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Objectives: Policing is generally considered a high-risk profession for the development of mental health problems, but this assumption lacks empirical evidence. Research question of the present study is to what extent mental health disturbances, such as (very) severe symptoms of anxiety, depression and hostility are more prevalent among police officers than among other occupational groups. Design: Multicomparative cross-sectional study using the data of several cross-sectional and longitudinal studies in the Netherlands. Participants: Two samples of police officers (N=144 and 503), employees of banks (N=1113) and employees of banks who were robbed (N=144); employees of supermarkets (N=335), and a psychiatric hospital (N=219), employees of a governmental social welfare organisation (N=76), employees who followed a training based on rational-motive therapy to strengthen their assertiveness (N=710), soldiers before deployment (N=278) and before redeployment (N=236) and firefighters (N=123). The numbers refer to respondents with complete data. Primary outcomes: Prevalence of severe (subclinical level) and very severe symptoms (clinical level) were computed using the Dutch norm tables (80th percentile and 95th percentile, respectively) of the Symptom Check List Revised (SCL-90-R). All comparisons were controlled for age, gender and education. Results: Multivariate logistic regression and analyses showed that the prevalence of clinical and subclinical levels of symptoms of anxiety, depression and hostility among police officers were not significantly higher than among comparison groups. The same pattern was found for the other SCL-90-R subscales. Conclusions: We found no indications that self-reported mental health disturbances were more prevalent among police officers than among groups of employees that are not considered high-risk groups, such as employees of banks, supermarkets, psychiatric hospital and soldiers before deployment. [ABSTRACT FROM AUTHOR]

Background: Most studies examining medically unexplained symptoms (MUS) have been performed in primary or secondary care and have examined symptoms for which patients sought medical attention. Disasters are often described as precipitating factors for MUS. However, health consequences of disasters are typically measured by means of questionnaires, and it is not known whether these self-reported physical symptoms are presented to the GP. It is also not known if the self-reported symptoms are related to a medical disorder or if they remain medically unexplained. In the present study, three research questions were addressed. Firstly, were self-reported symptoms among survivors presented to the GP? Secondly, were the symptoms presented to the GP associated with a high level of functional impairment and distress? Thirdly, what was the GP's clinical judgment of the presented symptoms, i.e. were the symptoms related to a medical diagnosis or could they be labeled MUS? Methods: Survivors of a man-made disaster (N = 887) completed a questionnaire 3 weeks (T1) and 18 months (T2) post-disaster. This longitudinal health survey was combined with an ongoing surveillance program of health problems registered by GPs. Results: The majority of self-reported symptoms was not presented to the GP and survivors were most likely to present persistent symptoms to the GP. For example, survivors with stomachache at both T1 and T2 were more likely to report stomachache to their GP (28%) than survivors with stomachache at only T1 (6%) or only T2 (13%). Presentation of individual symptoms to the GP was not consistently associated with functional impairment and distress. 56 - 91% of symptoms were labeled as MUS after clinical examination. Conclusion: These results indicate that the majority of self-reported symptoms among survivors of a disaster are not presented to the GP and that the decision to consult with a GP for an individual symptom is not dependent on the level of impairment and distress. Also, self-reported physical symptoms such as headache, back pain and shortness of breath are likely to remain medically unexplained after the clinical judgment of a GP. [ABSTRACT FROM AUTHOR]

The Big Five personality factors (PF) are considered to be predictive of mental health problems, but it is unclear if these factors equally contributed to mental health problems during the COVID-19 pandemic compared to before the pandemic. This prospective study aimed to fill this knowledge gap. For this purpose data was extracted from the population-based LISS-panel. We included adult respondents (N males = 1,838, N females = 1892) who participated in three surveys before the pandemic (T1 March-2019 , T2 May-2019 , T3 November-2019 ) and in three surveys during the pandemic in 2020 (T4 March-2020 , T5 May-2020 , T6 november-2020 ). Multivariate logistic regression analyses were used to examine and compare the longitudinal associations between PF at T2 May-2019 and moderate-severe anxiety and depressions symptoms (ADS) at T3 November-2019 , and longitudinal associations between PF at T5 May-2020 and ADS at T5 November-2020 among males and females. Control variables (pre-existing ADS, lack support, demographics) were retrieved from the T1 March-2019 and T4 March-2020 surveys, respectively. For the present study we distinguished five levels (very high to very low) of each PF. For both sexes, those with (very) low emotional stability and/or conscientiousness had considerably higher rates of ADS compared to those with very high levels of the same trait. These findings were similar both before and during the pandemic. Moreover, we found no indications that those with a certain level of a PF during the pandemic were more of less at risk for ADS or persistent ADS, than those with the same level of the same PF before the pandemic. Thus, we found no indications that the pandemic affected the impact of personality factors on moderate-severe anxiety and depressions symptoms., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Victims of violence, accidents and threats are at risk for mental health problems. Lower coping self-efficacy and social support levels increase this risk. Although highly relevant, it is unknown if the coronavirus disease 2019 (COVID-19) pandemic amplifies these risks., Aims: To examine if the prevalence, incidence and/or mean scores for post-traumatic stress disorder (PTSD), anxiety and depression symptoms, general mental health problems, coping self-efficacy, lack of emotional support and social acknowledgement are higher among adults victimised in the year after the COVID-19 outbreak compared with adults victimised in a similar period before the outbreak. Also, to compare symptoms, problems and support within non-victims during the same period., Method: Data was extracted from four surveys of the VICTIMS study (March 2018, 2019, 2020, 2021), based on a random sample of the Dutch population. Multivariate logistic regression analyses and mixed-effects models were used to examine differences between the two victim groups (2019: n = 421, 2021: n = 319) and non-victims (n = 3245)., Results: Adults victimised after the outbreak more often had PTSD, anxiety and depression symptoms, general mental health problems and lower coping self-efficacy than those victimised before. They did not differ in lack of support and acknowledgement. Both victim groups differed from non-victims, where mental health problems and lack of support levels were much lower and almost stable., Conclusions: The COVID-19 pandemic had a negative impact on the mental health and coping self-efficacy levels of victims, whereas mental health problems among non-victims remained virtually stable. Mental healthcare workers, general practitioners and victim services should take this impact into account.

Objective: Findings on the relationship between social support and mental health problems after potentially traumatic events vary across studies. Aim of our longitudinal study is to assess to what extent initial postdisaster mental health, somatic, and social functioning problems affect social support 1.5 years later. This is relevant for the discussion about social causation versus social selection processes., Method: Data from Time 1 (T1; 2 to 3 weeks postevent) and Time 2 (T2; 1.5 years postevent) from the Dutch longitudinal Enschede Fireworks Disaster Study were extracted ( N = 781). Latent profile analysis (LPA) was used to identify classes of (mental) health and social problems at T1 among disaster affected adult residents, using anxiety, depressive and PTSD symptoms, and somatic and social functioning problems as indicators. Relationships between classes at T1 and lack of social support at T2 were assessed using analyses of covariance (ANCOVAs)., Results: LPA identified the following seven classes: very resilient (10.6%), resilient (7.2%), minor problems (16.1%), elevated problems (28.8%), subclinical problems (20.5%), clinical problems (13.9%), and severe clinical problems (2.9%). In general, classes with subclinical to severe clinical levels at T1 showed higher lack of everyday, emotional, esteem, instrumental, companionship, and informative support at T2 while controlling for demographics and disaster experiences., Conclusions: Affected adults who belong to the subclinical to severe clinical classes in the first weeks suffered more often from a lack of social support 1.5 years postevent than did others. Mental health policies should target the risk of lack of social support among these groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Aims: Victims of violence, accidents, theft, and serious threat (hereafter abbreviated as victims) are more than nonvictims at risk for problems in different domains, varying from mental health to legal problems. However, the extent to which victims with these problems compared to nonvictims with similar problems receive problem-related professional or formal help is unclear. It is unknown if predictors of unmet needs differ between victims and nonvictims. Aim of the present study is to fill this gap of knowledge., Methods: Data was extracted from surveys of the VICTIMS-study (2018, 2019 and 2020), conducted with the Dutch population-based longitudinal LISS panel. Each survey assessed 1.) experiences with physical violence, accidents, theft, and serious threat and other traumatic or stressful events in the past 12 months and 2.) various problems and use of professional help, e.g. do receive help, do not need help, could use help but do not use it, cannot find or afford help for these problems. Multivariate logistic regression analyses were performed to assess differences in problems, in the use of problem-related professional help, and in predictors of unmet needs between victims (N = 1,756) and nonvictims (N = 5,000)., Results: Victims more often had assessed problems than nonvictims. Victims compared to nonvictims with similar problems had 1.5 to 2 times more often unmet needs: they could not find or afford professional help for their mental, physical, partner/family, financial and legal problems. In addition, victims less often received help for legal and administrative problems. Most predictors of unmet needs, e.g. could use help but do not use it, cannot find or afford help, were not significant and hardly differed between both groups., Conclusions: The findings that victims compared to nonvictims more often have various problems and more often cannot find or afford problem-related professional help, suggest that there is room for improvement for victims services., Competing Interests: The authors have declared that no competing interests exist.

We aimed to obtain reliable reference charts for sleep duration, estimate the prevalence of sleep complaints across the lifespan and identify risk indicators of poor sleep. Studies were identified through systematic literature search in Embase, Medline and Web of Science (9 August 2019) and through personal contacts. Eligible studies had to be published between 2000 and 2017 with data on sleep assessed with questionnaires including ≥100 participants from the general population. We assembled individual participant data from 200,358 people (aged 1-100 years, 55% female) from 36 studies from the Netherlands, 471,759 people (40-69 years, 55.5% female) from the United Kingdom and 409,617 people (≥18 years, 55.8% female) from the United States. One in four people slept less than age-specific recommendations, but only 5.8% slept outside of the 'acceptable' sleep duration. Among teenagers, 51.5% reported total sleep times (TST) of less than the recommended 8-10 h and 18% report daytime sleepiness. In adults (≥18 years), poor sleep quality (13.3%) and insomnia symptoms (9.6-19.4%) were more prevalent than short sleep duration (6.5% with TST < 6 h). Insomnia symptoms were most frequent in people spending ≥9 h in bed, whereas poor sleep quality was more frequent in those spending <6 h in bed. TST was similar across countries, but insomnia symptoms were 1.5-2.9 times higher in the United States. Women (≥41 years) reported sleeping shorter times or slightly less efficiently than men, whereas with actigraphy they were estimated to sleep longer and more efficiently than man. This study provides age- and sex-specific population reference charts for sleep duration and efficiency which can help guide personalized advice on sleep length and preventive practices.

Background: The effects of the COVID-19 pandemic on the mental health and emotional support among the general population are unclear. We therefore assessed if the prevalence of high Anxiety and Depression Symptoms (ADS) levels and lack of Emotional Support (ES) increased, and if risk factors of ADS and ES changed., Methods: Data was extracted from surveys conducted with the Dutch longitudinal population-based LISS panel (N = 3,983). ADS and ES were assessed in March 2019 and 2020. Risk factors for ADS and ES were extracted from surveys in November 2018 and 2019. These were: ADS, gender, education, domestic situation, employment, age, ethnicity, lung and heart problems, and diabetes., Results: The prevalence of high ADS levels and lack of ES did not increase compared to the pre-outbreak prevalence. ADS, non-native ethnic background, (partial) work disabilities and lung problems were predictive of both ADS and lack of ES in March 2019 and 2020. Job seekers, students and those who take care of housekeeping were more at risk for ADS in March 2020, but not in 2019. While 35-49 years old respondents were less at risk for ADS in March 2019, they were more at risk in 2020. Parents with child(ren) at home and those who take care of housekeeping more often lacked ES in March 2020, but not in 2019., Limitations: No other mental health problems were assessed., Conclusions: No increase in the prevalence of ADS and lack of ES was found. Some risk factors remained significant after the outbreak, while others changed notably., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Our knowledge about the effects of perceived emotional support on PTSD, anxiety and depressive symptoms after serious threat and violence is primarily based on post-event studies. Very little is known about the extent to which (1) victims lacking pre-event emotional support are more at risk of post-event symptoms and lack of post-event support than victims with pre-event emotional support, and (2) victims with pre-event emotional support and victims lacking emotional support are more at risk of post-event anxiety and depressive symptoms than nonvictims with similar pre-event support levels. For this purpose, we conducted a 2-wave prospective study (VICTIMS) using the Dutch population-based longitudinal LISS panel. Multivariate logistic regression analyses were conducted, controlling for pre-event demographics, symptoms, and physical, work-related and financial problems. As hypothesized, victims (N victims total = 187) lacking pre-event support more often had high post-event PTSD, anxiety and depressive symptoms than victims with pre-event support. No significant differences were found between victims and nonvictims with pre-event emotional support (N nonvictims total = 2,828, not exposed to any event). Since victims and nonvictims with pre-event support did not differ in post-event symptoms and support, the findings offer strong evidence for the buffering hypothesis of emotional support., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Military personnel are exposed to severe stressors across different stages of their career that may have a negative impact on mental health and functioning. It is often suggested that psychological resilience plays an important role in the maintenance and/or enhancement of their mental health and functioning under these circumstances., Method: A systematic literature search was conducted using PsycINFO, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, Web of Science, and PubMed up to August of 2019 retrieving 3,698 reports. Schmidt and Hunter meta-analytical techniques were used to assess the predictive value of psychological resilience on ten different military relevant mental health and functioning outcomes. Multivariate meta-analysis assessed the origin of heterogeneity among bivariate effect sizes., Results: The effect sizes of 40 eligible peer-reviewed papers covering 40 unique samples were included in the meta-analysis. Seventy-eight percent of these studies were published after 2010 and were predominantly conducted in western countries. Bivariate effect sizes were low to medium (absolute values: 0.08 to 0.36) and multivariate effect sizes, adjusting for across studies varying sets of covariates, were low to trivial (absolute values: 0.02 to 0.08). Moderator analyses using multivariate meta-analysis on 60 bivariate effect sizes, revealed no significant effect of type of psychological resilience scale, time-lag, and career stage., Conclusions: The current review found no indications that different conceptualizations of psychological resilience across a variety of research designs, are strongly predictive of mental health and functioning among military personnel. Future directions (moderator/mediator models, stressor type specifications, and directionality) for prospective studies are discussed. Our results question the usefulness of interventions to enhance the resilience of soldiers to improve their mental health and functioning., (Copyright © 2020. Published by Elsevier Ltd.)

The aim of the study reported here was to assess whether the prevalence of mental health problems (MHP) among Dutch 19-24 year old adults increased in the past decade and/or whether the distribution of latent profiles of mental health problems changed over the years. For this purpose, data was extracted from the LISS panel, based on a representative national sample of the Dutch population. We focused on three exclusive groups who were 19-24 years old in 2007 (n = 383), 2012 (n = 351) or 2017 (n = 362). Multivariate logistic regression analyses showed that the 2012 and 2017 group did not have more MHP according to seven mental health-related indicators including mental health services utilization. Latent profile analysis identified 4 classes of MHP profiles, labeled "healthy" (82.2%), "at risk" (9.6%), "clinical" (4.2%) and "treatment" (3.9%). The 2007, 2012 and 2017 cohorts were equally distributed across these four classes. However, females had systematically more health problems than males and more often belonged to the "at risk", "clinical" and "treatment" class. In sum, our findings do not support concerns about an increase in MHP or that problems have become more complex among Dutch young adults over the past decade., (Copyright © 2019 Elsevier B.V. All rights reserved.)

A specific type of social support after potentially traumatic events is called "social recognition". It is the acknowledgement or validation of event-related thoughts, behavior, and feelings by the individual or others. It consists of positive individual or societal reactions that recognize and acknowledge victims' traumatic experiences and difficulties. Current studies suggest that social recognition protects against the development of PTSD symptomatology, but there is a lack of population-based studies assessing the longitudinal interplay between PTSD symptomatology and social recognition. For this purpose, we conducted a longitudinal study using the Dutch LISS panel, based on a random sample of the Dutch population. Structural equation modeling showed that among recently affected adults (0-2 months ago), those with relatively higher levels of social recognition had lower levels of PTSD symptomatology 6 months later. Victims with high levels of PTSD symptomatology at baseline received less social recognition 6 months later. On the intermediate term (affected 5-12 months ago), baseline social recognition was no longer predictive of PTSD symptoms 6 months later, in contrast to PTSD symptomatology predicting lack of social recognition. In sum, PTSD symptom levels eroded social recognition on the short and intermediate term, while the protective role of social recognition was limited to the short term., (Copyright © 2019 Elsevier B.V. All rights reserved.)

In the original article, Tables 2 and 3 have published with incorrect alignment. The correct tables are given below. The original article was corrected.

Objective: The aim of this study was to examine the effects of potentially traumatic events (PTEs), posttraumatic stress symptoms (PTSS), and coping self-efficacy (CSE) on post-event job satisfaction., Methods: Repeated analysis of variance (ANOVA) was used to assess differences in the course of job satisfaction during 1 year between population-based samples of affected and nonaffected workers. Multivariate regression analyses were conducted with pre-event health, job satisfaction and insecurity, and postevent PTSS and CSE as predictors., Results: About 16% of the affected workers had probable PTSD. The course of job satisfaction between affected (n = 123) and nonaffected workers (n = 644) did not differ significantly. PTSS and CSE did not independently predict post-event satisfaction, in contrast to pre-event job satisfaction., Conclusion: Findings suggest that when needed social support is provided, concerns about the negative effects of potentially traumatic events on job satisfaction could be somewhat relaxed.

Psychological resilience is considered an important predictor for mental health disturbances among rescue workers. To what extent resilience predicts mental health disturbances among police officers at different stages while adjusting for existing (mental) health disturbances is unclear. Among 566 police officers resilience was operationalized by the Resilience Scale-nl and the Mental Toughness Questionnaire-48 questionnaires (8 scales in total). Mental health disturbances (such as depression symptoms and PTSD) and other health-related variables were assessed at baseline and follow-ups at three and nine months. Hierarchical logistic regression analyses assessed the predictive values of the 8 resilience scales for mental health disturbances at baseline (n = 566), three months (n = 566) and nine months (n = 364), adjusted for demographics, work circumstances, and health-related factors at baseline. Seven of the eight resilience scales at baseline were cross sectional associated with mental health disturbances at baseline. Only four scales were independent predictors for mental health disturbances at three months. When examining mental health disturbances at nine months, only one resilience scale remained a significant predictor. In sum, psychological resilience has a declining protective capacity for mental health disturbances over a medium time-span, specifically when corrected for baseline mental health disturbances., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Purpose: Examine to what extent adults affected by recent potentially traumatic events (PTE) with different PTSD-symptom levels are more at risk for post-event loneliness than non-affected adults are in the same study period., Methods: We extracted data from the Dutch longitudinal LISS panel to measure pre-event loneliness (2011) and post-event loneliness (2013 and 2014), pre-event mental health problems (2011), PTE and PTSD symptoms (2012). This panel is based on a traditional random sample drawn from the population register by Statistics Netherlands., Results: Results of the multinomial logistic regression analyses showed that affected adults with high levels of PTSD symptoms were more at risk for high levels of post-event loneliness than affected adults with very low PTSD-symptom levels and non-affected adults, while controlling for pre-event loneliness, pre-event mental health problems and demographics. However, affected adults with very low levels of PTSD symptoms compared to non-affected adults were less at risk for medium and high levels of post-event loneliness while controlling for the same variables. Yet, pre-event loneliness appeared to be the strongest independent predictor of loneliness at later stages: more than 80% with high pre-event levels had high post-event levels at both follow-ups., Conclusions: Remarkably, potentially traumatic events have depending on PTSD-symptom levels both negative and positive effects on post-event loneliness in favor of affected adults with very low PTSD symptoms levels. However, post-event levels at later stages are predominantly determined by pre-event loneliness levels.

Rationale: Trauma-related coping self-efficacy (CSE) - in brief, the perceived ability to cope with the aftermath of a traumatic event - has been shown to affect psychological outcomes. A previous study showed that CSE affects subsequent PTSS levels, but not vice versa among a sample exposed 0-6 months ago., Objective: In this four-wave follow-up study we examined the cross-lagged relationships between CSE and posttraumatic stress symptoms (PTSS) among those exposed to PTEs (potentially traumatic events) 1-2 years before T1 in order to examine direction of influence. Research questions were: 1) what are the cross-lagged associations between CSE and PTSS levels among those exposed to PTE in the relatively long-term (1-2 years ago, called PTE long-term group), and 2) to what extent do these associations differ from the cross lagged associations among those exposed to PTE in the relatively short-term (0-6 months ago)?, Method: Study samples consist of adult respondents of a representative internet panel who experienced a PTE between 1 and 2 years before T1, and did not experience any new PTE between T1 and T3 (long-term group, N = 438) and those exposed in the six months before T1, and not exposed to any additional PTE (short-term group, N = 400). Levels of CSE and PTSS were measured with 4-month intervals. In addition, prospectively assessed personality traits and peritraumatic distress were entered in the analyses., Results: Structural equation modeling showed that CSE perceptions will continue to influence subsequent PTSS levels in the long-term, just as they did in the short-term. Contrary to the more short-term post-exposure period however, CSE levels do not just influence recovery from PTSS. Over time, degree of PTSS experienced also influences subsequent CSE perceptions., Conclusion: Results suggest that while trauma-related CSE perceptions are relatively robust in the short-term recovery period, they can be affected by posttraumatic stress in the long-term., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

It is unknown to what extent classes of trajectories of pre-event mental health problems (MHP) and health-related disabilities (HRD), predict post-event traumatic stress symptoms (PTSS), MHP and HRD. Aim of the present 7-wave study was to assess the predictive values using a representative sample of adult Dutch (N=4052) participating in three health-surveys in November-December 2009 (T1), 2010 (T2), 2011 (T3). In total, 2988 out of 4052 also participated in trauma-surveys in April(T4), August(T5) and December(T6) 2012 and a fourth health-survey in November-December 2012 (T7). About 10% (N=314) was confronted with potentially traumatic events (PTE) in the 4 months before T4 or T5. Latent class analyses among 4052 respondents identified four classes of pre-event MHP and HRD. Series of multivariate logistic regression analyses with class membership, peri-traumatic stress, type of event, gender, age and education as predictors, showed that classes with high levels of MHP or HRD, were more at risk for high levels of PTSS at baseline and follow-ups at 4 and 8 months, than classes with low levels of MHP or HRD. These classes were very strong predictors for high levels of post-event MHP and HRD: no differences were found between non-affected and affected respondents with different levels of peri-traumatic stress., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Objective: To assess and compare the (independent) predictive value of trauma-related coping self-efficacy (CSE) for posttraumatic stress symptoms (PTSS) among a treatment sample and a comparison group of nontreatment seeking victims., Method: Both the treatment (N = 54) and comparison group (N = 144) were exposed to potentially traumatic events (PTEs), experienced a heightened level of PTSS (IES > = 19), and were matched on work status and time between PTE and first measurement (T1). Respondents completed both baseline (T1) and follow-up measures (T2) approximately 8 months after T1., Results: Multiple regression analyses among the treatment sample showed that neither PTSS at T1 (start of treatment) nor CSE levels at T1 predicted PTSS at T2 among the treatment group. Among the comparison group, higher CSE levels at T1 and younger age were significantly associated with lower PTSS at T2. In both the treatment group and the comparison group PTSS levels were significantly lower at T2 than at T1. As expected, treatment seeking victims have higher PTSS and lower CSE levels than nontreatment seeking victims., Conclusions: Pretreatment CSE did not affect recovery during treatment: higher pretreatment CSE perceptions do not give treated individuals an advantage while CSE is predictive of PTSS among untreated victims., ((c) 2016 APA, all rights reserved).)

Aim: To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed the prevalences among this group, little is known about predictors, to what extent PTE's are WPV-related and their abilities to prevent escalations., Design: A longitudinal study with a 6 months' time interval ( N  =   103)., Methods: At T1 demographics, workplace violence and potentially traumatic events in the past year, mental health, personality, handling of rules, coping and social organizational stressors were assessed. Confrontations with aggression were also examined at T2., Results: Multivariate logistic regression analyses showed that only problems with superiors independently predicted repeated verbal aggression and that only the (absence of the) ability to compromise very easily predicted repeatedly being on guard and repeatedly confronted with any form of aggression. Due to very low prevalences, we could not examine predictors of repeated confrontations with physical aggression ( N  =   5) and serious threat ( N  =   7). A large majority reported that in most workplace violence cases they could prevent further escalations. About 2% reported a potentially traumatic event in the year before T1 that was WPV related and perceived as very stressful.

Trauma-related coping self-efficacy (CSE), the perceived capability to manage one's personal functioning and the myriad environmental demands of the aftermath of potentially traumatic events (PTE), has been shown to affect psychological outcomes after these events. Aim of the present four-wave study was to examine the cross-lagged relationships between CSE and posttraumatic stress disorder (PTSD) symptoms following PTEs in order to examine direction of influence. Levels of CSE and PTSD symptoms were measured with 4-month intervals. In addition, prospectively assessed personality traits and general self-efficacy perceptions as well as peritraumatic distress were entered in the analyses. The study sample consists of adult respondents of a representative internet panel who experienced PTE in the six months before T1, and did not experience any new PTE or life event between T1 and T3 (N = 400). Respondents were administered the coping self-efficacy scale (CSE-7), impact of event scale (IES) and arousal items of IES-R at each wave (T1 through T3), as well as questions on peritraumatic stress and prospectively measured personality traits (T0). Results of structural equation modeling showed that the effect of CSE on subsequent PTSD symptom levels was dominant. CSE significantly predicted subsequent symptoms, over and above earlier symptom levels, with higher CSE associated with lower PTSD. Symptoms in turn, did not predict subsequent levels of CSE. Higher peritraumatic distress was associated with both higher initial PTSD symptoms and lower initial CSE levels. Higher levels of the personality traits of emotional stability and agreeableness were associated with higher initial CSE levels. This supports a model in which CSE perceptions play an important role in recovery from trauma., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Social organizational stressors are well-known predictors of mental health disturbances (MHD). However, to what extent these stressors predict post-disaster MHD among employed victims hardly received scientific attention and is clearly understudied. For this purpose we examined to what extent these stressors independently predict MHD 1.5 years post-disaster over and above well-known risk factors such as disaster exposure, initial MHD and lack of general social support, life-events in the past 12 months and demographics (N=423). Exposure, social organizational stressors and support were significantly associated with almost all examined mental health disturbances on a bi-variate level. Multivariate logistic regression analyses showed that these stressors, i.e. problems with colleagues, independently predicted anxiety (Adj. OR=5.93), depression (Adj. OR=4.21), hostility (Adj. OR=2.85) and having two or more mental health disturbances (Adj. OR=3.39) in contrast to disaster exposure. Disaster exposure independently predicted symptoms of PTSD symptoms (Adj. OR=2.47) and agoraphobia (Adj. OR=2.15) in contrast to social organizational stressors. Importantly, levels of disaster exposure were not associated nor correlated with (levels of) social organizational stressors. Findings suggest that post-disaster mental health care programs aimed at employed affected residents, should target social organizational stressors besides disaster-related stressors and lack of general social support., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Objective: To examine the effects of the mass shooting in the city of Alphen aan den Rijn, the Netherlands, on 9 April 2011 on the health and healthcare utilisation of those affected, compared with a reference group of neighbouring residents., Design: Observational longitudinal study., Method: Those affected by the shooting incident and a reference group of neighbouring residents were identified using patient and health care data from various care providers (Dutch Victim Support (SHN), Dutch Association of Mental Health and Addiction Care, social work), in which the request for assistance was documented. The health and healthcare process of 161 affected persons and 115 local residents in the year before and the year after the mass shooting could be followed with data extracted from the electronic medical records of general practices. The effects of the mass shooting on health and healthcare utilisation were analysed with logistic and Poisson multilevel regression analyses for repeated measurements., Results: After the mass shooting, the prevalence of psychological and social problems presented to the GP increased for affected persons (OR: 2.99; 95% CI: 1.75-5.12) compared with the year before the shooting incident, and differed from the reference group (OR: 2.68; 95% CI: 0.93-7.72). In particular, there was a sharp increase in the prevalence of anxiety and stress reactions (OR: 4.07; 95% CI: 1.86-8.92) and the prescription of hypnotics and sedatives (OR: 2.32; 95% CI: 1.08-4.98) and benzodiazepines (OR: 187; 95% CI: 1.07-3.26). However, these problems declined significantly after the first quarter. A small group of people was treated by mental health care for a post-traumatic stress disorder while half of those affected had registered with SHN., Conclusion: For a limited period of time, the mass shooting had a negative impact on the psychological well-being and healthcare utilisation of those affected.

Search and rescue workers play an important role in rescuing trapped disaster victims. However, it is unclear whether they are at risk for post-disaster mental health problems. For this purpose we prospectively examined pre- and post-deployment health among Dutch search and rescue workers (USAR NL) deployed in the devastating Haiti earthquake disaster (2010). The evening before departure (T1, response=100%) and 3 months post-deployment (T2, response=91%), Search and rescue workers were administered standardized questionnaires assessing health (SCL-90-R, RAND-36), including use of substances and mental health services utilization (N=51). At T2 event-related PTSD-symptoms (IES) and coping self-efficacy (CSE), and experiences during and after deployment were examined. At both surveys health problems were almost absent and no significant increases in health problems and use of substances were found. PTSD-symptomatology was very low and coping self-efficacy rather high. Protective factors such as good team functioning, recognition and job satisfaction were clearly present, while risk factors such as sustained injuries or death of a co-worker were absent. Findings suggest that post-disaster health problems may (partly) be prevented by enhancing or restoring protective factors., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: A serious life event is likely to shape attributions relating to symptoms experienced afterwards. While they may play an important role in prognosis and seeking care, such perceptions have hardly been studied among survivors of a disaster., Objective: To investigate the association between self-reported health problems that have been attributed to an extreme life event and the symptoms presented to GPs., Methods: A two-wave longitudinal survey (2-3 weeks and 18 months) among survivors of a fireworks disaster was combined with a continuous morbidity surveillance in general practice. Symptoms attributed to the disaster reported in an open-ended question in the two waves were analysed using descriptive statistics. Differences in presented symptoms over time were analysed using logistic multilevel analysis., Results: More than half of the respondents reported health problems, which were, in their opinion, related to the disaster. Psychological problems were most frequently reported in association with the disaster, and in contrast to physical attributed symptoms, presentation of these problems in general practice decreased over time. In the total sample, musculoskeletal symptoms were less frequently presented in the longer term. Survivors who attributed symptoms to the disaster at both waves or after 18 months only most often presented such symptoms to the GP., Conclusion: Survivors attributed psychological problems and physical symptoms to the disaster at short-term and midterm post-disaster. Most of these survivors presented such symptoms to the GP. Attribution of symptoms to an extreme life event such as a disaster may therefore require special attention from the GP.

Background: Medically unexplained symptoms (MUS) are a common reason to seek medical care. When presented to the general practitioner (GP), more than three-quarters of symptoms such as stomach ache, headache, and pain in bones and muscles cannot be explained by a medical disorder., Objective: The authors examined the course of MUS presented to the GP in the 1 year before the disaster and in the 4 years after a disaster in order to study the risk factors for MUS., Method: Data were extracted from the electronic medical records of survivors and from a questionnaire (N=1,216)., Results: Although the mean number of MUS was significantly increased statistically in the first 2 years post-disaster, the increase was not clinically significant., Conclusion: The authors identified several important risk factors, such as immigrant status and psychological problems, that are easy for GPs to recognize. Despite this, the sensitivity of the regression model was relatively low.

We conducted a systematic review of prospective studies examining the independent predictive value of peritraumatic dissociation (PD) for posttraumatic stress disorder (PTSD) symptomatology following single traumatic events. Insight into the independent predictive value may help to identify victims at risk for PTSD symptomatology. For this purpose a literature search was carried out using the online databases PsycINFO, Medline/Pubmed, and PILOTS. Studies were included if they were published in peer-reviewed journals (before 2007), focused on more or less single traumatic events (Type I trauma), assessed PD within 1 month, had follow-ups 3 months or later, and which controlled for mental health problems at the time PD was assessed. The majority of the 17 identified studies showed no or only weak indications of an independent predictive value of PD for PTSD symptomatology following type I traumas. Only 3 of the 6 studies with positive results reported a strong independent predictive value of PD. Although bivariately associated with PTSD symptomatology, there is no general consensus across prospective Type I trauma studies that PD qualifies as an important independent predictor of PTSD symptomatology. Results indicate that initial mental health problems, among other factors, are better predictors of PTSD symptomatology than PD.

The authors assess the correlates of mental health services utilization (MHS) after a disaster among adults with mental health problems. Data of a three-wave longitudinal study among adult survivors of a fireworks disaster (T1: 2-3 weeks, T2: 18 months, T3: almost 4 years postdisaster) were linked with their electronic medical records (N = 649). Multivariate logistic regression analyses showed that triple comorbidity of PTSD and high levels of anxiety and depression symptoms were positively associated with self-reported MHS utilization at T2 (n = 270) and T3 (n = 216). Private insurance, predisaster psychological problems, and relocation were associated with MHS utilization at T2 while female gender, being single, and migrant status was associated with MHS utilization at T3. Receiving treatment at T2 was positively associated with receiving treatment at T3, as opposed to medium optimism at T2.

Studies have shown that the chronically ill are at higher risk for reduced health-related quality of life (HRQL) and for mental health problems. A combination with traumatic events might increase this risk. This longitudinal study among 1216 survivors of a disaster examines whether chronically ill survivors had a different course of HRQL and mental health problems compared to survivors without chronic diseases. HRQL and mental health problems were measured 3 weeks, 18 months and 4 years post-disaster. Data on pre-disaster chronic diseases was obtained from the electronic medical records of general practitioners. Random coefficient analyses showed significant interaction effects for social functioning, bodily pain and emotional role limitations at T2 only. Chronically ill survivors did not consistently have a different course of general health, physical role limitations, and mental health problems. In conclusion, chronic diseases were not an important risk factor for impaired HRQL and mental health problems among survivors.

This 4-year prospective study (N=662) of victims of a fireworks disaster examines the independent predictive value of peritraumatic dissociation for self-reported intrusions, avoidance reactions, and posttraumatic stress disorder (PTSD) symptom severity at both 18-months (T2) and almost 4-years postdisaster (T3). Peritraumatic dissociation was measured 2-3 weeks after the disaster (T1). Hierarchical multiple regression analyses revealed that peritraumatic dissociation was not a strong independent predictor for intrusions and avoidance reactions and PTSD symptom severity at T2 or at T3 above initial intrusions, avoidance reactions, and psychological distress (T1). Results suggest that an early screening procedure for peritraumatic dissociation, which is aimed at identifying disaster victims who are at risk for long-term psychological disturbances can be omitted.

Very few longitudinal health studies after disasters published data on the determinants of loss to follow up. However, these determinants provide important information for future disaster studies to improve their response and reduce selection bias. For this purpose we analyzed the data of a longitudinal health survey which was performed among residents and emergency workers, at 3 weeks (n = 3662) and at 18 months (n = 2769) after a major firework disaster in The Netherlands (Enschede, May 13, 2000). The response was lower among immigrants (54%) than among native Dutch (81%). Severe damage to the house due to the disaster (OR: 1.8; 95% CI: 1.1-3.0) and being involved as an emergency workers (OR: 2.1; 95% CI: 1.2-3.4) were associated with higher response among native Dutch, while this was not the case among immigrants. Non-western immigrants with health problems in the first study were more likely to participate in the second study (for example physical symptoms OR: 2.5: 95% CI: 1.4-4.4), while the native Dutch with these symptoms were less likely to participate (OR: 0.7; 95% CI: 0.5-0.9). In conclusion, disaster-related characteristics were associated with higher response in native Dutch. Health problems were associated with higher response among non-western immigrants and with lower response among the native Dutch.