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In diesem Beitrag wird aufgezeigt, dass das Gesundheitspersonal während der COVID-19-Pandemie nicht nur physisch, sondern auch psychisch stark belastet war. Unterschiedliche Risikofaktoren wie ein junges Alter, das weibliche Geschlecht, ein niedriger sozioökonomischer Status und bereits bestehende psychische Erkrankungen spielten eine Rolle. Das Gesundheitspersonal zeigte erhöhten Stress, Symptome von Posttraumatischen Belastungsstörungen, Depressionen, Ängsten und Schlafstörungen. Eigene Studien zeigen auch, dass moralische Konflikte und eine unzureichende Unterstützung durch die Organisation und die Gesellschaft zu weiteren Belastungen führten. Die Bedeutung von Resilienz, die auf individueller, team- und organisationsbezogener Ebene gefördert werden sollte, spielt eine entscheidende Rolle. Hierfür sind Maßnahmen wie Stressmanagement-Trainings, Unterstützungssysteme, Kommunikation, Weiterbildung, emotionale Unterstützung und Partizipationsmöglichkeiten erforderlich. Auch politische Maßnahmen sind erforderlich, um das Wohlergehen des Gesundheitspersonals zu fördern, das sie die Gesetzgebung sowie die Verfügbarkeit von Akutunterstützung und die Förderung von Forschung und Innovationen beeinflussen.

The aim of this study was to determine the predictive value of corona-specific variables and post-traumatic stress symptoms associated with the COVID-19-pandemic, considering sociodemographic data and health-related quality of life, on the affective well-being of preschool children and to identify predictors of positive and negative affect. A secondary analysis of third-party assessment data by parents of three- to six-year-old preschool children from the Tyrolean COVID-19 Children's Study at two measurement time points (123 records at t₁ in summer 2020; 467 records at t₂ in winter 2020/21) was conducted. To answer the research question hierarchical multiple regression analyses were performed.The largest part of the variance explanation of affective well-being was explained by health-related quality of life: while self-esteem and psychological well-being were measurement-time-independent, effects of physical well-being, preschool, family, and friends were only significant in winter. Coronaspecific variables caused additional variance explanation due to subjective threat experience in winter; post-traumatic stress symptoms had an effect at both measurement-times. In times of crisis children's self-esteem, psychological well-being, and post-traumatic stress symptoms should be considered.Measurement-time-dependent results suggest that the pandemic course plays a decisive role regarding the influence on children's affective well-being. Everyday life and routines must be redefined accordingly and communicated to the children.

In the project "Resilient Children", a resilience promotion program for kindergartens and elementary schools was directly applied and evaluated during the COVID-19-crisis.The aim of the study was to strengthen the three sources of resilience according to Grotberg (1995) I HAVE, I AM and I CAN through targeted exercises and resilience-promoting communication (transfer to everyday life). Additionally, gender differences with regard to the effect of the programme were addressed. "Resilient Children" was evaluated at the impact level (pre-post design) and process level. Eight kindergartens and three elementary schools with 125 children participated. A total of 122 teachers and 70 parents provided information about the children. The results at the impact level showed that from the parent and teacher perspective, and from the self-perspective (children), the three sources of resilience were significantly strengthened. With regard to gender differences, the results from the perspective of teachers and parents showed that girls were characterised by greater changes than boys. Compared to the girls, the physical andmental well-being of the boys improved fromthe parents' point of view. The results of the process evaluation revealed a high level of motivation and enthusiasm for participation in the programme on the part of participating children and teachers. The success of "Resilient Children" depends on the identification of the teachers with the program.

The COVID-19 crisis caused extensive mental health strains. Sense of coherence (SOC) is considered a protective factor for mental health in crisis that might also be decisive during the COVID-19 pandemic, but the mechanisms are not yet well understood. Using longitudinal survey data of 117 Austrian university students collected in 2020, we tested both moderating and mediating effects of SOC for the association of different stressors with later wellbeing. SOC did not buffer but mediated the effects of stressors on wellbeing. Students especially suffered from reduced feelings of manageability when confronted with financial strains, dissatisfying study situations, or disrupted plans. Supporting them in managing the difficulties of the crisis should therefore be considered a crucial part of psychosocial support., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

The COVID-19 pandemic and the accompanying containment measures such as physical distancing and school closures led to major changes in children's everyday lives. By means of a mixed-methods study, the "Tyrolean COVID-19 Children's Study" investigated the effects of the pandemic and factors influencing mental health and health-related quality of life of North Tyrolean (Austria) and South Tyrolean (Italy) children aged 3-13 years. Parents filled out N = 2,691 online questionnaires (951 preschool children: 3-6 years; 1,740 schoolchildren: 7-13 years) at four measurement time points (March 2020, December 2020, June 2021, December 2021). For both age groups, children's mental health outcomes (internalising problems, posttraumatic stress symptoms) were worse in December 2021 (t4) than children's mental health outcomes in March 2020 (t1). With regard to aggressive behaviour, this difference was only found among schoolchildren. Thematic analysis of an open ended, written question revealed the following positive changes in children during the Corona crisis: (1) the importance of intra- and extra-familial relationships, (2) new competences and experiences, (3) values and virtues, (4) use of time, and (5) family strength. Using multilevel modelling, threat experience, economic disruption, and perceived posttraumatic growth were shown to be the strongest predictors of all outcomes. Additionally, male gender was shown to be a predictor of aggressive behaviour. In terms of age, schoolchildren showed more internalising problems, aggressive behaviour, and threat experience than preschool children. With regard to time, parents in December 2021 reported more threat experience in older children and less perceived posttraumatic growth in both older and younger children, than parents at the beginning of the pandemic. Targeted support for vulnerable children may prevent longer-term development of psychopathologies and contribute to society's psychosocial resilience in the current COVID-19 pandemic. Moreover, sustainable promotion of children's posttraumatic growth can also contribute to children's mental health and could even offer a chance to turn the crisis into an opportunity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wenter, Schickl, Sevecke, Juen and Exenberger.)

Numerous measures were implemented to contain the COVID-19 pandemic. Adhering to these measures as well as getting vaccinated is associated with subjective costs and benefits. Since young people like university students largely feel less vulnerable to the virus, other costs and benefits than health might be more decisive for them. This article combines the results of a qualitative and a quantitative longitudinal study conducted with university students mainly living in Tyrol, Austria. The studies focused on the second wave of infections of the COVID-19 pandemic. Health concerns, altruistic concerns, worrying about the economic consequences of the measures and reactance played an important role for students in deciding what measures to follow and their vaccination attitudes. The effects were partially mediated by understanding the measures' necessity. Qualitative results enabled further insights into thought processes during these decisions and revealed additional aspects, such as concerns about mental health consequences. This research suggests that students make their decisions about adherence and vaccinations based on a variety of aspects that they weigh against each other. Understanding the individual assessments of costs and benefits is crucial to promote both adherence to the measures against the COVID-19 pandemic and vaccination readiness., (© 2021 The Authors. Applied Psychology: Health and Well-Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.)

The global crises of climate change and of the COVID-19 pandemic are straining young peoples' mental health and their mitigation behaviours. We surveyed German-speaking university students aged 18 to 30 years on their negative emotions regarding both crises repeatedly before and during the COVID-19 crisis. Different emotional patterns emerged for climate change and for COVID-19 with negative emotions regarding COVID-19 increasing during the pandemic. We were further able to differentiate between emotional responses associated with impaired wellbeing and those associated with mitigation efforts. Our findings emphasise the need to focus on a mixture of highly inactivating and activating emotions regarding COVID-19 as they are associated with both reduced wellbeing and mitigation behaviours. The findings broaden the understanding of how young adults react to the burden of two global crises and what role negative emotions play., Competing Interests: The authors declare that they have no competing financial or non-financial interests to disclose that could appear to have influenced the work reported in this paper., (© 2022 The Authors.)

Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed n = 149,394 studies from Web of Science and n = 34 studies from EBSCOhost. Nineteen studies were included in the review. Conditions representing moral stressors and PMIEs as well as MD and MI as their potential outcomes in healthcare contexts during COVID-19 are presented and discussed. Highlighting MD and MI in HCWs during COVID-19 brings attention to the need for conceptualizing the impact of moral stressors of any degree. Therefore, the development of a common, theoretically founded model of MD and MI is desirable.

This study aims at investigating the nature of resilience and stress experience of health care workers during the COVID-19 pandemic. Thirteen healthcare workers from Italian and Austrian hospitals specifically dealing with COVID-19 patients during the first phase of the pandemic were interviewed. Data was analysed using grounded theory methodology. Psychosocial effects on stress experience, stressors and resilience factors were identified. We generated three hypotheses. Hypothesis one is that moral distress and moral injury are main stressors experienced by healthcare workers. Hypothesis two states that organisational resilience plays an important part in how healthcare workers experience the crisis. Organisational justice and decentralized decision making are essential elements of staff wellbeing. Hypothesis three refers to effective psychosocial support: Basic on scene psychosocial support based on the Hobfoll principles given by trusted and well-known mental health professionals and peers in an integrated approach works best during the pandemic., Competing Interests: The authors have declared that no competing interests exist.

Peer victimisation (PV) in childhood and adolescence can come along with psychological stress through the life span. Even though there exist a large number of questionnaires that measure PV, evidence of the use is often missing. Particularly instruments for capturing cyberbullying lack psychometric calculations such as factor analysis for investigating scales and data on validity and reliability. An exception constitutes the Multidimensional Offline and Online Peer Victimization Scale (MOOPV) of Sumter et al., which is only available in Dutch. This questionnaire is not medium-specifically designed, has been psychometrically properly explored, and differentiates between direct and indirect as well as online and offline PV. The present study aims to investigate the psychometric properties of the German version of the Multidimensional Offline and Online Peer Victimization Scale (MOOPV). The factor structure, validity and reliability was examined in a sample of 777 pupils aged 10-20. Confirmatory factor analysis supported the original four-factor model. The scales direct offline, indirect offline, direct online, and indirect online demonstrated high internal reliability and construct validity. The MOOPV can be used as a validated instrument in research and practice to capture PV in childhood and adolescence., Competing Interests: Die Autoren geben an, dass kein Interessenskonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background : Highly adverse events can shatter fundamental assumptions about one's self and the expected course of life actuating a process of adjustment regarding new appraisals. This struggle in the aftermath of adversity might yield posttraumatic growth (PTG), which refers to positive transformation within the person. PTG is a concept that has been established within a Western cultural framework and has both universal and culture-specific characteristics. Although across cultures individuals perceive benefits from their struggles with life crises, the nature of PTG might be coloured by cultural factors. Objective : This study aimed to identify aspects of PTG in a German-speaking sample (Austria and Germany) that are unique to this individualistic culture and not yet covered by the Posttraumatic Growth Inventory (PTGI). Method : We used a convergent parallel mixed methods design. In sum, 188 German-speaking adults were recruited via snowball sampling. They reported on their worst experience ever and completed the PTGI, and 54 participants detailed in open-ended questions possible positive changes additionally to the questionnaire. Results : The existing growth dimensions of the German PTGI were confirmed by participants' qualitative statements. Additionally, qualitative data analysis revealed the elaboration of two PTGI dimensions, and the emergence of two new domains: (1) 'lessons learned', which involves newfound knowledge about oneself and one's life, and (2) 'processing of adversity with potential growth experiences', which illustrates the tightrope walk of growth. Conclusions : The results support Tedeschi and Calhoun's model of the process and outcomes of PTG. By including qualitative methodology this study contributed to (1) revealing culture-specific growth experiences (i.e. different sub-forms of individualism were identified), and (2) underscoring the importance of 'potential growth' so that further promotion of growth is possible at an early stage of processing adversities., (© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Differences in Conflict-Based Play Behavior, Socio-Emotional and Cognitive Development of Preterm Children Compared to Full-Term Children at Preschool Age Preterm children are at increased risk for socio-emotional and cognitive developmental difficulties at preschool age. This study investigates whether preterm children (n = 50) at the age of five years show different socio-emotional competencies in conflict situations and in the corresponding conflict resolution capacity in comparison to full-term children (n = 50). For this purpose, the MacArthur Story Stem Battery was used as the central examination method. In addition, parents completed the Strengths and Difficulties Questionnaire to obtain information about the children's behavior; moreover, the Wechsler Preschool and Primary Scale of Intelligence - Third Edition was applied to examine cognitive development. The parental reports did not reveal any behavioral differences between preterm and term children. However, significant group differences regarding their play behavior were detected. In their narratives, preterm children included content themes of interpersonal conflict and dysregulation more frequently compared to term born controls. Concerning empathic and moral themes and narrative coherence, no group difference could be detected. This could indicate that preterm children show no clinically manifest behavioral disorders at preschool age, but differences concerning intrapsychic experience compared to controls. In addition, preterm children had significantly lower IQ scores than term-born controls. Gestational age was a significant predictor of IQ and hyperactivity and attention problems. The results clarify the need for long term clinical follow up of preterm children and should be used to provide more specific care and support.

Prevalence and characteristics of peer victimisation in adolescent psychiatric inpatients Abstract. Objective: Repeated and long-lasting victimisation, as defined by bullying, represents a wide spread health hazard. The aim of the present study was to present the prevalence of bullying in adolescent psychiatric inpatients. We analysed relations between bullying and sociodemographic and psychopathological variables. Furthermore, we investigated the number and nature of bullies, feasible resources, and parental perception on bullying in adolescence. Method: In total, 128 adolescent inpatients were surveyed with a bullying questionnaire and youth self-report. In addition, their clinical symptomatology was investigated. Results: Bullying affected one third of our sample. Male and female victims showed significantly more internal problems. Girls in addition revealed more external behaviour problems. Unlike non-suicidal, self-harming behaviour, suicidal ideation and suicidal behaviour occurred significantly more in patients with bullying experience. Conclusion: A significant number of adolescent in our sample experienced bullying and associated psychological strains. This should especially be considered in child and adolescent anamnesis.

Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project "Operationalizing Psychosocial Support in Crisis" (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: "planning and delivery system" (Cronbach's alpha 0.82); "general evaluation criteria" (Cronbach's alpha 0.82); and "essential psychosocial principles" (Cronbach's alpha 0.75). "Measures and interventions applied", theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation.

The Impact of Risk Factors and Effective Factors on Success in Crisis Intervention for Children and Adolescents This article focuses on the evaluation of (inpatient) crisis interventions for children and adolescents, who can be admitted into the residential area of the KIZ for up to eight weeks in order to provide acute protection against massive violence, neglect or family conflicts in emergency situations. How successful the crisis intervention is or can be depends on various factors that have been worked out in this study. Various factors have an impact on success in crisis intervention; above all the participation, a good relationship and/or cooperation with the Counselors in the Crisis Intervention Center contribute to a great success. Restoring their own possibilities for action after a massive crisis, the strengthening of self-efficacy in crisis intervention must be considered critically. The young clients see little change here. The crisis intervention must therefore not only focus on its most important function, protection and security, but also on the strengthening of self-esteem and a positive sense of coherence as part of the crisis intervention.

The study focuses on psychosocial functioning of female Turkish immigrants in Austria with recurrent depressive disorder participating in self-help groups. Self-help groups guided by group leaders of Turkish descent should increase autonomy in participants, providing the opportunity to follow their ethnic health beliefs. Turkish immigrant women (n = 43) with recurrent depressive disorder participated in self-help groups over four months. Qualitative data of participants and group leaders, containing interviews, group protocols and supervision protocols of group leaders were analyzed using the qualitative content analysis for effects on psychosocial function, such as interaction with others, illness beliefs and benefit from self-help group. Women reported feelings of being neglected and violated by their husbands. They stated that they had gained strength and had emancipated themselves from their husbands. Self-help groups functioned as social resources and support for changes in participants' lives. Further interventions should integrate the functional value of depressive symptoms and focus on social support systems and social networks.

Grief in Children und Adolescents as a Result of Acute Traumatization Specifities of grief in children after trauma will be presented as well as potential reactions to acute traumatization and resulting needs of children and adolescents in order to discuss adequate interventions.

This qualitative study was carried out to investigate the effectiveness of cognitive-behavioral therapy (CBT) for Iranian migrants suffering from major depressive disorder (MDD) and living in Austria for an average of 14 years. The qualitative data were collected through interviews based on the Farsi version of the Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, to obtain more information from the participants, they were asked to talk in more detail about their childhood and teenage years, reasons for immigration, their lifestyle before and after immigration, and their social activities. Interviews were conducted at four time points: preintervention, postintervention, 1-month follow-up, and 6-month follow-up. Patients who did not complete the interventions were interviewed on a voluntary basis to explain their reasons. Preintervention interviews were conducted to get some useful information about participant's' expectations of psychotherapy, especially group-based cognitive-behavioral therapy (GCBT), and also to assess the reasons for depression from their own point of view. The postintervention interviews were conducted to examine the participants' psychological situations as well as the reasons for positive effects of interventions. The interviews on average lasted 50 minutes, and field notes were taken. The results of this study showed a reduction in depression symptoms after the interventions. However, the effect of treatment was not persistent. The findings suggest that the main reasons behind Iranian migrants' depression in Austria is related to their dysfunctional acculturation attitude. The effectiveness of GCBT for Iranian migrants with depression also may be related to their sociocultural background.

Millions of volunteers respond after disasters, with a 24% to 46% risk of developing posttraumatic stress disorder (PTSD). It is unclear which symptom trajectories develop and how they differ between core (volunteering before the disaster) and noncore volunteers (joining after the disaster) and which factors predict trajectories. Symptoms of PTSD were assessed at 6-, 12-, and 18-months postearthquake in 449 volunteers in Indonesia. Demographics, previous mental health service use, self-efficacy, social acknowledgment, and type of tasks were assessed at 6 months. In both core and noncore volunteers, 2 PTSD symptom trajectories emerged: a resilient trajectory (moderate levels of symptoms with a slow decrease over time; 90.9%) and a chronic trajectory (higher levels of symptoms with an increase over time; 9.1%). In both trajectories, core volunteers had fewer symptoms than noncore volunteers. Core volunteers in the chronic trajectory were characterized by having sought prior mental help, reported lower levels of self-efficacy and social acknowledgment, and were more likely to have provided psychosocial support to beneficiaries (Cramér's V = .17 to .27, partial η(2) = .02 to .06). Aid organizations should identify and follow up chronic PTSD trajectories in volunteers, including the noncore, who may be out of sight to the organization after the acute response phase., (Copyright © 2016 International Society for Traumatic Stress Studies.)

Disaster work has shown to cause PTSD symptoms and subjective health complaints in professional emergency personnel. However, very little is known about how disaster work affects community volunteers. This first time longitudinal study examined factors contributing to post-traumatic stress disorder symptoms (PTSD) and subjective health complaints in volunteers working in an earthquake setting. At six and eighteen months post disaster, a sample of 506 Indonesian Red Cross volunteers were assessed using the Impact of Event Scale-Revised and the Subjective Health Complaints Inventory. Factors analyzed in relation to the outcomes included: peri-traumatic distress, level of personal affectedness by the disaster, sleep quality and loss of resources as a consequence of the disaster. At 18 months post-disaster the findings showed high levels of PTSD symptoms and subjective health complaints. Quality of sleep was related to both outcomes but resource loss only to PTSD symptoms. Neither peri-traumatic distress nor level of affectedness by the disaster (external versus directly affected volunteers), were predictive of symptoms. This study indicates that characteristics of disaster work e.g. low quality of sleep, may be an important contributor to PTSD symptoms and subjective health complaints in volunteers., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Relationship Pattern of Mothers with Functional Constipated Infants The present article investigates whether or not mothers of infants with functional constipation have a specific relationship pattern. This question is addressed by analyzing the data collected at the day care clinic for infant regulation disorders with appropriate methods like the questionnaire for the assessment of adjustment of mothers with children in infancy (EMKK, Engfer u. Codreanu, 1984) described here. The evaluation of data was performed in two ways: first with regard to the clinical study group of mothers with infants (age range from one to five years) suffering from functional constipation, and then compared to a clinical control group of mothers with infants who are coping with regulation disorders (by definition per Papouŝek, Schieche, Wurmser, 2010). With this comparison differences between the two groups are made visible and clinical interventions can be deduced accordingly. If the groups do not differ in their pattern described by the EMKK, the possible interventions can be adopted from the well-studied area of regulation disorders. The focus on analyzing the data of mothers with functional constipated infants serves as an important starting point for providing the best possible alignment of clinical intervention.

Background: Given the high prevalence of approximately 5% of Attention Deficit and/or Hyperactivity Disorder in children the level of knowledge of Tyrolean educators at selected educational institutions was examined., Methods: As part of the thesis of A. Aglan 170 questionnaires were distributed at selected Tyrolean schools from May to October 2010. The questionnaires were completed voluntarily and anonymously by educators working there and then turned in. The questionnaire consisted of 43 items and was evaluated by means of conventional statistical methods., Results: 98 (58%) of the questionnaires sent out were returned. 93 questionnaires (55%) were evaluated using standard statistical methods. Teachers were well informed about generic aspects of Attention Deficit and/or Hyperactivity Disorder. Knowledge gaps could be identified regarding the underlying causes of the disorder and available treatment options. Teachers demonstrated great willingness to actively cooperate and to learn more about Attention Deficit and/or Hyperactivity Disorder through further education in order to improve the situation of all parties involved., Conclusions: Lack of knowledge was found regarding the subtopics "causes of Attention Deficit and/or Hyperactivity Disorder" and "Treatment Options". The majority of the teachers would appreciate specialized training and is willing to adapt their lessons to the requirements of children, pupils and students affected by Attention Deficit and/or Hyperactivity Disorder.

During disasters, aid organizations often respond using the resources of local volunteer members from the affected population who are not only inexperienced, but who additionally take on some of the more psychologically and physically difficult tasks in order to provide support for their community. Although not much empirical evidence exists to justify the claim, it is thought that preparation, training, and organizational support limit (or reduce) a volunteer's risk of developing later psychopathology. In this study, we examined the effects of preparation, training, and organizational support and assigned tasks on the mental health of 506 Indonesian Red Cross volunteers who participated in the response to a massive earthquake in Yogyakarta, Indonesia, in 2006. Controlling for exposure level, the volunteers were assessed for post-traumatic stress disorder (PTSD), anxiety, depression, and subjective health complaints (SHCs) 6, 12, and 18 months post-disaster. Results showed high levels of PTSD and SHCs up to 18 months post-disaster, while anxiety and depression levels remained in the normal range. Higher levels of exposure as well as certain tasks (e.g., provision of psychosocial support to beneficiaries, handling administration, or handing out food aid) made the volunteers more vulnerable. Sense of safety, expressed general need for support at 6 months, and a lack of perceived support from team leaders and the organization were also related to greater psychopathology at 18 months. The results highlight the importance of studying organizational factors. By incorporating these results into future volunteer management programs the negative effects of disaster work on volunteers can be ameliorated.

This article reviews the literature on mental health of volunteers after working in disasters. When mobilized they often are a community's major source for rescue and recovery. PsychINFO, PubMED, and Web of Science were searched for relevant articles published until October 2009. Of 448 articles screened, only 9 articles fulfilled our inclusion criteria. They examined the aftermath of earthquakes (4 articles), terrorist bombings (1), explosions (1), aviation disasters (1), tsunami (1), and a bus accident (1).Findings showed that, compared with professional workers, volunteers tend to have higher complaint levels. The following factors were found to contribute to mental health complaints of volunteers: Identification with victims as a friend, severity of exposure to gruesome events during disaster work, anxiety sensitivity, and lack of postdisaster social support. The review reveals the need for more research regarding predictors of stress in volunteers.