A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study

Background Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions. Methods/design We plan to consecutively recruit N = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7 < 7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey. Discussion The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation. Trial registration German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.

Developing a School-Based Risk and Resilience Network to Implement the Youth Aware of Mental Health (YAM) Program with Texas Adolescents

BackgroundDespite the school setting presenting an ideal place to address youth depression and suicide prevention, there continues to be a need for innovative and effective school-based mental health interventions. MethodsThe University of Texas Southwestern Medical Center’s Center for Depression Research and Clinical Care developed a collaborative school-based prevention effort, the Risk and Resilience Network (RRN), to develop and test approaches to aid in enhancing resiliency factors, prevention of depression and suicide, and improve early identification and care linkage for youth with depression and/or suicidality. The aims of RRN were: 1) to build collaborative partnerships with schools and youth-focused community organizations to study risk and resilience in youth, and 2) in collaboration with school partners and youth-focused community organizations, to engage school stakeholders and families in developing and testing innovative strategies for addressing depression and suicide prevention in schools. To engage schools in the RRN, a cornerstone, evidenced-based program was selected (Youth Aware of Mental Health, YAM, program) to offer to schools as part of an implementation project. This report uses the RE-AIM framework to describe the rationale, design, implementation process, and YAM program evaluation results from the initial years of a school-based network focused on depression and suicide prevention.ResultsDescriptive data are presented, using the RE-AIM framework, on the first three academic years of the RRN and YAM program partnerships (2016-2017, 2017-2018, and 2018-2019), which included 24 RRN partnerships. Eleven (73.3%) out of the 15 school systems who agreed to RRN partnerships agreed to implement the YAM program, resulting in 14,061 students who participated in YAM.ConclusionsThe RRN is a collaborative school-based prevention effort to develop and test approaches to aid in enhancing resiliency factors, preventing of depression and suicide, and improving early identification and care linkage for youth with depression and/or suicidality. Trial Registration: Not applicable

Trends in Moral Injury, Distress, and Resilience Factors among Healthcare Workers at the Beginning of the COVID-19 Pandemic

The coronavirus severe acute respiratory syndrome (COVID-19) pandemic has placed increased stress on healthcare workers (HCWs). While anxiety and post-traumatic stress have been evaluated in HCWs during previous pandemics, moral injury, a construct historically evaluated in military populations, has not. We hypothesized that the experience of moral injury and psychiatric distress among HCWs would increase over time during the pandemic and vary with resiliency factors. From a convenience sample, we performed an email-based, longitudinal survey of HCWs at a tertiary care hospital between March and July 2020. Surveys measured occupational and resilience factors and psychiatric distress and moral injury, assessed by the Impact of Events Scale-Revised and the Moral Injury Events Scale, respectively. Responses were assessed at baseline, 1-month, and 3-month time points. Moral injury remained stable over three months, while distress declined. A supportive workplace environment was related to lower moral injury whereas a stressful, less supportive environment was associated with increased moral injury. Distress was not affected by any baseline occupational or resiliency factors, though poor sleep at baseline predicted more distress. Overall, our data suggest that attention to improving workplace support and lowering workplace stress may protect HCWs from adverse emotional outcomes.

Compassion Fatigue and Resiliency Factors in Animal Shelter Workers

This phenomenological study explored compassion fatigue and resiliency factors in animal shelter workers. Compassion fatigue is a phenomenon in which individuals become traumatized through the process of helping others. The sample included seven current and former animal shelter workers. The researchers conducted semi-structured interviews to examine general experiences with animal shelter work as well as compassion fatigue. The researchers read the transcripts multiple times and coded the data into themes and sub-themes. Four major themes and five sub-themes emerged from the data. These themes were 1) Intrinsic Motivations including (a) Right reason, (b) Affinity with animals and (c) Attachment to animals; 2) Purpose, including (a) Making a difference and (b) Focusing on the positive; 3) Social supports; and 4) Coping Strategies. The study has important practical implications, including the potential benefits of screening job applicants for intrinsic motivations and fostering positive relationships between coworkers and the animals they work with.