Social Support among Disaster First Responders A Review of Literature

Transcription

1 Social Support among Disaster First Responders A Review of Literature Johnrev Guilaran, MA 1,2 Ian de Terte, PhD 1 Krzysztof Kaniasty, PhD 3 Christine Stephens, PhD 1 1 Massey University, New Zealand 2 University of the Philippines Visayas, Philippines 3 Indiana University of Pennsylvania, USA

2 An event is considered a disaster* when 10 or more people reported killed 100 or more people are affected Declaration of a state of emergency Call for international assistance GEOPHYSICAL avalanche tsunami storm tornado typhoon volcanic eruption earthquake frost METEOROLOGICAL landslide HYDROLOGICAL flood wild fire blizzard storm surge BIOLOGICAL heat wave CLIMATOLOGICAL TECHNOLOGICAL animal plagues disease epidemics industrial accident conflict terrorist attacks transport accident OTHER HUMAN-MADE displacement *Emergency Database (EM-DAT) definition (Guha-Sapir, Hoyois, & Below, 2015) Definition: Disaster

3 Interpersonal Changes Phobia Panic Disorder Posttraumatic Stress Disorder Intrusion arousal Acute Stress Disorder Depression Financial Problems Sleep Problems Nonspecific Distress Anxiety Death Anxiety Demoralization Negative Affect Physical Health Problems Substance Use Familial Changes Ecological Changes Social Support Decline Psychosocial Consequences of Disasters

4 Social Support and Related Constructs support from colleagues friendship community support social integration emotional support social network SOCIAL SUPPORT social relationships practical support love help assistance family relationships empathy advice-giving caring tangible aid assistance from supervisors

5 Social Support Social Interactions Provide Actual Assistance + Embed People in a Web of Social Relationships Loving Caring Readily Available Informal Spontaneous Definition: Social Support

6 Protection + Disaster First Responder Preservation of Life Property Environment After Disasters Disaster First Responders

7 Disaster First Responder Types Traditional o Police Officer at 9/11 o Firefighter after a fire o Ambulance Workers after a hurricane Non-traditional o Construction Workers after 9/11 o Social Workers after a flood o Teachers after an earthquake Responders who are mandated to respond in the aftermath of an emergency/disaster Responders who are not mandated to respond, but act as responders in the aftermath of an emergency/disaster Disaster First Responders

8 Who? What Support? What Outcome? Disaster First Responder Social Support Psychological Outcomes Gaps and Limitations Purpose of the Review

9 Article Search Article Screening Coding Quantitative Descriptive Statistics Variable Mapping Qualitative Directed Content Analysis Merged Results Methodology

10 Inclusion Criteria Psychological Studies PsycINFO [66] Web of Science [224] Studies that explicitly investigated social support Exclusion Criteria Studies where social support is the outcome variable Studies outside the disaster context Manual Search + Articlesat-Hand PubMed [32] 25 Scopus [88] Number of Articles after the Screening Studies Reviewed

11 Map of the different disasters [ ] and the nationalities of the responder-samples [ ]. The number in black text signifies the number of studies with responders having nationalities in those countries. Geographical Distribution of Disasters and Responders in the Studies

12 Number of disaster types in the studies reviewed General 8% Biological 4% Terrorism/ Mass Violence 28% Most studied: 9/11 WTC Attack Technological 16% Natural 44% Types of Disasters

13 Total estimated sample size according to type of responder (n=54,907). Parts of the chart shaded blue are traditional responders. Parts shaded orange/brown are non-traditional responders. Other Non-trad. 9,732 Military 15,799 Construction 8,020 Social Work 315 Other Trad. 1,026 S&R 579 Fire 3,153 EMT 1,974 Police 14,309 Types of Responders

14 Received Support e.g., receiving actual help Perceived Support e.g., knowing somebody will help you in times of need Social Embeddedness e.g., being surrounded by people who are ready to help you Types of Social Support

15 Studies were coded according to the following social support types: o Received Support o Perceived Support o Social Embeddedness + o General Social Support o Social Support-Seeking Types of Social Support

16 The number of scales per type of social support and the total number of social support measures per type Scales with psychometric Data Total No. of Scales Reliability Coefficients { } Types of Social Support

17 Scales used in the studies aggregated according to type of support Standardised SS Scale Standardised Proxy Scale Nonstandardised SS Scale Nonstandardised Proxy Scale Types of Social Support

18 Map of Variable Relationships

19 Positive Relationship Negative Relationship No Relationship Social Support Social Support Map of Variable Relationships

20 Positive Relationship Negative Relationship No Relationship Positive Outcomes Map of Variable Relationships

21 Positive Relationship Negative Relationship No Relationship Negative Outcomes Map of Variable Relationships

22 Positive Relationship Negative Relationship No Relationship Positive Outcomes Social Support Negative Outcomes Social Support Map of Variable Relationships

23 Social Support Stress- Buffering Effects Main Effects Exposure Psychological Outcomes How Social Support Affects Outcomes

24 General Associations between Social Support and Psychological Outcomes Lower/Fewer o Distress o O/C Symptoms o PTSD Symptoms o Anxiety o Depression Social Support Higher/Better o Self-esteem o Stress Management o Resistance o Resilient Outcomes o Positive Affect

25 Associations between Sources of Support and Outcomes Support from Family o Primary source of support o Source of practical assistance o Important in post-deployment transition o Effective but difficult to elicit/often unavailable (esp. spouse/partner) Support from Non-family/Friends o Helps in Coping Support from Workplace o Crucial in post-deployment transition o May hinder social support-seeking

26 Social Support and Psychological Outcomes The link between social support and psychological outcomes: not straightforward Social Support Psychological Outcomes

27 Received Support Perceived Support Exposure PTSD Social Support Moderating Exposure and PTSD Recovery Not all types of social support are observed as beneficial in the different phases of the development of, and recovery from, PTSD.

28 High Availability Social Support-Seeking and Availability on Coping Social Support- Seeking Support Availability (+) Coping Low Availability (-) Coping Social support-seeking interacts with social support availability in relation to coping.

29 Hardy Responders High Exposure (+) Coping High Level of Support Low-Hardy Responders Low Exposure Social Support Exposure Personality Interaction Illness Behaviours

30 Research Issues Raised by the Different Social Support Studies Reviewed Measurement-Related Issues o Measurement Validity o Low Response Rate o Possible Response Bias Design-and-Method-Related Issues o Cross-sectional Design o Small Sample Size o Sample Representativeness o Generalizability

31 Majority of studies are on traditional responders. Non-traditional responders seen most in large-scale disasters. Generally, very few studies focus on the topic. A large percentage of studies are US-based. Most studies simply looked at correlations. Most studies focused on perceived social support. Most studies focused on negative outcomes. General Observations

32 More studies in the area Further studies that point to causation Studies that look into: o o o o o The type of social support that works Sources of support that work best Conditions where social support works How social support works Socio-cultural aspect of social support Recommendations

33 Why study social support among disaster first responders? o o o It s a naturally-occurring psychosocial resource. It s a practical and sustainable form of intervention. It can be applied to areas outside the disaster context. Recommendations

34 Thank you. For correspondence: John Guilaran PhD Candidate School of Psychology Te Kura Hinengaro Tangata College of Humanities and Social Sciences Massey University, Wellington This paper presentation is supported by the Resilience Cluster Fund, School of Psychology, Massey University.