Secondary traumatic stress and burnout in child welfare workers: a comparative analysis of occupational distress across professional groups

This study describes predictors of secondary traumatic stress and burnout in a national sample of helping professionals, with a specific focus on the unique responses of child welfare (CW) workers. Specific worker and exposure characteristics are examined as possible predictors of these forms of occupational distress in a sample of 669 professionals from across the country who responded to mailed (e-mail and post) invitations to participate in an online survey. E-mail and home mailing addresses were secured from licensure boards and professional membership organizations in six states from across the country that had high rates of child related deaths in 2009. Respondents completed the Professional Quality of Life IV (Stamm, 2005) to ascertain compassion fatigue (CF) and burnout symptoms. Being male, young, Hispanic, holding rural residence, and endorsing a lack of religious participation were significant predictors of secondary traumatic stress. Similarly, being male and young predicted high burnout rates, while actively participating in religious services predicted lower burnout. CW worker job status as a professional was significantly more likely to predict CF and burnout compared to all other types of behavioral healthcare professionals. Based on the findings from this study, this paper proposes strategies for enhancing self-care for CW workers, and describes the essential elements of a trauma-informed CW agency that addresses secondary traumatic stress and burnout.     

Racial identity, racial discrimination, perceived stress, and psychological distress among African American young adults

This study examines the direct and indirect relationships among racial identity, racial discrimination, perceived stress, and psychological distress in a sample of 555 African American young adults. A prospective study design was used to assess the influence of two dimensions of racial identity attitudes (i.e., centrality and public regard) on other study variables to investigate the relationship between racial identity attitudes and psychological distress. The results show some evidence of a direct relationship between racial centrality and psychological distress, as well as evidence of indirect relationships for both centrality and public regard through the impact of racial discrimination and perceived stress. In addition, racial centrality was both a risk factor for experiencing discrimination and a protective factor in buffering the negative impact of discrimination on psychological distress. Results are discussed within the context of identifying multiple pathways to psychological well-being for African American young adults within the context of racial discrimination.     

Cumulative victimization, psychological distress, and high-risk behavior among substance-involved women

This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women's engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.     

Impact of marital and psychological distress on therapeutic alliance in couples undergoing couple therapy

In this study, we describe the psychometric properties of the Couple Therapy Alliance Scale--revised (CTAS-r) and investigates the impact of marital and psychiatric distress on alliance. Seventy-nine couples in therapy completed a French version of the Dyadic Adjustment Scale and of the Psychiatric Symptoms Index at session one, and a French version of the CTAS-r at session three. Results indicate that the French version of the CTAS-r has adequate psychometric properties, although the subscales of the instrument are highly intercorrelated. Furthermore, marital adjustment predicts alliance scores, whereas psychiatric symptoms do not. Finally, male marital adjustment and female psychiatric symptoms are lower in couples where spouses have divergent perceptions of the alliance. Future research directions are discussed.     

Childhood abuse history,secondary traumatic stress,and child welfare workers

Social workers are exposed to trauma vicariously through the trauma of their clients. This phenomenon, called secondary traumatic stress, vicarious traumatization, or compassion fatigue, presents a risk of negative personal psychological consequences. Based on a sample of 166 child welfare workers and using standardized measures, the study findings document the link between a personal history of primary trauma, childhood abuse or neglect, and the heightened risk for secondary traumatic stress in child welfare workers.     

Family structure, stress, and psychological distress: a demonstration of the impact of differential exposure

In this article, we evaluate the relative power of differential exposure and differential vulnerability to stressors to account for variations in psychological distress between single and married mothers. The data for this assessment are derived from a longitudinal survey of 518 single mothers and 502 married mothers living in London, Ontario, Canada. Both cross-sectional and longitudinal analyses clearly reveal that the higher levels of psychological distress experienced by single mothers compared to married mothers are almost entirely related to their greater exposure to stress and strain rather than to any group differences in vulnerability to stressful experiences. Across a number of different dimensions of social stressors, single mothers are consistently more exposed to these stressors than married mothers are. Moreover, this differential exposure persists over time. In contrast, there is no evidence that single mothers are more vulnerable or reactive to stressors than are married mothers. We discuss these findings in terms of their implications for the sociology of mental health and for primary prevention.     

Co-occurrence between marital aggression and parents' child abuse potential: the impact of cumulative stress

Evidence suggests that marital aggression and parent-to-child aggression sometimes occur within the same family, but little is known about why certain families are vulnerable to multiple forms of family aggression. According to family systems theory, negative affect in one family relationship can spread to other family relationships. According to family stress theory, aversive circumstances increase families' vulnerability to disruption and conflict. Based on these theories, the present study tests the hypothesis that cumulative family stresses potentiate the association between marital aggression and parents' child abuse potential. In a series of additive interactional models, husband-to-wife aggression was linked to husbands' and wives' child abuse potential in a context of both high financial stress and high parenting stress but was not linked in a context of low stress. Wife-to-husband aggression was linked to wives', but not husbands', child abuse potential in a context of high stress. These results highlight the potential role of contextual factors in the pervasiveness of aggressive exchanges across multiple family subsystems.     

The Slut-Shaming Instrument: Preliminary validation,correlates, and links with psychological distress among adolescent girls

Despite social awareness of the problem of slut-shaming for adolescent girls, no existing measure captures this construct. Using data from a sample of 202 girls from Québec, Canada (ages 14–17; 68% White), preliminary validation is provided for the Slut-Shaming Instrument, a seven-item measure of negative peer experiences related to being perceived as too sexually active, sexualized, or flirtatious. The measure showed strong psychometric properties including good reliability and factor structure, expected associations with daily experiences of slut-related victimization and sexual harassment, and links with number of sexual partners and other forms of peer victimization. Slut-shaming was associated with distress accounting for these other forms of victimization (including sexual harassment), suggesting the pertinence of addressing this type of gender-based victimization.     

Race, socioeconomic status, and psychological distress: an examination of differential vulnerability

Using data from a 1985 epidemiological survey of 2,115 adults in Florida, this research has two goals: it tests the proposition that race and SES jointly influence mental health, and it examines the contribution of undesirable life events and economic problems to psychological distress across SES groups. Using multiple indicators of SES and mental health, we found that the evidence for a model of joint influence of race and SES on mental health varied with the measures being used. The most general conclusion is that SES interacts with race to increase psychological symptoms of distress. Partitioning the sample into three SES categories (low, middle, high), we examined the contribution of stressors to the greater distress among lower-SES blacks compared to other blacks and lower-SES whites. Lower-SES blacks are more vulnerable than lower-SES whites to the impact of undesirable events, but they are less vulnerable than lower-SES whites to the impact of economic problems. Lower-SES blacks are more vulnerable than middle-SES blacks to the impact of both discrete events and economic problems. Limitations of the study indicate a need for future longitudinal studies with measures of coping resources and support networks to further our understanding of the race, social class and psychological distress relationship.     

The evaluation of a mind/body intervention to reduce psychological distress and perceived stress in college students

The authors examined the effect of a 6-week mind/body intervention on college students' psychological distress, anxiety, and perception of stress. One hundred twenty-eight students were randomly assigned to an experimental group (n = 63) or a waitlist control group (n = 65). The experimental group received 6 90-minute group-training sessions in the relaxation response and cognitive behavioral skills. The Symptom Checklist-90-Revised, Spielberger State-Trait Anxiety Inventory, and the Perceived Stress Scale were used to assess the students' psychological state before and after the intervention. Ninety students (70% of the initial sample) completed the postassessment measure. Significantly greater reductions in psychological distress, state anxiety, and perceived stress were found in the experimental group. This brief mind/body training may be useful as a preventive intervention for college students, according to the authors, who called for further research to determine whether the observed treatment effect can be sustained over a longer period of time.     

Socioeconomic status, neighborhood disadvantage, and poverty-related stress: Prospective effects on psychological syndromes among diverse low-income families

Living with persistent poverty is toxic for one’s psychological health. This study examined SES, income, neighborhood disadvantage, and poverty-related stress as predictors of a wide range of psychological problems including anxiety, depression, aggression, relationship problems, physical problems, and trouble with the law. Longitudinal analyses were conducted with a low-income multiethnic sample of 98 families recruited from the greater Denver, CO metropolitan area (300 family members: 136 adults, 82 preadolescents, 82 adolescents) using hierarchical linear modeling to predict all eight ASEBA narrow band syndromes. Analyses showed that poverty-related stress was directly related to anxious/depressed symptoms and social problems and interacted with prior symptoms, contributing to worsening symptoms for delinquency, attention problems, somatic complaints, and anxious/depressed symptoms. Hollingshead SES also had direct predictive effects for certain syndromes, though these effects were in the opposite direction predicted. In contrast, lower income-to-needs predicted more problems as expected. Neighborhood disadvantage also predicted psychological syndromes. Developmental differences are discussed. Our data show that parents are not the only family members who are affected by stress from living in poverty. SES, neighborhood disadvantage and poverty-related stress take a toll on children, adolescents, and adults.     

The impact of serial transitions on behavioral and psychological problems among children in child protection services

This study focuses on the impacts of serial transitions on externalized and internalized behavior disorders, anxiety, and depression among children in child protection services. The research was carried out with a sample of 741 children. The findings demonstrate that the number of times a family is blended is a stronger predictive factor for children's adjustment than is the family structure at the time of the interview. In predicting externalized and internalized behavior problems among children, however, the effect of family structure disappears in favor of the variables associated with family functioning and family climate.     

Screening for trauma exposure, and posttraumatic stress disorder and depression symptoms among mothers receiving child welfare preventive services

The role of parental trauma exposure and related mental health symptoms as risk factors for child maltreatment for parents involved with the child welfare (CW) system has received limited attention. In particular, little is known about the extent to which mothers receiving CW services to prevent maltreatment have experienced trauma and suffered trauma-related psychopathology. This study examined screening data collected from 127 mothers receiving CW preventive services. There were high levels of trauma exposure among screened mothers and their young children. Among mothers, 91.6% experienced at least one traumatic event (M = 2.60) and 92.2% reported their children had been exposed to one or more traumas (M = 4.85). Mothers reported high levels of trauma-related symptoms: 54.3% met probable criteria for posttraumatic stress disorder (PTSD) or depression (61.7%). Nearly half (48.8%) met criteria for co-morbid PTSD and depression. The large majority of the clients with trauma-related disorders were not receiving mental health services. Latina women had significantly more severe PTSD symptoms than African American women. Case planners reported that the screening process was useful and feasible. These findings underscore the feasibility and importance of trauma screening among parents receiving CW preventive services.     

Parental role strains, salience of parental identity and gender differences in psychological distress.

Although past research indicates that women's higher levels of psychological distress can be accounted for by their greater exposure and vulnerability to role-related stress, the social psychological factors contributing to female vulnerability have not been fully identified. This paper applies identity theory to the phenomenon of gender differences in distress among parents. From an identity perspective, I propose that salience of the parental identity in women's self-conceptions contributes to their vulnerability to parental role strains. Using 1988 survey data from a stratified random sample of married and divorced Indianapolis residents (N = 448), I find that gender differences in distress are explained by differences in exposure to parental role strains. Further analyses reveal, however, that salience of the parental identity contributes to both men's and women's vulnerability to parental role strains. These findings underscore the utility of identity theory for explaining psychological distress among women and men.     

Sexual satisfaction, perceived availability of alternative partners, and marital quality in newlywed African American couples

The goal for this project was to examine the manner in which husbands' and wives' sexual satisfaction was related to their perceptions of the availability of alternative partners and overall marital quality. Participants were 470 newlywed African American couples residing in the southern region of the United States. Path analysis was used to simultaneously examine actor (individuals' sexual satisfaction on their own outcomes) and partner (individuals' sexual satisfaction on their partners' outcomes) effects. Wives' and husbands' sexual satisfaction was strongly and positively associated with their own reports of marital quality, although it was not associated with their partners' reports of marital quality. For both wives and husbands, higher sexual satisfaction was associated with lowered perceptions that they would be able to find other acceptable partners should their current relationship end. Perceived availability of alternative partners was, in turn, negatively associated with reports of marital quality.     

Gender, household labor, and psychological distress: the impact of the amount and division of housework.

Using a national longitudinal survey of a representative sample of 1,256 adults, I assess the impact of the amount of household labor performed and its division within the household on men's and women's depression levels, adjusting for prior mental health status. I test two alternative explanations of the contributions of household labor and the division of household labor to gender differences in depression: differential exposure and differential vulnerability. The results indicate that men's lower contributions to household labor explain part of the gender difference in depression. Inequity in the division of household labor has a greater impact on distress than does the amount of household labor. Employment status moderates the effect of the division of labor on depression. Among those who describe themselves as keeping house, depression was lowest for those who performed 79.8 percent of housework. In contrast, for those employed full-time the minimum level of depression occurs at 45.8 percent of the household labor. Men report performing 42.3 percent of the housework in their homes compared to 68.1 percent reported by women. Thus, on average women are performing household labor beyond the point of maximum psychological benefit, whereas men are not. Social support mediates the effects of the division of household labor. The only gender difference in effects occurred among those who are married, for whom social support was associated with lower levels of depression for women than men.