Psychological Distress, Depression, Anxiety, and Burnout among International Humanitarian Aid Workers: A Longitudinal Study
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Date
2012Author
Uddin, Monica
Lopes Cardozo, Barbara
Gotway Crawford, Carol
Eriksson, Cynthia
Zhu, Julia
Sabin, Miriam
Ager, Alastair
Foy, David
Snider, Leslie
Scholte, Willem
Kaiser, Reinhard
Olff, Miranda
Rijnen, Bas
Simon, Winnifred
Metadata
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Uddin, M., Lopes Cardozo, B., Gotway Crawford, C., Eriksson, C., Zhu, J., Sabin, M., Ager, A., Foy, D., Snider, L., Scholte, W., Kaiser, R., Olff, M., Rijnen, B. & Simon, W. (2012) Psychological Distress, Depression, Anxiety, and Burnout among International Humanitarian Aid Workers: A Longitudinal Study, PLoS ONE, vol. 7, , pp. e44948,
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-_=-_00027); 22 (10.4%) reported depression symptoms, compared to 33 (19.5%) at post-deployment (p-_=-_00117) and 31 (20.1%) at follow-up (p-_=-_.00083). History of mental illness (adjusted odds ratio [AOR] 4.2; 95% confidence interval [CI] 145-1250) 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 11; 95% CI 102-1.20) 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 09; 95% CI 084-095), psychological distress (AOR-_=-_0.9; [CI] 0.85-0.97), burnout lack of personal accomplishment (AOR 095; 95% CI 091-098), 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.