. 2003;84(4):463–70.CrossRef
58.
59.
Smith AJ, Kleijn WC, Trijsburg RW, Hutschemaekers GJ. How therapists cope with clients’ traumatic experiences. Torture. 2007;17(3):203–15.PubMed
Metadata
Title
Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings
Authors
Heidi Grundlingh
Louise Knight
Dipak Naker
Karen Devries
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1327-x

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