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Browsing by Subject "Protective Factors"

Now showing 1 - 2 of 2
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    Moral Injury: A Statewide Assessment on the Burden, Risk, and Protective Factors in Minnesota Firefighters
    (2022-07) DeMoulin, Douglas
    IntroductionThe construct of moral injury is relatively new, primarily studied in trauma-exposed military personnel, and measurement scales recently available to screen symptoms of moral injury. However, no scale exists for firefighters; consequently, resulting in limited data for the risk and protective factors of moral injury in firefighters. Firefighters are considered one of the most stressful occupations, responding to critical incidents involving personal threat or harm to self, a violation of core beliefs about the world, and witnessing pain and suffering of others. Exposures to a single traumatic event or cumulative traumatic events can result in posttraumatic stress disorder (PTSD), depression, suicide ideation and possibly risk for moral injury. The objective of this study aims to address the gap in available instruments by developing a moral injury scale for firefighters and assess the potential risk and protective factors of moral injury in firefighters. MethodsA multi-phased study was conducted using qualitative methods to modify an established moral injury scale used in veterans by employing the Delphi method paired with cognitive interviewing with firefighters, and quantitative methods testing the psychometric properties. A cross-sectional study was conducted using dual-frame sampling methods to recruit Minnesota firefighters statewide assessing the association between moral injury and perceived stress towards traumatic calls, perception of being trained to cope with mental health of firefighting, and moral injury comorbidity with PTSD, depression, and suicide ideation. This study assessed the use of department debriefs and department resources (chaplains, critical incident stress management “CISM”, city employee assistance programs “CEAP”, and department employee assistance programs “DEAP”) and the protective effects for moral injury in trauma-exposed firefighters. ResultsPsychometric properties of the EMIS-F are comparable to the original military scale. The internal consistency of the EMIS-F was excellent (ω=0.94), inter-item correlations showed evidence of EMIS-F measuring a unidimensional construct (ρ=.30-.72). Multivariable analyses identified the risk factors for change in mean moral injury risk scores, which were firefighters self-reporting high perceived stress levels of calls involving fatalities (β=7.7) and children (β=3.1), and strongly disagreeing that they were trained to cope with mental health of firefighting (β=9.9). Firefighters with two or more mental health comorbidities showed over a 16.0 increase in mean moral injury risk scores, and greatly influenced by PTSD comorbidity. The protective factors of moral injury among firefighters self-reporting their most traumatic experience was those that used department debriefs and found them helpful, chaplains, and DEAP. Firefighters who found debriefs unhelpful showed evidence of debriefs as a risk factor for moral injury, in addition to using CEAP and CISM. Stigma showed evidence as a potential effect modifier regarding the impact or use of debriefs and increased moral injury risk scores. ConclusionThis study provides a reliable and valid moral injury scale that can be applied in research, clinical, and fire organization settings to screen symptoms of moral injury in firefighters. Knowledge of specific risk and protective factors presented not only serve for interventions, but an opportunity to evaluate and improve existing practices to enhance the well-being of firefighters.
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    Parenting Resilience in the Context of Homelessness: Risk and Protective Factors
    (2015-08) McCormick, Christopher
    Homelessness among families with children has become a surprisingly common and persistent problem. Children who experience the disruptions of homelessness are at increased risk for difficulties with academic, social, emotional, and behavioral development. Decades of research on resilience suggests that effective parenting helps to mitigate the effects of adversity on child development. However, relatively little is known about factors that predict parenting quality during family homelessness. This study examined predictors of parenting quality among 138 families who were staying in three Minneapolis emergency housing shelters, with the goal of identifying distal and proximal influences on parenting in families facing homelessness. Based on transactional-ecological systems perspectives on the determinants of parenting, and research on risk and protective processes for parenting under stress, current parenting in a shelter context was expected to relate to recent and past adversity of the parent and current health and social resources. Current trauma, anxiety, and depressive symptoms in parents were expected to interfere with effective parenting. Two basic dimensions of parenting, warmth and structure, were expected to underlie observed parenting assessed by three empirically validated observational coding techniques. Factor analyses indicated two dimensions of parenting; however, these reflected a blend of warmth/structure and a distinct factor of negativity. Thus, subsequent analyses predicted parenting on each of these two dimensions, using linear methods of path analysis and multiple regression to test for predictive, mediating, and moderating effects of earlier and recent adversity, physical and mental health, and available resources on parenting quality. Also tested was the moderating influence of resources, specifically cognitive resources and social support, on the relationship between adversity, mental health, and parenting quality. Finally, a person-centered analytic approach was used to provide an integrated portrait of resilient parenting in the context of homelessness. Controlling for parent age, sex, and child behavior, parents’ adverse experiences in childhood were positive related to warmth/structure, contrary to expectations, whereas current resources, as predicted, were positively and independently associated with this aspect of effective parenting. Resources did not moderate any of these relationships. Parents classified as showing resilience in the person-focused analyses had greater cognitive, social, and emotional resources than parents classified as maladaptive. Strengths and limitations of this study are discussed in relation to future research and the goals of identifying malleable protective influences on parenting for families in challenging situations.