Associations between trauma and substance use among healthcare workers and public safety personnel during the SARS-CoV-2 (COVID-19) pandemic: the mediating roles of dissociation and emotion dysregulation

• Published in: European journal of psychotraumatology Vol. 14; no. 1; p. 2180706
• Main Authors: Patel, Herry, Easterbrook, Bethany, D'Alessandro-Lowe, Andrea M., Andrews, Krysta, Ritchie, Kimberly, Hosseiny, Fardous, Rodrigues, Sara, Malain, Ann, O'Connor, Charlene, Schielke, Hugo, McCabe, Randi E., Nicholson, Andrew A., Lanius, Ruth, McKinnon, Margaret C.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 2023; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Alcohol; Canada - epidemiology; Clinical; Coronaviruses; COVID-19; COVID-19 - epidemiology; desregulación emocional; dissociation; Drug use; emotion dysregulation; Emotions; Health Personnel; Humans; Medical personnel; Pandemics; Post traumatic stress disorder; Public safety; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; substance use; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Trauma; uso de substancias; 创伤; 情绪失调; 物质使用; 解离; 酒精; Canada; alcohol; substance use; 创伤; 情绪失调; dissociation; 物质使用; desregulación emocional; 解离; emotion dysregulation; uso de substancias; Trauma; 酒精
• DOI: 10.1080/20008066.2023.2180706
• ISSN: 2000-8066

Background: Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP. Methods: A subset of data (N =  498 ; HCWs =  299 ; PSP =  199 ) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators. Results: Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect β = .133, p = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect β = .151, p = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects β = .184, p = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (ps >.05) had any effects. Conclusion: To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic. Among healthcare workers, dissociation mediated relation between posttraumatic stress disorder (PTSD) severity and alcohol-related problems and emotion dysregulation mediated relation between PTSD severity and substance-related problems. Among public safety personnel, emotion dysregulation mediated relation between PTSD severity and alcohol-related problems. Neither dissociation nor emotion dysregulation mediated relation between PTSD severity and substance-related problems. Results underscore dissociation and emotion dysregulation as potential key therapeutic targets for intervention for healthcare workers and public safety personnel struggling with PTSD and comorbid alcohol/substance use-related problems.