Coping with catastrophe: emotion regulation, adult attachment security, and mindfulness as predictors of posttraumatic stress among mental health disaster responders

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Allison Marsh Pow (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Craig Cashwell

Abstract: A growing body of research on the traumatic impact of disaster (e.g., Norris, Friedman, & Watson, 2002b; Norris et al., 2002a) has led to escalating demand for mental health disaster responders (MHDRs), mental health professionals who help provide emotional support to victims following disaster (American Red Cross, 2012; Spokane, Inman, Weatherford, Davidson, & Straw, 2011). MHDRs are exposed to direct and secondary trauma that may compromise their mental health and, subsequently, the effectiveness of their response (Creamer & Liddle, 2005; Eidelson, D'Alessio, & Eidelson, 2003). Despite the documented prevalence of posttraumatic stress disorder (PTSD) among 10-20% of non-mental health professional disaster responders (Berger et al., 2012; Kleim & Westphal, 2011), no studies completed to date have explored PTSD severity among MHDRs. Additionally, little is known about mechanisms of adaptive coping that may mitigate trauma associated with disaster response work. Emotion regulation, a vital component of self-managed coping, evolves from healthy and secure attachment relationships in early life (Mikulincer, Shaver, & Pereg, 2003) and, in adulthood, becomes central to adaptive functioning and the development of cognitive abilities that are imperative to successful disaster response work (Diamond & Aspinwall, 2003; Spokane et al., 2011). Elements of mindfulness are woven throughout the four dimensions of emotion regulation (Gratz & Roemer, 2004), which hinge on practices of present moment awareness, nonjudging, patience, and acceptance (Kabat-Zinn, 1994). Additionally, emotion regulation has been empirically tied to lower rates of PTSD (Ehring & Quack, 2010) - a finding that aligns theoretically with the avoidance model of PTSD symptom development (Thompson, Arnkoff, & Glass, 2011). A correlational study was conducted to assess the severity of PTSD symptoms among 172 MHDRs and to examine the roles of emotion regulation, adult attachment security, and mindfulness in predicting symptoms of PTSD within this sample. Independent samples t-tests were used to compare MHDRs' mean PTSD scores to other trauma-exposed groups assessed in previous studies. MHDRs scored significantly lower than all comparison groups on PTSD severity. Multiple linear regression analyses indicated that mindfulness was not a significant independent predictor of PTSD, while emotion regulation and adult attachment security (indicated by the absence of attachment anxiety) were significant independent negative predictors of PTSD. Additional multiple linear regression analyses also supported emotion regulation as a mediator for adult attachment security in predicting PTSD. Study results support the need for additional investigation of MHDRs' trauma risk and indicate that training in emotion regulation skills may reduce the risk of traumatization, particularly among MHDRs with high attachment anxiety.

Additional Information

Language: English
Date: 2014
Attachment, Disaster, Emotion Regulation, Mental Health, Mindfulness, Responder
Crisis intervention (Mental health services)
Emergency management $x Psychological aspects
Disasters $x Psychological aspects
First responders $x Mental health
Post-traumatic stress disorder
Emotions $x Health aspects

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