Top

Published in:

Open Access 01-12-2018 | Research article

The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study

Authors: Masanori Nagamine, Jun Shigemura, Toshimichi Fujiwara, Fumiko Waki, Masaaki Tanichi, Taku Saito, Hiroyuki Toda, Aihide Yoshino, Kunio Shimizu

Published in: BMC Psychiatry | Issue 1/2018

Abstract

Background

Disaster workers suffer from psychological distress not only through the direct experience of traumatic situations but also through the indirect process of aiding disaster victims. This distress, called secondary traumatic stress, is linked to dispositional empathy, which is the tendency for individuals to imagine and experience the feelings and experiences of others. However, the association between secondary traumatic stress and dispositional empathy remains understudied.

Methods

To examine the relationship between dispositional empathy and mental health among disaster workers, we collected data from 227 Japan Ground Self-Defense Force personnel who engaged in international disaster relief activities in the Philippines following Typhoon Yolanda in 2013. The Impact of Event Scale-Revised and the Kessler Psychological Distress Scale were used to evaluate posttraumatic stress responses (PTSR) and general psychological distress (GPD), respectively. Dispositional empathy was evaluated through the Interpersonal Reactivity Index, which consists of four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Hierarchial linear regression analyses were performed to identify the variables related to PTSR and GPD.

Results

High PTSR was significantly associated with high Fantasy (identification tendency, β = 0.21, p < .01), high Personal Distress (the self-oriented emotional disposition of empathy, β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.15, p < .05). High GPD was associated with high Personal Distress (β = 0.28, p < .001), marital status (married, β = 0.22, p < .01), being female (β = 0.18, p < .01), medical unit (β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.13, p < .05).

Conclusions

Among Japanese uniformed disaster workers, high PTSR was associated with two subtypes of dispositional empathy: the self-oriented emotional disposition of empathy and high identification tendency, whereas high GPD was associated with high identification tendency. Educational interventions that aim to mitigate these tendencies might be able to relieve the psychological distress of disaster workers.

National Disaster Risk Reduction and Management Council. Final report re: effects of typhoon “Yolanda” (Haiyan). In: NDRRMC update; 2013. http://ndrrmc.gov.ph/attachments/article/1329/FINAL_REPORT_re_Effects_of_Typhoon_YOLANDA_(HAIYAN)_06-09NOV2013.pdf. Accessed 24 Apr 2018.

Cabinet Office of Japan. International contributions of Japan self-defense forces. In: We are Tomodachi; 2014. http://www.japan.go.jp/tomodachi/2014/spring-summer2014/international_contributions_of_apan.html. Accessed 24 Apr 2018.

Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K. 60,000 disaster victims speak: part I. an empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65:207–39.CrossRef

Perrin MA, DiGrande L, Wheeler K, Thorpe L, Farfel M, Brackbill R. Differences in PTSD prevalence and associated risk factors among world trade center disaster rescue and recovery workers. Am J Psychiatry. 2007;164:1385–94.CrossRef

Figley CR. Compassion fatigue as secondary traumatic stress disorder. In: Figley CR, editor. Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Routledge; 1995. p. 1–20.

Benedek DM, Fullerton C, Ursano RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28:55–68.CrossRef

Berger W, Coutinho ES, Figueira I, Marques-Portella C, Luz MP, Neylan TC, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47:1001–11. https://doi.org/10.1007/s00127-011-0408-2.CrossRefPubMed

Fullerton CS, McCarroll JE, Ursano RJ, Wright KM. Psychological responses of rescue workers: fire fighters and trauma. Am J Orthop. 1992;62:371–8.CrossRef

Guo YJ, Chen CH, Lu ML, Tan HK, Lee HW, Wang TN. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res. 2004;127:35–41. https://doi.org/10.1016/j.psychres.2004.03.009.CrossRefPubMed

10.

Marmar CR, Weiss DS, Metzler TJ, Ronfeldt HM, Foreman C. Stress responses of emergency services personnel to the Loma Prieta earthquake interstate 880 freeway collapse and control traumatic incidents. J Trauma Stress. 1996;9:63–85.CrossRef

11.

Leffler CT, Dembert ML. Posttraumatic stress symptoms among U.S. navy divers recovering TWA flight 800. J Nerv Ment Dis. 1998;186:574–7.CrossRef

12.

Ursano RJ, McCarroll JE. Exposure to traumatic death: the nature of the stressor. In: Ursano RJ, McCaughey BG, Fullerton CS, editors. Individual and community responses to trauma and disaster: the structure of human chaos. Cambridge: Cambridge University Press; 1994. p. 46–71.CrossRef

13.

Alexander DA, Wells A. Reactions of police officers to body-handling after a major disaster. A before-and-after comparison. Br J Psychiatry. 1991;159:547–55.CrossRef

14.

Jones DR. Secondary disaster victims: the emotional effects of recovering and identifying human remains. Am J Psychiatry. 1985;142:303–7.CrossRef

15.

Cetin M, Kose S, Ebrinc S, Yigit S, Elhai JD, Basoglu C. Identification and posttraumatic stress disorder symptoms in rescue workers in the Marmara, Turkey, earthquake. J Trauma Stress. 2005;18:485–9. https://doi.org/10.1002/jts.20056.CrossRefPubMed

16.

Regehr C, Goldberg G, Hughes J. Exposure to human tragedy, empathy, and trauma in ambulance paramedics. Am J Orthop. 2002;72:505–13.CrossRef

17.

Ursano RJ, Fullerton CS, Vance K, Kao TC. Posttraumatic stress disorder and identification in disaster workers. Am J Psychiatry. 1999;156:353–9. https://doi.org/10.1176/ajp.156.3.353.CrossRefPubMed

18.

Decety J, Svetlova M. Putting together phylogenetic and ontogenetic perspectives on empathy. Dev Cogn Neurosci. 2012;2:1–24. https://doi.org/10.1016/j.dcn.2011.05.003.CrossRefPubMed

19.

Davis MH. Measuring individual differences in empathy: evidence for a multidimensional approach. J Pers Soc Psychol. 1983;44:113–26. https://doi.org/10.1037/0022-3514.44.1.113.CrossRef

20.

Batson CD, Fultz J, Schoenrade PA. Distress and empathy: two qualitatively distinct vicarious emotions with different motivational consequences. J Pers. 1987;55:19–39.CrossRef

21.

Stepien KA, Baernstein A. Educating for empathy. A review. J Gen Intern Med. 2006;21:524–30.CrossRef

22.

Figley CR. Compassion fatigue: Psychotherapists’ chronic lack of self care. J Clin Psychol. 2002;58:1433–41. https://doi.org/10.1002/jclp.10090.CrossRef

23.

Klimecki O, Singer T. Empathic distress fatigue rather than compassion fatigue? Integrating findings from empathy research in psychology and social neuroscience. In: Oakley B, Knafo A, Madhavan G, Wilson D, editors. Pathological altruism. New York: Oxford University press; 2012. p. 368–83.

24.

Asukai N, Kato H, Kawamura N, Kim Y, Yamamoto K, Kishimoto J, et al. Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): four studies of different traumatic events. J Nerv Ment Dis. 2002;190:175–82.CrossRef

25.

Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, et al. The performance of the Japanese version of the K6 and K10 in the world mental health survey Japan. Int J Methods Psychiatr Res. 2008;17:152–8. https://doi.org/10.1002/mpr.257.CrossRefPubMed

26.

Weiss DS, Marmar CR. The impact of event scale-revised. In: Wilson JP, Keane TM, editors. Assessing psychological trauma and PTSD. New York: The Guilford Press; 1997. p. 339–411.

27.

Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32:959–76.CrossRef

28.

Sakurai K, Nishi A, Kondo K, Yanagida K, Kawakami N. Screening performance of K6/K10 and other screening instruments for mood and anxiety disorders in Japan. Psychiatry Clin Neurosci. 2011;65:434–41.CrossRef

29.

Himichi T, Osanai H, Goto T, Fujita H, Kawamura Y, Davis MH, et al. Development of a Japanese version of the interpersonal reactivity index. Shinrigaku Kenkyu. 2017;88:61–71.CrossRef

30.

Corp IBM. SPSS statistics for windows version 22.0.0. Armonk: IBM Corp; 2013.

31.

Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Upper Saddle River: Pearson Prentice Hall; 2010.

32.

Gleichgerrcht E, Decety J. Empathy in clinical practice: how individual dispositions, gender, and experience moderate empathic concern, burnout, and emotional distress in physicians. PLoS One. 2013;8:e61526. https://doi.org/10.1371/journal.pone.0061526.CrossRefPubMedPubMedCentral

33.

Decety J, Jackson PL. The functional architecture of human empathy. Behav Cogn Neurosci Rev. 2004;3:71–100. https://doi.org/10.1177/1534582304267187.CrossRefPubMed

34.

Decety J, Lamm C. Human empathy through the lens of social neuroscience. Sci World J. 2006;6:1146–63. https://doi.org/10.1100/tsw.2006.221.CrossRef

35.

Pross C. Burnout, vicarious traumatization and its prevention. Torture. 2006;16:1–9.PubMed

36.

Fox R, Lief H. Training for “detached concern” in medical students. In: Lief HI, Lief VF, Lief NR, editors. The psychological basis of medical practice. New York: Harper & Row; 1963. p. 12–35.

37.

Sodeke-Gregson EA, Holttum S, Billings J. Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients. Eur J Psychotraumatol. 2013;4. https://doi.org/10.3402/ejpt.v4i0.21869.CrossRef

38.

Derksen F, Bensing J, Lagro-Janssen A. Effectiveness of empathy in general practice: a systematic review. Br J Gen Pract. 2013;63:e76–84.CrossRef

39.

McCarroll JE, Ursano RJ, Fullerton CS, Lundy A. Traumatic stress of a wartime mortuary: anticipation of exposure to mass death. J Nerv Ment Dis. 1993;181:545–51. https://doi.org/10.1097/00005053-199309000-00003.CrossRefPubMed

40.

Fullerton CS, Ursano RJ, Wang L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry. 2004;161:1370–6.CrossRef

41.

McLay RN, Deal WE, Murphy JA, Center KB, Kolkow TT, Grieger TA. On-the-record screenings versus anonymous surveys in reporting PTSD. Am J Psychiatry. 2008;165:775–6. https://doi.org/10.1176/appi.ajp.2008.07121960.CrossRefPubMed

42.

Goto T, Wilson JP. A review of the history of traumatic stress studies in Japan: from traumatic neurosis to PTSD. Trauma Violence Abuse. 2003;4:195–209 doi: July 1, 2003. https://doi.org/10.1177/1524838003004003001.CrossRef

Title: The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study
Authors: Masanori Nagamine
Jun Shigemura
Toshimichi Fujiwara
Fumiko Waki
Masaaki Tanichi
Taku Saito
Hiroyuki Toda
Aihide Yoshino
Kunio Shimizu
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-018-1915-4

At a glance: The STEP trials

Springer Medicine

The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Perception of inpatients following remission of a manic episode in bipolar I disorder on a group-based Psychoeducation program: a qualitative study

Effectiveness of aripiprazole once-monthly in schizophrenia patients pretreated with oral aripiprazole: a 6-month, real-life non-interventional study

Maternal mental health priorities, help-seeking behaviors, and resources in post-conflict settings: a qualitative study in eastern Uganda

Factors influencing early withdrawal from a drug and alcohol treatment program and client perceptions of successful recovery and employment: a qualitative study

Using motivational techniques to reduce cardiometabolic risk factors in long term psychiatric inpatients: a naturalistic interventional study

Prolonged exposure therapy and supportive counselling for posttraumatic stress disorder in adolescents in a community-based sample, including experiences of stakeholders: study protocol for a comparative randomized controlled trial using task-shifting