Psychological Distress, Depression, Anxiety, and Burnout among International Humanitarian Aid Workers: A Longitudinal Study

Uddin, Monica and Lopes Cardozo, Barbara and Gotway Crawford, Carol and Eriksson, Cynthia and Zhu, Julia and Sabin, Miriam and Ager, Alastair and Foy, David and Snider, Leslie and Scholte, Willem and Kaiser, Reinhard and Olff, Miranda and Rijnen, Bas and Simon, Winnifred (2012) Psychological Distress, Depression, Anxiety, and Burnout among International Humanitarian Aid Workers: A Longitudinal Study. PLoS ONE, 7 (9). e44948. ISSN 1932-6203

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Official URL: http://dx.doi.org/10.1371/journal.pone.0044948

Abstract

Background International humanitarian aid workers providing care in emergencies are subjected to numerous chronic and traumatic stressors. Objectives To examine consequences of such experiences on aid workers' mental health and how the impact is influenced by moderating variables. Methodology We conducted a longitudinal study in a sample of international non-governmental organizations. Study outcomes included anxiety, depression, burnout, and life and job satisfaction. We performed bivariate regression analyses at three time points. We fitted generalized estimating equation multivariable regression models for the longitudinal analyses. Results Study participants from 19 NGOs were assessed at three time points: 212 participated at pre-deployment; 169 (80%) post-deployment; and 154 (73%) within 3–6 months after deployment. Prior to deployment, 12 (3.8%) participants reported anxiety symptoms, compared to 20 (11.8%) at post-deployment (p = 0·0027); 22 (10.4%) reported depression symptoms, compared to 33 (19.5%) at post-deployment (p = 0·0117) and 31 (20.1%) at follow-up (p = .00083). History of mental illness (adjusted odds ratio [AOR] 4.2; 95% confidence interval [CI] 1·45–12·50) contributed to an increased risk for anxiety. The experience of extraordinary stress was a contributor to increased risk for burnout depersonalization (AOR 1.5; 95% CI 1.17–1.83). Higher levels of chronic stress exposure during deployment were contributors to an increased risk for depression (AOR 1·1; 95% CI 1·02–1.20) comparing post- versus pre-deployment, and increased risk for burnout emotional exhaustion (AOR 1.1; 95% CI 1.04–1.19). Social support was associated with lower levels of depression (AOR 0·9; 95% CI 0·84–0·95), psychological distress (AOR = 0.9; [CI] 0.85–0.97), burnout lack of personal accomplishment (AOR 0·95; 95% CI 0·91–0·98), and greater life satisfaction (p = 0.0213). Conclusions When recruiting and preparing aid workers for deployment, organizations should consider history of mental illness and take steps to decrease chronic stressors, and strengthen social support networks.

Item Type: Article
Divisions: School of Health Sciences > The Institute for Global Health and Development
Date Deposited: 10 Dec 2015 12:14
Last Modified: 02 Feb 2017 15:44
URI: http://eresearch.qmu.ac.uk/id/eprint/4233

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